• Title/Summary/Keyword: Primary health care post

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Effects of Preparation for Death and Depression in Elders on Geriatric Quality of Life in Rural Communities (일 농촌지역 노인의 죽음준비도와 우울이 삶의 질에 미치는 영향)

  • Jeong, Migyung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.13 no.1
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    • pp.3-19
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    • 2018
  • Purpose: This study was done to identify effects of preparation for death and depression on geriatric quality of life in rural communities and to identify whether preparation for death has a moderating effect on the relationship between depression and geriatric quality of life. Methods: Data from 210 rural elders over 65 years of age were obtained through face-to-face interviews with the elders and were analyzed using SPSS 22.0 program. Results: Quality of life of elders who had prepared for death was lower than for elders who had not prepared for death. Elders with higher psychological preparation for death had a higher quality of life. Ritual preparation for death had negative effects but they were not statistically significant. Psychological preparation for death had a moderating effect on depression and quality of life for elders in the rural community. The explanation power was 36.1% while ritual preparation for death had no moderating effect on either depression or quality of life. Conclusions: It is necessary to provide rural elders with intervention programs designed to improve positive thinking and attitudes to living considering religion in the process. Intervention programs to improve psychological preparation for death are also required to alleviate depression.

Compliance with a Low-Salt Diet, Sodium Intake, and Preferred Salty Taste in the Hypertensive Elderly (노인 고혈압 환자의 저염식이 이행, 나트륨 섭취 및 짠 맛에 대한 기호도)

  • Lee, Young-Hee;Kim, Hyun-Kyung;Kwon, Gyoung-Hee
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.311-322
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    • 2010
  • Purpose: This study aimed to examine the compliance to a low-salt diet, sodium intake, and preferred salty taste in elderly patients with hypertension. Methods: A cross-sectional descriptive design was used. Participants were 105 elderly patients with hypertension living in a rural area. The compliance with a low-salt diet, sodium intake, and preferred salty taste, blood pressure, body mass index, and waist circumference were measured, and compared according to the general characteristics and the levels of blood pressure. Descriptive statistics, $X^2$-test, t-test, and ANOVA were used for data analysis. Results: compliance with a low-salt diet was marginally elevated. Sodium intake was relatively high and the main sources were seasonings and vegetables. The participants tended to prefer high levels of salt. Sodium intake was significantly higher the hypertensive individuals (stage I and II) compared to prehypertensive subjects on a normal maintenance diet. Sodium intake from vegetables was also significantly different between the two groups. Conclusion: Nursing intervention for hypertensive elderly patients should include strategies to decrease sodium intake.

A Survey on Activities of Community Health Practitioners in Rural Area (농촌지역 보건지료원의 업무활동 분석)

  • Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.139-148
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    • 1987
  • The community health practitioners (CHP) play an important role in primary health care services to the underserved population in rural area. Time and motion study of 26 CHPs in Kyungpook Province was conducted through work diary method for 6 consecutive days from the time they arrived until they left the primary health post(PHP) during the past 3 weeks from November 16 to December 5, 1987. The allocation of activity time by working category, service category, location of activity and CHP's function was analyzed according to the characteristics of CHPs i. e., age, marital status and experience as CHP. The major findings are as follows : The mean activity time per CHP in a week was 2,918 minutes. The length of their working hours was longer for older, married and more experienced CHPs than others. About 80% of the CHP's activities took place within the PHP and only about 20% occured outside of the PHP. Working hours for the outdoor activities were longer for younger, single and less experienced CHPs than others. The allocation of activity time by working category showed 46.3% in the technical work and 18.7% in the administrative work. Working hours for the technical activities were longer for younger, single and less experienced CHPs than others. The percentage of activity time revealed greatest as much as 63.1% for direct patient care in technical work and 61.6% for record keeping in administrative work. Of the total working hours in a week, direct patient care and public health activities accounted for 29.2% and 16.2%, respectively. Of the indoor activities, working hours for direct patient care were longer than those for public health activities. However, of the outdoor activities, working hours for public health activities were longer than those for direct patient care. The allocation of activity time by CHP's function showed 49.7% in management of common disease, 31.8% in management of PHP and technical supervision of village health workers, 9.5% in MCH and family planning, 6.6% in community health management and 2.4% in community approach. Based on these findings, it was found that CHPs were mainly working in the PHP with a majority of their time being spent for direct patient care rather than preventive and promotive health cares. To enhance the preventive and promotive health services of the CHPs and to involve the activities for community development, refresher course for CHPs should be reinforced and supervision mechanism of the CHPs should be established and operated in Gun- and province-level.

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Implementation of Patient Experience Assessment and Subsequent Changes at the Ground Level in Health Care: Patient Experience Employees' Perspective (환자경험 평가와 의료 현장의 변화: 의료기관 환자경험 업무 담당자의 관점)

  • Song, Yeong-Chae;Yoon, Eun-Sil;Han, Se-Young;Tae, Ji-Yeon;You, Soo-Kyeong;Do, Young-Kyung
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.14-33
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    • 2022
  • Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.

