• Title/Summary/Keyword: Primary Care

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Factors Influencing Stress Appraisal of Cancer Patients' Primary Caregivers (암환자의 일차간호제공가족의 스트레스 인지평가 영향 요인 분석)

  • Shin, Gye-Young;Kim, Mae-Ja
    • Korean Journal of Adult Nursing
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    • v.14 no.1
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    • pp.125-134
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    • 2002
  • Purpose: The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. Method: The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. Results: Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. Conclusion: These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.

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Reorienting health services: Health promotion services in primary care (보건의료서비스 방향 재정립: 일차의료에서 건강증진 서비스)

  • Kim, Young Sik
    • Korean Journal of Health Education and Promotion
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    • v.32 no.4
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    • pp.59-65
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    • 2015
  • Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.

Factors Related to the Output of Health Centers (보건소의 사업성과에 관련된 요인)

  • 차병준;박재용
    • Health Policy and Management
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    • v.6 no.1
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    • pp.29-58
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    • 1996
  • This study was conducted to identify the factors that affect the output of health conters. An analystical model employed in this study was developed by modifying 'input-output model' and 'organizational behavior model'. Data were collected form two source; the 1995 report of thealth center which was submitted to the Ministry of Health and Welfare and a mail survey questionary of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows: That analysis has identified the factors associated with dependent variables: medical services provided by the health center and health program performance(HPP). The number of primary medical facilities was negatively associated with health center performance while the number of staffs, job satisfaction, and professional background of health center directors were positively associated. These independent variables accounted for 40.1% of the variance of dependent variables. The variance of HPP was significantly explained by the number of health subcenter and primary health post, priority level of public health program by hief executive officers(CEOs) and legislator. A significant relationship was found between leadership types of health center directors and the performance of maternal and child health program. Considering these results, the authors suggested that the role in medical care service of health center in the should be rearranged at local level because medical care service of the health center is competing with primary medical facilities in the same region. It is also suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.

Effects of a Primary Healthcare Post Obesity Management Program for Middle-Aged Obese Women Living in Rural Areas (농촌 거주 중년 비만여성을 위한 비만관리 프로그램의 효과)

  • Park, Chun Im;Woo, Jin Ju
    • Journal of Korean Academy of Rural Health Nursing
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    • v.11 no.1
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    • pp.15-22
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    • 2016
  • Purpose: The purpose of this study was to analyze changes in body weight (kg) and body mass index (BMI) in middle-aged women following a 12 week exercise program. Methods: The obesity management program for primary health care posts, which consists of exercise therapy and dietary counseling, was provided for obese women aged 40 to 64 (N=15). General characteristics of the women and differences in body weight and BMI before and after the program were analyzed using SPSS 22.0. Results: The major findings of this study are as follows; Average body weight before the program was 65.7 kg, and it was significantly reduced to 63.9 kg after the program (z = -3.41, p = .001). The average level of BMI decreased considerably from 27.9 kg/m2 to 27.2 kg/m2 (z = -3.41, p = .001). Conclusion: The findings from this study show a significant decrease in body weight and BMI after the program. Continuous study is needed to develop a variety of obesity management programs for middle-aged obese women. When developing programs regional characteristics need to be considered and there is a need to confirm the effectiveness of the programs.

A Survey of School Health Nurses Competency and Professional Attitude (보건교사의 학교보건 실무능력 인지도와 전문직 태도에 대한 조사연구 - 초.중.고등학교 보건교사를 대상으로 -)

  • Yoo, Il-Young;Lee, Kyu-Young;Yoo, Moon-Sook
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.808-816
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    • 2002
  • Purpose: The study was aimed to assess the competency and professional attitude of school health nurses who are occupied with adolescent health, and to provide basic information for the development of continuing education programs for them to improve their competencies. Method: The self-reported questionnaire based on WHO assessment tool were used to assess the competencies of the school health nurses providing health care for adolescents. The subjects were 584 school health nurses and the data were collected from January 28 to March 5, 2002. Result: The school health nurses in middle schools showed significantly higher scores than the school health nurses in primary schools on the level of competency. The nurses were scored the highest in the area of dealing with sexual issues for the students, followed by providing them direct care and application of primary care concept to the field of school health nursing. The areas showing the lowest scores were counseling and utilization of the system. There was a significant positive correlation between competency and professional attitude of the school health nurses. Conclusion: Based on the results of this study, it is necessary to develop various continuing educational programs for school health nurses using different teaching methods such as web-based program.

