• 보건행정학회지
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• 제21권1호
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• pp.1-22
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• 2011

This study investigated unmet health care needs and associated factors among patients with hypertension and those with diabetes. Patients were identified by medical professionals. Patients who did not take pharmaceuticals to treat their disease(s) were defined as those with unmet health care needs. Using data from 2005 National Health and Nutrition Examination Survey, 3,635 hypertension patients and 1,431 diabetes patients were analyzed. A multivariate logistic regression analysis was employed to examine factors associated with unmet needs. Overall, 16.6% of hypertension patients, 20.3% of those with diabetes presented unmet needs. Common factors associated unmet needs for both hypertension and diabetes were sex, insurance type, self-reported health status and length of disease. Study findings suggest that hypertension and diabetes should be treated in early stage and further study is needed to examine the reasons for unmet needs to improve patient's status effectively.

• 한국치위생학회지
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• 제17권5호
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• pp.805-816
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• 2017

Objectives: The purpose of this study is to analyze the oral health knowledge among workers at nursing homes, and needs to educate them on elderly oral care. Methods: A self-reported questionnaire was filled out by 241 workers at nursing homes in Gwangju and Jeonnam, Korea from May to June, 2016. The data were analyzed with the SPSS 19.0 program for independent t-test or one-way ANOVA analysis. Results: The data analysis showed that workers at nursing homes had lower knowledge about periodontal diseases (65.1%) than about denture management (78.5%). The knowledge of periodontal disease and denture management of workers with experience of oral care education for elderly was significantly higher than that of non-experienced ones (p<0.01). On the question whether those workers should get oral health care education is necessary or not, respondents answered positively (They scored 4.10 points on the 5-point Likert scale from 1 point - Not at all to 5 points - definitely yes). Conclusions: It is necessary to provide elderly oral care education to workers at nursing homes. Furthermore, oral health professionals should be deployed for systematic and practical oral care for elderly.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.870-883
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• 1997

The health center has to play an important role in promoting community health and satisfying a variety of community health needs and demands in the decentralized Korea. The nearly enacted Community Health Act compels every health center to make its own health plans which intend to deal with local health problems and plan its future health care. This obligation is obviously a big burden to most health centers. They do not have experiences in and abilities of making local health care plans. In order to establish a systematic community health plan, health centers have to concentrate their efforts on enhancing the ability of making health care plan through gathering and analysing the local health informations. However, it is very difficult in reality. This is simply because it will take long time to accomplish these activities. It seems natural that various professionals and researchers participate in carrying out the process of making community health plan in the initial stage. No standardized methodology and analysing framework exist even in the health professional society. Nonetheless, it is common to introduce survey research methodologies in analysing consumer's health care utilization and cost, and in identifying factors influencing health behaviors. Many researchers and professionals have applied social survey methodologies in obtaining information on providers and health policy makers as well. The authors have found that few studies have ever utilized local health data stored at the self-employed medical insurance society as the data source of planning activities. The purpose of this study is to illustrate the usefulness of the data stored at the Sung-Dong Gu Self-employed Medical Insurance Society in establishing the community health plan. The major contents of this study are as follows ; 1. frequency of utilization by age, area, sex, type of medical care institutions, and some major diseases 2. Medical treatment by type of medical care institutions, by classification of 21 diseases, by frequency of three-character categories 3. Medical treatment of major neoplasm and some chronic diseases by age, sex, and area. The conclusion of this study is that it is of great potentiality to find out the local health problems and to use them in blueprinting the community health plan through comparing the frequency of medical utilization analyzed by a variety of variables with NHI health data or the health data from survey research.

• Journal of Hospice and Palliative Care
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• 제27권1호
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

• 한국의료질향상학회지
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• 제27권2호
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• pp.30-44
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• 2021

Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.255-259
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• 2013

