• Title/Summary/Keyword: primary health care

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The Effects of Self-Care Activities on the Physical and Mental Health of Primary Caregivers of Functionally Impaired Elderly (기능손상 노인을 돌보는 주보호자의 자기 돌봄 활동이 자신의 신체·정신건강에 미치는 영향)

  • Kim, Jeong Eun;Choi, Hae Kyung
    • Korean Journal of Family Social Work
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    • no.55
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    • pp.157-188
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    • 2017
  • The purpose of this study was to examine the effects of self-care activities on physical and mental health of primary caregivers of functionally impaired elderly. Data were collected from 185 primary caregivers who were caring for their spouses or parents with functional impairment at home in Daejon. SPSS 21.0 software was used for descriptive analysis and hierarchical regression analysis. The results showed that (1) primary caregivers reported their physical health status as poor (2) the domains of health responsibility, physical activity in their self-care activities were significant predictors of their physical health level (3) primary caregivers reported very high level of depression (4) their mental health was significantly influenced by spiritual growth among self-care activities. Based on these findings, social work intervention and policy suggestions were discussed.

Effects of a Self-control Promotion Program on Self-efficacy, Self-care and Physiological Indicators of Patients with Diabetes Living in Local Communities (자기조절증진 프로그램이 지역사회 당뇨병환자의 자기효능과 자가간호행위 및 생리적 지표에 미치는 영향)

  • Kim, Young-Sin;Jo, Yeon-Soon;Choo, Hyang-Im;Han, Eun-Hae;Kim, Chun-Mi
    • Journal of Korean Academy of Rural Health Nursing
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    • v.5 no.1
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    • pp.5-15
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    • 2010
  • Purpose: This study was conducted to examine the effects of a self-control promotion program on self-efficacy, self-care and physiological indicators of patients with diabetes who live in local communities. Method: This research was designed using a nonequivalent control group pre, posttest study. Data were collected from December, 2008 through March, 2009. The participants of the study consisted of 93 patients with diabetes who live in a local community. A self-control promotion program was provided for the experimental group for 12 weeks. Data were collected through self-report questionnaires and direct measurements, and analyzed using descriptive statistics, $X^2$-test, and repeated measures ANOVA. Results: There were significant differences in self-efficacy and self-care between the experimental and control groups. However, there were no significant differences in physiological indicators such as fasting blood sugar, HbA1C, BMI, and BP between the two groups. Conclusion: The results indicate that the self-control promotion program was effective in promoting self-efficacy and self-care, which are crucial factors in controlling diabetes mellitus. However, a longitudinal study needs to be done to confirm the effects of self-control promotion programs on long-term glucose control.

Prevalence and Forms of Workplace Bullying Among Health-care Professionals in Cyprus: Greek Version of "Leymann Inventory of Psychological Terror" Instrument

  • Zachariadou, Theodora;Zannetos, Savvas;Chira, Stella Elia;Gregoriou, Sofia;Pavlakis, Andreas
    • Safety and Health at Work
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    • v.9 no.3
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    • pp.339-346
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    • 2018
  • Background: Workplace bulling is a pervasive phenomenon with negative consequences for the health of victims and the productivity of organizations. The aim of this study was to measure the prevalence and forms of workplace bullying among employees working at the public health-care sector of Cyprus using the Greek version of Leymann Inventory of Psychological Terror (LIPT) instrument. Methods: A translation process was followed from the French to the Greek version of LIPT questionnaire. Test-retest reliability expressed by Pearson's correlation coefficient was 0.98 indicating excellent reproducibility. Internal consistency reliability assessed by Cronbach ${\alpha}$ coefficient was 0.87 suggesting high reliability. LIPT instrument was distributed among 403 employees working at the primary health-care setting and at the largest public hospital of Cyprus with response rate of 73.4%. Results: Women comprised the majority of participants (71.4%). Mean age was 43.3 years. Prevalence of workplace bulling according to Leymann's definition was 5.9%. Most common forms of bullying were "Being continuously interrupted" (17.2%) and "continuously being given new work assignments" (13.5%). Women were significantly more often exposed to at least one mobbing behavior than men within the previous year (49% vs. 35.7%, p = 0.038), whereas nurses were significantly exposed to at least one mobbing behavior as compared to physicians (53.3% vs. 31.4%, p = 0.004). Conclusion: This was the first study that examined the prevalence of workplace bullying in the public health-care sector by elaborating the Greek version of LIPT instrument. Results showed that workplace bullying is a common and complex phenomenon among health-care organizations.

A Study on the Most Frequent Diseases of Health Insurance Program and the Primary Care Physicians in Korea (의료보험 다빈도 상병과 1차진료 의사에 관한 연구)

