The purpose of this study is to develop a healthcare service based on standard protocol and information communication technology for mother's sustainable postpartum care. The developed service was consisted of a client area where mothers measure, manage and transmit their vital signs using their own smartphone and personal health devices, and a server area that manages and shares with the received mother's vital signs and the results of examination results and personal health records. The client area collects vital signs through the IEEE 11073 Personal Health Device (PHD) using the m-health application of the previous study and Continua Health alliance certified personal health devices and transfers to Health Level Seven (HL7) V2.4, Continuity of Care Record (CCR) and Continuity of Care Document (CCD). The server area consists of a mobile web that manages and shares the HL7 Fast Healthcare Interoperability Resources (FHIR)-compliant personal health records to ensure interoperability of examination results, and a mobile web where the postpartum caregiver enters and manages the results of the mother's examination results and provides it to the mother. In this way, the healthcare service of this study securing continued exchanges between the mother and postpartum caregiver improves the quality of life of the mother not only to satisfy the needs of the mother who was discharged but also through self-management and postpartum. In the future, we will conduct a study applying mothers and postpartum caregiver after approval of a clinical trail at a university hospital to evaluate developed healthcare services.
Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients' urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.
Purpose: This study was conducted to examine the experience of nurse in comprehensive nursing care. Methods: Experiential data collected from 9 nurses through in-depth interviews. Participants were selected from nurses working in the comprehensive nursing care unit at general hospital. The main question was "Can you describe your experience in the comprehensive nursing care unit?" All interviews were recorded and transcribed, then analyzed using Colaizzi's method. Results: Nine themes were derived from the analysis: 'Practice nursing care', 'Feel thankful of the client', 'Difficulty in nursing due to absence of patients' guardian', 'Tired of over-demanding patient and distrust of guardian', 'Confusion regarding one's identity as a nurse', 'Not enough to support system', 'Insufficient pre-training for nurse and client', 'Requirement of work establishment for nurse and nurse aid', 'Concerns about low rewards and high safety accidents'. Conclusion: As a comprehensive nursing service, the nurses provided total patient care, and patient satisfaction and expression of appreciation increased. However, disadvantages were identified, such as patients' excessive needs, communication difficulties, lack of support systems, low compensation, and a high number of safety accidents. Therefore, systematic comprehensive nursing will be achieved if these shortcomings are addressed.
The role of medical service quality to provide patients enhances influence on the hospital performance under being severe competition among the large size hospitals and increasing the right of patients. When a large hospital perceived factors of quality that a customer expects and feels value of care and it invests its resources to improve the factors of quality, it can get successful performances. Therefore, the purpose of the study explores the factors of quality affecting the trust of care and the patient satisfaction, and tests relationship among the trust of care, patient satisfaction and revisit intention. When considering the factors, a large size hospital can increase the trust of care and the patient satisfaction, through this process the hospital can assure patients' revisit and increase its revenue. This study uses interview data on outpatients visiting clinics in about 1000 beds sized training hospital located in Seoul. This study uses casual relationship model for the analysis. This study finds that 1) the trust of care and the procedure of care significantly influence the value of care felt by patients, 2) the trust of care, quality of doctors' care, procedure of care significantly influence the patient satisfaction, 3) the trust of care increases the patient satisfaction, and 4) the value of care and the patient satisfaction increase revisit intention.
The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.
Objectives : This study is for suggesting the data base for help mother and child improve the oral health enhancement action from understanding child's oral health enhancement action from mother's oral health education experience and researching the effects of mother's oral health enhancement action on child's oral health enhancement action. Methods : The subject was 220 children and mothers of some kindergarten in Jeollabuk-do, Korea out of convenience'sampling. The results were collected by carrying out a survey out of self record method from visiting the kindergarten from June 24th to July 12th. and were analyzed. Results : 1. The mother's and child's oral health enhancement action was satisfactory in the factor of 'toothbrushing', 'oral hygiene care item' and 'periodic visits' in case the subjects have experienced oral health education, and that data was meaningful statistically. 2. In the oral health enhancement action practiced by mother to child from existence or absence of the mother's oral health education experience, the data was meaningful statistically in the factor of 'directly brushing its teeth more than once a day', 'washing its tongue' and 'coaching that child could keep the toothbrush not to overlap with other toothbrushes'. 3. In the factor that affect to oral health enhancement action practiced by mother to child, 'toothbrushing' and 'oral hygiene care item' were high level of the mother's oral health enhancement action, and that data was meaningful'statistically. Conclusions : The children's oral health condition could be influenced by mother's oral health knowledges and attention. Accordingly, oral health education for the mother and child has to be enforced'systematically'suited for the characteristic change of oral condition with children age groups. Also, utilizing human resources who have expertise and development of the oral health education program are needed.
