• Title/Summary/Keyword: Quality Improvement in Health Care

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Experiences of Ageism and "Self-Ageism" (노인차별 경험과 자기연령주의(self-ageism))

  • Kim, Juhyun;Oh, Hyein;Ju, Kyonghee
    • 한국노년학
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    • v.40 no.4
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    • pp.659-689
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    • 2020
  • This study focuses on the process of internalizing the perception of negative discrimination among elderly people who have experienced age discrimination. The grounded theory method was used to identify the age discrimination experienced by the elderly in their daily lives and to explore the consequences of such discrimination through self-ageism. According to the analysis results, the elderly respond not only to explicit discrimination but also to implicit discrimination. In this process, the stronger the pain of old age (poverty, disease, ignorance, and solitude) and the stronger the memory of failing to respond to discrimination, the higher the level of self-ageism. "Self-ageism" has internalized the negative image of the elderly, who have been discriminated against by age, resulting in disadvantages in terms of quality of life through various reject/separate/suspension actions in reality. In the presence of supportive resources such as health, institutional support, and caregivers, the elderly have room to overcome self-ageism through more active ways. However elderly people who cannot motivate themselves and they lack these resources, elderly are trapped in negative reflux caused by self-ageism and sustained a depressed and shrinking life. In this state, it is not easy to motivate themselves and make physical, cognitive, emotional and social responses. Therefore, in this analysis, we specifically noted two aspects, contextual conditions and interventional conditions, and proposed programs for synchronizing senior citizens and improving resiliency from a microscopic point of view, and argued for the need to develop systems such as supplementing welfare and health service systems related to the entire life cycle, expanding accessibility and 'age-integration' through 'Community Care', awareness improvement and anti-discrimination laws.

"Healthy Japan 21" - A new Perspective on Health Promotion Policy for Japan in the 21st century - (건강한 일본 21 - 21세기 일본의 건강 증진 정책에 대한 새로운 전망 -)

  • Hasegawa, Toshihiko
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.59-88
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    • 2004
  • ' Healthy Japan 21 ' is a new health policy that has been proposed for the 21st century: it embodies a totally new concept for its viewpoints and methods. To start with, for its goal, the focus is placed on the ' quality of life ' or a life that is tree of diseases, rather than mere prolongation of life. For its doctrine, the emphasis has shifted dramatically from improving the health of the entire population (the traditional approach for health improvement) to ' achieving an ideal health status for each individual. The ultimate aged society that arrives first in Japan is a society in its ultimate form for human being. Why did Japan become westernized, giving up her traditional culture? Why did she go through industrialization, sacrificing her nature? And why does she try so hard to industrialize the developing countries? These efforts are all preparation for the arrival of a ultimate aged society. During the 20th century, we believed in unlimited possibilities and expanded our social frontier. 1n the 21st century, on the other hand, a super-aged society (the ultimate society), a glimpse of which we have witnessed from time to time, will descend on us sooner or later. It is expected to arrive first in Japan. ' Healthy Japan 21 ' is intended to prepare for the arrival of the hitherto unheard of super-aged society by building the physiological basis of people. This policy is social experimentation on an immense social scale, in which questions are posed on the understanding of health, the relationship between individuals and society, the relationship between administration and citizens, the manner by which central and local governments operate, and the new relationship between prevention and therapy. ' Healthy Japan 21 ' may be summarized as an experiment on a huge scale directed to the ultimate form of human society, in which Japan and each of her citizens playa role and set an example for the rest of the world. Even just by considering various approaches newly suggested for this venture, one may be convinced that it is a policy with features suitable for a country that has already achieved the world's highest longevity.

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Influence of Individual and Job Characteristics, Professional Job Perception, and Group Cohesiveness on Organizational Citizenship Behavior of Physical Therapists in Hospitals (물리치료사의 개인 및 직무특성, 전문직업성, 집단응집성이 조직시민행동에 미치는 영향)

