• 가정∙방문간호학회지
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• 제28권3호
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• pp.233-242
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• 2021

Purpose: This study investigated the degree of, and factors influencing the spiritual care among home healthcare nurses. Methods: The subjects were 168 advanced practice nurses working in 94 hospital-based facilities for home health care located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from January 14, 2019, to March 7, 2019, using structured questionnaires on spiritual care and related variables based on the literature. Data were analyzed by t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis (stepwise) using SPSS Version 23.0 program. Results: The results showed that the degree of spiritual care of home health care nurses was 3.44 points out of a possible 5 points. Factors affecting nurses' spiritual care were spiritual well-being(𝛽=.36, p<.001), recognition of spiritual care as the nature of nursing(𝛽=.17, p=.016) and role of nurses(𝛽=.22 p=.002), regular-based education for spiritual care(𝛽=.23, p<.001), patients' discomfort with spiritual discussion(𝛽=-.18, p=.001), and nurses' experience in home health care area(𝛽=.14, p=.010), which explained 57.2% of the observed variation in spiritual care. Conclusion: This study suggests the need to develop regular-based education programs for facilitating spiritual care and strengthening home health care nurses' spiritual well-being and their positive perceptions toward spiritual care.

• 가정∙방문간호학회지
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• 제29권3호
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• pp.251-262
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• 2022

Purpose: The purpose of this study was to identify the extent to which in-hospital-based home health nurses' perceptions and anxiety about death following terminal care, affects their attitudes toward terminal care. Methods: The subjects were 128 advanced practice nurses working in hospital-based facilities for home health care, located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from May 3, 2019, to June 3, 2019, using structured questionnaires, on terminal care and related variables based on the literature. Data were analyzed by performing the Student's t-test, one-way ANOVA, Pearson's correlation, and multivariable stepwise regression using the SPSS Version 25.0 program. Results: The scores of the attitudes toward terminal care of home health care nurses was 3.25 points out of a possible 4 points. Factors affecting nurses' attitudes toward terminal care were their concern about death(β=0.45, p<0.001), religion(β=-0.26, p=0.001) and the anxiety of others about dying(β=-0.23, p=0.003), which explained 32.0% of the observed variance concerning the factors affecting nurses' attitudes toward terminal care. Conclusion: Through this study, concern about death, anxiety about how other people process dying, and religion, were found to be associated factors. The more concerned the nurses were about death and the less their anxiety about how others process dying, the better the home health care nurses' attitude toward implementing terminal care.

• 농촌의학ㆍ지역보건
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• 제44권1호
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• pp.28-38
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• 2019

본 연구에서는 우리나라 보건소 방문건강관리사업과 노인장기요양보험의 방문간호, 의료기관의 가정간호사업 등 가정방문간호사업 현황을 살펴보고, 향후 발전과정을 모색하고자 수행되었다. 본 연구를 위하여 각 가정방문간호사업의 관련 법령, 통계자료, 지침과 안내서, 연구논문과 학술대회 자료집 등을 검색하여 관련 문헌을 고찰하였다. 연구결과 보건소 방문건강관리사업은 지역보건법에 근거하여 주로 취약계층을 대상으로 간호사에게 의해 비용부담 없이 제공되고 있으며, 2017년 12월을 기준으로 1,261,208명 등록 관리되는 것으로 나타났다. 보건소 방문건강관리사업 등록 대상자는 흡연율, 걷기 실천율, 혈압조절율, 혈당조절률 등이 향상되는 것으로 나타나, 건강행위와 질병관리 측면에서 긍정적인 효과가 있고, 비용-편익이 있다고 보고되었다. 노인장기요양보험에서의 방문간호는 노인장기요양보험법에 근거하여 간호사 또는 간호조무사에 의해 재가장기요양기관에서 방문간호를 제공하고 있으며, 시간당 정해진 수가에 따라 비용을 받고 있는데, 2017년에 전체 요양급여비의 0.2%만이 방문간호로 이용하는 것으로 나타났다. 재가장기요양보험 방문간호 이용자는 비이용자에 비해 의료비도 더 적게 쓰고, 입원일도 적다고 보고되었다. 의료기관 가정간호는 의료법에 근거하여 2명 이상의 가정간호사(가정전문간호사)를 고용한 의료기관에서 의사의 처방 하에 가정간호서비스를 제공하는데, 2017년 460명의 가정간호사가 가정간호서비스를 제공하고, 전체 의료비의 0.038%가 가정간호비용으로 지불된 것으로 나타났다. 우리나라 가정방문간호 유형은 관련법이나 인력, 사업 대상이 다르지만, 서비스 이용자의 건강관리에 효과가 있고, 비용-편익이 상당히 높은 것으로 나타났다. 우리나라 가정방문간호를 발전과 활성화를 위해 세 개 유형의 가정방문간호 서비스가 통합적으로 제공될 수 있는 방안을 모색하고, 근로 조건의 개선, 가정방문간호서비스 제공인력기준이나 방문간호수가 체계의 개선과 같은 법령의 개정 등을 고려할 필요가 있다고 본다.

