• Title/Summary/Keyword: 가정간호사정

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HOME NURSING CARE NEEDS IN RURAL KOREA (한국 농촌 지역의 가정간호 요구에 관한 연구)

  • KIM, SUNG SILL
    • Journal of Korean Academy of Nursing
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    • v.18 no.1
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    • pp.44-69
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    • 1988
  • 보건의료기술이 고도로 발달되었다 하더라도 의료의 혜택이 필요할 때 누구에게나 언제든지 제공될 수 없는한 전체 국민의 건강요구를 포괄적으로 충족시킬 수 있는 제도나 방법이 필요하게 된다. 본 연구는 사회 집단의 최소 단위인 가정을 중심으로 수행되고 있는 지역사회 가정간호의 합리적 수행에 필요한 기초자료를 얻기 위하여 가정간호 요구의 사정 및 가정간호 수행에 관하여 연구하였다. 가정 간호(Home Nursing Care, Home Health Care)는 추후관리를 받아야 할 대상자, 고령자, 만성질환자에게 규격화되어 있는 병원간호를 가정이라는 친숙한 분위기에서 개별적으로 제공되는 가정 중심의 심리적 안정은 물론 시간과 경비를 절감하는 효과적 간호수단이다. 본 연구의 목적은 첫째 우리나라 농촌가정의 가정간호의 요구는 무엇이며 그 요구의 원인은 무엇인가\ulcorner 둘째, 농촌가정에서 가지고 있는 상병에는 어떠한 것이 있으며 행하여 지고 있는 가정간호의 내용에는 어떤 것들이 있는가\ulcorner 셋째, 가정간호 수행자는 누구이며 이에 대한 수혜자의 만족도는 어느 정도인가\ulcorner 본 연구의 방법은 1985년 6월 18일 부터 8월 7일 까지 C군에 거주하는 주민중 11개소 보건진료소가 소재한 반의 주민 전체 1,027명 중 상병자 159명과 30세 이상의 인구 440명, 가구주 239명을 대상으로 가정방문을 통한 면접으로 질문지를 기록케 하여 자료를 수집하였다. 연구의 도구는 첫째 간호요구의 측정을 위한 도구로 Virginia Henderson의 기본간호활동 14가지를 기초로 지역주민 50명과 현직 간호원 50명에게 개방질문으로 얻은 내용을 중심으로 제작하였으며 둘째, 가정간호수행에 대한 도구로 Orem의 간호이론 중 간호방법 5가지를 근거로 개발하였다. 본 연구의 내용은 보건진료원에 의하여 사정된 간호요구와 그 원인들을 인간의 기본요구 영역별로 분류하여 가정간호진단을 위한 지역사회 가정간호사정 및 진단도구로 쓸 수 있도록 개발하였으며, 상병자에 대한 가정간호 수행은 수행빈도와 수행내용에 따른 수행자와 수행 만족도를 측정하였다. 1. 가정간호요구에 대하여 1) 가정간호요구 측정은 신체영역 중 몸을 청결히 하고 몸차림을 단정히 하여 피부를 보호하기 내용에서 더위나 추위에 대하여 옷을 맞추어 조절하기의 요구, 적절한 식사와 수분섭취하기 내용에서 배변의 요구, 또한 몸을 움직이고 바람직한 체위를 유지하기 내용에서 한가지 자세를 계속하기의 요구가 높았고 정상호흡하기 내용에는 일상활동시 호흡에 대한 요구가 높은 편이었다. 사회, 심리, 영적 간호요구 영역에서는 자신이 신앙에 따라 예배하기 내용에서 신앙으로 어려움을 극복하려는 요구가 높았으며 여러가지 오락의 형태를 취하여 이에 참여하기 내용에서는 취미생활의 요구가 높았다. 2) 가정간호요구는 연령이 높을수록 높았고 성별로는 여자의 가정간호요구가 남자보다 높았으나 내용별 요구의 차이는 없었다. 2. 가정간호수행에 대하여 1) 가정에서 수행되는 가정간호내용으로는 직접간호가 가장 많이 수행되었으며 내용으로는 구강청결, 옷 갈아 입기, 투약, 음식투여, 대ㆍ소변보기의 빈도가 많았다. 건강한 환경제공의 간호수행내용에서는 적당한 실내온도 유지하기의 빈도가 많았으며 안내와 지도내용에서는 투약요령 알기의 빈도가 많았으며, 보호와 지지내용과 교육의 간호수행내용에서는 현 상태 인정하기와 투약 방법에 대한 교육하기의 간호수행빈도가 가장 많았다. 2) 간호수행자에 있어서 직접간호 수행은 본인 스스로 하는 빈도가 가장 많았으며 안내와 지도 및 교육의 간호수행은 전문가가 많았고 보호와 지지간호는 가족이 많았고 건강한 환경제공간호는 배우자에서 더 많았다. 3) 간호수행자에 대한 만족도는 직접간호 방법에서는 가족이, 안내와 지도는 배우자가, 보호지지, 건강한 환경제공 및 교육에서는 전문가에 의한 간호수행 만족도가 높았다. 4) 상병상태에 따른 주 증상은 관절통 요통이 가장 많았고 상병자는 남자가 많았고 주 중상에 대한 성별간의 큰 차이는 없었다. 이상 가정간호요구와 정도 및 가정간호 수행의 내용을 기반으로 가정간호사업의 시행이 시급하다는 결론을 내릴 수 있었으며 가정간호사업의 시행을 위한 제도적 보완개선책이 요구된다고 결론을 지을 수 있다.

