PURPOSE: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. METHODS: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. RESULTS: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. CONCLUSION: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.
Community Health Centers ; Community Health Nursing ; Community Health Services ; Cooperative Behavior ; Delivery of Health Care ; Health Resources ; Hospice Care ; Hospices ; Humans ; Models, Organizational ; Optic Disk ; Organization and Administration ; Pilot Projects

PURPOSE: The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. METHODS: A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. RESULTS: Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. CONCLUSION: This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.
Adult ; Case Management/*organization & administration ; Community Health Nursing ; Female ; Humans ; Interviews as Topic ; Korea ; Managed Care Programs ; Nurse-Patient Relations ; Nursing Staff/*organization & administration ; Power (Psychology)

PURPOSE: This study aimed to evaluate a pilot project of the Nursing Feeding Center “Posyandu Plus” (NFCPP) through local food-based complementary feeding (LFCF) program designed to improve the nutritional status of children aged 6–36 months at community health centers in Indonesia. METHODS: A quasi-experimental design was used to obtain data regarding the nutritional status of 109 children who participated in the project from 6 rural areas. The NFCPP was conducted for 9 weeks, comprising 2 weeks of preintervention, 6 weeks of intervention, and one week of postintervention. The LFCF intervention consisted of 12 sets of recipes to be made by mothers and given to their children 4 times daily over 6 weeks. The weight-for-age z score (WAZ), height-for-age z score (HAZ), weight-for-height z score (WHZ), and body mass index-for-age z score (BAZ) were calculated using World Health Organization Anthro Plus version 1.0.3. RESULTS: LFCF intervention significantly increased WHZ, WAZ, and BAZ scores but decreased HAZ scores (P<0.001). Average scores of WHZ (0.96±0.97) and WAZ (0.45±0.72) increased; BAZ increased (1.12±0.93) after 6 weeks of LFCF. WAZ scores postintervention were 50.5% of normal, and WHZ scores were 77.1% of normal. However, the HAZ score decreased by 0.53±0.52, which indicated 57.8% had short stature. CONCLUSION: The NFCPP program with LFCF intervention can improve the nutritional status of children in rural areas. It should be implemented as a sustained program for better provision of complementary feeding during the period of lactation using local food made available at community health centers.
Child* ; Community Health Centers ; Female ; Humans ; Indonesia* ; Infant ; Infant Nutritional Physiological Phenomena* ; Lactation ; Mothers ; Nursing ; Nutritional Status* ; Pilot Projects ; World Health Organization

PURPOSE: The purpose of this study was to examine cognitive functions, depression, and life satisfaction among the elderly receiving visiting nursing services. METHODS: The subjects of this study consisted of 221 elderly individuals who were receiving visiting nursing services from a public health center located in Gyeonggi-do. The Mini-mental State Examination Korea version (MMSE-K), Geriatric Depression Scale-short form-Korea version (GDS-K), and Life Satisfaction Scale were utilized to determine cognitive functions, depression, and life satisfaction. Collected data was analyzed by the SPSS PC Win 12.0 program. RESULTS: The prevalence of cognitive impairment (MMSE-K< or =24) was 86.4%, and the proportion of severe depression (GDS-K> or =10) was 22.6%. Older age, lower education, and low income were associated with cognitive impairment, and low education, no religion, and low income were associated with depression. Cognitive function negatively correlated with depression. Life satisfaction level was fairly low and was not associated with any variables. CONCLUSION: The high prevalence of cognitive impairment and low life satisfaction status were determined among low-income elderly who were registered at a visiting health care center. Thus, in the future at visiting health care services, efficient and various programs for the elderly should be tried, to improve cognitive functions and reduce depression. Additionally, consistent evaluation studies for those programs will be required.
Aged ; Aged, 80 and over ; Cognition Disorders/*epidemiology ; Community Health Nursing/organization & administration ; Depression/*epidemiology ; Female ; Humans ; Male ; Middle Aged ; *Personal Satisfaction ; Quality of Life ; Questionnaires