• 가정∙방문간호학회지
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• 제21권2호
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• pp.147-155
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• 2014

Purpose: Clinical decision-making carried out by nurses is a complex process that influences the quality of care provided and various patient outcomes. This study examined the relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Method: The study had a non-experimental correlational design. Data were collected from 100 home health advanced practice nurses in 20 hospitals. Results: The mean critical thinking disposition score was $3.69{\pm}.39$ out of 5 and the mean score for clinical decision-making abilities was $3.48{\pm}.22$ out of 5. In this correlation analysis, a significant positive correlation (r=.58, p<.001) was found between critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses. Conclusion: In order to improve the clinical decision-making ability of home health advanced practice nurses, we need to improve their critical thinking disposition. In order to make this change, appropriate training program are needed to increase the critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.195-205
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• 2016

Purpose: The aims of this study were to describe the levels of personal coping resources, perceived organizational supports, and job stress, and to examine factors that affect job stress in hospital-based home care nurse practitioners. Methods: A cross-sectional survey was conducted. Data were collected from 170 subjects with a structured questionnaire from April to July, 2016 and analyzed using descriptive statistics, t-tests, One-way ANOVA, Pearson's correlation, and multiple regressions. Results: The means for personal coping resources, perceived organizational supports, and job stress were $3.7{\pm}0.43$, $3.4{\pm}0.55$, and $3.4{\pm}0.55$ out of 5, respectively. Personal coping resources and perceived organizational supports were significantly correlated. However, both had no associations with job stress. In the multiple regression analysis, the experiences of home care nursing and hospital location were found to be predictors of job stress. Both personal coping resources and perceived organizational supports were not statistically significant predictors of job stress. Conclusions: It is necessary to carry out organization-based educational programs and support systems aimed at enhancing personal abilities to cope with stress at work. Additionally, further studies are needed to identify other hospital-related characteristics that can lead to job stress in home care nurse practitioners.

• 대한간호학회지
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• 제33권3호
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• pp.395-404
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• 2003

Purpose: To make a contribution to raising the quality of nursing and home healthcare services through reviewing the present state of home healthcare nurse specialist training institutions and education programs and creating concrete measures to establish high-quality education courses. Method: International comparative study of accreditation criteria and curriculum in home healthcare nurse specialist program. Result: The Authorization Standards of home healthcare nurse training institutions consists of 8 items, 23 evaluation criteria and 72 evaluation indexes. Proposal to develop a specialist training program: Curriculum. Modify and complement a present homecare nurse education program. Curriculum I. Designate two forms of certification. The first certification has been granted the authority to serve as a manager and open a home healthcare agency to nurses having masters degrees and clinical experience for five years. The second certification is allowed to perform general home healthcare after having completed a short term training course. Currculum 2. To meet increasing demands, granting a certification to perform home healthcare to registered nurses having clinical experience of more than three years. Conclusion: These results can be utilized in the home healthcare educational program for raising the quality of nurses and home healthcare services.