  • Lim, Jung-Do;Lee, Key-Hyo;Kim, Won-Joong
    • Korea Journal of Hospital Management
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    • v.8 no.2
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    • pp.70-92
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    • 2003
  • The main objective of this paper is to investigate the factors affecting organizational citizenship behavior of hospital employees, and based on the investigation, to suggest some implications for effective human resources management of hospitals. For this purpose, physical therapists were selected as the subject of the research. Using their individual characteristics, job characteristics, professionalism and group cohesiveness as the variables affecting organizational citizenship behavior, an empirical model was constructed and tested. A survey was conducted through structured and self-administered questionnaire for the physical therapists working at hospitals of Busan-Kyongnam area, and data from 240 therapists were utilized in the final analysis. Major results of the empirical analysis are as follows: First, perception on professionalism and the degree of organizational citizenship behavior were higher for male, older, relatively more-educated and higher-grade employees. It is necessary to develope some measures to educate and motivate the employees who are in lower state of professionalism and organizational citizenship behavior. Second, among the individual characteristics, need for growth was found to have significant, positive influence on professionalism and group cohesiveness, but no direct effect on organizational citizenship behavior. On the other hand, extroversion had direct, positive effect on organizational citizenship behavior, as well as on professionalism and group cohesiveness. This result suggests that personnel selection and personality education should be conducted carefully. Third, job characteristics appeared to have very large, positive effect on professionalism, but not directly on organizational citizenship behavior. Fourth, professionalism was found to have very large, positive influence on group cohesiveness and direct, positive effect on organizational citizenship behavior. This implies that enhancing professionalism of physical therapists can strengthen organizational citizenship behavior in hospitals, and hence top management should actively support the programs for job re-design, skill education and quality improvement to enhance professionalism of their employees. Fifth and last, as an intervening factor, group cohesiveness appeared to have the largest, direct, positive effect on organizational citizenship behavior. It is, therefore, important for top management to improve group cohesiveness by exploring ways toward greater harmony and solidarity among the members of physical therapy department.

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Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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Nutrition Survey in Koje Island (거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査))

  • Oh, Seoung-Ho;Chang, Soo-Kyung;Park, Michael Myung-Yun
    • Journal of Nutrition and Health
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    • v.10 no.4
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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The Determinants of Consumption Characteristics and Patterns of Elderly Households (고령자 가구의 소비특성 및 소비패턴 결정요인)

  • Kim, Jinhun
    • 한국노년학
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    • v.36 no.3
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    • pp.905-926
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    • 2016
  • Although the concept of the elderly varies depending on scholars and laws, as consumption expenditure is deeply associated with income due to the nature of this study, 55 years old was set as the low limit standard for the elderly according to Prohibition of Discrimination on Age in Employment and Employment Promotion for the Aged Act and the elderly households were limited to single-elderly person household and an elderly couple family household for this study. It is considered consumption characteristics as a significant analysis subject in terms of social welfare because it could be understood as an expressed need which was a reflection of desire. Therefore, the present study aimed to investigate the consumption characteristics of the elderly households by stereotyping the consumption pattern of the elderly households, and find the determining factors for consumption patterns and thus contribute to the establishment of related policies through the expressed needs of the elderly households. K-means of cluster analysis was performed by putting the consumption expenditure of the elderly households to investigate inherent structural type of consumption pattern of the elderly households, which were the investigation subjects. As a result, four groups were stereotyped and named as below: 'health care-centered type', 'saving-centered type', 'livelihood-centered type', and 'food expenses-centered type' Binary Logistic Regression analysis was used to identify the factors that influence the decision of consumption pattern of the elderly households. The result of study showed that the elderly households faced all different needs and problems and thus there is a need for various approach plans to solve this situation. In particular, although the elderly have been viewed as economically poor people so far, the study showed that there were also kind of prepared households through saving. Overall, livelihoodcentered type accounted for the highest portion and, as a factor that influenced this, marital state and household income played an important role. Therefore, it is considered that more active efforts to increase the income of the elderly households are needed. In addition, age, owning of house and subjective health state were found to also have significant influence. Through these results of the study, the elderly's own improvement of awareness on health, presentation of overall standard for health state of the elderly, securement of the elderly's access to cultural life, and financial management coordination for improvement of quality of life, development and dissemination of jobs suitable for the elderly, and dissemination of communal life household, which is a cooperation residential type, were presented as institutional task in the conclusion.

The Effect of the Integrated Therapy of Neurofeedback, Brain Gymnastics, and Oriental Herbal Tea on the Improvement of Brain Functions and the Quality of Life of Elders living alone (뉴로피드백·뇌체조·한방차를 병행한 통합요법이 독거노인의 뇌기능 향상 및 삶의 질에 미치는 영향)