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Arab Women's Breast Cancer Screening Practices: A Literature Review

  • Donnelly, Tam Truong;Al Khater, Al-Hareth;Al-Bader, Salha Bujassoum;Al Kuwari, Mohammed Ghaith;Al-Meer, Nabila;Malik, Mariam;Singh, Rajvir;Jong, Floor Christie-De
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4519-4528
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    • 2013
  • Breast cancer incidence and mortality rates are increasing in the Arab world and the involved women are often diagnosed at advanced stages of breast cancer. This literature review explores factors influencing Arab women's breast cancer screening behavior. Searched databases were: Medline, PubMed, Cochrane Database of Systematic Reviews, CINAHL Plus, Google Scholar, Index Medicus for WHO Eastern Mediterranean, and Asian Pacific Journal of Cancer Prevention. Breast cancer screening participation rates are low. Screening programs are opportunistic and relatively new to the region. Knowledge amongst women and health care providers, professional recommendation, socio-demographic factors, cultural traditions, beliefs, religious, social support, accessibility and perceived effectiveness of screening influence screening behavior.

Position Value for Relative Comparison of Healthcare Status of Korea in 2019: Comparison with Countries of the Organization for Economic Cooperation and Development (2019년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교)

  • Park, Minah;Youn, Hin-Moi;Park, Eun-Cheol
    • Health Policy and Management
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    • v.32 no.1
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    • pp.113-121
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    • 2022
  • This study aims to compare the healthcare status of South Korea and other member of the Organization for Economic Cooperation and Development (OECD) using the OECD health statistics 2021. We used the position value for relative comparison (PARC) index to measure the five elements of the healthcare system, demand, supply, accessibility, quality, and cost. For the statistical analysis, Mann-Kendall test was performed to examine the trend of the PARC values from 2000 to the most recent year. The results showed that supply, demand, accessibility, and quality were above median than the OECD median and the cost was below median. In sectors such as primary care, health employment and mental health care were below median average. With these result, necessary steps for a sustainable healthcare should be taken into effort by policy makers.

A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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Causes of Chronic Hip Pain Undiagnosed or Misdiagnosed by Primary Physicians in Young Adult Patients: a Retrospective Descriptive Study

  • Lee, Yun Jong;Kim, Sang-Hwan;Chung, Sang Wan;Lee, Young-Kyun;Koo, Kyung-Hoi
    • Journal of Korean Medical Science
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    • v.33 no.52
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    • pp.339.1-339.11
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    • 2018
  • Background: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ${\leq}50years\;old$. Methods: We retrospectively analyzed a consecutive cohort of 150 patients (${\leq}50years\;old$) with chronic hip pain (${\geq}6weeks$), which was not diagnosed or misdiagnosed based on the information provided on the referral form. Results: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. Conclusion: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.

The Factors Influencing Service Outcomes of Group Homes and Residential Care Centers : Focusing on Blinder-Oaxaca Decomposition (그룹홈과 아동양육시설의 운영성과에 영향을 미치는 요인 : Blinder-Oaxaca 분해를 중심으로)

  • Chung, Ick Joong;Woo, Seok Jin;Kang, Hyun Ah;Chun, Jong Serl;Lee, Jung Ae
    • Korean Journal of Child Studies
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    • v.33 no.4
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    • pp.107-127
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    • 2012
  • This study investigates the factors influencing service outcomes of group homes and residential care centers, as well as the factors causing any differences between the two service outcomes. 119 and 137 5-6th graders were selected from group homes and residential care centers respectively, using the cluster sampling method. Multiple regression and Blinder-Oaxaca decomposition were used in this study. The results revealed that 'stigma', 'school adjustment', and 'social support' were significant factors influencing service outcomes among children in group homes, while 'stigma', 'primary caregivers' attitude', and 'peer relations' were identified as significant factors among children in residential care centers. The study also found that the mean service outcome score for group homes was higher than that of residential care centers. The 74 percent of this difference in the mean scores was due to the difference in children' characteristics of the two out-of-home care service types. The remaining 26 percent of this difference was due to unobserved characteristics. Finally, the implications of this study in child welfare practices were also discussed.