Background: Cancer is the leading cause of death in Taiwan. Spouses are generally the main caregivers of affectyed patients but previous studies have seldom investigated the needs of male spouses of patients with metastatic cancer. Purpose: To explore the lived experiences of such male spouses. Methods: A qualitative design using in-depth interviewswasconducted with male spouses of patients with metastatic cancer being treated at the oncology outpatient department in a teaching hospital in northern Taiwan. Results: Nine participants aged 31-78 were interviewed. Content analysis of the interviews revealed five themes: suffering and struggling, difficulty in focusing on communication and interaction, shouldering responsibility, cherishing the love between husband and wife, and enabling each other to live better. This study demonstrated how male spousse experienced physical and psychological suffering when their wives suffered from metastatic cancer. They had to bear the pain of their wife's suffering, and also had to shoulder the responsibility for everything. All their efforts were put towards enabling each other to live a better life. They cherished the rest of the time they could spend with their wives, even though they had to live a hard life. As the male spouses of patients with metastatic cancer, the participants exhibited both the masculinity of men and the ability to express care and tenderness. Conclusions: The results showed that male spouses need more attention in terms of communication and bearing with suffering. Health care professionals should more actively understand the needs and provide assistance when facing the male spouse of patients with cancer, so as make sure that they possess the ability to take care of their wives. Health care professionals should also assist and properly act as a bridge of communication between husbands and wives.

• Journal of Hospice and Palliative Care
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• 제26권2호
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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.

• 약학회지
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• 제59권4호
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• pp.190-200
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• 2015

Evaluation Project on Appropriate Prescribing (EPAP) which is analysing prescribing pattern and providing physicians feedback has begun in 2001. EPAP indicators are related to antibiotics for acute respiratory tract infections, overuse of injection, polypharmacy (no. of drugs prescribed together, no. of prescriptions with 6 or more drugs), prescribing of specific medication group (drugs for acid related disorders, NSAIDs, corticosteroids) and medication expenditure per prescription day. The aim of this study was to suggest a development plan for EPAP indicators suitable for domestic situation. A consensus group consisting of seventeen health care professionals evaluated significance of each therapeutic class for EPAP indicators expansion considering information such as magnitude of issue, prescribing indicators of foreign countries, reimbursement criteria by each therapeutic class. Based on the data and group survey, 5 classes were selected as candidates for prescribing indicators and we presented 24 indicators regarding 5 classes. The results suggested that we need to augment evaluation indicators of additional area.

• 의학교육논단
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• 제19권3호
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• pp.152-157
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• 2017

Interprofessional education (IPE) fosters effective team-based collaborative practice among members of different health care professions to advance high-quality and safe patient care. Although the importance of IPE has been recognized and IPE initiatives have expanded rapidly in the past decades, substantial difficulties in IPE assessment still exist. At present, a lack of consensus on the optimal approach to IPE assessment contributes to uncertainty about the level of attainment of collaborative team performance. This paper aims to provide an overview of the benefits and current challenges associated with IPE assessment. Furthermore, a multifactor model with an assessment matrix and assessment blueprints from a recent study is briefly discussed. We also provide examples of assessment blueprints for the team management of stroke patient discharge covering a competency examination at the levels of individuals, the team, and the task.

• 한국가족복지학
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• 제61호
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• pp.59-91
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• 2018

본 연구는 노인환자 치료경험이 있는 노인 의료전문가를 대상으로, 그들이 인식하는 연령주의를 확인하는 동시에, 이러한 장벽을 없애기 위하여 연령통합적인 차원의 노력과 경험들을 어떻게 해왔는지에 초점을 둔다. 연구대상자인 9명의 의료전문가들의 연령주의와 연령통합에 대한 보다 다양한 인식과 경험을 담아내기 위해 CQR 질적연구 방법을 활용해 분석하였다. 의료전문가들은 연령주의(Ageism)에 대한 자기고백의 이중성을 보이고 있었으며, 의료현장에서는비적정진료, 노인 소외와 보호자 의존, 양극화 된 서비스와 빈곤노인에 대한 이중차별의 방식으로 연령주의가 실재(實在)하고 있었다. 이를 완화 혹은 해결하기 위한 방안으로서의 연령통합적 의료서비스 제공에 대해 어려움을 느끼고 있었으나, 소통을 위한 장벽 허물기를 추구하거나, 노인 뿐 아니라 모두에게 보편적(universal)으로 편안한 환경을 제공하거나, 제도와 서비스 기준을 확대 및 다양화하는 방식으로 연령통합적 서비스를 위한 적용노력을 하고 있는 것으로 나타났다. 급격히 증가하는 노인환자들의 건강한 삶과 적정한 의료서비스 보장을 위해첫째, 연령주의를 가속화 시키는 한국 의료체계 내 요소들에 대한 비판적 고찰, 빈곤노인에 대한 관리체계 개선, 의료전문가 제도 내 연령통합관련 커리큘럼 포함, 노인전문 의료서비스와인력양산 그리고 노인과 노인대상 의료영역에 대한 인식개선을 제안하였다.