• 제목/요약/키워드: Relationships between medical care providers

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의료공급체계 구조의 개혁방향에 대한 조직이론적 시각 (An Organization Theory Perspective on the Structural Reform of the Health Care Delivery System)

  • 한달선
    • 보건행정학회지
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    • 제28권3호
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    • pp.197-201
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    • 2018
  • There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

간이식 수혜자의 자가간호이행, 사회적 지지, 생리학적 지표 (Self-care, Social Support, and Biological Markers in Liver Transplant Recipients)

  • 김현경;최모나;김소선;김순일
    • 성인간호학회지
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    • 제27권2호
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    • pp.170-179
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    • 2015
  • Purpose: To examine the relationships between self-care, social support, and biological markers in liver transplant recipients. Methods: The participants included 118 liver transplant recipients who visited outpatient clinic at Y University Hospital in Seoul from April to May, 2013. Questionnaires consisted of self-care and social support scales. The biological markers were collected by reviewing electronic medical records. Data were analyzed with descriptive statistics, t-test, ANOVA with Scheff$\acute{e}$ post-hoc test, and Pearson's correlation. Results: The self-care score was significantly higher in a patient group within 6 months post-transplant when compared to a patient group post-transplant 3 to 5 years (F=3.10, p=.018). The self-care showed positive correlation with social support with statistical significance (r=.36, p<.001). Conclusion: As the self-care in liver transplant recipients had a positive correlation with social support from family and healthcare providers, the development of comprehensive long-term nursing intervention systems including counseling, education, and support in consideration of progress of time period after transplantation is necessary to enhance self-care behaviors among this population.

Evaluation of Quality of Life of Breast Cancer Patient Next-of-kin in Turkey

  • Ogce, Filiz;Ozkan, Sevgi;Okcin, Figen;Yaren, Arzu;Demiray, Gokcen
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2771-2776
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    • 2013
  • Introduction: Quality of life (QoL) issues are of importance in relatives of women with breast cancer (BC)as caregivers in neglecting their own needs due to care of a patient and also as women regarding the potential risk of themselves developing BC. The objectives in the present study were to compare the QoL of female relatives of women in treatment for breast cancer. To date, no study had examined multi-dimensional QoL in accompanying people as compared them into two groups of female relatives whose first degree and second degree. Methods: QoL of female relatives was assessed using the Quality of Life-Family Version (QOL-FV) scale. Relationships between socio-demographic characteristics and QoL scores were analyzed using the Mann-Whitney U, Kruskal Wallis and Crosstabs tests. Results: The mean age of the female relatives was 37.6 years, and nearly 48% had a university education. It was found that first degree relatives had worse QoL in all domains except physical wellbeing than second degree relatives. Conclusion: This study showed that being female relatives of BC, especially first-degree, affect QoL negatively. Health care providers are of an important role in the stage of information related to genetic influence of BC.

Personal and Socio-Cultural Barriers to Cervical Cancer Screening in Iran, Patient and Provider Perceptions: a Qualitative Study

  • Bayrami, Roghieh;Taghipour, Ali;Ebrahimipour, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3729-3734
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    • 2015
  • Background: Although cervical cancer is preventable and early screening might decrease the associated mortality, challenges faced by the women and health care providers can postpone early detection. This qualitative study aimed to establish patient and provider perceptions about personal and socio-cultural barriers for cervical cancer screening in Mashhad, Iran. Materials and Methods: In the present study, which was conducted in 2012, eighteen participants, who were selected purposefully, participated in individual in-depth, semi-structured interviews, which were recorded, transcribed verbatim, and analyzed using conventional content analysis and Atlas-Ti software. Results: One theme and two categories were derived from data including: cognitive/behavioral factors (lack of a community-based approach to cervical cancer, lack of awareness, wrong attitude and lack of health seeking behaviors) and socio/cultural issues (socio-cultural invasion, mismatch between tradition, modernity and religious, extra marital relationships and cultural taboos). Conclusions: Providing community based approach education programs and employing social policy are needed for preventing of cervical cancer in Iran.

혈액투석환자의 이행과 건강관련 삶의 질 간의 관계 (Relationships between compliance and health-related quality of life in patients with hemodialysis)

  • 차지은
    • 한국산학기술학회논문지
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    • 제16권10호
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    • pp.6495-6503
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    • 2015
  • 본 연구는 혈액투석환자의 이행 수준을 파악하고 이행과 생리적 지표, 건강관련 삶의 질 간의 관계를 조사하였다. 지역 투석의원 27곳에서 220명의 혈액투석환자로부터 자료를 수집하였다. 이행은 투석 간 체중증가, 혈중 칼륨과 인과 함께 환자역할행위이행 도구로 측정하였고 건강관련 삶의 질은 MOS-SF 12로 측정하였다. 자료는 서술통계, t-test, ANOVA, 피어슨 상관계수로 분석하였다. 이행의 평균 점수는 4점을 기준으로 2.92점이었고, 전체 15개 이행 항목 중 투석스케줄 지키기에서 가장 높은 점수를 보였다. 이행 수준은 연령, 결혼상태, 투석기간에 따라 유의한 차이가 있었으며, 이행 항목 중에서 복약, 감염관리, 수면, 야채와 과일섭취가 건강관련 삶의 질과 유의한 상관관계를 보였다. 본 연구결과는 혈액투석환자의 삶의 질을 향상시키기 위해 환자중심 접근이 도움이 될 것임을 시사한다. 건강돌봄제공자들은 환자에게 중요한 이행을 확인하고 환자의 가치와 우선순위를 고려함으로써 환자들의 입장을 이해할 필요가 있다.

