• 제목/요약/키워드: 가정간호 효과

검색결과 118건 처리시간 0.025초

조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구 (A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis)

  • 박경숙;정연강
    • 대한간호학회지
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    • 제24권4호
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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청소년의 성교육을 위한 가정통신문 성교육 방법과 성교육 프로그램 적용 방법의 효과 비교 (The Study of the Effectiveness of Sex Educational Programs in the Middle School Students)

  • 임지현;이향련
    • 동서간호학연구지
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    • 제13권2호
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    • pp.118-129
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    • 2007
  • Purpose: The purpose of this study was to examine how effective the existing sex education programs and letter to parents from school were for their know ledge and attitudes towards sex of the middle school students. Methods: Subjects were selected from first grade students in a middle school from May 30 through July 19, 2005. The subjects were divided into three groups of 70 students each, two experiment groups and one control group. The study was conducted by nonequivalent control group non-synchronized design. The information letter from school to parents was made into four editions on double-sided A4 size paper and was handed out to students during weekly meeting. Both the students and their parents were required to read it and the parents were told to sign the papers. The sex education program applied in this study was recomposed based on the programs which were previously made by Sun Hee Park(2004) and Eun Ja Jung(2000). Content provided in the sex education program is identical to the one's in the information letter to parents. Experimental group 1 was required to read the four information letters to parents for two weeks, together with their parents. Group 2 experienced the sex education program four times in two weeks of time. The above two experimental groups and the control group were assessed on their knowledge and attitude towards sex twice, before and after the experiment. Results: There were significant differences in sexual knowledge about sex between the three subject groups and such data supports the first hypothesis. There was significant difference in attitude towards sex between the three subject groups and such data support the second hypothesis. Conclusion: According to the experiment results, both the information letter to parents and programs about sex education were effective for the middle school students. Yet, teaching students with the program format was more successful than handout formats. However, using information letters to parents to educate students does not waste any school hours, so if school nurses can provide the students more papers, the educational effect will be greater.

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만성폐쇄성폐질환자의 가정호흡재활 프로그램 효과에 대한 체계적 고찰: 무작위시험설계 (A Systematic Review of Home based Pulmonary Rehabilitation in COPD Patients: Randomized Controlled Trials)

  • 안민희;최자윤;김윤희
    • 재활간호학회지
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    • 제19권2호
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    • pp.82-99
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    • 2016
  • Purpose: The purpose of this study was to review systematically the effects of home based pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) patients using qualitative synthesis. Methods: Studies designed randomized controlled trials were identified to extract data and to assess the quality of studies in 8 domestic and 3 foreign search engines, and hand search reference reviews. Results: A total of 9 studies met the inclusion criteria. Overall, the methodological quality of the studies ranged from average to poor. Home based pulmonary rehabilitation consisted of exercise, education, and psychosocial interventions. Several exercises such as aerobic, strength, respiratory muscle training, and flexibility were used in home based pulmonary rehabilitation for COPD patients. Upper muscle exercise and walking were the most frequently used exercises. The most common topics for education were 'knowledge of the illness' and 'drug management'. Walking distance test (WDT) and quality of life (QoL) were the most frequently measured as the dependent variables to evaluate rehabilitation outcomes, followed by pulmonary function test (PFT) and dyspnea. WDT was the most effective outcome, followed by dyspnea, QoL and PFT. Conclusion: This study informed about the details of scientific and effective home based rehabilitation programs in COPD patients for future researchers and clinicians. These findings can help expand the recognition and accessibility of home based rehabilitation in COPD patients.

중년층을 위한 웹기반 노년기 준비프로그램의 학습효과 (The effects of a web-based senescence preparation program for a middle-aged group)

  • 정영미
    • 한국노년학
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    • 제29권3호
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    • pp.1025-1041
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    • 2009
  • 본 연구는 중년층에게 시공간 제약 없이 가정에서도 노년기 준비교육을 받을 수 있도록 개발된 웹기반 노년기 준비프로그램에 대한 학습효과를 평가함으로써 예비 노년층을 위한 노년기 준비교육의 효율적인 학습전략을 위한 기초자료를 제시하고자 시도하였다. 연구대상자는 대구지역에 거주하는 만 40-59세의 중년층(실험군 36명, 대조군 34명) 70명이었으며, 자료수집기간은 2008년 3월부터 11월까지로 연구변수는 노인에 대한 지식과 태도, 노년기 생활설계를 조사하였다. 자료분석은 서술통계, χ2-test, t-test, repeated measure ANOVA 분석을 이용하였으며, 일반적 특성, 연구변수에 대한 동질성 검정과 학습효과를 파악하였다. 본 연구결과, 실험군과 대조군간 측정시기에 따른 노인에 대한 지식과 태도, 노년기 생활설계에서 측정시기별, 그룹 간과 그룹 내에서 통계적으로 유의한 변화를 나타냈다. 결론적으로 본 프로그램은 중년층으로 하여금 자신의 노년기를 예측하고 준비하여 노후설계를 할 수 있도록 지지하였으며, 원하면 언제든지 노년기 준비교육이 가능하도록 유도하였다.

