• Title/Summary/Keyword: Primary Care Activity

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A Validation Study for the Korean Version of Chronic Obstructive Pulmonary Disease Assessment Test (CAT)

  • Hwang, Yong Il;Jung, Ki-Suck;Lim, Seong-Yong;Lee, Yil-Seob;Kwon, Nam-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.256-263
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    • 2013
  • Background: Health status measure is not only important for clinical research studies but also for clinical practices of chronic obstructive pulmonary disease (COPD) patients. The objective of this study is to evaluate the validity of the Korean Version of COPD Assessment Test (CAT) in primary care clinics as well as in referral hospitals. Methods: Smokers or ex-smokers, aged 40 years or older, with a smoking history of >10 pack-years; and a COPD diagnosis in the past 6 months or more, were recruited from 4 primary care clinics and 2 referral hospitals. Demographic, medical, and spirometry data was collected from patients who completed the CAT and St. George Respiratory Questionnaire (SGRQ), and had their dyspnea been assessed. The primary endpoint was the correlation between of the Korean version of CAT with SGRQ in patients with COPD. Results: A total 100 patients were enrolled. The mean age and smoking amounts were $69.2{\pm}8.4$ years and $40.6{\pm}22.3$ pack-years, respectively. Sixty-seven percent of the patients reported at least one exacerbation in the past year. The mean CAT score was $16.9{\pm}8.0$. The internal consistency assessed by Cronbach's alpha was 0.85. The CAT score was positively correlated with the SGRQ score (r=0.76, p<0.0001) and each component of SGRQ: symptoms, activity and impacts; r=0.68, r=0.61, and r=0.72, respectively (all p<0.0001). These positive correlations were preserved in the different groups (r=0.86, p<0.0001 in primary care clinic group; r=0.69, p<0.0001 in hospital group). The CAT score was also positively correlated to the Medical Research Council dyspnoea scale (r=0.46, p<0.0001). Conclusion: The Korean version of CAT had good internal consistency and showed good correlations with SGRQ. It can be used for assessing the impacts of COPD on the patient's health including primary care setting.

A Study on Performance and Achievement of Village Health Workers in Rural Primary Health Care Program (농촌 일차 보건사업에 있어서 마을건강원 업무량 및 업적에 관한 연구)

  • Hur, Dal-Young;Lee, Myoung-Sook;Yum, Yong-Tae;Kim, Soon-Duck
    • Journal of agricultural medicine and community health
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    • v.12 no.1
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    • pp.36-53
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    • 1987
  • It is utmostly important to establish the efficient fitable way of peoples' active participation in primary health care especially in the areas where the public or governmental service input for the basic health care is insufficient like as in rural areas of Korea. In light of above reason, this study focused mainly on the evaluation of roles and activities of village health workers (VHWs) who were selected from grass- root level of village people in order to derive further motivation for active participation. This is believed to be a sort of feedback mechanisms. Actually, the authors collected the activity reports of VHWs who had been devoting themselves in the primary health care services of Jeomdong Area, of Yeoju Gun one of Korea University Community Health Action Programmes and survey record on the VHWs activity from correspondent people. 1 hose data were analyzed through computer programmed package. The activities performed by VHWs were limited to the performance in 1985 for conveniance. The summarized results were as follows; 1) General characteristics of VHWs. Among a total of 28 VHWs in the area, about 39.3g of them have been replaced up to the date since the implementation in 1983, because of moving out, occupational employment and of others. The age of majority (75.0%) lied between the range of 30-50, and educational background of 67.9% belonged to category of primary school graduation, about 50% of them experienced to be or were also entiled "chief of women club" of corresponding villages. 2) Work-load of VHWs. Each VHW was assigned for tasks of health care for average 55 households of 248 persons. They shared approximately 6 days a month for the activity in average and it covered 17 cases of basic health care in a month. A half of the VHWs performed home visits irregularly without solidified schedule. 3) Work performance analysis. Informations collected through VHWs were compared with data from official vital registration at local administration center "Myon Office" in 1985. VHWs collected 100.8 of new born, 116.2 of death, 58.3 of move in and 74.8 of move out in comparison with 100.0 of official registration each. Pregnant women of 79.8% of mothers among the total pregnancy of 94 which were confirmed as normally delivered or aborted cases by all means afterwards had been detected by VHWs as being pregnant and all of them received some of antenatal cares by VHWs. All(100%) of delivered women were detected by VHWs through home visits and they were cared postnatally. Whereas, according to the records of birth registration, the places of delivery were clinic in 33.7%, and mother's home in 66.3%, VHWs reported them to be clinic in 48.9%, midwifery in 20.2%. It was cleared that most of misinformation was caused by uncautious filling of birth registration at notification. Among the total of 717 eligible women under age 44 years, family planning status of 92.6% was reported by VHWs confirming practice of control to be 70.8% of reported fertile women. 4) Attitude of VHW on the roles and functions. Although 92.0% of VHWs expressed VHWs to be worthwhile, only 52.0% of them had dignity and satisfaction in their activity and 44.0% of them had passive attitude of working saying they followed direction regardlessly. Concerning difficulties in performance as a VHW, 60.7% of them pointed out lacking of medical and health related knowledge by themselves. Still, 64.0% of them thought visiting unfamilier house to be awful and 40.0% complained forms of activity to be difficult and hard. It was also revealed that 56.6% confessed lack of interest on community health service itself. Most of VHWs needed more educational training especially on clinical fields such as cares of gynecological diseases, hypertension, diabetes, and other chronic diseaes of the aged. Regular on-the-job basic trainings were said to be needed twice a year.

