• 대한간호학회지
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• 제18권1호
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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.

• 한국가정간호학회:학술대회논문집
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• 한국가정간호학회 2005년도 추계학술대회
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• pp.1-17
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• 2005

• 한국가정간호학회:학술대회논문집
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• 한국가정간호학회 2005년도 추계학술대회
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• pp.33-49
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• 2005

• 대한간호
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• 제32권4호
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• pp.28-32
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• 1993

• 간호행정학회지
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• 제17권2호
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• 지역사회간호학회지
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• 제19권4호
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• pp.673-683
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• 2008

Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.

• 지역사회간호학회지
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• 제13권3호
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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.

• 지역사회간호학회지
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• 제23권2호
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• pp.127-133
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• 2012

Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.

• 지역사회간호학회지
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• 제15권2호
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• pp.209-217
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• 2004

Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

• 가정간호학회지
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• 제14권2호
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• pp.65-75
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• 2007

Purpose: This study was conducted to provide fundamental information for policy integration of the home health care system. Methods: Focused review was performed from 8 studies out of 48 literature related to home care needs. Results: Females utilized home care based on hospital and public health centers at a higher rate than males. While there had been more rate of the elderly above 60 year-old at hospital and community based home care, on the other hand below 45 year-old at public health center. The most common disease amongst users in all three types was cerebrovascular disease, the second was cancer based at hospitals, hypertension and arthritis at public health centers. There were more needs for those using artificial respiratory equipment, cancer patients, and puerpera. However, the needs for hospital and community based home care were very similar. Conclusions: Due to similar disease characteristics but varied severity at the three home care based settings, they should be managed with flexibility. Home care curriculum should be developed according to common disease type, and home care services should be strengthened for its expertise.