• Title/Summary/Keyword: Primary Care

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Analysis of the Results of Health Service Programs in the Primary Health Care Posts (보건진료소 보건사업 현황 분석)

  • Son, Gye-Soon;Moon, Ja;Park, Choon-Hee;Lee, Eun-Gyung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.3 no.1
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    • pp.24-33
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    • 2008
  • Purpose: To analyze health programs of the PHCP (Primary Health Care Posts) Method: From August 2006 to July 2007, data on the general quality and health program of the PHCP was requested by official letter and replies were received via E-mail. From December 8 to December 30, 2007, data from 1,268 (66.8%) PHCP out of 1,897 PHCP were analyzed using SPSS 12.0 Win program. Results: The average population covered by each PHCP is 878.3 people. For the health and special programs, Community Health Practitioners report high motivation for programs on health promotion, management of chronic illness, social welfare (40-50%). Demand by the residents was reported at 10% and increases in the health of the residents were attributed to high interest and demand. Volunteer work was 83.3% for bathing, 54.5% for equipment support and 46% for exercise programs. As elders make up 30% of the population in rural areas, there is an increasing demand for volunteer work in bathing programs. Conclusions: As the number of elders in the population increases and there is an increased need for more medical treatment for older people who are sick, the role of PHCP must be strengthened to include visits to homes of community residents. Where financial support for the PHCP is difficult, it is necessary to develop sound data on demographic characteristics of the population in order to develop efficient and effective health promotion programs. The finding that 54.7% of the population need management of chronic illness has difficulty in seeing a physician indicates a need to enhance the health care delivery system by strengthening the role of the Community Health Practitioners and including them in the civil service system to ensure stability of the PHCP.

Time Spent for Child Care among Employed and Non-Employed Mothers with Young Children (취업 여부에 따른 어머니의 미취학자녀 돌봄시간 사용 양태 : 단독주행동, 동시주행동, 동시부행동을 기준으로)

  • Kwon, SoonBum;Chin, Meejung
    • Journal of Families and Better Life
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    • v.34 no.3
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    • pp.27-43
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    • 2016
  • This study aims to better estimate the amount of time spent for child care and to understand the characteristics of time spent for child care among employed and non-employed mothers with children under age 6 by taking concurrent activities into account. To assess time spent for child care, I differentiate child care activities into three types: primary activity without concurrent activities, primary activity with concurrent activities, and secondary activity with concurrent activities. The Major results of this study are as follows: First, employed mothers spent 145 minutes less than non-employed mothers in the total amount of time spent for child care during weekdays and this difference diminished to 62 minutes on weekends. Specifically there were differences in all types of time spent for child care among employed and non-employed mothers during weekdays, while the difference was only significant in the average amount of primary time spent for child care without concurrent activities on weekends. Second, there was no difference in the average ratio of time spent for child care with concurrent activities among employed and non-employed mothers during weekdays. By contrast, the average ratio of time spent for child care with concurrent activities of employed mothers was 5% higher than non-employed mothers on weekends. Lastly, the highest concurrent activity with child care activities was leisure followed by housework. This means that child care, leisure, and housework are somewhat related to each other among mothers.

Medical Care Utilization Pattern of Medical Aid Program Beneficiaries (의료보호대상자(醫療保護對象者)의 의료이용(醫療利用) 양상(樣相))

  • Kim, Ju-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.37-45
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    • 1984
  • This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

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Caregiver Burden of Patients with Dementia and Day Care Center of Small Size Model within a Zone of Life (치매환자 부양자부담과 생활권 내 소규모 주·야간 돌봄 서비스 모델)

  • Na, Seung-kwon;Park, Eun-Ju
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.9 no.4
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    • pp.428-438
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    • 2016
  • The aim of this study, in order to reduce the support burden of dementia primary caregiver, within the framework of long-term care insurance system to present its founding model for the development of new services. Previous research as analytical materials and based on the CARE study between 2012 to 2013. Primary caregiver burden of patient are both physical, psychological and economic aspects as well as difficulties in many aspects and had influence on many factors such as age, care burden, economic, health, and social support. It also came high-risk primary caregiver suffer from depression. This primary caregiver to take advantage of the elderly long-term care insurance system implemented at the time of the institutional support necessary for since 2008, presented additional services in this study. Of increasing the small sizes day care center (tentative name) to open an as established in the settlements at a scale of less than nine, within 5 minutes from the residence, limited dementia by expertise in the disease home care services scale model of the current system service It was to improve the quality of existing shares, small group sizes for day care centers and community life apart.