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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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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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A Study on Knowledge and Attitude of Housewives toward Health Care and Antibiotics in a Rural Area (농촌주부(農村主婦)들의 의료(醫療)와 항생제(抗生劑)에 대(對)한 지식(知識)과 태도(態度)에 관(關)한 조사(調査))

  • Kim, Soon-Ki
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.147-151
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    • 1976
  • A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondants possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occure in a family, 13.0% out of 242 respondants had chosen physician's clinics for inicial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondants were skin diseases with 43.8%, suppurated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondants had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondants had obtained antibioties from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eighty-nine percent of the respondants were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.

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Current status of physical activity and policy proposals of the national level (신체활동 현황과 국가수준의 정책 제안)

  • Yang, Yun Jun
    • Korean Journal of Health Education and Promotion
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    • v.33 no.4
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    • pp.47-54
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    • 2016
  • Objectives: The prevalence of insufficient physical activity is relatively high in the Republic of Korea and it is increasing. The national strategies to improve physical activity are essential and are suggested in this paper. Methods: National level of physical activity is compared globally by WHO statistics. Korean National Health and Nutrition Survey showed the level of physical activity. National strategies to improve physical activity were suggested referring to the other countries' strategies, public health books and Health Plan 2020. Results: Prevalence of insufficient aerobic exercise in 2010 were 33.4%, 94.8% in over and 18 years old, 11~17 years old, respectively. And it is increasing. Sufficient exercise to fit the national guidelines of physical activity were done by 15.6% of Korean older and 19 years old. Prevalence of insufficient physical activity was high in the elderly, female, adolescent, rural area and lower income. The national spread of the physical activity guidelines, primary care physicians involvement, supports for the physical activity programs, development of the evaluation protocol for the programs and environmental supports are suggested. Conclusions: The government induced various efforts to improve the level of physical activity is needed urgently.

Barriers to Promoting Physical Activity among Overweight and Obese Children from Low-income Families Using Community Child Care Centers (저소득가정 비만아동의 신체활동 증진 장애요인 : 지역아동센터 이용 아동을 중심으로)

  • Lee, Ja-yin;Park, Jiyoung;Kim, Hee-Soon;Kim, Wan-Soo;Hwang, Gahui
    • Journal of Korean Public Health Nursing
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    • v.31 no.2
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    • pp.327-340
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    • 2017
  • Purpose: The aim of this study was to identify the barriers to promoting physical activity among obese children from low-income families using community child care (CCC) centers. Methods: This study employed an exploratory-descriptive qualitative research using focus group interviews. The participants were recruited from CCC centers, and 4 focus group interviews were conducted with 10 overweight and obese children and 14 primary caregivers. All interviews were recorded and transcribed verbatim. The data were analyzed using content analysis. Results: The barriers to promoting physical activity were classified into three areas: 1) individual, a lack of will for physical activity; 2) interpersonal, a change in communicative mean with the peer group, absence of parental monitoring due to work-family balance, and an absence of consistent rules; and 3) organizational, lack of physical activity programs and human resources, and confined space for physical activity. Conclusion: The physical activity of children in low-income families is influenced by a range of ecological barriers. These findings can be used to develop tailored intervention to prevent and manage childhood obesity in low-income children.

The Effects of Nuclear Factor-κB Decoy Oligodeoxynucleotide on Lipopolysaccharide-Induced Direct Acute Lung Injury (리포다당질로 인한 직접성 급성폐손상에서 Nuclear Factor-κB Decoy Oligodeoxynucleotide의 효과)