The involvement of health-care professionals in tobacco-control activities is essential to prevent smoking-related morbidity and mortality. The purposes of this predictive correlational study were to examine tobacco-control activities and to identify the predictors of such activities of community health practitioners (CHPs). Of the 1,813 members of the Korean Association of CHP, 1,247 participated in this study. A mailed survey was conducted to collect data. The majority of CHPs supported tobacco-control policies and recognized tobacco-control activities as an important role for them. Only 44.3% of CHPs were confident in their knowledge and skills regarding tobacco-control activities, and only 30.8% had received professional tobacco-control education. While the majority of the CHPs "asked, advised, and assessed"their clients, only a small number "assisted or arranged". The tobacco-control activities of CHPs were predicted by their attitude toward it, age, experience of tobacco-control education, educational level, and general perception of the risk of smoking; these variables accounted 13.5% of variance in the tobacco-control activities of CHPs. These findings provide the basis for developing a continuing education program for CHPs. CHPs should be encouraged to integrate tobacco-control activities into their routine practice, and CHP education programs should be adjusted to increase the time spent on the tobacco-control intervention techniques.
Adult ; Aged ; Analysis of Variance ; *Attitude of Health Personnel ; Clinical Competence/standards ; Community Health Nursing/education/*organization & administration ; Cross-Sectional Studies ; Education, Nursing, Continuing/standards ; Educational Status ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Middle Aged ; Needs Assessment ; *Nurse's Role ; Nursing Methodology Research ; Nursing Staff/education/organization & administration/*psychology ; Predictive Value of Tests ; Questionnaires ; Regression Analysis ; Risk Factors ; Self Efficacy ; Smoking/*prevention & control ; Smoking Cessation

INTRODUCTIONWe assessed the pedagogical value of a student-led community-based experiential learning project called the Public Health Screening (PHS) run by medical and nursing students of the National University of Singapore's Yong Loo Lin School of Medicine (NUS YLLSoM).

MATERIALS AND METHODSWe conducted a cross-sectional study using a self-administered anonymised questionnaire on medical and nursing students who participated in PHS using the Fund for the Improvement of Postsecondary Education (FIPSE) Survey Instrument. Participants also gave an overall score for their learning experience at the PHS.

RESULTSThe participation rate was 93.1% (576/619) for medical students and 100% (37/37) for nursing students. All participants gave the PHS learning experience a high rating (median = 8 out of maximum of 10, inter-quartile range, 7 to 9). A majority of participants felt that PHS had helped them to improve across all domains surveyed. For medical students, those in preclinical years and females were independently more likely to feel that PHS had helped them to improve in communication skills, teamwork, ability to identify social issues, taking action, and gaining and applying their knowledge than those in clinical years and males. Improved ability to interact with patients (β=1.64, 95%CI, 1.01-2.27), appreciation of challenges to healthcare faced by Singaporeans from lower income groups (β=0.93, 95%CI, 0.49-1.37), thinking of others (β=0.70, 95%CI, 0.04-1.37) and tolerance of different people (β =0.63, 95%CI, 0.17-1.10) were strongly associated with the overall rating score.

CONCLUSIONPHS was a positive learning experience in a wide range of domains for all students involved. This suggests that student-organised community-based experiential learning projects have potential educational value for both medical and nursing students.

Attitude of Health Personnel ; Community Health Services ; organization & administration ; Confidence Intervals ; Cross-Sectional Studies ; Data Collection ; Education, Medical ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Learning ; Logistic Models ; Male ; Mass Screening ; Models, Educational ; Odds Ratio ; Program Development ; Program Evaluation ; Public Health Practice ; Schools, Medical ; Singapore ; Students, Medical ; Students, Nursing ; Surveys and Questionnaires ; Teaching ; Volunteers