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Sudo K, Noda S, Kobayashi J, Wongwatcharapaiboon P, Sakolwasan U, Takahashi K. The role of community nurse in the implementation of health policy for the elderly in Thailand. Glob Health Med 2023; 5:345-353. [PMID: 38162425 PMCID: PMC10730923 DOI: 10.35772/ghm.2023.01032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/23/2023] [Accepted: 09/01/2023] [Indexed: 01/03/2024]
Abstract
In the implementation of the policy for the elderly, the nurses who have the competency to pull out their potential power to continue living with several stakeholders' support are required to provide care in the community. Community nurse in Thailand has the responsibility to deliver adequate medical care and also social care for the elderly. The study aimed to identify the role of community nurse in the implementation of Thai health policy for the elderly. Codes regarding the role of community nurse in the implementation of Thai health policy for the elderly were extracted from descriptive data interviewed with 15 policy implementors in Thailand. The codes were categorized by similarities using thematic analysis. The role of community nurse was 16 categories and 102 codes out of factors promoting implementation of Thai health policy for the elderly, with 27 categories and 416 codes. The main roles were Coordination, Service delivery, and Monitoring and evaluation, composing seven categories and 45 codes, eight categories and 51 codes, and one category and six codes, respectively. It was conspicuous in coordination mechanisms, especially between the organizations and disciplines in providing Primary Health Care. Both health promotion activities and medical treatment were crucial roles for community nurses. The role of community nurse was one of promoting factors of Thai health policy for the elderly. The community nurse acts as a lubricant between the hospital and the community, which means that the community nurse implements seamless service delivery for the elderly integrating medical care and welfare.
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Affiliation(s)
- Kyoko Sudo
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichiro Noda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Jun Kobayashi
- Graduate School of Health Sciences, University of the Ryukyus, Okinawa, Japan
| | | | | | - Kenzo Takahashi
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
- Department of Pediatrics, Navitas Clinic Kawasaki, Kanagawa, Japan
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Han E, Quek RYC, Tan SM, Singh SR, Shiraz F, Gea-Sánchez M, Legido-Quigley H. The role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease: A systematic review. Int J Nurs Stud 2019; 100:103415. [PMID: 31670215 DOI: 10.1016/j.ijnurstu.2019.103415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 07/13/2019] [Accepted: 08/28/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals with cardiovascular disease. DESIGN A systematic review and narrative synthesis. DATA SOURCES Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR and WPRIM) were searched from inception to 16 March 2018 without language restrictions. REVIEW METHODS We included studies evaluating the outcomes of interventions led by, or primarily delivered by, nurses for individuals with cardiovascular disease in community settings. Study selection, data extraction and risk of bias assessments were performed by at least two independent reviewers. RESULTS Twenty-eight studies met the inclusion criteria and were included in this review. Community-based nursing interventions improved outcomes in four key areas: (1) self-care, (2) health, (3) healthcare utilisation, and (4) quality of care. Significant improvements were reported in patients' knowledge and ability to self-manage, severity of disease, functional status, quality of life, risk of death, hospital readmission days, emergency department visits, healthcare costs and satisfaction with care. Facilitators to intervention effectiveness included the use of an individualised approach, multidisciplinary approach, specially trained nurses, family involvement and the home setting. Conversely, barriers to intervention success included limitations in nurses' time and skills, ineffective interdisciplinary collaboration and insufficient intervention intensity. CONCLUSIONS The overall evidence is positive regarding the role of community-based nursing interventions in improving outcomes for individuals with cardiovascular disease. However, this review highlights the need for more robust research establishing definitive relationships between different types of interventions and outcomes as well as evaluating the cost-effectiveness of these interventions to aid the development of sustainable policy solutions.
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Affiliation(s)
- Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore
| | - Rina Yu Chin Quek
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore
| | - See Mieng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore
| | - Shweta R Singh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore
| | - Montserrat Gea-Sánchez
- GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain; Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-03, Tahir Foundation Building, Singapore 117549, Singapore; GESEC Group, Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 25198 Lleida, Spain
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Kadivec S, Lainščak M, Košnik M, Farkaš-Lainščak J. Zadovoljstvo bolnikov s kronično obstruktivno pljučno boleznijo z obravnavo koordinatorja odpusta. OBZORNIK ZDRAVSTVENE NEGE 2015. [DOI: 10.14528/snr.2015.49.3.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Dobra priprava na odpust zveča kakovost življenja bolnika s kronično obstruktivno pljučno boleznijo in zmanjša število hospitalizacij. Z namenom opredelitve zadovoljstva bolnikov s kronično obstruktivno pljučno boleznijo z obravnavo koordinatorja odpusta je bila izvedena neeksperimentalna kvantitativna raziskava.
