• Journal of Korean Academy of Nursing
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• v.33 no.6
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• pp.847-855
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• 2003

Purpose: This study was done to develop a bereaved family care program by identifying characteristics of a grief healing process in a child loss. Method: The subjects were five bereaved mothers who have lost their children with cancer. Data was collected with in-depth interviews using grief phase assessment tool and grief reaction assessment tool from 1, February, 2001 to 31 August, 2002. Data was analyzed on the basis of two tools. Result: Process of grief in general was as follows: evading phase was within one week - one month, confrontation phase was 5 - 12 months, and reconciliation phase was after 9 months and still going on when the study was finished. Grief reaction in five (physical, cognitive, emotional, social, and spiritual) dimensions was stabilized when the phase moved into reconciliation phase. Influencing factors were intimacy and expectation towards child, social support, personality, prior loss experience, coping style, religion, culture, family cohesion, openness of communication, and stress events. Conclusion: These results suggest that a bereaved family care program considering characteristics of Korean culture should be developed and activated.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.217-236
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• 1971

Introduction: The integration of theoretical material in the classroom with clinical practice in the field is an important concept in nursing education. nursing students at all levels need to acquire individual patient's needs, and applying creativity in the comprehensive nursing care. Problem solving and observation skills are important aspects in the development of nursing skills. Nursing students during their clinical work in maternal and child health observed that the major difficulties experienced by new mothers centered around psychological and physiological changes. Breast engagement and throbbing breast pain were the most frequent complaints by primiparas during the postpartum phase. In order to understand the factors affecting the discomfort, and to devise appropriate nursing care, these complaints were experimented. resent study represents an attempt to evaluate the impact of antepartal care (including breast care) on the subsequent of breast feeding difficulties. For the research purposes, hypotheses were made as follows: 1. There is a relationship between breast care and anthemata care attendance. 2. If primiparas practice treat care during their anthemata relied, they will have less throbbing breast pain during the postpartum phase. 3. If primiparas practice breast care during their antenatal period, they will have less breast engagement during the postpartum phase. Method: The researcher selected two highly specialized nurses in maternity clinical ward. They checked mother's chest circumference on the top line of breast every morning including mother's fever, caked breast, and lymphnodes on axillae. These nurses checked mother's breast while they staying hospital for four days. The total number of primiparas were 62 during June 5th to July 15th in 1971 at the Severance Hospital. For 40 days among 62 members of new mothers, 28 of them had breast care during antenatal period. Rest of them did not have breast care during antenstal period. Result: The result of this research revealed that the first hypothesis was accepted that the group which had breast care during antenatal period, had positive relationship with antenatal care. If the mothers were more educated, the more anticipated to antenatal care including breast care. For the second hypothesis, on the delivery day, there was no change on breast between two groups. On the first day of delivery, there were breast throbbing pains to the group who did not receive breast care, than the group who received the breast care. Therefore, second hypothesis was also accepted. For the third hypothesis, there was no breast engagement difference between two groups for the entire period. The third hypothesis was rejected.

• Journal of Korean Clinical Nursing Research
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• v.23 no.3
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• pp.376-387
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• 2017

Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

• Women's Health Nursing
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• v.7 no.1
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• pp.67-79
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• 2001

This study was designed to verify the effect of Doula-type-delivery nursing care on plasma $\beta$-endorphin, serum cortisol, related to delivery stress during labor, and postpartum anxiety of primipara by a quasi experiment(nonequivalent control group pretest-posttest design), from December, 1999 to August, 2000. The subjects of this experiment consisted of sixty eight primipara, with single gestation, full term, uncomplicated pregnancies, thirty three for the experimental group and thirty five for the control group. Their mean age was 26.1 years for the experimental group and 25.5 years for the control group. Their mean gestation period was 39.7 weeks for the experimental group and 40.1 weeks for the control group. As treatment, Doula-type-delivery nursing care was given for the experimental group. Data assessed plasma $\beta$-endorphin, serum cortisol during labor, and anxiety during postpartum. Plasma $\beta$-endorphin, serum cortisol were measured in the latent phase before treatment(pre-test) and the transition phase after treatment(posttest). Also, anxiety was measured in the latent phase before treatment(pre-test) and 24 hours postpartum after treatment(posttest). Data was analyzed by t-test, $x^2$-test, Repeated measures ANOVA with SAS Program. The results of this study were as follows; 1. Plasma $\beta$-endorphin was significantly elevated in the experimental group who were cared for with Doula-type-delivery nursing care during labor(P=.0463). 2. No significant group effects were found, but significant time effects were found for serum cortisol. 3. The postpartum anxiety of the experimental group was significantly lower than the control group(P=.0110). In conclusion, these findings indicate that Doula-type-delivery nursing care during labor could be effective in increasing maternal plasma $\beta$-endorphin and decreasing postpartum anxiety. Doula-type-delivery nursing care during labor could be applied as an effective nursing treatment for primipara.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.3
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• pp.391-402
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• 2009

Purpose: The purpose of this research was to describe the decision making experience of VIP ward nurses in the clinical practice adjustment process. The research question was about "how nurses adjust their clinical practice to nursing situations and develop decision making process in a VIP ward." Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin(1998). The data was collected through in-depth interviews with 10 nurses from July to November, 2007. Results: The core category of nursing care decision making process was named as "adjusting with flexibility and deepened insight." The clinical practice adjustment process in nursing care decision making has progressed through four preceding interlocking phases: 1) dependent phase, 2) defensive phase, 3) independent phase, 4) integrative phase. These phases were classified by the level of nurses' dependency, proactivity, presupposition and integration. Conclusion: The result of this study indicated that nurse's decision making depended on their experiences and the nature of social context in which nursing occurs. Therefore, it is important to elaborate an effective training program for nurses to develop the phases of nursing care decision making.

• Physical Therapy Korea
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• v.1 no.1
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• pp.83-87
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• 1994

The purpose of this paper is to provide an overview of the clinical physical therapy program used at the University of Yonsei Rehabilitation Hospital, for the practicing university trained physical therapists who may be unfamiliar with patients who have suffered a myocardial infarction. The four primary phases of the cardiac physical therapy graded exercise program are: 1) coronary care unit program (phase I), 2) general ward program (phase II), 3) convalescence program (phase III), 4) maintenance program (phase IV). The exercise prescription defines the exercise intensity, duration, frequency, and mode of exercise a after pre- discharge low level graded exercise test(LL-GXT) or symptom limited maximum graded exercise test. A typical exercise routine consists of preparation warm-up exercise, therapeutic exercise, cool-down exercise. Physical therapy is involved in the acute care and rehabilitation of the patient after a myocardial infarction. Therefore, the physical therapist must throughly comprehened the cardiac anatomy, cycle, performance, conduction system, pathogenesis, risk factors, and exercise benefits.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1543-1555
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• 2000

Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.

• Journal of Home Health Care Nursing
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• v.26 no.3
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• Childhood Kidney Diseases
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• v.22 no.1
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• pp.7-11
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• 2018

Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.