In a situation where competition becomes intense, health care organizations constantly strive to provide more services with given personnel and time. While not only the 'quantity' of the services but also the 'quality' becomes increasingly important, various problems that can occur during the 'process' of service provision can be effectively managed by applying the methods of management science. In this study, we introduce the cases where the methods of management science can be applied for the management of health care organizations in Korea and abroad. There are many cases where various scenarios for improving the patients' accessibility to the services and for maximizing the efficient use of limited resources are established, and simulation or basic statistical analysis methods are used to solve the problems more systematically or to develop improvement plans. In this study, several exemplary cases, such as no-show of patients, crowding in the emergency room, prediction of the number of available beds in the intensive care units, nurse scheduling, delay of arrival of patients, and ordering of the proper amount of therapeutic materials, are introduced and discussed. From the perspective of administrators or clinicians, however, it may not be easy to master the methodology that requires considerable mathematical background or apply the theories to practice directly. Therefore, it is suggested that more practical and relatively simple analytical methods should be applied. Also, having a more positive attitude toward improving the current performance (e.g., a belief that 'we can always be better than now'), and paying attention to improving the job satisfaction by addressing problems, with experimental spirit and data-driven decision management.
Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.
Objectives: This study was intended to provide the base of developing countries' Health Partnership Strategy by investigating the Paraguay's awareness level of health and analyzing the actual state. Methods: The data was collected from 11 government employees, 20 hospital staffs, 26 local residents on Asunci$\acute{o} $n, Paraguay in February, 2012. The method of the study was the questionnaires consisting of 62 questions including 7 questions of general features, 3 questions of awareness on maternal health care, child health care, planned parenthood program, 52 questions of awareness on health. The questionnaires was translated into Spanish which is local language in Paraguay. Results: The results of this study are summarized as follows; 1) The most important awareness on maternal healthcare, child healthcare, planned parenthood program was providing child health care. 2) The most important awareness to prevent non-health behavior was sufficient nutrition. The most important awareness to reduce the rate of chronic disease was diabetes. The most important awareness to eradicate communicable disease was HIV/AIDS. 3) The most important awareness to provide healthcare service was vaccination. 4) The most important awareness on healthcare delivery system was policy. The most important awareness on health education was student's health education. 5) The most important awareness to strength healthcare capacity was developing domestic economy. Conclusion: The results of this study suggest that awareness levels on health are high against low health behavior status in Paraguay. But awareness on health can lead to health behavior by healthcare system. Therefore, it has to induce the healthcare network and system by injecting public health funds, infrastructure, human resources on prevention of disease and healthcare management.
This study was performed as a part of survey for the operation and interim evaluation of the on-going pilot project of community health in Jeomdong-Myon, Yeoju-Gun, Kyunggi-Province since 1982. Seven Villages (Ri) were selected purposively for the survey from a total of 26 villages in Jeomdong-Myon, target area, under the consideration of the socio-economic background and the distribution of health resources. The target population was the women in age group of 15-44 years in that area and a total of 156 women were interviewed. This study was done by the interview survey using questionnaire which was composed with questions about MCH and FP. The results were as follows; 1) ln the status of maternal health, (1) the proportion of receiving antenatal care was relatively high (67.1%) in this area, but the starting time of antenatal care was delayed to 7 months or more of gestational period in 22 percent. Therefore some intervention would be necessary for advancing the time of antenatal care. (2) The proportion of home delivery was decreased according to the rank of birth-order. And more than 50 percent of delivery attendants were mothers-in-law or neighbors. The fact indicates that the health education for non-professional delivery attendents would be necessary for improving home delivery and the content of education would be preferable to focussing to the method of hygienic delivery attending. (3) The comprehensive health service and education would be recommended for the postnatal care, because of the extremely low rate of postnatal care in this area. 2) In the status of child health, (1) the pro-portion of breast feeding was 90.2 percent, and the weaning started after 12 months of birth in 12.7 percent. This indicates the necessity of education about the weaning program. (2) The proportion of completed basic vaccination was 39.6% and the main reason of missing vaccination was poor accessibility in terms of time. For that, the supply of vaccine to primary health care units (health subcenters) should be continuous, not infrequent nor occassional. 3) The proportion of respondants who were using contraceptive methods currently was 79.8 percent and in 44.7 percent they accepted the permanent contraceptive methods. Those results are distinct in this area. But it seems a serious health problem that 53.2 percent of respondants were experienced the induced abortion for birth control.
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