노인의 자가 보고에 따른 의료정보 이해 및 활용수준 (Older Adults' Self-reported Difficulty in Understanding and Utilizing Health Information)

  • 김수현
    • 한국노년학
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    • 제30권4호
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    • pp.1281-1292
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    • 2010
  • 본 연구의 목적은 노인의 자가 보고에 따른 각종 의료정보의 주관적인 이해 및 활용수준에 대해 조사하고 신체적, 정신적 건강상태와의 연관성을 확인하며, 노인의 연령대 및 교육수준에 따라 구체적으로 어떠한 의료 정보의 이해와 활용에 어려움이 있었는지를 파악하기 위함이다. 본 연구의 대상자는 총 103명으로 2007년 7월부터 8월까지 대구, 경북, 부산지역의 노인복지회관과 노인정에서 선정되었다. 연구결과 노인의 자가 보고에 따른 의료정보 이해수준의 전체 평균점수는 15-75점 기준에 약 50점이었고, 가장 이해하기 어려워 한 부분은 의료인으로부터 받은 자료, 환자 교육자료, 병원서식 자료였다. 노인의 의료정보 활용수준은 노인의 신체적, 정신적 건강상태와 연관성이 있었으나, 의료정보 이해수준은 신체적, 정신적 건강상태와 연관성이 없었다. 또한 후기노인들은 전기노인들보다 약물명 이해수준과 병원용지 기입에 대한 자신감이 더 낮았고, 병원자료 이해부족으로 인한 건강상태 파악, 복약 설명서 이해부족으로 인한 약물 복용, 병원 설명서 이해부족으로 인한 예약 시간 도착에 있어서 더 많은 어려움을 경험하였다. 이 밖에도 초등학교 이하의 교육수준을 가진 노인일수록 의료인으로부터 받은 자료, 환자 교육자료, 병원서식, 진료 예약표, 약물명, 안내표지판 등에 대한 이해수준이 낮았고, 병원용지 기입이나 복약설명에 따른 약 복용에 대한 자신감이 낮았으며, 병원용지 기입과 건강상태 파악에 문제를 경험한 적이 더 많았다. 본 연구 결과를 바탕으로 의료인들은 의료기관의 시설 및 서식, 교육자료 등의 개발에 있어서 노인의 연령과 교육수준을 고려하여 정보의 이해와 처리를 강화할 수 있는 방법을 활용하여야 할 것이다.

성인여성의 건강행위에 관한 연구 (An Exploration of Adult Women Health-Behaviors)

  • 김명희;전미영
    • 한국보건간호학회지
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    • 제16권2호
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    • pp.239-253
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    • 2002
  • Health care for women regularly focuses on the reproductive system to the exclusion of other health needs. The lack of research focusing on women's common health issues is a major problem to the enhanced optimal level of women's health. Health care providers have to recognize biological and social differences between men and women. This study was conducted to identify the baseline data and their correlation of health perception, health behavior, and health status of adult women for developing nursing intervention. The study was a descriptive correlational design. A convenient sampling method was used for collecting data from 103 adult women, over 18 years of age, during the period from Sep 1 to Nov 30, 2001. The study's subjects were interviewed using a structured questionnaire. The instruments for this study were the health perception scale modified by Lee(1985) based on the tool developed by Ware(1977) and Jenkins (1966), and the health behavior scale by Ko, Kumja(1987). Health status was measured by the short form Cornell Medical Index(CMI) modified by Nam, Hochang(1965). The data were analyzed SPSS PC+, by frequency, mean, t-test, ANOVA, and Pearson correlation coefficients. Also, the Duncan test was utilized for a post hoc test of ANOVA. The results of this study are as follows: 1. The mean score for health perception was 3.02(S.D=0.39) on a 5 point scale. 2. The mean score for health behavior was 3.08(S.D=0.43) on a 5 point scale. 3. The mean score for health status was 18.54 on 58 items. The mean score for physical symptoms of a subscale of health status was 11.30 on 36 items and the mean score for psychological symptoms was 7.37 on 22 items. 4. The relationship of sociodemographic variables to health perception. health behavior, and health status of women.: 1) There were significant differences in the scores of health perception by disease experience(t=-3.37, p=0.00). 2) There were significant differences in the scores of health behavior by age(F=10.52, p=0.00), height(F=4.73, p=0.01), marital status(t=-5.56, p=0.00), educational background(t=2.90, p=0.00), and drinking or non-drinking(t=2.17, p=0.03). 3) There were significant differences in the scores of health status by educational background(t=2.28, p=0.02) and disease experience(t=2.61, p=0.01). 5. Health perception showed significant positive correlation with health behavior(r=0.39, p=0.00). Health perception showed significant negative correlation with health status(r=-0.44, p=0.00), that is, the more women perceived health, the less she complained about unhealthy symptoms. Health behavior had no significant correlation with health status but showed a positive correlation with psychological symptoms of a subscale of health status(r=-0.19, p=0.05). Many of the leading causes of disease are preventable through changes in health perception and behavior. The need to increase individual awareness of relationships among health perception, health behavior, and health status and to enhance knowledge regarding the long-term effects of positive health behaviors, is an important nursing strategy for women's health promotion.

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