  • 김철환;문옥륜
    • Health Policy and Management
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    • v.3 no.1
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    • pp.124-145
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    • 1993
  • General practitioners, internists, pediatricians, and family physicians are classified as so-called primary care physicians in the United States. We carried out this study for the purpose of answering the following question; "Who are the primary care physicians in Korea\ulcorner" We analyzed the 663, 154 claims which were drawn from the health insurance processing file made during the period of one month, April 1992 on the basis of systemic random sampling technique. The 663, 154 cases were matched with the doctor's file registered at the National Federation Medical Insurance by using the indivisual physician code number and analyzed according to the kind of specialty. If we follow the Geyman's definition of primary care physician in the United States, this study shows that they can take care of 43.2% of the total private clinic's claims in Korea. Provided that general practitioners and family physicians are considered the same way as in the United Kingdom, they could with only 8.3% of the total claims in Korea. The most frequent diseases are those which rank first to 46th in the total private clinic's claims. The proportion of the most frequent diseases was highest for pediatricians(90.4%) and followed by internists(81.4%), otolaryngologists(78.7%) and family physicians(76.5%). The proportion of the most frequent diseases in the most common 46 diseases was highest for radiologists(80.4%) and the next was as follows : general practitioners(78.3%), family physicians(67.4%), and internists(67.4%). We classified the most common 20 diseases of each specialty into 17 categories of ICD-9 and compared it with those of general practitioners. The specialists who had managed a similar disease pattern to those of general practitioners were identified as anesthesiologists, family physicians, general surgeons, and internists. Some specialists practicing at private clinics managed the diseases which were not quite appropriate for their specialties. After we evaluated each specialty by the most common diseases, the most frequent diseases, and the most frequent 20 diseases of each specialty in terms of the 17 categories of ICD-9, a tentative assumption is made that the primary physicians in the Republic of Korea are general practitioners, anesthesiologists, family physicians, internists, and general surgeons. This study has concluded that the categories of the primary care physicians are so diverse that their roles and distributions are distorted accordingly. Vigorous health policy efforts in correcting the malcomposition need to be made for the better provision of primary health care in Korea. in Korea.

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Nurse Practitioner Roles and Curriculums in the United States (미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰)

  • Lee Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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The Relationship between Sense of Loss and Suicidal Ideation among Rural Elders use Primary Health Care Post's Services : Mediating Effect of Depression (보건진료소를 이용하는 농촌노인의 상실감과 자살생각과의 관계: 우울의 매개효과)

  • Bong, Eun Ju
    • Journal of agricultural medicine and community health
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    • v.45 no.1
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    • pp.1-12
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    • 2020
  • Purpose: The purpose of this study was to examine the mediating effects of depression on relationship between sense of loss and suicidal ideation among Rural Elders use Primary Health Care Post's Services. Methods: This study was conducted using a descriptive survey design. Participants were 345 rural elders use Primary Health Care Post's Services in Jeollanam-do. Data were collected from August 1 to 31, 2017 using self-report questionnaires. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, hierarchical regression and Sobel test with SPSS 21.0. Results: There were significant positive correlations between sense of loss, depression and suicidal ideation. It was found that physical loss is very high and significantly different only subjective health status on suicidal ideation. Also, Depression partially mediated the relationship between sense of loss and suicidal ideation of Rural Elders. Addtionally, The results show that depression plays a key role in suicidal ideation of Rural Elders. Conclusions: Based on the present findings, nursing interventions should be developed to decrease depression, with additional consideration towards sense of loss, specially physical loss, in order to prevent suicidal ideation among Rural Elders use Primary Health Care Post's Services.

The Effect of Health Promotion Program on the Frailty of Rural Elderly Women Implemented at Primary Health Care Posts (일부 보건진료소에서 실시한 건강증진프로그램이 농촌여성노인의 노쇠에 미치는 효과)

  • Kim, Min-Kyung;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.44 no.3
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    • pp.115-123
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    • 2019
  • Objective: This study was conducted to examine the effects of a health promotion program on the health condition of rural elderly women implemented at primary health care posts using Korean Frailty Index. Methods: The research was designed a nonequivalent control group pretest-posttest setting. The participants in this study were 50 residents (intervention group: 25, control group: 25) selected from 4 villages 2 primary health care posts in J city Gyeongsangnam-do. The health promotion program was conducted at the primary health care posts twice a week for 12 weeks. This program consisted of basic exercises(Gukseondo + Theraband muscle strength training) and additional activities(including modified Theraband activity, rubber ball exercise, ball massage, nutrition class, singing class). Collected data were analyzed by descriptive statistics, paired t-test, and repeated measures ANOVA with SPSS 21.0. Results: Results of the health promotion program showed that the health conditions(measured by perceived health status, frailty score, upper/lower flexibility, maximum grip strength, dynamic balance test Timed Up and Go) of the experimental group(25) all statistical significantly improved. Conclusion: Study findings indicate that the health promotion program implemented at primary health care posts on rural elderly women is effective and can contribute to a developed health promotion program for local residents in the future.

Evaluation of a Community Health Practitioner Self-care Program for Rural Korean Patients with Osteoarthritis

  • Lee, Chung Yul;Cho, Yoon Hee
    • Journal of Korean Academy of Nursing
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    • v.42 no.7
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    • pp.965-973
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    • 2012
  • Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

Salt Processed Food and Gastric Cancer in a Chinese Population

  • Lin, Si-Hao;Li, Yuan-Hang;Leung, Kayee;Huang, Cheng-Yu;Wang, Xiao-Rong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5293-5298
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    • 2014
  • To investigate the association between salt processed food and gastric cancer, a hospital based case-control study was conducted in a high risk area of China. One hundred and seven newly diagnosed cases with histological confirmation of gastric cancer and 209 controls were recruited. Information on dietary intake was collected with a validated food frequency questionnaire. Unconditional logistic regression was applied to estimate the odds ratios with adjustment for other potential confounders. Comparing the high intake group with never consumption of salt processed foods, salted meat, pickled vegetables and preserved vegetables were significantly associated with increased risk of gastric cancer. Meanwhile, salt taste preference in diet showed a dose-response relationship with gastric cancer. Our results suggest that consumption of salted meat, pickled and preserved vegetables, are positively associated with gastric cancer. Reduction of salt and salt processed food in diets might be one practical measure to preventing gastric cancer.

A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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