• 가정∙방문간호학회지
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• 제27권3호
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• pp.356-371
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• 2020

Purpose: This study was conducted to assess the working conditions of home health nurses in hospital-based home health institutions nationwide. Methods: A secondary data analysis study was conducted based on the survey data on the working conditions of home health nurses, jointly conducted by the Korean Home Health Care Nurses Association and the Academic Society of Home Health Care Nurses in September 2020. Results: Of the home health nurses respondents, 82.4% worked in tertiary hospitals and general hospitals. Most of the working hours of home health nurses were 40 hours a week. Traffic accidents accounted for a significant proportion of accidents experienced by the home health nurse while performing their duties. Most of welfare and benefits systems applicable to home health institutions were in place. The time allocated to provision of home health nursing services was usually more than 30 minutes but less than 1 hour. The type of position of the individual in charge of home health care differed according to the type of medical institution. Conclusion: It is recommended that continuous investigation and analysis be conducted in order to establish a direction for improvement of home health nurses' working conditions, based on the related accumulated data.

• 가정∙방문간호학회지
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• 제29권3호
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• pp.263-277
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• 2022

Purpose: This descriptive study examined the management status of the home health care visiting vehicles and the nurse bags, by the home health care center of hospitals (at the hospital level or higher) in Korea, and identified the relevant factors. Methods: Of 120 managers or home health care nurses from medical institutions at hospital level or higher that provide home nursing, 93 individuals participated in the study in July 2021. Results: Hospitals that followed standard guidelines were more likely to perform internal disinfection of home health care visiting vehicles, and distinguished between clean and contaminated areas inside the visiting vehicles. Further, hospitals that followed standard guidelines were more likely to use more barrier surfaces to protect the surfaces of nurse bags to prevent infection. In addition, hospitals supporting the washing cost of the interior of home health care visiting vehicles were more likely to conduct the washing, and hospitals supporting nurse bags were more likely to use barrier surfaces to protect the bags' surfaces. Conclusion: This study only investigated home health care centers at hospital level or higher. Therefore, to generalize the results of the study, it is necessary to conduct a qualitative study involving additional investigation of home health care visiting vehicles and nurse bags and interviews with nurses from all domestic home health care centers.

• Tuberculosis and Respiratory Diseases
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• 제41권6호
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• pp.587-596
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• 1994

COPD의 치료에 대해 약술하였다. 예방을 위해서는 개인적으로는 금연, 국가사회적으로는 공해의 해결이 필요하며 진행된 질병에서는 진행을 막기 위한 감염의 예방 및 감염시 즉각적인 항균제 치료, 필요에 따라서 항염증제, 그리고 생활의 질을 높이기 위해서 각종 재활요법이 필요하다. 원활한 재활요법을 위해서는 필요한 기구 장비의 구입이 쉬워야 하고 치료진에서는 호흡기 전문의사, 호흡치료사, 의료기사, 병원 및 가정간호사, 사회사업가(social worker), 정신과의사, 영양사 등의 팀으로의 접근이 필요하고 제도적으로 보험적용이 되도록 해야 하겠다. 불구가 심한 예에서는 폐이식이 시도되며 기술적인 문제는 다소 해결된듯하나 장기공여자 등의 문제로 보편화되지는 않고 있다.

• 대한간호학회지
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• 제36권1호
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• pp.103-113
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• 2006

Introduction: It is important to understand the nature of the identity through the live experiences of Home Care Nurse Practitioner(HCNP) because the role identity of a professional is constructed by continuous social interactions, This study aims to understand the construction of the role identity of HCNP. Method: Data was collected from 12 hospital based HCNPs. This study involved two focus group discussion sand four in-depth individual interviews. The main question was 'what is the role of HCNP?' The debriefing notes and field notes were analyzed using consistent comparative data analysis method. Result: First, Home care (He) is a small clinic. HCNP brings it to home to provide various services. Second, HC is the real nursing and HCNP is the 'genuine' nurse who actualizes the essence of nursing in practice. Third, HC is empowering activity to promote self-care ability of the patients and their caregivers. Forth, HC is like the dish-spinning required high-level mastery and HCNP is an expert who provides the most appropriate services to the patients. Conclusion: HCNPs have the role identity as a highly qualified professional who delivers services from hospital to home, actualizes the essence of nursing in practice, empowers the patients and their caregivers to have self-efficacy to recover, and offers the most appropriate nursing care.