Community health practitioner's practice guideline for a changing health care: Korean contribution.

AIMS AND OBJECTIVES: The specific aims of the study were (1) to identify community residents' health problems and community health practitioners' activities, (2) to explore community health practitioners' perception of the practice guidelines and (3) to provide recommendations for the development of a new practice guideline in the future.

BACKGROUND: Community health practitioners in Korea are recognised as a critical component of the public health workforce in rural areas. Community health practitioners are registered nurses with six months special training, who have the chief responsibility of delivering primary health care to remote or isolated communities. Although there has been numerous changes in focus of community health practitioners practice over the two decades, community health practitioners guidelines have never been updated since being first developed in 1981.

DESIGN: This investigation employed a cross-sectional survey and focus group interview.

METHODS: The samples included two different groups: 1003 community health practitioners participated in a survey and a group of 12 community health practitioners participated in a focus group interview. A measure of perception of the guideline was developed from Mansfield's work. Goolsby's criteria were revised and used to guide the focus group interview.

RESULTS: The participants recognised that the role of community health practitioners is in a process of transition and expect to use well developed guidelines that will allow an appropriate response to the needs of the community. Community health practitioners are generally supportive of practice guidelines although they report various contextual, social and resource barriers to the use of practice guidelines. Finally, the researchers have provided recommendations for the development of new community health practitioners practice guidelines.

CONCLUSION: A newly developed community health practitioners guideline should assist in articulating new roles and responsibilities in the practice of community health practitioners and establish a foundation for knowledge, skills and training necessary for them to work independently.

RELEVANCE TO CLINICAL PRACTICE: New services made available for under-recognised health problems may be a direct outcome of newly developed guidelines.