Performance of a Community-based Noncommunicable Disease Control Program in Korea: Patients 65 Years of Age or Older

Background@#In Korea, the Korean Community-based Noncommunicable Disease Prevention and Control Program (KCNPC) was implemented in 2012 for the management of patients with chronic diseases. Nineteen primary care clinics, public health centers, and education and consulting centers (ECCs) participated in the implementation of this program. This study assessed the effectiveness of this chronic disease control model by comparing mortality rate and the incidence of complications between patients participating in the KCNPC program and a control group. @*Methods@#Using data from the National Health Insurance Service and data from hypertension and diabetes patients registered with 19 ECCs between January 1, 2010 and December 31, 2012, hypertension and diabetes patients who had been treated at a clinic were selected. The final analysis included 252,900 patients, with the intervention group and control group having 126,450 patients each. Survival for the two groups was analyzed using the Kaplan-Meier method. Complications were analyzed using the Cox proportional hazards model. @*Results@#The 5-year survival rate in the intervention group (0.88) was higher than that in the control group (0.86). Cox proportional hazards analysis showed that the intervention group had lower risk for mortality (0.84; 95% confidence interval [CI], 0.82–0.86) compared to the control group. Hospitalization due to complications and the proportional risk of hospitalization were also lower in the intervention group. @*Conclusion@#The KCNPC model for prevention and control of chronic disease in Korea was found to be effective for hypertension and diabetes patients. Therefore, the KCNPC will be necessary to strengthen the capabilities of local communities, primary medical institutions, and individuals for prevention and control of chronic disease. Expanding the efficient prevention and control policies of the KCNPC to a nationwide scale may be effective as has been demonstrated through limited implementation in some regions.

The Influence of Cognitive Function, Pain, and Body Image on the Activities of Daily Living in Patients with Brain Injury / 재활간호학회지

PURPOSE: This study is a descriptive study to analyze the relationship between the cognitive function, body image and pain, and the influencing factors on the daily life performance of brain injured patients. METHODS: The study subjects were 119 inpatients with brain injury who gave informed consent. The activities of daily living (ADLs), cognitive function, pain and body image were measured by Modified Barthel Index (K-MBI), K-MMSE (Mini-Mental State Examination), Visual Analog Scale (VAS), Semantic Differential Method (SDM), respectively. RESULTS: ADLs was significantly associated with body image, cognitive function, and pain. Multiple regression analysis showed that paralysis, consciousness, cognitive function, and pain were significant factors influencing ADLs. Overall, approximately 48% of total variability in the ADLs could be explained by the 4 variables (R²=.477, p<.001). CONCLUSION: To improve ADLs of brain injury patients, a deeper understanding of paralysis, consciousness, cognitive function, and pain of patients is required and active nursing invention should be conducted.

Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases / 재활간호학회지

PURPOSE: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). METHODS: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. RESULTS: Mean age was 68.8+/-11.63 years, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. CONCLUSION: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

A Phenomenological Study on Happiness Experienced by Career Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to understand the meaning and essence of happiness by exploring and describing career nurses' lived experiences. METHODS: Qualitative research was used in this study. Hospital nurses who had 3~5 years of experience in the clinical setting were interviewed and the data were analysed using Giorgi's phenomenological method. RESULTS: Six main meanings and seventeen themes emerged. The six main meanings were as follows: self-confidence as a professional nurse, passion for self-realization, feeling of satisfaction in performance of nursing care, being grateful for working environment, emotional intimacy in interpersonal relationships, and taking delight and pleasure in leisure life. CONCLUSION: The results of this study provide deep understanding of happiness as positive experiences that increase job satisfaction and aid retention to the nursing profession. These results can be used in the development of effective strategies to improve and expand nurses' happiness.

Lived Experiences of New Graduate Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to explore the lived experiences of new graduate nurses in personal life and in clinical setting during their first year. METHODS: Eleven new graduate nurses were interviewed and the data were analyzed using the Giorgi's phenomenological method. RESULTS: The main results of this research were negative experiences such as poor nursing skills, inability to enjoy personal life, physical exhaustion and health problems, and uncertainty of nursing values. On the other hand, there were some positive aspects on their minds: adjustmental/developmental needs, sense of responsibility, receptive capability, and proficiency with their work. They gradually found themselves being endured and changing to adapt. CONCLUSION: Transition from students to staff nurses is a very stressful experience for new graduate nurses. It may negatively affect their personal lives as well. However they tried to keep themselves positive to overcome their difficulties. It is necessary for them to be given time, a systematic program, and a supportive environment to adapt.