• 제목/요약/키워드: Patterns of care study

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A Study on Recognition of Autism Spectrum Disorder Among Infants and Toddlers by Childcare Teachers : With a Focus on Focus Group Interviews (보육교사의 영유아 자폐스펙트럼장애 인식에 관한 연구: 포커스 그룹 인터뷰(FGI)를 중심으로)

  • Lee, Kyung-Sook;Park, Jin-Ah
    • Korean Journal of Childcare and Education
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    • v.12 no.3
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    • pp.211-238
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    • 2016
  • This study examines indicators and factors for identification of ASD(Autism Spectrum Disorder) characteristics of infants and toddlers and early screening of children with ASD by day care teachers. Focus group interviews were conducted with 11 teachers by a semi-structured questionnaire developed by the authors. The findings are: 1) key problems and indicators of behavioral characteristics of children with ASD included problems with social communication and interactions, restricted and unusual interests, outstanding ability in specific areas, insistence on sameness and ritualized patterns, problems with language development and communication, sensory abnormalities; 2) counseling with parents of children with ASD revealed a lack of recognition of parents, negative expressions of emotions and resistance, and difficulties in referral to and association with experts; 3) needs for ASD in the child care field included visiting by experts, provision of test scales, training of child care teachers and parents, and building cooperative systems; and 4) demands of development and execution of a Korean-style scale for early screening of children with ASD.

Health Pattern of Elderly According to Age Group Who Living Alone in an Urban Area (일 도시 독거노인의 연령 군별 건강양상)

  • Kang Hae-Young;Seo Nam-Sook;Kim Young-Hee
    • Journal of Korean Academy of Nursing
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    • v.34 no.6
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    • pp.1057-1068
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    • 2004
  • Purpose: This study was conducted to identify the differences of health patterns; health-related characteristics, health behaviors, health problems, and self-care levels of elderly, living alone in an urban area according to age roup. Method: The study design was a descriptive survey and the subjects were 1,800 elderly consisting of 937 young old, 704 middle old, and 159 old old. Data was collected from May to July 2003 using the structured questionnaire and analyzed by descriptive statistics, $\chi$$^2$-test, Fisher's exact probability test, ANOVA and Scheffe test using SPSS/PC. Result: The health related characteristics which involved body mass index, mental status, use of assistant devices, perceived health, concern of health, and social support were different among the groups and more aggravated by aging. Health behaviors and health problems were also significantly aggravated in the old old group. The self-care levels measured by ADL, physical activity, and self-care ability scores were also significantly decreased in the old old group. Conclusion: For the level of health status, health behaviors and self-care ability were significantly decreased by aging, health care services for the elderly should be planned considering the difference in the health pattern by age group.

The Long-term Care Utilization of the Elderly with Dementia, Stroke, and Multimorbidity in Korea (치매, 중풍 노인의 장기요양서비스 이용현황과 이용수준 관련 요인)

  • Jeon, Boyoung;Kwon, Soonman;Kim, Hongsoo
    • Health Policy and Management
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    • v.23 no.1
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    • pp.90-100
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    • 2013
  • Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

Patterns of Fazther-Infant Play Interaction : A Pilot Study (아버지와 영아의 놀이 상호작용 양상에 관한 연구)

  • Kim Young Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.31-44
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    • 1998
  • In our time the parent's role is changing from sexually differentiated to androgynous pattern. Mother's interction with infant includes caring and father's interaction especially have play. Father and mother share the caring and play because they have complementary nature. Infants have a tendency to show more positive responses to their fathers than mothers in play situations. For that reason we can help the promotion of father's interaction with his infant through ascertaining patterns of father-infant play interaction. This study was to find out patterns of father-infant play interaction in order to improve the Interaction between father and infant. Data was video-taped from 6 fathers and infants who were healthy and first-timed and 7-11 weeks old in their houses. I used Father-Infant Play Interaction Scale that was applied to father instead of mother as a care-giver. The scale was checked up by experts in this field for content validity and the reliability was 0.95 in this study. The results were as follows : 1. Father's play behaviors were the patterns of responses about infant's cue. The mean score was 33.16(SD, 9.11), This means they come up to the standard level of responses about infant's cue. 2. Infant's play behaviors were the patterns of responses about father's cue. The mean score was 7.00(SD,3.10). This means they get the higher level of responses about father's cue. 3. The patterns of simultaneous responses occured together between father and infant. The mean score was 9.58 (SD, 3.96). This means they reach the standard level of simultaneous responses between father and infant. 4. The patterns of interactional behaviors occured interpersonally between father and infant. The mean score was 49.75(SD, 15.80). This means they interact on the standard level of play interaction. In view of the results father's play interaction seems to reveal an average level and play patterns are similar to mother's. In order to ascertain definitely patterns of father-infant play interaction we need further research which has more subjects and variables to have important effects.

