PURPOSE: The aim of this study was to explore the attributes, antecedents, and consequences of patient-centered care (PCC) for older adults with multimorbidity in acute care hospitals.METHODS: The concept analysis performed by Walker and Avant was used to analyze PCC. Fifteen studies from the literature related to PCC appear in systematic literature reviews in the fields of theology, medicine, psychology, and nursing.RESULTS: PCC in acute care hospitals was defined according to the five attributes of ‘maintaining patient autonomy’, ‘empowering self-care’, ‘individualized and relationship-based care’, ‘shared decision-making’, and ‘creating a homelike environment’. Antecedents of PCC were found to be a respect for patients' preferences, qualifications of the nursing staff, care coordination and integration, and organizational support. Consequences of effective PCC were a functional status; health-related quality of life; satisfaction with care, mortality, and medical costs from the perspective of the patient and family; and quality of care and therapeutic relationships from nurses' viewpoints.CONCLUSION: PCC as defined by the results of this study will contribute to the foundation of institutionalization and the creation of a safe and healthy acute care hospital culture focused on patients' preferences and values.
Adult ; Comorbidity ; Humans ; Institutionalization ; Mortality ; Nursing ; Nursing Staff ; Patient-Centered Care ; Psychology ; Quality of Life ; Theology ; Walkers

BACKGROUND AND PURPOSE: We investigated predictors of institutionalization in patients with Alzheimer's disease (AD) in South Korea. METHODS: In total, 2,470 patients with AD aged 74.5±7.8 years (mean±standard deviation, 68.1% females) were enrolled from November 2005 to December 2013. The dates of institutionalization were identified from the public Long-Term-Care Insurance program in January 2014. We used a Cox proportional-hazards model to identify predictors for future institutionalization among characteristics at the time of diagnosis in 2,470 AD patients. A similar Cox proportional-hazards model was also used to investigate predictors among variables that reflected longitudinal changes in clinical variables before institutionalization in 816 patients who underwent follow-up testing. RESULTS: A lower Mini Mental State Examination score [hazard ratio (HR)=0.95, 95% confidence interval (CI)=0.92–0.97] and higher scores for the Clinical Dementia Rating and Neuro-Psychiatric Inventory (HR=1.01, 95% CI=1.00–1.01) at baseline were independent predictors of institutionalization. The relationship of patients with their main caregivers, presence of the apolipoprotein E e4 allele, and medication at baseline were not significantly associated with the rate of institutionalization. In models with variables that exhibited longitudinal changes, larger annual change in Clinical Dementia Rating Sum of Boxes score (HR=1.15, 95% CI=1.06–1.23) and higher medication possession ratio of antipsychotics (HR=1.89, 95% CI=1.20–2.97) predicted earlier institutionalization. CONCLUSIONS: This study shows that among Korean patients with AD, lower cognitive ability, higher dementia severity, more-severe behavioral symptoms at baseline, more-rapid decline in dementia severity, and more-frequent use of antipsychotics are independent predictors of earlier institutionalization.
Alleles ; Alzheimer Disease* ; Antipsychotic Agents ; Apolipoproteins ; Behavioral Symptoms ; Caregivers ; Dementia ; Diagnosis ; Follow-Up Studies ; Humans ; Institutionalization* ; Insurance ; Korea*

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life — and the need for institutionalization — is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management.
Anhedonia ; Anxiety ; Apathy ; Compulsive Behavior ; Delusions ; Dementia ; Depression ; Dopaminergic Neurons ; Hallucinations ; Humans ; Institutionalization ; Neurodegenerative Diseases ; Parkinson Disease* ; Prevalence ; Psychotic Disorders ; Quality of Life ; Risk Factors ; Substantia Nigra