  • Kim, Je Hyeong;Yoon, Dae Wui;Jung, Ki Hwan;Kim, Hye Ok;Ha, Eun Sil;Lee, Kyoung Ju;Hur, Gyu Young;Lee, Sung Yong;Lee, Sang Yeub;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.2
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    • pp.95-104
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    • 2009
  • Background: The pathophysiologic mechanisms of early acute lung injury (ALI) differ according to the type of primary insult. It is important to differentiate between direct and indirect pathophysiologic pathways, and this may influence the approach to treatment strategies. NF-$\kappa$B decoy oligodeoxynucleotide (ODN) is a useful tool for the blockade of the expression of NF-$\kappa$B-dependent proinflammatory mediators and has been reported to be effective in indirect ALI. The purpose of this study was to investigate the effect of NF-$\kappa$B decoy ODN in the lipopolysaccharide (LPS)-induced direct ALI model. Methods: Five-week-old specific pathogen-free male BALB/c mice were used for the experiment. In the preliminary studies, tumor necrosis factor (TNF)-$\alpha$, interleukine (IL)-6 and NF-$\kappa$B activity peaked at 6 hours after LPS administration. Myeloperoxidase (MPO) activity and ALI score were highest at 36 and 48 hours, respectively. Therefore, it was decided to measure each parameter at the time of its highest level. The study mice were randomly divided into three experimental groups: (1) control group which was administered 50 ${\mu}L$ of saline and treated with intratracheal administration of 200 ${\mu}L$ DW containing only hemagglutinating virus of Japan (HVJ) vector (n=24); (2) LPS group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing only HVJ vector (n=24); (3) LPS+ODN group in which LPS-induced ALI mice were treated with intratracheal administration of 200 ${\mu}L$ DW containing 160 ${\mu}g$ of NF-$\kappa$B decoy ODN and HVJ vector (n=24). Each group was subdivided into four experimental subgroups: (1) tissue subgroup for histopathological examination for ALI at 48 hours (n=6); (2) 6-hour bronchoalveolar lavage (BAL) subgroup for measurement of TNF-$\alpha$ and IL-6 in BAL fluid (BALF) (n=6); (3) 36-hour BAL subgroup for MPO activity assays in BALF (n=6); and (4) tissue homogenate subgroup for measurement of NF-$\kappa$B activity in lung tissue homogenates at 6 hours (n=6). Results: NF-$\kappa$B decoy ODN treatment significantly decreased NF-$\kappa$B activity in lung tissues. However, it failed to improve the parameters of LPS-induced direct ALI, including the concentrations of tumor necrosis factor-$\alpha$ and interleukin-6 in BALF, myeloperoxidase activity in BALF and histopathologic changes measured by the ALI score. Conclusion: NF-$\kappa$B decoy ODN, which has been proven to be effective in indirect models, had no effect in the direct ALI model.

A Comparative Study on the Prevalence of Refractive Errors Between Urban and Rural Primary School Children (초등학생의 지역간 시력차이에 관한 연구 -대구 및 영천지역을 중심으로-)

  • Jin, Mi-Sun;Suk, Kui-Duk;Shin, Im-Hee
    • Journal of the Korean Society of School Health
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    • v.14 no.2
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    • pp.187-206
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    • 2001
  • The study was carried out to estimate the prevalence and possible causes of refractive errors in primary school children. At one primary school in urban Daegu, one in the medium-sized city of Yongcheon and 2 in rural areas, children wearing glasses and children with visual acuity of less than 0.7 were given our questions. 354 out of 378 children responded to our questions. The research was done from March 2000 to February 2001. The data were analyzed by percentage, x2 test, t-test, ANOVA and Scheff method. Children with eyesight problems were more prevalent in urban areas than rural areas. The lack of luminosity during reading (p=0.015), length of reading time (p=0.08) and posture which watching TV (p=0.023) appeared leading causes of progressing myopias. The visual impairment caused by refractive errors may affect the mental and physical activity of primary school children and lead to social isolation, loneliness and depression. However, little attention may be paid by professionals engaged in providing health care to the children. Once we have recognized the impact of visual impairment, we may be in a better position to prevent progressing refractive errors.

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A Study on the Current Situation about the Path of Flow in the Care Facilities (노인전문요양시설의 동선에 관한 연구)

  • Chu, Yeon Cheol;Lee, Dong Suk;Yoon, Choong Yeul
    • Journal of the Korean Institute of Rural Architecture
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    • v.10 no.4
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    • pp.9-16
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    • 2008
  • The purpose of this study is to compare and seize the type of the path of flow for nurses and living assistant, of the path of flow for evacuation and walking practice by analysis plan for the care facilities in the out-of-home service. It supposed many problem for living in the care facilities for the aged get down activity, especially their relates with difficulty in walking. And services of nurses and living assistant get mixed properties by that problem for the aged with difficulty in walking. It classified into T type, L type, H type, ${\Box}$ type, - type all the path of flow for nurses and living assistant on the longest from nursing station to each bedroom, the path of flow for evacuation from each room to exit, the path of flow for walking practice on the corridor and lobby. The three path of flow are influenced by an inner court, especially passable court is the important primary factor in the communication between the aged, a course and time required of flow.

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