  • Jeong, Eun-sil;Lee, Jung-eun;Jung, Hyun-mo;Kim, Soo-Kyung;Youn, Mee-Kyung;Lee, Eun-han
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.569-581
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    • 2016
  • This experimental study employs a pretest -posttest method concerning the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea effects on seniors living alone. The purpose of the study is to identify effects on brain functions and quality of life. The study participants included 23 seniors living alone (male 10, female 13), ranging in age from 65~90. The experiment lasted 8 weeks, from December 22, 2014, to February 28, 2015. The neurofeedback training utilized the 2 Channel neurofeedback system by Braintech Corporation and was conducted a total of 16 times over 8 weeks, having two sessions per week lasting for 30 minutes focusing on relaxation, concentration and memory. Brain gymnastics, developed by the Korean Science Institute of Psychiatry, ran for 30 minutes, twice a week for a total of 16 sessions administered over 8 weeks. Participants were required to drink 3 cups of oriental herbal tea developed according to Donguibogam for 8 weeks. The results of applying integrated therapy found positive effects on brain function resulting from changes in level of tension and anti-stress quotient. Quality of life, daily life basic measurements, and depression symptoms were significantly influenced by decreases in blood pressure and blood sugar. Results of this study find the integrated therapy of neurofeedback training, brain gymnastics, and oriental herbal tea can significantly enhance brain functions and quality of life within seniors living alone. Therefore integrated therapy involving neurofeedback, brain gymnastics, and oriental herbal tea is a necessary intervention to improve the quality of life of seniors living alone, and will improve the quality of life through healing both mind and body in a more practical and systematical manner.

A Study on e-Healthcare Business Model: Focusing on Business Ecosystem Approach (e헬스케어 비즈니스모델에 관한 연구: 비즈니스생태계 접근 중심으로)

  • Kim, Youngsoo;Jung, Jai-Jin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.1
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    • pp.167-185
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    • 2019
  • As most G-20 countries expect medical spending to grow rapidly over the next few decades, the burden of healthcare costs continues to grow globally due to an increase in the elderly population and chronic illnesses, and the ongoing quality improvement of health care services. However, under the rapidly changing technological environment of healthcare and IT convergence, the problem may become even bigger if not properly recognized and not properly prepared. In the context of the paradigm shift and the increasing problem of the medical field, complex responses in technical, institutional and business aspects are urgently needed. The key is to derive a business model that is appropriate for businesses that integrate IT in the medical field. With the arrival of the era of the 4th industrial revolution, new technologies such as Internet of Things have been applied to eHealthcare, and the need for new business models has emerged.In the e-healthcare of the Internet era, it became a traditional firm-based business model. However, due to the characteristics of dynamics and complexity of things Internet in the Internet of things, A business ecosystem-based approach is needed. In this paper, we present and analyze the major success factors of the ecosystem based on the 3 - layer structure of the e - healthcare business ecosystem as a result of research on e - healthcare business ecosystem based on emerging technology such as Internet of things. The three-layer business ecosystem was defined as (1) Infrastructure Layer, (2) Character Layer, and (3) Stakeholder Layer. As the key success factors for the eHealthCare business ecosystem, the following four factors are suggested: (1) introduction of the iHealthcare concept, (2) expansion of the business ecosystem, (3) business ecosystem change process innovation, and (4) business ecosystem leadership innovation.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

Research Methods on Scalp and Hair Management through the Pass of Time (시대적 흐름에 따른 두피와 모발관리에 대한 연구방법)

  • Kim Myung-Joo;Baek Seung-Hwa
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.123-132
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    • 2003
  • It is considered to be important to create aesthetically beautiful style through the change of external shape, however for the hair stylists, whose beauty expression is through hair, the role of hair doctor is becoming even more important with focus to improve the hair healthiness. Hair clinic is management of hair and scalp. It is the management process of preventing damages, while improving and cultivating healthy and shiny hair. The current concept in hair management is moving from simple hair styling to emphasis at hair management. As far as hair management is concerned, it usually includes treatment tools such as shampoo, conditioner, hair treatment and scalp scaling system, which is used for diagnosis of hair condition in order to treat the scalp. As the interest of hair healthiness becoming more wide spread, so does the breadth of clinic menu. The wide choice is to fulfill the profound desire of people, whose demands are simply to have variety in their choice. This is resulting in faucets of new value-added and differentiated products. The values that make-up the hair styles consist of mainly design (trend, preference), function(styling, management convenience) and clinic(hair quality improvement, damage repair). Shampoo and conditioner have gone beyond their original function of cleansing to providing combinational functions of treatment, to care and remedy, and advanced massage effectiveness. These are, to name a few that seem to go beyond their original function to satisfy the mental healthiness in people, the King Kong shampoo of shampooings in forward-backward manner, 5-minute shampoo massage that applies sports and relaxation massage, scalp acupunctural message and aural(ear) massage. More and more people are complaining about the damaged hair and hair loss problems due to perms, dyeing and bleaching of hair, in addition to natural scalp and hair damaging factors. Such complaints have stimulated many beauty products and various hair treatment systems being introduced with focus to provide nutrition and prevent damages to scalp and hair. As the living standards improve and the desire of people is to pursue differentiated lives, their demand also increases in hair styling products to fulfill the needs of healthy and aesthetical aspects of their lives.

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