• Title/Summary/Keyword: Assessment of Health Care Needs

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Analysis of Functional Status and Care Needs among the Community-Dwelling Disabled Persons with Cerebral Impairment (재가 중증 뇌병변 장애인의 기능상태 및 케어요구 목록 평가)

  • Ko, Ryeo-Jin;Yoo, Weon-Seob;Yi, Ggod-Me;Lee, So-Na;Kim, Kyo-Hyun;Oh, Hee-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.4
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    • pp.421-431
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    • 2008
  • Purpose: Using comprehensive and valid instrument, MDS-HC 2.0, this study aimed to analyze the functional status and to evaluate the care needs of the community-dwelling disabled with cerebral impairment. Method: With a convenient sample of 88 disabled with cerebral impairment, the data were collected at a community health center located in rural area in Choongchung providence in August 2005. Subject's functional status and care needs were evaluated using Minimum Data Set-Home Care version 2.0. Result: Significant proportion of subjects were totally dependent for locomotion-outdoor (26.1%), personal hygiene (24.1%), bathing (24.1%). For IADLs, over 40% of subjects were totally dependent for ordinary house work, managing finances, or shopping. Top five ranked care needs were preventive health care measures (100%), communication disorders (71.6%), visual function (55.7%), health promotion (52.3%), and pressure ulcers (48.9%). The proportion of triggered clinical assessment protocols were significantly higher in disability level I group for the risk of institutionalization (p=<.001), communication disorders (p=.004), cognitive problems (p=.001), pressure ulcers (p=<.001), skin and foot conditions (p=.010), and urinary incontinence and indwelling catheters (p=<.001). Conclusions: It is necessary to provide community based rehabilitation services that are individualized for their service needs thus enhance optimal level of functioning.

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A New Disability-related Health Care Needs Assessment Tool for Persons With Brain Disorders

  • Kim, Yoon;Eun, Sang June;Kim, Wan Ho;Lee, Bum-Suk;Leigh, Ja-Ho;Kim, Jung-Eun;Lee, Jin Yong
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.5
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    • pp.282-290
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    • 2013
  • Objectives: This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool. Methods: The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools. Results: The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable. Conclusions: Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.

Development of Health Assessment Tool for Middle-aged Adults in Long-term Care Settings (중년기 요양 환자의 건강사정도구 개발)

  • Park, Yoon-Jin;Kim, Nam Cho
    • The Korean Journal of Rehabilitation Nursing
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    • v.20 no.1
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    • pp.1-11
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    • 2017
  • Purpose: This was a methodological study to develop a valid and reliable health assessment tool for middle-aged adults in long-term care settings (HATMAL). Methods: At the first stage of this study, initial 56-items HATMAL were derived via literature review, survey for needs assessment, and focus group interviews with experts. At the second stage, 54 items HATMAL were finalized via content validity test with 5 experts and a pilot study with 30 nurses. At the third stage, validity and reliability tests were conducted with 100 middle-aged patients in a long-term care hospital. Data were analyzed by factor analysis using SPSS 18.0 program. Results: Exploratory factor analysis resulted in 3 factors; functional assessment, symptom assessment, and comfort assessment. These 3 factors explained 83.8% of total variance and construct validity was confirmed. Test-retest reliability was .67 for appetite changes, .76 for regulating for behavior problems, and 1.0 for other items. Conclusion: Results indicate that HATMAL is valid and reliable to assess the health for middle-aged patients in long-term care settings. This study would contribute to provide more effective personalized treatment and care for middle-aged patients in long-term care settings considering their own characteristics.

Needs for Children's Health Promotion Education as Perceived by Child Care Center Teachers and Mothers (보육교사와 학령전기 아동 어머니의 아동 건강증진 교육요구)

  • Lee, Young-Ran;Park, Sun-Nam;Lee, Mi-Ran
    • Child Health Nursing Research
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    • v.24 no.2
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    • pp.186-198
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    • 2018
  • Purpose: The purpose of this study was to determine the needs for children's health promotion education programs as perceived by child care center teachers and mothers. Methods: This study conducted a survey of 88 child care center teachers and 70 mothers of preschool children in Seoul from January 4 to February 5, 2016. This study aimed to characterize the current conditions of health promotion education for preschool children and the needs for health promotion education as perceived by child care center teachers and mothers of preschool children. Results: Areas of high need for health promotion education included lifestyle improvements for preventing diseases in children and awareness of the importance of health in educational objectives, standardized educational manuals, health educators as educators, child care centers as educational places, local health centers as educational support organizations, regular class hours as educational time, role play for training, and actual models in the educational medium. The educational subjects for which a high need was reported included safety and accident prevention, the role of smartphones and TV watching in mental health, and personal hygiene and disease prevention. Conclusion: These findings suggest that it is necessary to develop a health promotion education program for preschool children.