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The Development of a Homecare Nursing Assessment Tool for Terminal Cancer Patients (말기암환자의 가정간호 사정도구 개발)

  • Kim, Hae-Young;Chung, Hyun-Suk;Jeon, Byoung-Hak;Cho, Young-Yi
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.18 no.2
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    • pp.108-117
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    • 2011
  • Purpose: The purpose of this study is to develop a homecare nursing assessment tool for terminal cancer patients, testing the validity and reliability of the tool. Methods: This was a methodological study. The tool was developed in four stages: first, preliminary items were developed based on Gordon' functional health pattern model; second, a panel of specialists reduced the number of preliminary items using validity tests for content; third, final items were selected from the results of a pre-test. Finally, from August 4th, 2011 to August 26th, 2011, reliability and validity were tested using a sample of 125 terminal cancer patients in Seoul and Gyeonggi-do. Results: The final tool consisted of 39 items, with Cronbach's ${\alpha}$ 0.70. Using factor analysis, 10 factors were extracted; the correlation coefficient of these was over 0.3. Conclusion: The tool developed in this study was identified as having a high degree of reliability and validity. Given this, the tool can be effectively utilized for implementing and improving home care for patients with terminal cancer.

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Understanding the Current Trend of Home Care Assessment in the Post-COVID-19 Era by Comparing Outcome and Assessment Information Set (OASIS)-D and E (미국 환자사정도구(OASIS) 개정 사례를 통한 포스트코로나 시대의 가정간호 환자사정 동향 파악)

  • Hwang, Jinkyoung;Lee, Hana;Kim, Aeri;Woo, Kyungmi
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.30 no.1
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    • pp.105-114
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    • 2023
  • Purpose: This study aimed to comprehensively analyze the recent revision of the Outcome and Assessment Information Set (OASIS)-D to version E in the United States to identify the most recent trends in home health care and provide suggestions for implementing home health care in Korea. Methods: This study is a comprehensive literature review. We compared all items in OASIS-D and OASIS-E and identified the most significant changes. Additionally, we have discussed the context in depth. Results: The addition of items related to health literacy and medication reconciliation, strengthening assessment in the cognitive and mood domains, and improving items related to pain assessment were identified. These major revisions resulted from a greater emphasis in the healthcare field on social determinants of health. Additionally, the COVID-19 outbreak highlighted the importance of monitoring and managing the symptoms of home care patients in the community. Conclusion: The key items of the OASIS amendment and their background analysis proposed in this study could serve as a cornerstone for the revision of home health care assessment tools or the development of systematic common assessment tools in Korea.

Identifying Minimum Datasets for Pressure Ulcer Assessment and Analysis of Nursing Records in Home Nursing (가정간호의 욕창 의사결정지원 서비스를 위한 욕창 사정 MDS 규명 및 간호 기록 분석)

  • Kim, Hyun-Young;Park, Hyeon-Ae
    • Research in Community and Public Health Nursing
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    • v.20 no.1
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    • pp.105-111
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    • 2009
  • Purpose: The purpose of this study was to identify minimum datasets for ulcer assessment and to map the minimum datasets to paper-based nursing records for pressure ulcer care in homecare setting. Methods: To identify minimum datasets for pressure ulcer assessment, the authors reviewed four guidelines for pressure ulcer care. The content validity of the minimum datasets was assessed by three homecare nurse specialists. To map the minimum datasets to nursing records, the authors examined 107 pressure ulcer events derived from 45 pressure ulcer patients who received home nursing from two hospitals in Gyeonggi Province. Results: The minimum datasets for initial assessment were anatomical location, stage, size, tissue, exudate, condition of periwound skin, undermining, odor, and pain. 'Location' was recorded best, accounting for a complete recording rate of 98.1%. 'Exudate' and 'pain' showed the poorest record, accounting for 2.8% and 0%, respectively. The minimum datasets for progress assessment were wound size, tissue, and exudate, each accounted for 31.8%, 2.8%, and 4.7%, respectively. Conclusion: This study concluded that data on pressure ulcer assessment was not sufficient homecare and it can be improved by adopting minimum datasets as identified in this study.

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Development of a Home Care Need Assessment Tool - Focused on Home Care Nursing Diagnoses based on Self Care - (우리 나라 가정.방문간호 사업을 위한 가정간호요구 사정도구 개발 - 자가간호개념에 근거한 가정간호진단을 중심으로 -)

  • So, Ae-Young;Cho, Byong-Hee
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.433-443
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    • 2002
  • Objectives; The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool. Method 1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000: specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group. Results Home Care Need Assessment Tool consists of three parts; -Part I : factors related to basic conditions -Part II : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part III : summative nursing diagnoses and nursing need intensity for the clients. Conclusion This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.