Metode: Raziskava je potekala anonimno, s pomočjo strukturiranega vprašalnika, poslanega po pošti. Sodelovalo je 107 bolnikov, ki so bili zaradi poslabšanja kronične obstruktivne pljučne bolezni hospitalizirani med 2. novembrom 2009 in 6. decembrom 2011 in bili obravnavani s strani koordinatorja odpusta. Vprašalnik je vrnilo 60 bolnikov. Za statistično obdelavo smo uporabili opisno statistiko, faktorsko analizo, linearnoregresijski model in multiplo linearno regresijo.
Rezultati: Z analizo smo ugotovili, da lahko s skupnim vplivom treh faktorjev (komunikacija, samoobvladovanje bolezni in doživljanje bolezni oz. simptomi) pojasnimo 84,02 % variance zadovoljstva bolnikov s koordinatorjem odpusta. Z zadovoljstvom bolnikov s koordinatorja odpusta je najbolj povezana komunikacija, sledi ji doživljanje bolezni oz. simptomi.
Diskusija in zaključek: Bolniki so zadovoljni z aktivnostmi koordinatorja odpusta v postopku odpusta iz bolnišnice, kar ugotavljajo tudi drugi avtorji. Raziskava pokaže na smiselnost uvedbe profila koordinatorja odpusta v obravnavo bolnikov s kronično obstruktivno pljučno boleznijo. Spremljanje zadovoljstva bolnikov je smiselno, saj pokaže priložnosti za izboljšave dela z vidika bolnika.
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Langer A, Meleis A, Knaul FM, Atun R, Aran M, Arreola-Ornelas H, Bhutta ZA, Binagwaho A, Bonita R, Caglia JM, Claeson M, Davies J, Donnay FA, Gausman JM, Glickman C, Kearns AD, Kendall T, Lozano R, Seboni N, Sen G, Sindhu S, Temin M, Frenk J. Women and Health: the key for sustainable development. Lancet 2015; 386:1165-210. [PMID: 26051370 DOI: 10.1016/s0140-6736(15)60497-4] [Citation(s) in RCA: 227] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ana Langer
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA.
| | - Afaf Meleis
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Felicia M Knaul
- Harvard Global Equity Initiative, Harvard Medical School, Boston, MA, USA
| | - Rifat Atun
- Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | | | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
| | | | - Ruth Bonita
- University of Auckland, Auckland, New Zealand
| | - Jacquelyn M Caglia
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | | | | | - Jewel M Gausman
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | | | - Annie D Kearns
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Tamil Kendall
- Women and Health Initiative, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Rafael Lozano
- National Institute of Public Health, Cuernavaca, Mexico
| | - Naomi Seboni
- International Planned Parenthood Federation Governing Council, London, UK
| | - Gita Sen
- Indian Institute of Management, Bangalore, India
| | | | - Miriam Temin
- Center for Global Development, Washington, DC, USA
| | - Julio Frenk
- Harvard T H Chan School of Public Health, Boston, MA, USA
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Ogah OS, Sliwa K, Akinyemi JO, Falase AO, Stewart S. Hypertensive heart failure in Nigerian Africans: insights from the Abeokuta Heart Failure Registry. J Clin Hypertens (Greenwich) 2015; 17:263-72. [PMID: 25688932 PMCID: PMC8031496 DOI: 10.1111/jch.12496] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 11/11/2014] [Accepted: 11/13/2014] [Indexed: 11/30/2022]
Abstract
Data from the Abeokuta Heart Failure Registry were used to determine the clinical characteristics, mode of treatment, and short- and medium-term outcomes of patients with hypertensive heart failure. A total of 320 patients were consecutively studied, comprising 184 men (57.5%) and 136 women (42.5%) aged 58.4±12.4 and 60.6±14.5 years, respectively. Most patients (80%) presented with New York Heart Association functional class III or IV and around one third (35%) had preserved systolic function. Median hospital stay was 9 days (interquartile range 5-21) while intra-hospital mortality was 3.4%. The 30-day, 90-day, and 180-day mortality rates were 0.9% (95% confidence interval, -0.2 to 3.5), 3.5% (95% confidence interval, -1.7 to 7.3), and 11.7% (95% confidence interval, -7.8 to 17.5), respectively. In a multiple logistic regression analysis, only serum creatinine was an independent predictor of mortality at 180 days (adjusted odds ratio, 1.76; 95% confidence interval, -1.17 to 2.64). Hypertension is the most common etiological risk factor for heart failure in Nigeria. Most patients present in the fourth decade of life with severe heart failure and secondary valvular dysfunction and significant in-hospital mortality.
