• Title/Summary/Keyword: models of care

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Palliative Care Models in Intensive Care Units and Nurses' Roles in the Models (중환자실 완화의료 모델과 간호사의 역할)

  • Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.40-46
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    • 2014
  • Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.

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Models of Care for Frail Older Adults

  • Ersek, Mary;Byun, Eee-Seung
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.71-80
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    • 2011
  • The growth of the aging population in Korea will challenge health and social services. As Korean society changes, the U.S. models of end-of-life care and geriatric care for frail older adults may have increasing relevance for the Korean healthcare system. This article reviews three U.S. models of care for frail older adults: hospice and palliative care, the Program for All-Inclusive Care for the Elderly (PACE), and the transitional care model. We describe the strengths and limitations of each model and discuss ways in which these models could be adapted for the Korean healthcare system.

Models for Spiritual Care in Hospice and Palliative Care

  • Kang, Kyung-Ah
    • Journal of Hospice and Palliative Care
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    • v.21 no.2
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    • pp.41-50
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    • 2018
  • Spirituality is an essential part of human beings. Spiritual care, designed to meet the spiritual needs of terminally ill patients and their families, is one of the most important aspects of hospice and palliative care (HPC). This study reviewed and analyzed literature utilizing the most commonly used Korean and international healthcare databases to identify care models that adequately address the spiritual needs of terminally ill patients and their families in practice. The results of this study show that spirituality is an intrinsic part of humans, meaning that people are holistic beings. The literature has provided ten evidence-based theories that can be used as models in HPC. Three of the models focus on how the spiritual care outcomes of viewing spiritual health, quality of life, and coping, are important outcomes. The remaining seven models focus on implementation of spiritual care. The "whole-person care model" addresses the multidisciplinary collaboration within HPC. The "existential functioning model" emphasizes the existential needs of human beings. The "open pluralism view" considers the cultural diversity and other types of diversity of care recipients. The "spiritual-relational view" and "framework of systemic organization" models focus on the relationship between hospital palliative care teams and terminally ill patients. The "principal components model" and "actioning spirituality and spiritual care in education and training model" explain the overall dynamics of the spiritual care process. Based on these models, continuous clinical research efforts are needed to establish an optimal spiritual care model for HPC.

Gender Preferences for Men and Women Advertising Models in Saudi Arabia

  • Siddiqui, Kamran;Alahmadi, Marwah Adnan
    • Asian Journal for Public Opinion Research
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    • v.9 no.4
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    • pp.352-367
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    • 2021
  • Purpose: This research aims to examine gender preferences for men and women advertising models in Saudi advertisements. Saudi Arabia is known as one of the most gender-segregated society in the world, and it has gender-specific roles, characteristics, and behaviors that are undesirable for the other gender. Methodology: The questionnaire was developed with the help of earlier studies on perceptions towards advertising models and validated by a jury of experts and focus groups. The gender preferences for ten product categories (including automobiles, baby care products, cigarettes, cosmetics for women, fashion, food & beverages, motorcycles, personal care for men, personal care for women, sporting goods) were examined for men and women models. Similarly, three personal preferences characteristics for both genders (face beauty, voice quality, and Islamic dress), two characteristics for women models (body shape, femininity), and two characteristics for men models (height-weight balance, masculinity) were examined for men and women models separately. Finally, a survey was conducted to solicit responses from respondents (N=412). Findings: Results indicated significant gender preferences for gender-specific product categories and typical gender stereotypes in advertising models. Men models were preferred in men-specific products, and women models were required in women-specific products. Some product categories (including personal care for men and sporting goods) were ranked higher for men advertising models, while for women advertising models, other product categories (including personal care for women and cosmetics for women) were ranked higher. Masculinity was ranked highest as the preferred personal characteristic for men advertising models, while voice quality was highest for women advertising models. Finally, there is a significant difference between the preferred personal characteristic for men and women advertising models for three characteristics, including face beauty, Islamic dress, and masculinity and femininity. Implications: Saudi Arabia is a unique society with predominantly unique cultural dominance. Consequently, local culture greatly influences advertisements. It has stereotyped gender roles even in advertisements. This study will establish a baseline for further research on the subject area.