Historians of science have noted that modern nation-states and capitalism necessitated the systematic creation and implementation of a wide array of knowledge and technologies to produce a more productive and robust population. Commonly labeled as biopolitical practices in Foucauldian sense, such endeavors have often been discussed in the realms of public hygiene, housing, birth control, and child mortality, among others. This article is an attempt to extend the scope of the discussion by exploring a relatively understudied domain of nutrition science as a critical case of social engineering and intervention, specifically during and after World War I in the case of Japan. Research and dissemination of knowledge on food and health in Japan, like other industrializing nation-states, centered on new public hygiene initiatives since the late nineteenth-century. However, in the aftermath of WWI, or more precisely, after the Rice Riots of 1918, a new trend began to dominate the discourse of nutrition and health. In the face of wartime inflation and the resultant nation-wide riots, physicians and social scientists alike began to view the food choice and budget issue as a solution to the middle class crisis. This new perception drew on the conceptual framework to understand food, metabolism, and cost in the language of quantifiable nutrition vis-à-vis monetary values. By analyzing how specific nutritional knowledge was translated into the tenets for public campaigns to reform everyday life, this paper ultimately sheds light on the institutionalization of a new area of research, nutrition (eiyō) in Japan.
Budgets ; Capitalism ; Child ; Child Mortality ; Contraception ; Eating* ; Housing ; Hygiene ; Inflation, Economic ; Institutionalization ; Japan* ; Metabolism ; Nutritional Sciences* ; Rationalization ; Riots ; World War I

BACKGROUND: The Philippines has, mandatory service policies to address the insufficiency and maldistribution of human resources particularly for health services. Despite being perceived as an appropriate intervention to bridge the aforementioned HRH gaps, the past and present implementations of such programs in the country have never been formally studied.

OBJECTIVE: This paper aimed to present the history of mandatory service programs in the Philippines, look at their natures, and see how their different implementations relate to each other.

METHODOLOGY: Using a qualitative document analysis method, administrative issuances and reports relevant to past and current implementations of mandatory service policies in the Philippines were obtained and reviewed.

RESULTS: Mandatory service programs have been implemented in the country by institutions from both the private and public sectors as early as 1968. The focus of such has been mostly for government positions and specialized professions including physicians and scientists. While extensive efforts have been made through the years, the policies demonstrated fragmentation and recurring gaps in implementation. Such gaps include the lack of enabling policy mechanisms, formal monitoring and evaluation, and program institutionalization.

CONCLUSION: The historical narrative of return service programs in the country is a potential source for the development of an overarching mandatory service policy framework for human resources in the Philippines, one that is specific to the context and setting of the country. By articulating policy issues identified, this paper provided a stepping-off point for future mandatory service program policy planning, implementation, evaluation, and institutionalization in the Philippines.

Workforce ; Institutionalization ; Physicians

PURPOSE: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. METHODS: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. RESULTS: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. CONCLUSION: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.
Adult ; Aged ; Cohort Studies ; Frail Elderly ; Humans ; Institutionalization ; Korea* ; Long Term Adverse Effects ; Mortality ; Prevalence ; Prospective Studies

Traditionally, programs related to maternal health are regarded as purely a woman's domain. Nevertheless, the role of the male as the decision maker in the household gave way to the recognition of the male's role in maternal and reproductive health. This paper aimed to provide a review on male involvement strategies and their impact on maternal health based on related studies, discuss the strategies in the Philippine context and suggest interventions given the current state of the Philippine health care system. These strategies utilize the decision-making role of the male by positing itself on the reproductive, sexual and maternal health aspects encompassing important factors, such as birth spacing, first pregnancy, family planning, utilization of skilled birth attendants (SBAs), and delivery in health facilities, antenatal and postpartum care and nutrition. However, negative repercussions include stigmatization of single mothers and reinforcement of the notion of a man's control over a woman's body. Given the current state of the Philippine health care system, the suggested interventions try to veer away from it as much as possible. These include integration of the male involvement strategy into the Pantawid Pamilyang Pilipino Program (4Ps), coursing it through a public-private partnership (PPP) and non-government organizations (NGOs), involvement of educational institutions, strengthening of the health service delivery at the grassroots level, reinforcement of existing laws, and research on its institutionalization. With carefully-planned strategies that recognize existing gender norms and other sociocultural factors, male involvement in maternal health could be a possible catalyst in decreasing the Philippine maternal mortality rate (MMR).

