Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.
Kim, Gwang Suk;Chu, Sang Hui;Park, Yunhee;Choi, Jun Yong;Lee, Jeong In;Park, Chang Gi;McCreary, Linda L.
대한간호학회지
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제45권3호
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pp.439-448
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2015
Purpose: The purpose of this study was to examine validity and reliability of Webel and colleagues'HIV Self-Management Scale when used with a Korean sample. Methods: The original 20-item HIV Self-Management Scale was translated into Korean using translation and back-translation. Nine HIV nurse experts tested content validity. Principal component analysis (PCA) and confirmatory factor analysis (CFA) of data from 203 patients was used to test construct validity. Concurrent validity was evaluated using correlation with patients'self-rating as a "mart patient"measured using a visual analogue scale. Internal consistency was tested by Cronbach' alpha coefficients. Results: All items were rated as having satisfactory content validity. Based on PCA and consideration of conceptual meaning, a three-factor solution was selected, explaining 48.76% of the variance. CFA demonstrated the adequacy of the three-domain structure of the construct HIV self-management: daily self-management health practices, social support and HIV self-management, and chronic nature of HIV self-management. Goodness-of-fit indices showed an acceptable fit overall with the full model (${\chi}^2/df_{(164)}=1.66$, RMSEA=0.06, SRMR=0.05, TLI=0.91, and CFI=0.92). The Korean version of the HIV Self-Management Scale (KHSMS) was significantly correlated with patients'self-rated smart patient (r=.41). The subscale Cronbach' alpha coefficients ranged from .78 to .81; alpha for the total scale was .89. Conclusion: The KHSMS provides a valid and reliable measure of self-management in Korean patients with HIV. Continued psychometric testing is recommended to provide further evidence of validity with this population.
Purpose: The purpose of this study was to examine the relationship between self-efficacy, social support, sense of community and health-related quality of life (HRQoL), including the direct and indirect effects of the variables on HRQoL. Methods: A cross-sectional survey was conducted with a convenience sample of 249 middle-aged and elderly residents living in a rural community in A-County, K Province. The structured questionnaire included 4 scales from the Euro Quality of life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression), and measures of General Self-Efficacy, Social Support, and Sense of Community. Data were analyzed using SPSS WIN 20.0 and AMOS 21.0 program. Results: The mean HRQoL score for the participants was $0.87{\pm}0.13$. Self-efficacy (${\beta}$=.13, p=.039) and age (${\beta}$= -.38, p<.001) were significantly associated with HRQoL, explaining 21% of the variance. In the path analysis, self-efficacy showed a significant direct effect on HRQoL (${\beta}$=.14, p=.040) and significantly mediating relationships between both social support (${\beta}$=.05, p=.030) and sense of community (${\beta}$=.02, p=.025) and HRQoL. Conclusion: Although self-efficacy was found to be the main predictor for HRQoL, the findings imply that social environmental factors such as social support and sense of community need to be considered when developing interventions to increase HRQoL in middle-aged and elderly residents in rural communities.
In many countries the demographics clearly informs us that an aging population represent a serious problem. To this extent senior citizens welfare does matter it has developed into a public debate and genuine concern. it seems that the social issues are focused on how the socity views the social welfare policies. In a modern welfare state where the emphasis lies in pursing a high standard of living and thereby high quality of life. This does not cover the very well the old people in society, but the government clearly carries an obligation to look after and care for the retired & old people in the society. This obligation the social and economic impact that an old person faces as he/she grows old. it is important ensure that their lives carries a meaning and that they as a group will not be estranged from the mainstream of society just because they are considered to be part of the aging population. The key issues that must be addressed are 1) The impact of reduced spending power from less income. a lower income stream; 2) increasing health problems and costs; 3) the natural degradation of ones physical & mental powers; 4) and thereby an isolation from the public in general. So clearly the social policy related to the old people in society should be developed with the consent of what they believe is important to them. To ensure their minimum income level that a beneficiary of an old person's pension will receive, the monthly pension should be reflected by the official price index and be adjusted accordingly. by making the job market open for the senior citizens, expending the mandatory retirement age, give companiesincentives to hire senior citizens, there maybe an opportunity to extend to the aging population the possibility to continue to participate in the society at large.
경제 선진화에 따라 GDP중 서비스 산업의 비중은 점점 커지고 있다. 서비스 산업 발전은 고용 문제 해결과 내수 시장의 활성화를 유도하며, 의료, 교육, 문화 등의 수요 창출, 제조업의 경쟁력 강화 및 경제 전반에 발전을 기여할 것이다. 정보통신 기술의 발전과 그에 따른 삶의 질 향상, 그리고 글로벌 무한 경쟁 등 경쟁 환경 변화 등으로 기업, 공공 기관 등의 소비자 또는 고객의 욕구는 날로 증대되고 있다. 이러한 환경 속에서 기업 등은 고객과의 소통, 고객 불만 처리, 신규 고객 유치 및 유지 등의 목적으로 비대면 접점인 콜센터를 운영하고 있다. 본 연구는 비대면 접점인 콜센터의 성과 제고를 위하여 서비스 및 프로세스 개요, 업무 성과 평가, 콜센터 평가 등에 관한 연구를 통하여 문제점을 분석하고 콜센터의 '서비스 프로세스 모델링' 및 향후 정책과제를 도출하고자 한다.
