• 제목/요약/키워드: Primary Care

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How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study

  • Eli D. Medvescek;Sorana Raiciulescu;Andrew S. Thagard;Katerina Shvartsman
    • Journal of Preventive Medicine and Public Health
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    • 제56권2호
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    • pp.190-195
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    • 2023
  • Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

포스트 코로나시대 의료기관 CRM시스템 구축모형 : 의원급 의료기관을 중심으로 (A Study of Establishment of Medical CRM Model in the Post-Corona Era : Focusing on the Primary-Level Hospital)

  • 김강훈;고민석;김훈
    • Journal of Information Technology Applications and Management
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    • 제28권1호
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    • pp.1-12
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    • 2021
  • The purpose of this study is to analyze the medical ecosystem in the post-corona era. In addition, this study introduces a new medical CRM model that allows primary-level hospitals to overcome the economic difficulties and to occupy a competitive advantage in the post-corona era. The medical environment in the post-corona era is expected to be changed by non-face-to-face treatment, reinforcement of public medical care, the transformation of a medical system centered on the primary-level hospitals, and the use of AI and big data technologies. The medical CRM model presented in this study emphasizes the establishment of mutual customer relationships through close information exchange between patients, primary-level hospital, and the government. In the post-corona era, primary-level hospitals should not simply be approached as private hospital pursuing profitability. These should be reestablished as the hospitals that can provide public health care services while ensuring stable profitability.

일차보건의료조직에서의 방문간호사업 실태조사연구 (A Study on Visiting Nursing Service in Primary Health Care Units)

  • 임영옥;소애영
    • 지역사회간호학회지
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    • 제10권2호
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    • pp.480-493
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    • 1999
  • The visiting nursing service is an essential part of public health. The purpose of this study was to analyze the visiting nursing service in primary health service centers. The data were collected from visiting nurse records in Wonju City Health Center, Myun Health Center and Community Health Subcenters. The period of data collection was from April 6 to July 15, 1998. The major findings were as follows: 1. Characteristics of 36 service providers. 1) Age : Over 40 years old - 66.7% 2) Educational level: The proportion of registered nurses was 47.2% and nurse aids 52.8% 3) Career: The proportion of providers who worked over 11 years in Public Health Service was 7.8% 2. Characteristics of Subjects 1) The major health problems were cerebro vascular attack, hypertension, D. M., arthritis, gastrointestinal problems and psychiatric problems. The prevalence of chronic health problems increased with age, except for mental illness. 2) The prevalence of cancer was 4.3/1000. 3. Contents of Home Visiting Nursing Services. 1) The major service was education and counseling. 2) The other services were Direct Care(ROM exercise, wound care, physical therapy, basic nursing care etc,) as 56.5%, of the work involved Indirect Care(teaching, counseling, emotional support, etc,) 30.3%, medication - 11.7%, and referral to hospitals - 1.5%.

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초발 급성 심근경색증 환자의 불확실성과 자가간호 역량 및 생리적 지표 (Uncertainty, Self-care Agency and Physiological Index in Acute Myocardial Infarction Patients who Underwent Primary Percutaneous Coronary Intervention)

  • 조숙희;전경숙
    • 보건의료산업학회지
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    • 제9권4호
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    • pp.105-117
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    • 2015
  • Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.

보건진료소 중심의 주민 맞춤형 통합건강증진프로그램의 효과분석 (Analysis of the Effect of a Resident-tailored Integrated health Promotion Program based on the Primary Health Care Post)

  • 임정미;박현희;장숙랑
    • 한국농촌간호학회지
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    • 제10권2호
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    • pp.75-92
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of an integrated health promotion program provided by one community health post by comparing this program with more traditional health promotion programs provided by other institutions. Methods: The participants in this study were 110 selected local residents from I city. Of them, 55 residents participated in the integrated health promotion program in the community health post, and the other 55 participated in a program at another institution. SPSS 21.0 was used for descriptive analysis. Result: Scores for program effects, satisfaction level, quality of life related to health and depression were higher for the integrated health promotion program offered by the community health post compared to health promotion programs of the other institution. The differences were statistically significant. Conclusion: The findings of the study indicate that the integrated health promotion program can be helpful for community health posts in being successful in future plans to meet the needs of residents. Use of this program will also contribute to the development of community health posts but sustained research efforts need to be channeled into these programs.

