• Title/Summary/Keyword: health-care providers

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Health Problems and Health Services Utilization of Infants Born Prematurely in the U.S.

  • Lee, Hye-Jung;Rosemary, White-Traut;Park, Chang-Gi
    • Child Health Nursing Research
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    • v.14 no.2
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    • pp.146-154
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    • 2008
  • Purposes: The purposes of this study are to describe the health problems experienced by VLBW premature infants and their health care services utilization during the first year of life Method: Eighteen mothers of VLBW premature infants completed a survey questionnaire, asking socioeconomic/demographic information, health/developmental problems experienced by their infants, and their use of health care services. Results: Of the 18 infants, 78% experienced respiratory problems such as cold/running nose and wheezing during the first year and 33% experienced gastrointestinal problems such as vomiting, diarrhea and constipation. Twelve (67%) infants visited the emergency department at least one time and 10 infants (56%) were hospitalized at least once during their first year of age. Interestingly, infants without chronic lung disease visited the emergency department more than infants without chronic lung disease (p=.213). Infants living in non-disadvantaged neighborhoods were hospitalized more than infants living in disadvantaged neighborhoods (p=.000). Conclusions: Health care providers should initiate educating mothers, particularly those living in disadvantaged neighborhoods, about post-NICU discharge health care needs of their VLBW premature infants while their infants were still in the NICU so that unnecessary visits to the emergency department and rehospitalizations can be possibly prevented.

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Factors Influencing Attitude toward Advance Directives of Older Cancer Patients (노인 암 환자의 사전의사결정에 대한 태도와 관련요인)

  • Lee, Min Hye;Park, Yeon-Hwan
    • Korean Journal of Adult Nursing
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    • v.27 no.4
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    • pp.449-458
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    • 2015
  • Purpose: The aims of this study were to identify the reported attitudes of older patients with cancer toward advance directives (ADs) and the factors associated with their attitudes toward ADs. Methods: The design was a cross-sectional survey. The age mean of the 130 participants were 70.8, and 66.2% of the participants were male. The data were collected at one university hospital in Seoul, South Korea during the period from October $1^{st}$ to December $5^{th}$ in 2013. The data collecting instruments were the Advance Directives Attitude Survey (ADAS) and questionnaires including socio-demographic and disease-related characteristics, family function. Results: 30.0% of the participants were aware of ADs, only 9% of them had been informed by healthcare providers. Most participants (93.1%) intended to complete ADs. The mean score of ADAS was 48.29. The stepwise linear regression analysis indicated that family function, perceived health status, period of education, and age accounted for a significant percentage (52.0%, p<.001) of the variance in participants' ADAS. The variable with the greatest effect was family function. Conclusion: The findings suggest that family function and attitude of older cancer patients need to be considered for adapting ADs to Korean health care systems. Healthcare providers should include family members in advanced care planning discussions.

Gender Differences in Factors Affecting Caregiver Burden for Spouse Caregiving in Korea (배우자부양자의 부양부담에 영향을 미치는 요인: 성별차이를 중심으로)

  • Lee, Jeong-Seo
    • The Korean Journal of Community Living Science
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    • v.21 no.4
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    • pp.469-479
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    • 2010
  • Using data from the 2001 National Long-Term Care Survey database, this study analyzed gender differences in factors affecting caregiver burdens of spouse caregivers in Korea. Multiple regression was used to estimate factors influencing caregiver burdens of caregiving wives and caregiving husbands respectively. The results showed that there was a significant variability in predictors of caregiver burdens of spouses who take care of the impaired elderly. ADL functional status of care recipients and social support were significant for both the caregiving wives model and caregiving husbands model in influencing caregiving burdens. It was noticeable to report that a caregiver's self-rated health status, monthly caregiving expenses, a care recipient's self-rated health status were unique predictors for the caregiving wives model. These findings suggest that it is vital for planners and providers to take gender differences in spousal caregiving into account when designing and formulating community-based long-term care service programs.

Continued Innovation in Respiratory Care: The Importance of Inhaler Devices

  • Bosnic-Anticevich, Sinthia Zrinka
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.2
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    • pp.91-98
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    • 2018
  • When it comes to the use in inhalers in the management of chronic obstructive pulmonary diseases, there are many options, considerations and challenges, which health care professionals need to address. Considerations for prescribing and dispensing, administering and following up, education, and adherence; all of these factors impact on treatment success and all are intrinsically linked to the device selected. This review brings together relevant evidence, real-life data and practice tools to assist health care professionals in making decisions about the use of inhalers in the management of chronic obstructive pulmonary diseases. It covers some of the key technical device issues to be considered, the evidence behind the role of inhalers in disease control, population studies which link behaviors and adherence to inhaler devices as well as practice advice on inhaler technique education and the advantages and disadvantages in selecting different inhaler devices. Finally, a list of key considerations to aid health care providers in successfully managing the use of inhaler devices are summarized.