 

Human ; Male ; Female ; Pregnancy ; Maternal Mortality ; Reproductive Health ; Birth Intervals ; Family Planning Services ; Public-private Sector Partnerships ; Stereotyping ; Maternal Health ; Mothers ; Postnatal Care ; Parturition ; Family Characteristics ; Gender Identity ; Delivery, Obstetric ; Decision Making ; Institutionalization ; Health Facilities

'Health in All Policies' is a new strategy for governance for health in 21st century. The evolution of health promotion has affected the creation of the strategy through the efforts to tackle health inequalities by addressing social determinants of health. More concern about health inequalities, involving wider policy areas, and higher level of institutionalization distinguish the strategy from the old intersectoral collaboration such as intersectoral action for health and healthy public policy. Making intersectoral collaboration the mainstream of policy making is important to address integrated policy agendas such as 'Health in All Policies' and 'Sustainable Development Goals.' Political leadership and interpersonal skills are also required to strengthen the capacity of public health sector for implementing 'Health in All Policies' in local, national, and international circumstances.
Cooperative Behavior ; Health Promotion* ; Institutionalization ; Leadership ; Policy Making ; Public Health ; Public Policy ; Social Determinants of Health ; Socioeconomic Factors

Caring for people with dementia is associated with multiple devastating social, financial, physical, and psychological challenges. There is strong evidence that multicomponent tailored caregiver intervention is effective in improving caregiver well-being and delaying institutionalization. In US, the government is actively funding for developing caregiver program and to prove its efficacy through randomized controlled trials (RCTs) to translate into practice. Even with the introduction of Korean Long-term Care Plan, still, the most of the patients with dementia are being cared by the family members. The distress of caregiving is enormous, but structured therapeutic intervention program which efficacy is proven through RCT is very insufficient in Korea. The purpose of this article is to review the caregiver intervention programs of ongoing clinical trials comparing US and Korea, and to propose a tailored, therapeutic intervention program (I-CARE; A multicenter, randomized trial to assess efficacy of therapeutic intervention programs for decreasing caregiver burden in dementia caregiver) for hospital-care in Korea.
Caregivers* ; Dementia* ; Financial Management ; Humans ; Institutionalization ; Korea ; Long-Term Care

This article investigates the historical background and distinctive characteristics of the Korean food hygiene policy during the 1960s. The 3 main findings of this study are as follows. First, Food Sanitation Law in the 1960s was established too hastily and thus mistakenly accommodated two discordant laws as American style law and empire of Japan style law. The legislation of Food Sanitation Law was progressed too quickly for the justification purpose of 5·16 military coup, as one of reorganization tasks of the Korean legal structure established under Japanese imperialism, Second, a division in charge of food hygiene in the Ministry of Health and Social Affairs was newly installed in 1967, as an outcome reflecting a variety of social demand, at least, minimally. Rongalite shock in Korea prompted diverse suggestions for preventing unfortunate accidents from toxic and harmful food. However, Korean Government did not provide the division with necessary budget and manpower to implement relevant regulations. Third, "the special law against health crimes" legislated in 1969, was characterized by severe punishment policy which might be performed afterward but not by protective measures against accidents in advance. The law enabled regulators to punish corrupt dealers up to life sentence. For the constitutional amendment for President for the third term, Park Chung-hee's regime tried to calm down the complaints of people. In sum, the regulations of Korean food hygiene in the 1960s were identified as government practices using an interesting combination of low costs and severe punishments.
Asian Continental Ancestry Group ; Budgets ; Humans ; Hygiene* ; Institutionalization* ; Japan ; Jurisprudence ; Korea ; Legislation as Topic ; Military Personnel ; Punishment ; Sanitation ; Shock ; Social Control, Formal