• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.13 no.1
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• pp.46-53
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• 2006

Chunchoen Community Home Nursing Program (CCHNP) sponsored by Chuncheon City and Gangwondo Nurses Association was the first trial of community based home health nursing in Korea. The services have started since 1996. The purpose of the study was the evaluation CCHNP to establish standard of community based nursing program in Korea. The methods of evaluation were quantitative and Qualitative approaches. Evaluation for organization and management were conducted by the American Community Health Accreditation Program Standards With the result. several recommendations were suggested : It is necessary to expand the program to all the Gangwondo cities. And the liaison system is necessary between medical care facilities and community nursing home agency to establish the continuity of health care delivery system in home nursing program. Also it is necessary to set up the supporting system between community home nursing care agency and hospital home nursing department. Finally, the National Health Insurance should cover the cost of community home nursing care.

• Journal of Korean Academy of Nursing
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• v.32 no.6
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• pp.855-866
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• 2002

The purpose of study is to develop a home nursing care project model suitable for Korea's heath care system and policy directions for expansion and establishment of home nursing care. Method: The first, status of home nursing care program in medical institution and public health center was evaluated respectively in view of structure, process and performance. And then, issues of the program were analyzed in view of accessibility, safety, and sufficient supply. The second, demand projection of home nursing care according to income level and technical level of service that is needed to the subject was tried. In addition, the level of supply for home nursing care at present was estimated. The third, home nursing care program in advanced countries (Japan and U.S.A.) was examined. Result and Conclusion: Community-based home nursing care program is developed into public-operation model and private-operation model from above the sub-subject result. Functional network for referral system among related institutions is built up to meet various needs, regardless of accessibility to distance and economy. And prior settlements and policy directions for expansion and establishment of home nursing care are suggested.

• Child Health Nursing Research
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• v.8 no.2
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• pp.129-140
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• 2002

The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.

• Research in Community and Public Health Nursing
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• v.15 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.45 no.5
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1103-1112
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• 1999

In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabilitation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care activity and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used. Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contacted by phone. the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition. elimination, dressing. leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.620-626
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• 2001

Purpose: This study was aimed at investigating the recognition and attitude of inpatients for the purpose of facilitating the implementation of the home health care program in relation to the opening of the Home Care Department in P University Hospital in Pusan. Method: Data were collected from the questionnaires returned by 293 patients, who were admitted at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and the Fisher exact test. Results: In regard to the previous information about the home health care program, 55.6% of the inpatients heard about the name through the advertisement in the hospital. the mass communication, and from acquaintances. The percentage of right answers regarding the knowledge of home health care program was 43.9%. In regard to the acceptance of the home health care program, 97.1 % of patients agreed with the implementation of the home care program. The reasons for acceptance were: the maintenance of the continuity of care, the alleviation of the family burden of time. Conclusion: For the stabilization and successful implementation of a home health care system, it should be accompanied not only by advertisement but also education for patients about the home health care program, and a post-evaluative study after the implementation.