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Development of Nursing Process Information System for the Home Health Care (가정간호를 위한 간호과정 정보시스템 개발)

  • Cho, Hyun;Kang, In-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.5
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    • pp.1126-1132
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    • 2009
  • We carried out this study to reduce the gaps between medical institutes and between medical personnels and help to improve medical service quality, by classifying diagnoses and related intervention through the development of standard nursing intervention and by computerizing protocols. We considered two processes: one is the development process of home nursing standard intervention, and the other is the process of computerizing its related protocols. For the former, research covered analysis of home health care practices, development of client assessment protocol, of patients diagnosis protocols, and of patients intervention protocol. For the latter, strategies for home health care information systems should be set up and it constituted four research contents of analysis, design, management and evaluation of the systems. We also trained and educated home nurses who work at home health service center, by making them use the manual of home health care information systems at a certain city of P. In this study, therefore, we developed elements of standard home health care mediation so that they could be included in the forms of home health information note, home health progress note, and home health progress summary, home health discharge summary. Because standard home health care intervention has been developed, it became easier to exchange information between different home heath service center offices, can prevent from missing or redundant information, and contribute to standardization of hospital terminologies when EMR and HMR are developed.

Analysis on Nursing Diagnosis Classifications and Assessment Tools in Home Care (가정간호분야 간호진단 분류체계 및 사정도구 분석)

  • So, Ae-Young
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.3-21
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    • 2001
  • Nursing diagnosis classification is needed to define nursing phenomena and set up nursing plans. The purpose of this study is to develope common nursing diagnosis by comparing and analysing nursing diagnosis classification systems and assessment tools in home care. The target home care nursing diagnosis classifications and tools are HHCC. NANDA. OMAHA. MDS_HC 2.0. OASIS-Bl. Results of this study are as follows: - The number of components of nursing diagnosis classifications and tools is HHCC 4. NANDA 9. OMAHA 4. MDS_HC2.0 6. OASIS-B1 10. - The number of common nursing diagnosis in home care is summed up 51 which are physical heal th 17. social health 5. psychological health 11. health related behavior 13. environment 3.

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The Comparison of Health Status, Functional Status, and Home Environment Hazards in Terms of the Fear of Falling in Community-dwelling Older Adult (재가 노인의 낙상공포 여부에 따른 건강상태, 신체기능상태 및 가정환경 위험 비교)

  • Lim, Kyung-Choon;June, Kyung Ja;Yoon, Jong-Lull
    • 한국노년학
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    • v.29 no.4
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    • pp.1577-1589
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    • 2009
  • The purpose of this study was to compare the health status, functional status, and home environment hazards by the fear of falling and explore the factors that contribute to the fear of falling. This was a descriptive study. Data were collected for two years with 973 older adults who enrolled in a health center at A city. Trained nurses visited subjects' home and collected data using Resident Assessment Instrument MDS-HC. The average age of the subjects was 76.8 (±7.6) and female was 74.8%. 20.7% of subjects reported fear of falling. In terms of the fear of falling, two groups were compared. There were significant differences in vision, urinary incontinence, pain that interrupts daily activity, unstable gait, comorbidities, frequency of depressive or anxious sign. The greater the age, IADL and ADL dependency, comorbidities, unstabled gait, the more fear of falling. In conclusion, this study reassured the importance of assessing the major factors related to fear of falling such as age, IADL and ADL, comorbities, gait among older adults. This study will contribute to establish strategies for preventing fall. Reducing the fear of falling through the comprehensive nursing intervention will ultimately improve the quality of life in the elderly.

A Comparative Study on the Care Services According to Care Levels in the Korean and German Home Care System (한국과 독일 방문요양의 등급별 급여 비교 연구)

  • Park, Jong Duk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.2
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    • pp.243-252
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    • 2016
  • Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

Educational needs for the development of a simulation module of home visiting care for the frail elderly (시뮬레이션 기반 허약노인 방문간호 교육 요구도)

  • Ahn, Junhee;Yang, Youngran
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.1
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    • pp.68-79
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    • 2021
  • Purpose: This study aimed to identify the educational needs of nurses and nursing students for the development of a simulation module of home visiting care for frail, elderly people. Methods: Focus group interviews were conducted with 15 home visiting nurses working in public health centers and 14 nursing students who experienced home visiting from September 10 to October 10, 2018. Results: Bloom's taxonomy of learning objectives, namely, cognitive, affective, and psychomotor domains was used as a framework for data analysis. The defined educational needs for each domain were as follows: "understanding frail, elderly people" for the cognitive domain; "intervention for mental health" and "building a therapeutic relationship" for the affective domain; and "nursing skills", "health education for healthy lifestyles", "referral to the community resource connection", "protection for visiting nurses" for the psychomotor domain. Conclusion: Based on the findings of this study, a simulation module of home visiting care for frail, elderly people can be developed and used for nursing students and nurses to strengthen the capacity for home visiting care.