Introduction: Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh people in 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha, non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reduces the capacity to seek better nutrition, medical care and education. In line with the WHO Framework Convention on Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law on tobacco control. The Government of Odisha has shown its commitment towards enforcement and compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco control efforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selected districts. Materials and methods: A semi-structured interview schedule was developed, translated into Odiya and field-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 of COTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selected provisions of the Act. 1414 samples were interviewed. Results: The highest percentage of respondents was from the government departments. 73% of the illiterates consumed tobacco as compared to 34% post graduates. 52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about the provision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that they had 'very often' seen tobacco products being sold 'to a minor', while 31.2% had seen tobacco products being sold 'by a minor'. In addition, 24.8% had 'very often' seen tobacco products being sold within a radius of 100 yards of educational institutions.
The organizational effectiveness of hospital in various environmental fluctuations is a large and complex problem. Hospital CEO leadership characteristics may be a critical determinant of employees' job satisfaction and turnover intention. Several empirical studies on transformational leadership found that transformational leadership behaviors were positively related to workers' job satisfaction and turnover intention. Very little research related to this subject has been done in health care settings in Korea. The author explores the relationship between hospital CEO leadership style and its effect on job satisfaction and turnover intention among the all staffs of general hospital. The relationship of hospital CEO leadership style to employees' job satisfaction was investigated using the Bass's leadership paradigm of transformational and transactional leadership. The Multifactor Leadership Questionnaire(MLQ) and the index of job satisfaction and turnover intention were completed by 493 hospital employees(doctors, nurses, hospital administrators, technicians, and assistants). The findings show a similar trend to the previous studies. Hospital CEO leadership behaviors and employee outcomes were significantly correlated. Correlations showed a significant positive relationship between those hospital CEO exhibiting a transformational leadership style and the job satisfaction of their staffs. The results of multiple regression analysis indicate that the effect of charisma in transformational leadership behaviors is more higher than other variables. Transformational leadership style may be a more effective strategy and have a greater effect on staff outcomes, attitudes and behaviors. The findings of this study reveal implications for efficient hospital management and the importance of understanding relationship between hospital CEO's leadership style and subordinate behaviors in the context of CEO's desirable role and function for hospital strategy planning and future direction.
The purpose of this study was to identify a determent of mastery approach goal and performance approach goal using a basic concept of goal orientations and goal setting theory, and to evaluate a preference of goal achievement index as a balance score card (BSC). The study model proposed had a adoptable level of goodness of fit index(.94) and root mean square residual(.08). The meditating variable, goal contribution, totally mediated the impact of goal commitment, Y-theory human behavior, and self-efficacy but organizational resource contribution for pursuing goal orientation. Moreover, goal contribution significantly determined mastery approach goal(p<.01) and performance approach goal(.05). In standardized effects, the most powerful antecedent of mastery approach goal and performance approach goal were in order of organizational resource contribution(.27/.28), goal contribution(.21/.17), self-efficacy(.07/.06), and Y -theory human behavior and goal commitment(.05/.05), respectively. Moreover, goal contribution had a more powerful impact on mastery approach goal(.21) rather than performance approach goal(.17). In the preference of BSC, all job types preferred learning and growth index in first. In the second preference, medical doctors and pharmacists chose financial results, nurses customer service, and office managers internal processes. Each job type reflected its' own preferred BSC index to that of the other job types. In comparing a preference of four BSC index of each own job type, it was statistically different at p<.001. In conclusion, one who emphasize organizational goal contribution in pursuing goal orientation has a more strong orientation toward mastery approach goal rather than performance approach goal. A hospital should overcome and harmonize the different preferences of four BSC index since the differences might cause organizational conflicts among job types with having each unique professional norm.
The purpose of this study was to categorize the contribution evasion and develop the expected models for contribution arrears in National Health Care System. The modified logistic regression model in non-payments was used as logistic regression model based on the statistical method. By using this model, we arranged non-payment types and typical branches those are appeared by statistical technique. First fact, sex and age branches those are able to take a part in economy had effect mostly. Also they had difference in non-payment probability by existence of their incomes and property. Especially people who didn't have their own house and car were appeared in high non-payment probability, disease and reduction characteristic(rare diseases, reduction of seniors, handicaps, numbers of medical treatments) didn't effect much in probability. The reason for some characteristic of non-payment which is higher than the correct threshold value of Logistic Regression Model (a suggested model for predicting non-payment)'s distribution of probability was mostly moral hazard. Living difficulty was the bigger reason for non-payment, but moral slackening was the bigger reason for non-payment. But it is careless to decide that moral hazard is just the reason, there is a necessity to examine on the side of sociology based in family. By the reason, the member's non-payment reason can be classified by economy, population, and psychology, but there was a comprehension that losing of work desire could be one reason. So we analyzed informations for composition of family of members. In conclusion, we grasped that family conflict makes non-payment and conversion of member in the National Basic Livelihood Protection System difficult.
McLean, Lisa;Micalos, Peter Steve;McClean, Rhett;Pak, Sok Cheon
셀메드
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제6권3호
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pp.15.1-15.4
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2016
Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.
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