전남 도서지역 보건진료원 업무환경 개선방안 (Improvement for Work Status of Community Health Practitioners in Island Areas)

  • 김옥
    • 한국농촌간호학회지
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    • 제7권2호
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    • pp.59-66
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    • 2012
  • Purpose: The purpose of this study was to assess the work status of community health practitioners in island areas. Methods: Participants in this study were 59 community health practitioners in primary health care posts located on islands in J Province. Data were collected during December, 2011 and analyzed using SPSS 17.0 program. Results: Characteristics of the majority of community health practitioners in the island areas was that they were over 50 years old, married, and had 10 years job experience, The population under their jurisdiction was less than 200 and they had an average of 6-10 patients/day and worked less than 10 hours/day. Health education and practice were the most common of task, and they had various types of paperwork to complete. They visited senior citizens living alone, managed medications, gathered health data for research, waited for night treatment of emergency patients, carried out health promotion programs, and visited seriously ill patients at home after work hours. Conclusion: Results of the study indicate that in order to improve the role and function of the primary health care posts and to boost morale, the practitioners' opinions should be actively accepted by the community health practitioner association and competent government agencies.

마그마힐링 프로그램이 노인의 우울 및 자아존중감에 미치는 효과 (Effects of Magma Healing Program on the Depression and Self-esteem of the Elderly)

  • 배상희;최미영;이영희;신정은;장양민
    • 한국농촌간호학회지
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    • 제15권1호
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    • pp.16-29
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    • 2020
  • Purpose: The purpose of this study was to determine the effect on depression and self-esteem in elders taking part in the Magma healing program. Methods: This study was a single group pre-post quasi-experimental design. The participants were elders over 60 who had complained of depression more than once within the last 3 months, and who were living in the jurisdiction of a health clinic in the 3-area of Chungnam. Data from 14 elders who participated in the Magma healing program were analyzed using nonparametric paired t-test with SPSS 25.0. Results: The study results showed that the Magma healing program had statistically significant results in reducing depression (z=-2.91, p=.004) and improving self-esteem (z=-2.91, p=.004) in elders. Conclusion: The Magma healing program has been proven to be a very useful program to reduce depression in elders and promote self-esteem, thereby integrating their lives and leading to successful aging.

보건진료원의 보건의료서비스 공급에 관한 관련요인분석 (A Study on the Health Services Provision of Community Health Practitioners)

  • 김영임
    • 대한간호학회지
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    • 제18권2호
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    • pp.153-161
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    • 1988
  • The purpose of this study was to analyze the level of the services provision of community health practitioners (CHP) and to find out the influence factors on the services provision of CHP. In this study the dependent variables were the level of community health services(CHS), maternal and child health services(MCH), family planning services(FPS), primary care services(PCS) and the ratios of preventive health services(PHS). And independent variables were predisposing, community demographic and task factors. For this analysis, atepwise regression was used. Data collected for the study on reorganization of health centers organization in 1985 was partly used. The findings of this study can be summarized as follows : First, total variance of independent variables for CHS, MCH, FPS, PCS and PHS are shown 62.5 percent, 58.3 percent, 41.8 percent, 17 percent and 61.9 percent respectively. Second, the most important variables which explain CHS, MCH, FPS, PCS and PHS was ratios of household contacted ($R^2$=0.289), marital status ($R^2$=0.177), marital status($R^2$=0.167), ratios of household contacted($R^2$=0.119) and management of preventive health services($R^2$==0.203) respectively. The independent varivbles used in this analysis presented that the explnining for the provision of preventive health service are more influenced than primary care services. In summary this analysis suggests that the level of preventive health services provision of CHP is low and the provision of primary care services compared with preventive health services are occurred independentely. In the future, the strategies for active preventive services by CHP must to be strengthened.

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Effectiveness of a Brief Physician Counselling Session on Improving Smoking Behaviour in the Workplace

  • Han, Yung Wen;Mohammad, Mohazmi;Liew, Su May
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7287-7290
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    • 2014
  • Background: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour. Materials and Methods: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention. Results: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168). Conclusions: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

생활터 중심의 건강마을 만들기 사업 (The Healthy Village Projects Centered on the Living Site)

  • 최영미;김지은
    • 한국농촌간호학회지
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    • 제13권1호
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    • pp.21-33
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    • 2018
  • Purpose: The purpose of this study was to identify health problems in the community by providing healthy village projects centered and based on the actual living site and to enhance the empowerment of the community related to health. Methods: The participants were 600 people who lived in one of the 5 villages under the jurisdiction of one Primary Health Care Post (PHCP) in D city. The Community Health Practitioner (CHP) carried out the projects to increase geographical and temporal accessibility by building infrastructures through connecting human and physical resources in the community. The health leaders who were trained through the project consistently managed, and periodically checked the residents' health status. Results: The participants in the projects had significantly lower levels of depression, routine stress, and activity of daily living (ADL) disorders, and higher interpersonal relationships, and health-related quality of life (HRQoL) compared to the control group. Conclusions: The healthy village projects centered on the living site led to voluntary participation from the residents, improve HRQoL and enhanced empowerment of community.