• Title/Summary/Keyword: care policy

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Development of a Scenario and Evaluation for Simulation Learning of Care for Patients with Asthma in Emergency Units (SimMan 시뮬레이션 학습 시나리오의 개발 및 학습 수행 평가 - 응급실 내원 천식 환자사례를 중심으로 -)

  • Ko, Il-Sun;Kim, Hee-Soon;Kim, In-Sook;Kim, So-Sun;Oh, Eui-Gum;Kim, Eun-Jung;Lee, Ju-Hee;Kang, Se-Won
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.3
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    • pp.371-381
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    • 2010
  • Purpose: The purpose of this study was to develop a scenario and evaluate students' performance in simulation learning of care for patients with asthma in emergency units. Methods: Meetings of experts were used to develop a scenario based on actual patients and textbook material. An evaluation protocol was developed to evaluate the simulation learning. The scenario was used in 2006 with six groups of 26 senior nursing students who participated voluntarily. Results: The scenario was developed according to the nursing process for 15 minutes of simulation learning. The nursing students were able to demonstrate their knowledge and skills. The results showed a need to improve problem solving ability. In the self-evaluation, the students reported that simulation learning helped them to integrate their knowledge to practice and recognize their weaknesses and strengths. However, the scores for self-confidence about patient care after the simulation learning were low (4.8/10). Conclusion: The scenario in this study gave the students the experience of providing qualified and secure nursing care under conditions similar to reality. Further development of a variety of scenarios for simulation learning is needed.

Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study

  • Hyosin Kim;Signe Peterson Flieger
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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    • pp.42-50
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    • 2023
  • Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

Estimation of Willingness to Pay for Long-Term Care Insurance Using the Contingent Valuation Method (조건부가치측정법을 이용한 노인장기요양보험에 대한 지불의사금액 추정)

  • Lee, Tae-Jin;Lee, Sue-Hyung
    • Health Policy and Management
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    • v.16 no.1
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    • pp.95-116
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    • 2006
  • According to rapid increase of the population of senior citizens, there has been growing concern of Long-Tenn Care(LTC) services recently. Long-Tenn Care services, however, haven't been established systematically in Korea and the supply of LTC services is not sufficient despite the increase in the current social demand. This study aims to estimate the 'Willingness to Pay(WTP)' for LTC insurance which the government plans to introduce by means of social insurance, using Contingent Valuation Method(CYM). In addition, this study analyzes the factors affecting WTP for LTC insurance. An interview survey was carried out to derive WTP for LTC from 450 people who lived in Seoul aged 20 and above during the period from 16th to 21st of June 2003. Double-Bounded Dichotomous Choice Method was applied among several CVMs available to estimate both use value and no-use value of goods. There was pilot survey carried out prior to the main survey. The results show that the average monthly. WTP for LTC provided in home and residential setting is 18,192Won and 19,293Won, respectively. In the case of home care, WTP goes higher depending on reliability of LTC insurance policy and need for LTC insurance, as well as marital status, education and average monthly income. On the contrary, WTP is conversely affected by higher age and higher bids. In the case of institutional care, the factors affecting WTP are similar to those of home care, except age. This study followed NOAA's suggestions generally and the value derived through survey could be reliable. However, there can be the least bias in the process of survey because the CVM should be used under the supposed circumstances. Despite those limitations, it can be concluded that the amount the citizens are willing to pay for LTC is high enough to meet the costs needed to provide LTC.

A Chronological Study on the Transformation and the Spatial Characteristics of Inpatient Care Facilities in the United States (미국의료시설 병동부의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.3
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    • pp.57-69
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    • 2017
  • Purpose: This study aims to emphasize interrelation between healthcare policies, design standards and hospital architecture of the United States since 1950s; to examine spatial characteristics of inpatient care facilities through case studies; and to consider the social implication of these spatial changes. Methods: In this study, reviewing the overall healthcare system, design standards and inpatient care facilities of the United States since 1950s, a total of five inpatient care facilities, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing five case studies. Results: The distance between the nursing station, the support service, and inpatient room were getting closer. The spatial structure of inpatient care facilities is transformed from tree structures to annular tree structures. This result shows that the efficiency between patient, staff and support service is higher and the depth of the spaces is getting deeper, which indicates that efficiency for improving healthcare quality affect the spatial structure of inpatient care facilities. Implications: In the future, if Korea's health policy is changed to a demand-oriented health care policy, this conclusion predicts medical planning of hospital will be focused on the efficiency.

Patient Dissatisfaction with Health Care: A Content Analysis of Newspaper Articles Between 1990 to 2015 (의료에 대한 환자들의 불만: 1990-2015년 신문기사에 대한 내용분석)

  • Lee, Ji-Su;Kim, Jae-Won;Shin, Yu-Kyung;Kim, Tae-Jae;Do, Young-Kyung
    • Quality Improvement in Health Care
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    • v.26 no.1
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    • pp.35-45
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    • 2020
  • Purpose: This study was conducted to identify patients' dissatisfaction with health care through a content analysis of newspaper articles published between 1990 and 2015. It focused on developing a systematic coding scheme for content analysis as well as exploring changes over time. Methods: Among articles published by 8 major national newspapers, our content analysis used those that specifically covered the dissatisfaction of patients. Coding taxonomy was developed in two domains: (1) contents of dissatisfaction and (2) special circumstances and groups where complaints were filed. All articles were then coded according to this coding taxonomy to conduct descriptive analysis. Results: A total of 794 complaints were discovered in 338 articles. Contents of dissatisfaction were classified into 7 categories and 50 subcategories. Complaints regarding accessibility, technical care, and administration were noticeable in special circumstances, including strikes and spread of epidemic diseases, whereas complaints on interpersonal care and cost were prominent in general population and circumstances. When comparing the proportion of articles covering patient dissatisfaction in general population/circumstances between 1990-2000 and 2001-2015, complaints on administration and physical environment diminished over time, whereas complaints on outcome of health care increased. Conclusion: This study offers a rare window to view the responsiveness of the Korean health care system on a long time horizon.