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Affiliation(s)
- Okechukwu S. Ogah
- Division of CardiologyDepartment of MedicineUniversity College HospitalIbadanNigeria
- Soweto Cardiovascular Research UnitFaculty of Health SciencesUniversity of the WitwatersrandParktownJohannesburgSouth Africa
| | - Karen Sliwa
- Soweto Cardiovascular Research UnitFaculty of Health SciencesUniversity of the WitwatersrandParktownJohannesburgSouth Africa
- Department of MedicineFaculty of Health SciencesHatter Institute for Cardiovascular Research in Africa & IIDMMUniversity of Cape TownCape TownSouth Africa
| | - Joshua O. Akinyemi
- Department of Epidemiology and Medical StatisticsCollege of MedicineUniversity of IbadanIbadanNigeria
| | - Ayodele O. Falase
- Division of CardiologyDepartment of MedicineUniversity College HospitalIbadanNigeria
| | - Simon Stewart
- Mary MacKillop Institute for Health Research/NHMRC CRE to Reduce Inequality in Heart DiseaseAustralian Catholic UniversityMelbourneVictoriaAustralia
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Anuruang S, Hickman LD, Jackson D, Dharmendra T, Van Balen J, Davidson PM. Community-based interventions to promote management for older people: an integrative review. J Clin Nurs 2013; 23:2110-20. [PMID: 24354884 DOI: 10.1111/jocn.12445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review community programmes promoting self-care or self-management for older people with chronic disease in Thailand. BACKGROUND Identifying successful elements of culturally appropriate and effective community-based interventions to promote self-care with chronic illness is increasingly important. DESIGN Integrative review. DATA SOURCES CINAHL, Medline, Health Source Nursing Academic databases. METHODS Integrative review of peer-reviewed articles written between 1946-2012. Articles were included if they described self-care, self-management, chronic disease and community care interventions targeting older people in Thailand. RESULTS Of the 58 articles retrieved, only 13 articles met the eligibility criteria. Elements of effective interventions included: (1) providing culturally sensitive information, (2) including approaches of shared decision-making and mutual goal setting and (3) flexibility within the intervention to adapt to participant needs. CONCLUSIONS Shared decision-making and mutual goal setting between interventionists and patients improved health behaviours and outcomes. Moreover, the flexibility to adopt the intervention to local characteristics demonstrated positive results. RELEVANCE TO CLINICAL PRACTICE Promoting effective self-care and self-management behaviours is critical to improving outcomes for chronic conditions. The tailoring and targeting of interventions appropriate to individuals and communities are likely to be most effective in leveraging behaviour change. This review has identified that mutual goal setting improved health behaviours. The flexibility to adopt self-care interventions to community-based settings showed improved patient outcomes.
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Mannava P, Abdullah A, James C, Dodd R, Annear PL. Health systems and noncommunicable diseases in the Asia-Pacific region: a review of the published literature. Asia Pac J Public Health 2013; 27:NP1-19. [PMID: 24097936 DOI: 10.1177/1010539513500336] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Addressing the growing burden of noncommunicable diseases (NCDs) in countries of the Asia-Pacific region requires well-functioning health systems. In low- and middle-income countries (LMICs), however, health systems are generally characterized by inadequate financial and human resources, unsuitable service delivery models, and weak information systems. The aims of this review were to identify (a) health systems interventions being implemented to deliver NCD programs and services and their outcomes and (b) the health systems bottlenecks impeding access to or delivery of these programs and services in LMICs of the Asia-Pacific region. A search of 4 databases for literature published between 1990 and 2010 retrieved 36 relevant studies. For each study, information on basic characteristics, type of health systems bottleneck/intervention, and outcome was extracted, and methodological quality appraised. Health systems interventions and bottlenecks were classified as per the World Health Organization health systems building blocks framework. The review identified interventions and bottlenecks in the building blocks of service delivery, health workforce, financing, health information systems, and medical products, vaccines, and technologies. Studies, however, were heterogeneous in methodologies used, and the overall quality was generally low. There are several gaps in the evidence base around NCDs in the Asia-Pacific region that require further investigation.