Stress and Burn-Out Experience in Caregivers of Patients with Senile Dementia (치매환자 부양자의 스트레스와 소진경험)

  • Son, Gye-Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.1 no.1
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    • pp.40-48
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    • 2006
  • Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.

Related Factors between Health Status, Health Behaviors, Health-related Quality of Life by of Elderly (거주 지역에 따른 노인의 건강수준, 건강행태, 건강관련 삶의 질 관련 요인)

  • Ryu, Jung Im;Choi, Hye Seon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.9 no.2
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    • pp.59-70
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    • 2014
  • Purpose: The present study was to done ascertain variables related to health-related quality of life (HRQOL) and their related factors in elders from urban or rural areas. Methods: Data were collected from raw material of the 2009 community health survey. Participants were 2,140 elders. Health related quality of life (HRQOL) was measured using EQ-5D. Data were analyzed with SPSS 13.0. Results: Mean EQ index score for urban elders was $0.78{\pm}0.23$, Mean EQ index score for rural elders was $0.82{\pm}0.16$. Rural elders had significantly higher EQ-5D index value compared to urban elders. The urban elder HRQOL model accounted for 33.6% of the variance due to depression, age, stress perception. The rural elder HRQOL model accounted for 23.5% of the variance due to exercising walking, skipping breakfast, depression in that order. In comparison, depression, skipping breakfast, livelihood, arthritis, stress perception, hours of sleep and age are strongly associated with HRQOL in both groups. Conclusion: Results indicate that significant differences in HRQOL between elders from the two areas and thus, confirm claims that welfare services for elders should be provided with consideration of the different needs of elders in the two areas, and in particular for addressing depression in elders.

An Analysis of Articles for Health Promotion Behaviors of Korean Middle-Aged (국내 중년의 건강증진에 대한 선행연구 분석)

  • Kang, Young-Sil;Chung, Mi-Ja;Park, Yong-Sook;Lee, Yeong-Sook;Kim, Hyang-Sook;Lee, Dong-Mae;Lee, Dong-Won
    • Research in Community and Public Health Nursing
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    • v.20 no.1
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    • pp.75-86
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    • 2009
  • Purpose: This study has a purpose to suggest research and intervention directions for health promoting behaviors (HPB) of the Korean middle-aged in the future. Methods: Forty four articles on HPB of the Korean middle-aged were reviewed and analyzed. The articles analyzed are theses written for a doctoral or master's degree and published between 1995 and 2007. Results: 1. As for the major characteristics of the subject groups, most of them were between 40 and 60 years old (61.4%), were females (79.5%), and resided in cities (84.1%). 2. The dependent variables adopted were physiological, psychological and cognitive factors (self-efficacy, knowledge of health management, etc.), HPB and factors related to Health Promoting Lifestyle Profile (HPLP). 3. The average scores of HPLP were $1.57{\sim}3.08$ on a 4-point scale. The highest score was observed in self-actualization, and the lowest score in exercise. 4. Self-efficacy, perceived health status and income had significant correlations with HPB. 5. In regression analysis, self-efficacy, self-esteem and perceived health status were the most powerful predictors. Conclusion: It is necessary to develop intervention tools for more diverse HPB of the Korean middle-aged. The interventions are recommended to focus on increasing exercise and to use strategies for improving self-efficacy and self-esteem.

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The Current State of and Barriers to Quality Measurement, and Quality Managers' Reported Evaluation on Quality Indicators in Korea (국내 질 향상부서 중심의 질 지표 측정 현황, 장애요인과 평가)

  • Hwang Jee-In
    • Health Policy and Management
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    • v.15 no.4
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    • pp.26-45
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    • 2005
  • The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

Health Promotion Behavior, Health Problems, Perceived Health Status and Farmers' Syndrome of Rural Residents (농촌주민의 건강증진행위, 건강문제, 지각된 건강상태 및 농부증)

  • Park, Jeong-Sook;Kwon, Sang-Min;Oh, Yun-Jung
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.47-57
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    • 2009
  • Objectives: The purpose of this study was to identify the health promotion behavior, health problem, perceived health status and farmers' syndrome of rural residents. Methods: The subjects of this study were 637 adults of 19 primary health care post extracted from 1.875 primary health care post in Korea by quota sampling method. The collected data were analyzed by descriptive statistics, Pearson's correlation. Results: The average score of health promotion behavior was 2.23. In the sub-scales, the highest degree of performance was 'nutrition', followed by 'spiritual growth' and the lowest degree of performance was 'physical activity'. The most prevalent health problem was ailments in 'musculoskeletal system', followed by 'fatigue', 'eyes and ears', 'cardiovascular system'. The mean score of perceived health status was 8.54. The prevalence of farmers' syndrome was 98.4%. Health promotion behavior showed a significant positive correlation health status and perceived health status showed a significant negative farmers' syndrome. Conclusions: With the above findings, rural residents' physical activity is less than urban residents', and the rural resident's score of perceived health status, musculoskeletal system and fatigue are lower than urban residents'. The farmers' syndrome of the rural people is high. A tailored health promotion program for rural community is needed to develop in the consideration of these findings.

The Health Status of Rural Farming Women (농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究))

  • Park, Jung-Eun
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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