The purpose of this study was 1) analyze the current state of Sanhojoriwon; and 2) to suggest the new model for the community based mother infants health care delivery system: strategies of TMIC are related to Public Health policy, cost-effectiveness, mother infant care provision of medical professionalism, and so on. Method: Forty-seven workers from seventeen Sanhojoriwon participated to analyze several aspects of Sanhojoriwon. Using a questionnaire developed at Korean Sanhojori Research Forum (KSARF), such as the traditional and medical concept of the Sanhojori, postpartum care, Korean traditional postpartum care, job description on women and infant care at Sanhojoriwon, professional management, health care policy and the educational need. Results: Based on the descriptive study results, the TMIC, the community based transitional mother infants care center was suggested as a new model for the cyclic public health care system related on the reproductive health, using an already existing related center, Sanhojoriwon. Also, several strategies were presented on the TMIC.
This study was designed to search for the direction to develop housing service which assists the older people to live independently in their community and provides the systematization of community care. The subjects of the research include 533 older people between the age of 60 to 79 residing in Seoul and 84 welfare officials at a dong(in)-office and 67 social workers working at comprehensive social welfare institutions. The results were as follows: Both demanders and deliverers recognized that housing service for older people was necessary for community care, and, in particular, the deliverers had higher degree of necessity as people charged in welfare service. The most needed service was community alarm service which currently is proceeded partially for low-income and living-alone olders. It needed to expand the scope of the people to be served. It appeared that the need for inside safety measures rather than for housing space or structural problems. It requires less effort and cost for those who need simple repair, such as safety grips or slippery protection, and safety checks. Among financial support services, the need for tax benefits appeared the most necessary service for the older people. It suggested that more 'direct' financial support service is needed for the elderly people.
Purpose: We developed and tested the effects of a care program for dementia patients among community- dwelling older adult men. Methods: This study used a non-equivalent control group pre-and post-test design. To verify the effectiveness of the care program for dementia patients, 26 community dwelling older adult men participated in this study. We used multiple intervention strategies including improving understanding of dementia through education, activities for dementia prevention, and promoting psychological change. In particular, based on the current understanding of the care of the men older adults, we used strategies to promote motivation and reinforce strengths. Results: After completing the 6-week intervention program, when compared with the control group, older adult men in the care program intervention group showed significant differences in scores for the following: cognitive functions (p=.035), attitude toward dementia (p=.026), preventive behavior (p=.007), geriatric depression (p=.013), caring confidence (p=.018), and self-esteem (p=.013). Conclusion: These results indicate that the care program for dementia patients has positive effects on increasing their cognitive function, attitude toward dementia, preventive behavior, caring confidence, self-efficacy, and on decreasing depression rates in this population. Based on this, we can recommend this program to men caregivers for the improved care of dementia in community centers.
Background: This study aims to explore the effects of quality of care, image, and role performance perceived by community residents on medical service satisfaction to public hospitals. Methods: The subjects of this study were selected in the community residents around 39 district public hospitals. The questionnaire were included 4 factors and 16 items. The data were collected utilizing call-interview by a survey company. Results: The community satisfaction was positively correlated with quality of care, image, and role performance of public hospitals (p<0.001). As the results of multiple logistic regression, the significant variables of community satisfaction were quality of care (odds ratio [OR], 1.353; 95% confidence interval [CI], 1.211 to 1.511), image (OR, 1.487; 95% CI, 1.280 to 1.727), role performance (OR, 1.240; 95% CI, 1.085 to 1.416) among subjects having use experience of public hospitals. The significant variables of community satisfaction were quality of care (OR, 1.240; 95% CI, 1.175 to 1.309), image (OR, 1.328; 95% CI, 1.232 to 1.432), age (OR, 3.051; 95% CI, 1.385 to 6.724), monthly incomes (OR, 0.420; 95% CI, 0.198 to 0.892) among subjects not-having use experience of public hospitals. Conclusion: Public hospitals have to effort to improve image and satisfaction of community through providing quality of care, and role performance. It is possible to support them by the central and local government.
Objectives: This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods: This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results: No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions: Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.
Purpose: This study aimed to investigate the self-care education experience, self-care performance, and home care service needs of patients with rare and incurable diseases who use a home ventilator. Methods: From2 ventilator rental companies and 5 hospitals, records of 162 subjects were collected to obtain data regarding self-care education experience (23 items) and home care service needs (25 items). Results: Of the subjects, 65.4% were male and 55.6% had a myotrophic lateral sclerosis. The items with the highest and lowest levels of self-care education experience were "using the ventilator"(94.0%) and "community-available resource information"(27.0%), respectively. Meanwhile, self-care was performed well in terms of "personal hygiene"(59.6%) but not performed well in "community-available resource information"(23.7%). "Health status assessment" had the highest need(88.2%) of home care services. Generally, the need of home care services was higher for the patients using invasive ventilators than that for those using non-invasive ventilators. Conclusion: Home care nurses need to not only provide physical care for the patients but also strengthen their roles of enhancing patient access to and utilization of various community resources to provide systematic and individualized training and care.
Community involvement is to be the keystone of primary health care, Unfortunately, efforts to promote it failed in many countries. Author inquired into the reasons why such efforts fail, and the alternative strategies for effectively promoting it in Korean situation today. In doing so, the concept of community involvement is clarified as an amalgamation of two different concepts; one is that of the community development, and the other is that of approaches for overcoming the alienation of the people from the health care process. Stategies of community involvement in Korea so far followed the line of the community development, e.g. village health worker. It loses, however, the feasibility as Korea has experinced so cial and economic developpment. The strategies of the second line of thought is now more feasible; empowering the people by providing more information and enhancing comitment to health, improving acceptabilty of community involvemt on the part of the health professionals and the bureaucrats, and building the mechanism of community involvement into the health policy-making process.
The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.
Purpose: This study examined the definition of care coordination, and the activities and roles of nurse care coordinators. The study also proposed suggestions for establishing and expanding the role of nurse care coordinators in community health practice. Methods: This study derived its conclusions by conducting a literature review. Results: The definition of care coordination is a comprehensive concept that includes case management and transitional care, and can be summarized as organizer and integrator of care. According to the literature review, 12 activities and 6 roles of nurse care coordinator were identified such as a collaborator, an individualized care planer, an educator/counselor, a direct nursing care providers, a population care coordinator, and a program evaluator. Training for nurse care coordinators is currently addressed in the Primary Medical Chronic Disease Management Program. Visiting nurses working at the Eupyeong-dong visiting health and welfare service are expected to act as nurse care coordinators, and the role of nurse care coordinators will, in the future, gradually increase in various nursing facilities. Conclusion: In addition to developing competencies to act as a nurse care coordinator, there is need for approaches to health policy that develop both independent role and population focused role as care coordinators.
Johnson, Avita R.;Jayappa, Rakesh;James, Manisha;Kulnu, Avono;Kovayil, Rajitha;Joseph, Bobby
Safety and Health at Work
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제11권3호
/
pp.347-352
/
2020
Background: Low self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city. Methods: This cross-sectional study included a random sample of health-care workers of various cadres - doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom-Melamed Burnout Measure were used as study tools. Results: Among the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress. Conclusions: Health-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36-5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02-6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.
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