Long-Term Care Needs Assessment of the Disabled Workers After an Industrial Injury (산재장해인의 장기요양서비스 요구 분석)

  • Choi, Eun Sook;June, Kyung Ja
    • Korean Journal of Occupational Health Nursing
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    • v.16 no.2
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    • pp.188-196
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    • 2007
  • Purpose: The objective of this study was to evaluate long-term care needs using RAI MDS-HC and MI-CHOICE among the disabled workers. Methods: Data were obtained from 45 personal care recipients with the disability of mental and nervous system, and analyzed using SAS 9.1 by applying t-test, ${\chi}^2$ test, or fisher's exact test. Results: Only 'bed mobility' and 'indoor ambulation' items of ADL and problem activity were statistically significant factors by the level of personal care benefit. By MICHOICE grouping, 20.0 percent of subjects belonged to nursing home group, 51.5 percent were home care service, 28.9 percent were intermittent personal care. Conclusion: Personal care services in industrial accident compensation insurance have been categorized with two groups according to level of disability. But our results could contribute to provide personal care service according to the long term care needs.

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Physical and Psychospiritual Care Need by End-of-life Stages among Non-cancer Patient at Home: Based on the Importance and Difficulty of Care Need (재가 비암 환자의 생의 말기 단계별 신체적, 영적 간호요구도 - 간호요구의 중요도와 난이도를 중심으로 -)

  • Lee, Jong-Eun;Kim, Soon-Lae
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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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.

Women's Health Status Working at Traditional Marketplaces and Their Needs for Public Health Care Services (전통시장 근로여성의 건강실태 및 보건의료요구도 조사)

  • Hwang, Won Ju;Kim, Jin Ah;Kim, Hee-Gerl
    • Research in Community and Public Health Nursing
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    • v.28 no.1
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    • pp.44-54
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    • 2017
  • Purpose: The purpose of this study is to analyze health status of women working in traditional marketplace and their needs for public healthcare services. Methods: A descriptive survey of 500 women working at three traditional marketplaces was conducted. Results: street vendors' health status were much poorer than store merchants'. Furthermore, psychosocial factors like job stress and depression were increased in street venders. Thus, the public healthcare programs required by them included exercise programs (28.2%) and health checkup (26.8%). In addition, 31.2% of the participants reported that they needed visiting nursing care services. The rate of occupational health and safety or employment insurances was as low as 10.8%. Conclusion: Effective interventions including psychosocial factors for women workers at traditional marketplaces need to be developed based on these results. Also, it is recommended that public health care services such as outreach services and visiting nursing care services for women working at traditional marketplaces be provided. Furthermore, institutional provisions such as insurances for protecting these vulnerable groups' health are needed.

The Comparison of Functional Status and the Level of Health Care Needs in Elderly Koreans in Health Care Institutions (요양기관별 한국노인의 기능상태와 장기요양등급 비교)

  • Kim, Hyun-Sil;Jung, Young-Mi;Lee, Hung-Sa;Cho, Yoo-Hyang;Yoo, In-Young
    • Research in Community and Public Health Nursing
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    • v.21 no.4
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    • pp.386-397
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    • 2010
  • Purpose: The purpose of this study was to compare functional status and the level of health care needs in elderly Koreans in health care institutions. Methods: Data were collected from 2,521 elderly patients admitted in 50 health care institutions (hospitals, oriental hospitals, geriatric hospitals, and health care facilities) selected through proportional stratified sampling in 2008. We used a long-term care (LTC) assessment tool developed by the government, which consists of 52 items with 5 subscales. Results: Statistically significant differences were detected in functional status and the level of health care needs among the subjects in different health care institutions. Of the sample population in geriatric hospitals, 48.9% were eligible for LTC Category 1, 20.9% for Category 2, and 17.2% for Category 3, and 13.1% of the subjects were not eligible for any of the categories. Of the sample population in health care facilities, 29.9% were eligible for LTC Category 1, 20.5% for Category 2, and 21.8% for Category 3, and 27.0% of the subjects were not eligible for any of the categories. Conclusion: The findings of this study indicate the necessity of the development of an evaluation system that helps determine whether a subject is eligible for LTC.

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.

Predictive Factors of Supportive Care Needs in Patients with Hematologic Malignancy (혈액암 환자의 지지적 간호 요구도 예측요인)

  • Jung, Ah-Rang;Yi, Myung-Sun
    • Korean Journal of Adult Nursing
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    • v.23 no.5
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    • pp.460-471
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    • 2011
  • Purpose: This study was designed to investigate the levels of anxiety, depression, physical symptoms, and supportive care needs in patients with hematologic malignancy and to identify predictive factors of supportive care needs. Methods: The data were collected from 100 subjects undergoing treatments during 2010 in Korea. The questionnaires included the Hospital Anxiety-Depression Scale, the M. D. Anderson Symptom Inventory, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. Results: Forty percent of the subjects had anxiety and 58% had depression. Thirty-eight percent of the subjects reported to have moderate-to-severe levels of physical symptoms. The most severe physical symptom was lack of appetite, followed by fatigue and pain. In terms of supportive care needs, the health system and information domain showed the highest among all domains. Supportive care needs had a significant positive correlation with anxiety, depression, and physical symptoms. And its predictive factors were identified as anxiety, physical symptoms and marital status, with the explanatory power of 48.9%. Conclusion: These findings demonstrate that anxiety and physical symptoms should be assessed and treated to meet the supportive care needs of patients with hematologic malignancies.