Job Analysis of Nurse Care Coordinators for Chronic Illness Management in Primary Care Settings: Using Developing a Curriculum Process (데이컴 기법을 적용한 일차의료 만성질환관리 간호사 케어코디네이터 직무분석)

  • Hwang, Ju-Hee;Choi, Yong-Jun;Kim, Mi-Sook;Yi, Seng-Eun;Park, Yong-Soon;Kim, Ji-Hyang;Yoon, Ju-Young;Shin, Dong-Soo
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.758-768
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    • 2021
  • Purpose: This study aimed to conduct a job analysis of nurse carecoordinators and to identify the frequency, importance and difficulty of each task of their job. Methods: A committee for developing a curriculum (DACUM) was formed and members of the committee defined nurse care coordinators' jobs and enumerated the duties, tasks and task elements by applying the DACUM technique. Then nurse care coordinators enrolled in the pilot project evaluated the frequency, importance and difficulty of each task. Results: From the job descriptions of nurse care coordinators, we identified 12 duties and 42 tasks. Each task comprised 1~5 task elements. Among tasks, 'assess the patient's general health status' was carried out most frequently. Nurse care coordinators perceived that 'check vital signs' and 'strengthen patient competence to promote health behaviors' were more important than all other tasks. The most difficult task was 'develop professionalism as a nurse care coordinator'. Conclusion: The nurse care coordinators' roles developed in this study will serve as the key guidelines for human resource management of care coordinators. Further, job specifications for nurse care coordinators need to be developed, which is necessary for designing education and training programs. We also need to integrate primary health care as an essential component in nursing education.

Nurse Practitioner Roles and Curriculums in the United States (미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰)

  • Lee Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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Factors Affecting the Number of Hours Children Spent in Child Care Centers among Dual-working Families (맞벌이 가정 영유아의 어린이집 이용시간에 영향을 미치는 요인)

  • Shin, Nary;Ahn, Jaejin
    • Korean Journal of Human Ecology
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    • v.21 no.5
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    • pp.863-874
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    • 2012
  • This study examined the factors affecting the number of hours spent in child care centers by children of dual-working families. Data for this study was collected by way of a survey that involved a total of 33 child care centers. A total of 465 families took part in the study. Child factors, parental factors, household factors, and child care center factors were included in the hierarchical regression model on which this study was based. The results of this study identified eight primary factors related to the number of hours spent in child care centers by children of dual working families, which were as follows: (1) children's engagement in extracurricular activities, (2) maternal working hours, (3) parents' preference for child care center as a non-parental care provider, (4) the number of children attending the child care center in the household, (5) the presence of adults other than parents in the household, (6) accessibility to the child care center, (7) the satisfaction with child care services, and (8) the primary purpose of child care center use.

A Study of nursing process by Neuman's systems model in Primary Health Care (Neuman 모델에 의한 일차보건의료에서의 간호과정 적용연구)

  • Han Myung Hwa
    • Journal of Korean Public Health Nursing
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    • v.12 no.1
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    • pp.90-102
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    • 1998
  • The primary health care(PHC) movement officially began in 1977 when the 30th World Health Oranization(WHO) Assembly adopted a resolution accepting the goal of attaining a level of health that permitted all citizens of the world to live socially and economically productive lives. As a WHO member nation, Korea has endorsed primary health care as a strategy for achieving the goal of Health For All by the Year 2000. However, PHC, with its empasis on broad strategies, community participation, self reliance, and a multidisciplinary health care delivary team, is not the primary strategy for improving the of Korean. The Neuman's systems model has been described as a grand nursing theory. A grand nursing theory consists of a comprehensive conceptual framework that defines broad perspectives for practice. This model is an example of a conceptual framework that provides structure for development and analysis of an individual or group of patients in the community or in an oranization. One of the model's strength is that it can be useed ina variey of setting. So The Neuman's model is used a nursing process format for community health nursing. The Neuman's model is fully congruent with concept and philosophy of today's PHC.

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A Comparative Study of the Factors Influencing Burden of Primary Family Caregivers according to the Degree of Serious Illness of Elderly Patients Admitted in an Intensive Care Unit (중환자실 입원 노인 중증도별 주 부양가족의 부담감 영향요인 비교)

  • Kim, Kwuy-Bun;Han, Kyung-Suk;Sok, So-Hyune R.
    • Korean Journal of Adult Nursing
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    • v.21 no.2
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    • pp.187-198
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    • 2009
  • Purpose: This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit. Methods: Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics. Results: First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3. Conclusion: Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.

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Salt Processed Food and Gastric Cancer in a Chinese Population

  • Lin, Si-Hao;Li, Yuan-Hang;Leung, Kayee;Huang, Cheng-Yu;Wang, Xiao-Rong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5293-5298
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    • 2014
  • To investigate the association between salt processed food and gastric cancer, a hospital based case-control study was conducted in a high risk area of China. One hundred and seven newly diagnosed cases with histological confirmation of gastric cancer and 209 controls were recruited. Information on dietary intake was collected with a validated food frequency questionnaire. Unconditional logistic regression was applied to estimate the odds ratios with adjustment for other potential confounders. Comparing the high intake group with never consumption of salt processed foods, salted meat, pickled vegetables and preserved vegetables were significantly associated with increased risk of gastric cancer. Meanwhile, salt taste preference in diet showed a dose-response relationship with gastric cancer. Our results suggest that consumption of salted meat, pickled and preserved vegetables, are positively associated with gastric cancer. Reduction of salt and salt processed food in diets might be one practical measure to preventing gastric cancer.