Korean National Health Insurance Value Incentive Program: Achievements and Future Directions

  • Kim, Sun-Min;Jang, Won-Mo;Ahn, Hyun-Ah;Jeong, Hyang;Ahn, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.3
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    • pp.148-155
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    • 2012
  • Since the reformation of the National Health Insurance Act in 2000, the Health Insurance Review and Assessment Service (HIRA) in the Republic of Korea has performed quality assessments for healthcare providers. The HIRA Value Incentive Program (VIP), established in July 2007, provides incentives for excellent-quality institutions and disincentives for poorquality ones. The program is implemented based on data collected between July 2007 and December 2009. The goal of the VIP is to improve the overall quality of care and decrease the quality gaps among healthcare institutions. Thus far, the VIP has targeted acute myocardial infarction (AMI) and Caesarian section (C-section) care. The incentives and disincentives awarded to the hospitals by their composite quality scores of the AMI and C-section scores. The results of the VIP showed continuous and marked improvement in the composite quality scores of the AMI and C-section measures between 2007 and 2010. With the demonstrated success of the VIP project, the Ministry of Health and Welfare expanded the program in 2011 to include general hospitals. The HIRA VIP was deemed applicable to the Korean healthcare system, but before it can be expanded further, the program must overcome several major concerns, as follows: inclusion of resource use measures, rigorous evaluation of impact, application of the VIP to the changing payment system, and expansion of the VIP to primary care clinics.

Preferences for Care Near the End of Life among Hospital Employees (일 대학병원종사자의 생애말기 치료 선호도)

  • Kang, Jiyeon;Yun, Seonyoung;Kim, Soo Jeong;An, So Ra;Lee, Myeong Hee;Kim, Shinmi
    • Journal of muscle and joint health
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    • v.20 no.3
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    • pp.197-206
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    • 2013
  • Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.

Cancer Care Management through a Mobile Phone Health Approach: Key Considerations

  • Mohammadzadeh, Niloofar;Safdari, Reza;Rahimi, Azin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.4961-4964
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    • 2013
  • Greater use of mobile phone devices seems inevitable because the health industry and cancer care are facing challenges such as resource constraints, rising care costs, the need for immediate access to healthcare data of types such as audio video texts for early detection and treatment of patients and increasing remote aids in telemedicine. Physicians, in order to study the causes of cancer, detect cancer earlier, act in prevention measures, determine the effectiveness of treatment and specify the reasons for the treatment ineffectiveness, need to access accurate, comprehensive and timely cancer data. Mobile devices provide opportunities and can play an important role in consulting, diagnosis, treatment, and quick access to health information. There easy carriage make them perfect tools for healthcare providers in cancer care management. Key factors in cancer care management systems through a mobile phone health approach must be considered such as human resources, confidentiality and privacy, legal and ethical issues, appropriate ICT and provider infrastructure and costs in general aspects and interoperability, human relationships, types of mobile devices and telecommunication related points in specific aspects. The successful implementation of mobile-based systems in cancer care management will constantly face many challenges. Hence, in applying mobile cancer care, involvement of users and considering their needs in all phases of project, providing adequate bandwidth, preparation of standard tools that provide maximum mobility and flexibility for users, decreasing obstacles to interrupt network communications, and using suitable communication protocols are essential. It is obvious that identifying and reducing barriers and strengthening the positive points will have a significant role in appropriate planning and promoting the achievements of mobile cancer care systems. The aim of this article is to explain key points which should be considered in designing appropriate mobile health systems in cancer care as an approach for improving cancer care management.

Factors related to Family Caregiver Satisfaction with the Institutional care services under the Public Long-Term Care Insurance system (노인장기요양보험 시설서비스에 대한 가족수발자 만족도 영향 요인)

  • Kwon, Jin-Hee;Han, Eun-Jeong;Lee, Jung-Suk
    • Health Policy and Management
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    • v.19 no.4
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    • pp.78-97
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    • 2009
  • This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

Study on Sexual Harassment-related Experience, Awareness, Coping of Health Care Providers and Institutional Efforts to prevent Sexual Harassment (보건관리자의 성희롱과 관련된 경험, 인식, 대처 및 기관의 성희롱 예방 노력에 대한 실태조사)

  • Uhm, Dong Choon;Jung, Gye Hyun
    • Journal of Home Health Care Nursing
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    • v.25 no.2
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    • pp.219-229
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    • 2018
  • Purpose: This study explored the sexual harassment-related experience, awareness, coping, and institutional prevention schemes for health personnel in industrial settings. Methods: Data were collected using self - report questionnaires from 300 health personnels. Data were collected between September 1 and December 31, 2017. The collected data were analyzed using descriptive statistics. Results: Health personnels experienced 29% of sexual harassment, in order of verbal, visual, physical. The frequency of sexual harassment was higher when women were younger, particularly younger than men. Although the average health personnel's awareness of sexual harassment was high, the common coping style was passive such as distancing form the perpetrator. Institutional efforts to prevent sexual harassment included separating employees and staff, but perpetrators tended to account for a high proportion of the supervisors and staff. Conclusion: Health care managers should develop an effective and effective sexual harassment prevention education program by raising gender equality awareness in relation to the awareness of sexual harassment and identifying the influencing factors that can bring about appropriate sexual harassment coping behavior.

Successful Transition from Pediatric to Adult Care in Inflammatory Bowel Disease: What is the Key?

  • Kim, Jeongseok;Ye, Byong Duk
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.28-40
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    • 2019
  • The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.