• Title/Summary/Keyword: Primary Care

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From Self-care for Healthy People to Self-management for Cancer Patients with Cancer Portals

  • Azadmanjir, Zahra;Safdari, Reza;Ghazisaeidi, Marjan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1321-1325
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    • 2015
  • Self-care to prevent cancer and self-management to cope with the disease are two discrete effective mechanisms for improving of control and management of neoplasia. Both them have certain strategies and practices. Often the two are used interchangeably despite their different approaches. Strategies of self-care usually refer to prevention at different levels include primary, secondary and tertiary. In contrast, strategies of self-management are related to management and alleviation of unpleasant cancer-related symptoms and treatment-related side effects for improving the quality of life of cancer survivors. Successful promoting of self-care and self-management strategies need people and survivor empowerment. Within this context, innovative approaches open a new window. In this paper after a brief review of related strategies and practices, we provide an explanation of how cancer portals may play an important role in the empowerment process and what are key potentials for implementing of self-care and self-management strategies for cancer.

Position Value for Relative Comparison of Healthcare Status of Korea in 2017 (2017년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교)

  • Lee, Hyeon Ji;Oh, Sarah Soyeon;Park, Eun-Cheol
    • Health Policy and Management
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    • v.30 no.1
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    • pp.131-138
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    • 2020
  • The purpose of this study was to compare the health status of South Korea with those of Organization for Economic Cooperation and Development (OECD) countries and examine the trends. Position vAlue for Relative Comparison (PARC) was used as a gauge for comparison, and five sectors of the health care system were measured: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used as a statistical analysis method to examine trend of PARC values obtained from 2000 to recent years. According to the results, the demand, supply, accessibility, and quality sectors were higher than the OECD average, while the cost was lower than the average. However, there is a recent trend of sharp increases in health care costs. Some indicators: health employment, quality of primary care and mental health care were lower than the OECD average, and health determinants showed a worsening trend. Therefore, policy-makers need to take this into account and make efforts for sustainable health care.

The Effects of a Customized Integrated Health Care Program for Male Living Alone (독거남성을 위한 맞춤형 통합건강관리 프로그램의 효과)

  • Lim, Soon Hee;Jang, Yang-Min
    • Journal of Korean Academy of Rural Health Nursing
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    • v.11 no.2
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    • pp.17-28
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    • 2016
  • Purpose: This study aimed to determine the effects of a 'Customized Integrated Health Care Program' for male living alone in a single region and assist health promotion of the participants. Methods: This study was one-group pretest-posttest design. Eleven participants in the 'Happy Cooking Class for Male Living Alone' who made 100% of attendance from February 18 to September 8, 2016 were analyzed. Nonparametric paired T-test was performed to determine the differences in Blood pressure(BP), Blood sugar(BS), Cholesterol, Hemoglobin(Hb), Dementia screening test, Depression screening test of the participants in the Customized Integrated Health Care Program. Results: After applying the 'Customized Integrated Health Care Program', Hb level(z=-2.724, p=.006) and Dementia screening test(z=-1.974, p=.048) increased statistically significantly. Conclusion: As the elderly living alone increase in number, it seems that social support networks and health care programs contribute to health promotion of the participants and positively affect the rest of their life.

Comparative Study of Health Care System in Three Central Asian Countries: Kazakhstan, Kyrgyzstan, Uzbekistan

  • Dronina, Yuliya;Nam, Eun Woo
    • Health Policy and Management
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    • v.29 no.3
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    • pp.342-356
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    • 2019
  • Background: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. Methods: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. Results: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. Conclusion: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.