저체중출생아 어머니와 정상신생아 어머니의 정서와 지지 비교 및 보건소 저체중출생아 가정방문간호의 효과에 대한 연구 (Study on the Comparison of Emotion between the Mothers with Low-birth Weights and Normal Infants and the Effect of Home Visiting for the Low-birth Weights)

  • 방경숙;김용순;박지원
    • 부모자녀건강학회지
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    • 제5권1호
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    • pp.75-89
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    • 2002
  • This study was conducted to compare the emotional state between the mothers with low-birth-weights and mothers with normal infants, and to analyze the effects of home visiting for the low-birth-weights in one city. Data were collected from 51 mothers with low-birth-weights and 90 mothers with normal infants to compare emotional state, and from 26 mothers with low-birth weights to evaluate the effect of home visiting care. Summaries of results were as follows; 1. In mothers with low-birth-weights, social support form others was significantly lower than those of mothers with normal infants. Although the differences were not significant, mothers with low-birth-weights have more stress and child rearing burden, and less maternal self-esteem than those of mothers with normal infants. 2. Mothers with low-birth-weights, the more burden, postpartum depression, and the less husbands' support they felt. When they had lower maternal self-esteem and lower husbands' support, child rearing burden was higher. Also there was significant negative correlation between maternal self-esteem and postpartum depression. 3. In mothers with low-birth-weights, the score of post-intervention stress, care-giving burden, and postpartum depression were somewhat decreased, and maternal self-esteem was increased than pre-intervention data, although they were not statistically significant. 4. Mothers' satisfaction on the home-visiting care was considered to be high. In summary, mothers with low-birth-weights had lower social support even though they experienced more stress than mothers with normal infants. Therefore, public health nurse in community should pay more attention to them.

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슬관절 전치환술 환자의 조기퇴원 후 가정간호 운동 프로그램이 슬관절기능 상태와 삶의 질에 미치는 효과 (The Effects of Home Care Exercise Program on Knee Joint Function and Quality of Life in Patients with Total Knee Replacement Arthroplasty)

  • 이미경;이인희;주정혜;황문숙;서재곤;성영희
    • 근관절건강학회지
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    • 제12권2호
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    • pp.143-154
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    • 2005
  • Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

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초등학교 아동의 안전교육이 안전생활 실천에 미치는 효과 (Effects of School Safety Education on Safety Behavior among Elementary School Students)

  • 이재남;정명애;박지원
    • Child Health Nursing Research
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    • 제12권4호
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    • pp.506-513
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of school safety education for children to increase their safety behavior. Method: The participants were 262 fourth graders enrolled in S elementary school located in Anyang city. The participants were randomly assigned to three groups. For the first experimental group, school safety education was provided for both children and parents. For the second experimental group, safety education was provided only for the children. For the control group, no treatment was given. Result: The first experimental group showed the highest increment on the classroom safety activities score. The first experimental group also had the highest increment on the outside-the-classroom safety activities score. Further, the first experimental group showed the highest increment on the traffic safety activities score. Conclusion: Safety education in the elementary school is very effective to ensure children are protected from school and traffic accidents. Also safety education can be more effective if safety related parent education programs are provided to parents. Therefore safety education should be provided systematically for both children and their parents to prevent childhood accidents.

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자폐아동을 위한 어머니 훈련 프로그램이 가정에서의 사회적 상호작용에 미치는 효과 (Intervention Efficacy of Mother Training on Social Reciprocity for Children with Autism)

  • 원대영
    • Child Health Nursing Research
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    • 제11권4호
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    • pp.444-455
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    • 2005
  • Purpose: This study examined the efficacy of parent training interventions to facilitate social reciprocity and language development in children with autism. Methods: The social interaction behaviors of mothers and children over time were compared using single subject design experimentation methodology. five children who were diagnosed with autism and their mothers participated in the study. The participants were recruited from U city, Korea. The mothers were trained using training videotapes and demonstrations on how to facilitate social interaction with their children as well as promoting language development. following the training, data were collected three times per week by video taping mother-child interaction in their homes. Results: Four of the five mothers demonstrated increases in the use of imitation with animation and expectant waiting after the intervention compared to the baseline sessions; the children demonstrated noticeable increases in the use of initiation of interaction, vocalizations, and verbal production after their mothers received the training intervention. Conclusion : Results of this study demonstrate the efficacy of mother training to improve social interactions of children with autism. Additional important information can be gained by replicating this study with more participants and comparing intervention and control groups. Clearly, this intervention shows promise and has implications far clinical practice.