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Affiliation(s)
| | - Asnawi Abdullah
- University of Melbourne, Melbourne, Australia University Muhammadiyah Aceh, Indonesia
| | - Chris James
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Rebecca Dodd
- World Health Organization Western Pacific Regional Office, Manila, Philippines
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Lim SF, Childs C. A systematic review of the effectiveness of bowel management strategies for constipation in adults with stroke. Int J Nurs Stud 2012; 50:1004-10. [PMID: 23279967 DOI: 10.1016/j.ijnurstu.2012.12.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 12/03/2012] [Accepted: 12/03/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Constipation is one of the most common medical complications of acute stroke. Currently, management strategies to guide clinical practice are limited. This review aimed to examine the effectiveness of bowel management strategies for constipation in adults with stroke. DESIGN A systematic review of randomised controlled trials or other quantitative research designs in the absence of randomised controlled trials was undertaken. DATA SOURCES A comprehensive search of major electronic databases and all reference lists of relevant articles in the English language were performed from January 1990 up to March 2011. REVIEW METHODS Data were extracted and assessed by two independent reviewers. Due to differences in the study designs, the findings are presented in narrative form. RESULTS There were a total of three studies (two randomised controlled trials and one quasi-experimental study). One of the randomised controlled trials examined a single (once-only) structured nurse-led intervention and the other randomised controlled trial evaluated four bowel management programmes. Both studies yield improvements respectively in symptoms of bowel dysfunction and bowel training efficiency when the programme corresponded with the subjects' bowel patterns before the stroke onset. The quasi-experimental study compared the effectiveness of daily digital stimulation versus every other day and found higher bowel regularity with daily digital stimulation. CONCLUSION Constipation management strategies are limited. This review suggests that structured bowel programmes and nurse-led intervention in bowel care have a significant effect in improving bowel evacuations.
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Affiliation(s)
- Su Fee Lim
- Rehabilitation Medicine, Block 6, Level 9, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
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Abstract
Data from different national and regional surveys show that hypertension is common in developing countries, particularly in urban areas, and that rates of awareness, treatment, and control are low. Several hypertension risk factors seem to be more common in developing countries than in developed regions. Findings from serial surveys show an increasing prevalence of hypertension in developing countries, possibly caused by urbanisation, ageing of population, changes to dietary habits, and social stress. High illiteracy rates, poor access to health facilities, bad dietary habits, poverty, and high costs of drugs contribute to poor blood pressure control. The health system in many developing countries is inadequate because of low funds, poor infrastructure, and inexperience. Priority is given to acute disorders, child and maternal health care, and control of communicable diseases. Governments, together with medical societies and non-governmental organisations, should support and promote preventive programmes aiming to increase public awareness, educate physicians, and reduce salt intake. Regulations for the food industry and the production and availability of generic drugs should be reinforced.
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Kaufman ND, Rajataramya B, Tanomsingh S, Ronis DL, Potempa K. Nurse preparedness for the non-communicable disease escalation in Thailand: a cross-sectional survey of nurses. Nurs Health Sci 2012; 14:32-7. [PMID: 22304737 DOI: 10.1111/j.1442-2018.2011.00657.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chronic diseases are now the largest cause of mortality in Thailand, and form an increasingly large portion of the healthcare landscape. In the Thai health system, many patients with chronic conditions receive care and disease management services from nurses, yet specialized training in chronic diseases is not currently part of standard nursing degree programs. Given the evolving epidemiology of the Thailand population, we questioned whether practicing nurses remain confident in their knowledge and skills in chronic disease management. We conducted a cross-sectional, self-efficacy survey of nurses in eight randomly-selected provinces in Thailand, receiving 468 responses. Nurse self-efficacy was analyzed in prominent chronic disease types, including cancer, hypertension, diabetes, heart disease, cerebrovascular diseases, and pulmonary diseases. Factors, such as geographic location, education level, continuing education experience, and hospital size, were found to significantly affect nurse self-efficacy levels; nurses highly prioritized additional training in heart diseases and cerebrovascular diseases, followed by hypertension, cancer, and diabetes.
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Affiliation(s)
- Nicholas D Kaufman
- Research Division, Praboromarajchanok Institute, Ministry of Public Health of Thailand, Nonthaburi, Thailand.
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Davidson PM, De Geest S, Hill MN. Nurses addressing the challenges of chronic illness: From primary to palliative care. Collegian 2010; 17:43-5. [DOI: 10.1016/j.colegn.2010.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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