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Sleep patterns and it's influencing factors of hospitalized elderly in long-term care hospital (요양병원 입원 노인의 수면 양상 및 영향요인)

  • Jang, Hyo-Yoel;Kim, Tae-Im
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.3
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    • pp.773-789
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    • 2016
  • This study was conducted to identify the sleep patterns and influencing factors of hospitalized elderly in a long-term care hospital. The sleep patterns of 142 subjects were recorded using Sleep Charts. The average sleep time of subjects was 10.7 hours a day (3.9 hours in daytime and 6.8 hours in nighttime). Sleep regularity among participants were 71.7% in all day (58.1% in day time and 80.5% in night time). The presence of dementia patients in the room (PDPR) has been identified to be a statistically significant predictor of all day sleep, and pain, PDPR, and physical function have been found to be a significant predictors of sleep regularity in all day among subjects. It suggested that elderly patients in a long-term care hospital do not slept well during night, which leads to increase in daytime sleep and decrease the quality of their sleep. Therefore, an intervention program should be developed to promote the quality of sleep among hospitalized elderly.

Stress and Coping in Parents of Cerebral Palsy Children (뇌성마비아 부모의 스트레스와 대처방안에 대한 연구)

  • Song Young-Hwa
    • The Journal of Korean Physical Therapy
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    • v.6 no.1
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    • pp.49-60
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    • 1994
  • Stress is experienced when a person tries to maintain stability in the face of life change but is not able to meet the adaptive demands of change. This can be especially true for the parents who has a cerebral palsy childs who needs long term rare, where parents, are the primary source of care and responsibility. Successful coping leads to maintenance of the parents role and this has an effect on the health status of the child. This descriptive study was attempted to identify stress factors, levels and helpful coping patterns for parents who must take care of cerebral palsy children. Data were collected from 43 subjects who were parents of children diagnosed with cerebral palsy The informations gathered from March 25, 1994 to April 14, 1994 by means of structured questionnaires were analyzed. Two instruments were used to collect the data 1) Lee's stress questionnaire consisted of 33 stress factors and measured by four point Likert scale. 2) Modified Chronic Health Inventory for parents: The modified CHIP included 43 items of coping methods with four point Likert scale. The results of this study were as follows: 1) Stress items could have a maximum score of three points, for a total possible score of 132 points. The mean score for the total was 92.02 points. The item mean score was 2.85 points showing that the parents were experiencing moderate to much stress. 2) The items with the highest stress items were 16 items. The stress items with the lowest mean scores were 10 items. 3) Of the stress categories: The highest stress category was related to changes in the illness status of the child and difficulty in taking rare of the child. The second stressful category was related to the prognosis of the child's condition. The least stress was noticed to social-personal relationships and the responsibility of the care givers. 4) Items measuring coping in the parents had a maximum score of three points each with a total possible roping score of 172 points. The mean score for the total was 103,9 paints. The item mean score was 2.42 points indicating that there were responses of little helpful to moderately helpful on each coping pattern. 5) The most helpful coping items were 7 items. The least helpful coping items were 2 items. 6) Effectiveness of the coping for each patterns was examined : Understanding the illness condition from communication with parents of children with the same condition and consultation with the medical team was the most helpful coping pattern. Family's coorperation and integration and optimism were a moderately helpful coping pattern. Social support psychological stability and self esteem were the least helpful toping pattern. In conclusion, the highest stress for parents of children with cerebropalsy was found to be very stressful changes in the illness of the child and to taking care of a child who is suffering. The parents were helped by the coping methods using understanding of the illness condition through consultation with the medical learn and communication with parents in the same situation. Based on the knowledge, care could develop intervention strategies appropriate for them, help them to develop their effective coping patterns, and give support them in the process of coping with their stress.

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A Study on the Development of Standardized Nursing Care Plans for Computerized Nursing Service (간호업무 전산화를 위한 표준화된 간호계획의 개발에 관한 연구)

  • 김조자;전춘영;임영신;박지원
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.368-380
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    • 1990
  • A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

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The Effect of Long-Term Care Ratings and Benefit Utilization Characteristics on Healthcare Use (노인장기요양 등급 및 급여 특성이 의료이용에 미치는 영향)

  • Kang Ju Son;Seung-Jin Oh;Jong-Min Yoon
    • Health Policy and Management
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    • v.33 no.3
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    • pp.295-310
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    • 2023
  • Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

Impact of Changes in Medical Aid Status on Health Care Utilization

  • Kim, Woorim;Nam, Chung Mo;Lee, Sang Gyu;Park, Sohee;Kim, Tae Hyun;Park, Eun-Cheol
    • Health Policy and Management
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    • v.29 no.4
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    • pp.513-522
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    • 2019
  • Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.