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발반사 마사지가 유방암 환자의 수술 후 통증과 수면만족도에 미치는 효과 (The Effects of Foot Reflex Zone Massage on Patients Pain and Sleep Satisfaction Following Mastectomy)

  • 박지원;유혜라;이홍숙
    • 가정∙방문간호학회지
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    • 제13권1호
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    • pp.54-60
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    • 2006
  • This study, a quasi-experimental study using a nonequivalent control group pretest-posttest design. conducted a survey on 30 patients test group and control group of IS patients sampling an adjacent population at random - who are operated on the breast cancer and are in the A University Hospital located in Suwon, to examine into the effects of foot reflex zone massage on their pain and sleep satisfaction through the nursing interventions. It gave them a foot reflex zone massage for the total 30 minutes-basic massage 10 minutes and reflex massage 20 minutes required to alleviate their pain day in day out covering a two-month period from the first of July to the first of September 2004. for the purpose of collecting data. It launched into a two-round foot reflex zone massage at 6 and 24 hours since mastectomy through a direct visit at the hospital room to measure pain intensity, physiological index(pulse and blood pressure) and sleep satisfaction of them. The results are as follows. First, it showed that there is all the difference between pain intensity of test group and that of control group. In result, the first hypothesis, pain of test group. which measure at 6(p=.000) and 24 hours(p=.001) since mastectomies, will be bigger than that of control group, was established. Second, it showed that there is all the difference between physiological index of test group and that of control group. In result. the second hypothesis, pulse(p= .025, p= .002), systolic blood pressure(p= .004, p=.012) and diastolic blood pressure(p=.004. p= .003) of test group, which investigate at 6 and 24 hours since mastectomies, will be bigger than that of control group, was established. Third, it showed that there is a significant difference between sleep satisfaction of test group and that of control group(p=.000). In result, the fourth hypothesis, sleep satisfaction of test group. which examine in the morning after mastectomies, will be bigger than that of control group, was established. In the result. a foot reflex zone massage is seen to be effective in the pain reduction and sleep promotion of patients who are operated on breast cancer, and in providing them with more qualitative care by improving confidence between them and nurses through a physical touch. Also, it can be applied to a clinical examination through an independent nursing intervention.

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맞춤형 방문건강관리사업 상담매뉴얼 개발과 효과 (Development and Effectiveness of Counseling Manual for Community-based Visiting Nursing)

  • 최경원;임지영;김은주
    • 한국콘텐츠학회논문지
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    • 제12권9호
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    • pp.226-233
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    • 2012
  • 맞춤형 방문건강관리사업 담당인력의 실무적 역량 강화를 위하여 가정 방문 시 필수적으로 요구되는 대상자와의 치료적, 공감적 의사소통 및 상담 능력 향상을 위한 상담매뉴얼을 개발하고 이의 효과를 측정하였다. 상담매뉴얼은 1단계 상담준비, 2단계 신뢰형성, 3단계 진단발굴, 4단계 행동, 5단계 마무리 단계로 개발하였으며, 대상자의 상담요구에 따른 상담유형을 지지호소형, 문제해결요구형, 정보 및 조언요구형의 3가지로 분류하고 각각의 유형에 적합한 주요 상담 기법을 제시하였다. 주요 상담 기법은 지지호소형에서는 공감하기, 감정반응하기, 자기공개하기, 즉시 반응하기를, 문제해결요구형에서는 개방질문하기, 목표설정하기, 해결방안 모색하기, 요약하기를, 정보 및 조언요구형에서는 정보 제공하기, 제안하기, 해석하기 새로운 기술 가르치기를 중심으로 각각의 상담 예문을 제시하였다. 상담매뉴얼 교육 전, 후 맞춤형 방문건강관리사업 전담인력의 상담능력 향상 정도를 상담자 활동 자기효능감 척도(Counselor Activity Self-Efficacy Scales: CASES)를 이용하여 측정하였다. 측정 결과 조력기술 자기효능감과 회기관리 자기효능감 그리고 상담난제 자기효능감의 모든 영역에서 통계적으로 유의한 차이가 있는 것으로 분석되었고, 상담매뉴얼 교육을 받은 후에 맞춤형 방문건강관리사업 전담인력의 상담자활동 자기효능감이 증진된 것으로 나타났다.