Purpose: The purpose of this study was to identify the current management status and the policy issues of visiting nursing programs at public health center in urban area. Method: A questionnaire surveys was conducted on all public health nurses in 25 health centers in Seoul. Result: The major results were as follows: The characteristics of the visiting nurse showed that the average age was 41.1 years, and total nursing experience was 122 months. Their visiting nursing experience was only 30 months. The recipients of visiting nursing services consisted of 60.1% females, and 32.5% of the recipients were over 65 years. The major health problems of the recipients were hypertension, diabetes mellitus, arthritis and psychiatric problems. The visiting frequency was an average of 5.4 times per day, and 357 families were managed per visiting nurse. The major problems of visiting nursing programs were the shortages of visiting nurse manpower. The most important related policy issue was being in charge of a workload, which was not related to the visiting nursing services. Conclusion: By analyzing work for visiting nurses and identifying weak points, this research can present recommendations to be practically used as baseline data for establishing policy in relation to vitalizing visiting nursing programs.
Purpose: The purpose of this study is to identifying factors influencing organizational commitment of nurses in Korean Red Cross Blood Center (KRCBC). Methods: A cross sectional survey was conducted for 224 nurses who worked for more than three months in KRCBC. Data were collected using a structured questionnaire from August 28 to September 20, 2018. Data were analyzed using independent t-test, Mann-Whitney U test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression analysis with SPSS (ver. 23.0). Results: The mean score of organizational commitment was 3.37±0.52 on a scale of 5 points, the mean of positive psychological capital was 3.51±0.51, communication ability score was 3.60±0.48, and social support score was 3.68±0.57. The factors influencing organizational commitment of nurses in KRCBC were social support (β=.41, p<.001), job satisfaction (β=.27, p<.001), and total length of employment in KRCBC (β=.19, p=.016). The model explained 36.1% of the organizational commitment of the nurses. Conclusion: It is necessary to develop an organizational commitment program for strengthening social support and job satisfaction to improve organizational commitment of nurses in KRCBC. Such a program is eventually expected to improve the quality of nursing care of nurses with a short career in KRCBC.
Purpose: The purpose of this study was to explore how homeless shelter worker and public health nurses perceive health status and health care of homeless shelter residents (HSRs). Methods: Data collected through focus group interviews. In Focus group, in-depth discussions were between 150 to 160 minutes. Data analyzed using Krueger (1998) step analysis. Participants were seven experienced clinical social workers, nurses working homeless shelters, and public health center nurses for dosshouse people. Results: The results were 4 themes and 15 sub-themes: Characteristics of HSRs, perception of health and health problem of HSRs (alcohol related disease, hypertension Diabetics, gastro-intestinal disease, dental disease and infectios disease such as Tuberculosis, musculo-skeletal disease, prostate problem), health care status of HSRs(insufficient health care service, discrimination of medical staff, lack of health care management, low satisfaction community health care services), and the health care proposal of HSRs(nurse in homeless shelter, integrated health care system, understanding of homeless) Conclusion: Based on the findings of this study, health care programs focusing on understanding of HSRs and chronic diseases of HSRs increasing steadily although the management system is limited. Therefore, more systemized health care plan and health referral system for homeless people.
The purpose of this study was to identify the differences of the outcomes of visiting nursing service (VNS) between the two types by the organizational structure of health centers. Type I referred to 3 health centers with departmentalization for VNS and type II of 3 health centers providing VNS under the subunit of a department. Data were collected from 38 visiting nurses at the six health centers for their perceived formalization, decision-making authority and job satisfaction, 293 clients for the satisfaction level with VNS served and their records analysis for level of quality care and frequency by the contents of VNS through the questionares during the period from June, 1 to August 30, 1993. Data were analyzed using $\chi^2$, F. t or/and Scheffe test. The result were as follows: 1) There were no significant differences in perceived formalization and decision -making authority of visiting nurses between the two types of health centers. 2) There were significant differences in the level of quality care and frequency of the VNS contents between the two types of health centers. 3) There were no significant differences in perceived clients' satisfaction and job satisfaction of the visting nurses between the two types of health centers. From this study, Not only organizational differentiation with the development of job standards and supportive system but also personnel development are suggested when new health care service in health centers begins.
The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.
Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.
The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for 'home-delivered meal and side dish services are effective for checking older adults' conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.
Persons with disabilities have increased and among others, number of them in the community is at the high proportion. But they have a difficulty in physical, psychological adjusting and they don't be offered appropriate, sufficient rehabilitation services. Therefore, Community-Based Rehabilitation Services in Health Center be needed. With these backgrounds, this study was conducted to examine factors in relation to job performance of community-based rehabilitation program in Health Centers, and the factors are characteristics of district nurses, internal factors, external-environmental factors. This study provides guidelines for effective management for rehabilitation program. Subject in this study were 122 Health Centers randomly chosen. Data were collected from September, 16, 1998 to October, 9, 1998, and the data for analyses were ones of 105 respondents. The instrument of this study was job performance of community-based rehabilitation program is modified WHO guidelines. Credibility of instruments was 0.73-0.95 in main study. The summary of results was as follows. First, the mean of job performance of com munity-based rehabilitation program was 2.33 of full score 4.00. Significant differences were not obtained on the job performance among areas. Second, stepwise multiple regression analysis revealed that the most powerful predictor to job performance was community-based health program. The number of volunteer workers, the score of cooperation with other institution, the number of visiting nurse, the number of facilities for person with disabilities are accountable factor to the job performance of community-based rehabilitation program. In conclusions, for all the people with disabilities, Health Centers are necessary to promote community-based rehabilitation program and to increase participation of community residents and to cooperate with other institution.
Purpose: This study aimed to explore the difficulties and coping that advanced practice nurses (APNs) experience in home health nursing field. Methods: The participants were 12 APNs who had experience in home health nursing for over 5 years. Data were collected through two focus group interviews between August and September, 2017. The results were analyzed using a qualitative content analysis. Results: Out of 10 sub-categories and 29 codes, 4 categories emerged: "crushed by the responsibilities as the only healthcare professional", "worn out by family who interfere with work", "anxiety about my safety being threatened" and "using self-learned know-hows". Conclusion: APNs face difficulties due to the environmental characteristics of the homes, the characteristics of chronically critically ill (CCI) patients and their families, and legal or systematical limitations when dealing with problems based on their personal competence. In order to ensure that professional nursing care is more readily provided to CCI patients through home health nursing services in local communities, it is imperative that support systems at the organizational and institutional levels be established in a systematic way to resolve the issues faced by APNs.
Purpose: This study aimed at identifying the factors affecting the service satisfaction of urban elderly, focusing on the outreach community health service in Seoul, and suggesting policy directions for the successful implementation of community care. Method: Individuals aged 65 and 70 who used the outreach community health service from July 2017 to June 2019 were eligible for the survey. A total of 2,028 people were sampled using a proportional allocation method for each autonomous district in the survey which covered 25 districts. A multi-level logistic regression analysis was conducted, taking into account the individual's socioeconomic level, health status, type of service provided, and the healthcare-related environment and service provision period of the autonomous district. Result: The results revealed that the health status of the urban elderly, the type of services provided (health screening, linkage to community health center and clinic/hospital, medical checkup results counseling, frailty evaluation), and personal experience of the service were the major factors associated with the satisfaction with the outreach health services. Conclusion: The development of customized health services based on the close relationship between visiting nurses and the elderly may be considered to promote a sustainable community health care model.
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