A Study on TQM of Health Care Sector

  • Kim, Hee-Tak
    • Journal of Korean Society for Quality Management
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    • v.31 no.2
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    • pp.82-97
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    • 2003
  • The study attempts to review TQM models used in the health care sector and the obstacles to the application of TQM in the sector. Even though the TQM models in the manufacturing and service sectors were successfully applied, the applicability of TQM in the health care sector is still in question. The reason is the unique characteristics of the medical sector such as medical and management practices. The most of the TQM models in the health care sector come from manufacturing industries. The importance of the professional groups is, however, more emphasized in the sector than in manufacturing sector. The role of the groups are idiosyncratic to the sector. They generate some obstacles to the application of TQM in the sector. The barriers include cultural obstacles of health care organization. It naturally follows that the TQM in the health care sector requires the change of the organizational culture of the sector. The culture embraces the norms, rules, regulations, compensation system, morale, practices, and common experiences. To change the culture needs long term effort and modification of the rules, regulations, compensation system, and practices. It also requires staffs' training in the problem solving methods. The TQM in the health care sector needs that the interested parties should change. Since doctors group and nurses group are controlled in the bureaucratic and authoritative manner, they should learn the problem solving techniques which require the interaction with other groups. The management also needs to learn management skills and get thorough training on them.

On Determinants of Physician Utilization -A causal analysis- (의료이용(醫療利用)에 영향(影響)을 미치는 요인(要因)에 관(關)한 분석(分析))

  • Bae, Sang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.13-24
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    • 1985
  • This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Anderson Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows : First, the causal models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted $R^2$ is .144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the valiance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and edabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.

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A Study on Satisfaction of Service by the Models of Informal-formal Resources Linkages for Long-term Care Elder (장기요양대상노인의 비공식적·공식적 자원연계 유형에 따른 서비스 만족도 연구)

  • Kim, Geum-Yeol
    • 한국노년학
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    • v.30 no.4
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    • pp.1027-1044
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    • 2010
  • This study is to examine the effective system for providing services for long-term care elders, despite the expansion of formal care, informal care still is needed. Thus, this study's purpose is to classify the informal-formal resources linkages types of long-term care elders and looks into service satisfaction by these types and discover effective informal-formal resources linkages models. For that, this study is to divide informal-formal resources linkages types by the degree of providing services of informal and formal caregivers and discover the informal-formal resources linkages types using cluster analysis and explores the effectiveness of service satisfaction using multiple regression. The study's results is to suggest four models, such as family care, complementary, separation, formal service and complementary type was founded to be the most effective and then based on the result, we discuss as follows. First, we must strive to combine informal resources into formal service systemto the system for providing of service is made up the complementary type. Second, the system for providing services of long-term care elders is required integrated care system to alining of medical and long-term care services. Third, we have to consider a measure to improve of formal service type, for the satisfaction of formal service appears low relatively. Based on research findings, this study propose that the informal-formal resources linkages models are subdivided into the dimension of quantity and quality of care for improving the effectiveness of long-term care services.

Hospice and Palliative Care for Patients in the Intensive Care Unit: Current Status in Countries Other than Korea

  • Minkyu Jung
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.22-25
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    • 2023
  • Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

Survey on Nursing Care Delivery Systems of University Affiliated Hospitals in Korea (종합전문요양기관의 간호전달체계에 대한 실태조사 연구)

  • Kim, So Sun;Chae, Gye Soon;Kim, Kyeong Nam;Park, Kwang Ok;Moon, Seong Mi
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.167-175
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    • 2010
  • Purpose: This study investigated nursing care delivery systems in 44 university affiliated hospitals and satisfactions with the systems perceived by 226 unit managers (head nurses) of general medical surgical wards. Methods: Data were collected with questionnaires consisting of checklists asking the unit managers their nursing care delivery systems and their satisfactions with the systems. Results: Four models of nursing care delivery systems (primary, modified primary, team, and functional models) were drawn from the participants' responses. Among the four key models 35% of the units adopted team model whereas 24.3% adopted primary model and 22.6% adopted modified primary model. In spite of 35% of team model being under use, 60.6% (n=137) of the unit managers answered the nursing delivery system of their units as team model and only 6.2% (n=14) answered their units having primary or modified primary models, instead of 46.9% combining both. In regard to the satisfaction, critical thinking ability of staff nurses (members in their units) was the most dissatisfactory area regardless of models of service delivery. Conclusion: Introducing team model supplemented with core concepts of primary model (primary team delivery model) into nursing practice will reform the workplace and therefore deliver safe health care services to patients.

Prediction of Postoperative Lung Function in Lung Cancer Patients Using Machine Learning Models

  • Oh Beom Kwon;Solji Han;Hwa Young Lee;Hye Seon Kang;Sung Kyoung Kim;Ju Sang Kim;Chan Kwon Park;Sang Haak Lee;Seung Joon Kim;Jin Woo Kim;Chang Dong Yeo
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.203-215
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    • 2023
  • Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R2 and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R2 value was 0.27 and in set II, LightGBM was the best model with the highest R2 value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R2 value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.