Non-pharmacological Interventions for Chronic Pain in Older Adults in Long-term Care Facilities: A Scoping Review (장기요양시설 노인의 만성통증 관리를 위한 비약물적 중재: 주제범위 문헌고찰)

  • Kyung-Hye Hwang;Hyekyung Kim;Cho, Ok-Hee
    • Journal of Home Health Care Nursing
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    • v.30 no.3
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    • pp.298-310
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    • 2023
  • Purpose: This study synthesized the literature on non-pharmacological interventions for chronic pain in older adults in long-term care facilities. Methods: Scoping review and thematic analysis methods were combined. On June 1, 2023, searches of primary electronic databases, including PubMed, Embase, PsycINFO, CINAHL DBpia, KMbase, NDSL, and RISS, were performed, restricting the publication date from January 1, 2010 to December 31, 2022. Guidelines from the Joanna Briggs Institute were used as a framework to set and conduct the scoping review. Results: The review identified 1,095 abstracts, from which 14 studies were included in the review. Consequent to the study, there were 10 randomized controlled experimental study designs, and 6 out of 14 studies were conducted in China. The numeric rating scale was widely used for pain assessment. Exercise intervention was provided in 7 studies and physiotherapy was provided in three studies. The outcome variables measured were pain self-efficacy, physical functions, and depression. Conclusion: This comprehensive overview guided nursing staff in long-term care facilities for planning and intervention of effective non-pharmacological interventions for chronic pain in the elderly.

Establishment and Application of the Guideline for Hypertension by Delphi Method in the Field of Primary Medical Care (Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용)

  • Yang, Yun-Jun;Hong, Myung-Ho
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.68-84
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    • 1995
  • Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

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Development of a curriculum for Care Manager Education (케어매니저 양성을 위한 교육과정 개발)

  • Chong, Min-Yeong;Son, Myeong-Dong;Park, Cheon-Gyu
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.1064-1069
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    • 2009
  • The aged long-term care insurance for solving problems of the aged increasing rapidly in an aging society is a primary subject which have influence on. So, it is important to develop a curriculum for training care professionals who play an important role in operating of the aged long-term care insurance and especially care managers, because care managers are central professionals who intervene in a whole process of the aged long-term care insurance and provide the recipient with proper services. In this paper, we propose a curriculum for care managers. It includes a process classifying care manager students into a beginner and an experienced man, subdividing it into 3 parts-lecture, practice, field practice, assign time to subjects, train students by it, carry out a written examination, and certify in care manager training.

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Post-Intensive Care Syndrome Experience among Critical Care Survivors: A Meta-synthesis of Qualitative Research (집중치료 후 증후군 경험에 관한 질적 통합 연구)

  • Kang, Jiyeon;Jeong, Yeon Jin;Yun, Sun Young;Lee, Min Ju;Baek, Min Jung;Shin, So Yeung;Hong, Hee Jin;Kim, Soo Kyung;Cho, Young Shin
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.13-30
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    • 2017
  • Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.

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Care as a Constitutional Value (돌봄: 헌법적 가치)

  • Kim, Hee-Kang
    • 한국사회정책
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    • v.25 no.2
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    • pp.3-29
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    • 2018
  • By examining care from a normative perspective projected in the Constitution of South Korea, this paper attempts to assess care from the standpoint of justice and establish the status of care as a concrete political value. The point that this paper focuses on in the Constitution is about the "human worth and dignity" and "right to pursue happiness" clauses of the Article 10 at the beginning of Chapter II which defines the rights and duties of citizens. The clauses of "human worth and dignity" and the "right to pursue happiness" are generally interpreted as the highest values of the constitutional order. While exploring the human dignity and the pursuit of happiness clauses in light of care, this paper intends to address the value of care as human dignity, which is the highest ideology and constitutional principle of the Constitution and, at the same time, the limitation of explaining the freedom to care with a liberal concept of freedom implied in the pursuit of happiness. Ultimately, this paper argues for the justification of putting 'care' in the Constitution. In the end, this paper aims to emphasize the significance of care as a guiding principle for the maintenance of our lives and society, a primary principle of social regulation and public governance, and a direction for a just state which can identify and rectify care injustices.

Metastatic Bone Disease as Seen in Our Clinical Practice - Experience at a Tertiary Care Cancer Center in Pakistan

  • Qureshi, Asim;Shams, Usman;Akhter, Azra;Riaz, Sabiha
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4369-4371
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    • 2012
  • Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.