• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.60-68
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• 2023

Purpose: For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. Methods: This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. Results: During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P<0.001). Conclusion: To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

• Journal of Preventive Medicine and Public Health
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• 제28권2호
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• pp.347-363
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• 1995

The increase of health care expenditures is an important problem in the almost countries. Also, suppression of the health care expenditures is an important problem in the health field of Korea since the national health insurance for total people in 1989. Thus, it is very important to grasp the change of the health care expenditures of family and proportions of the health care expenditures to total expenditures of family, because they are the basis of national health care expenditures in Korea. While the health care expenditures of urban family were increased during 1980-1993 by 12.8% annually, the total expenditures of urban family were increased by 14.8% annually. Consequently, the proportions of health care expenditures to total expenditures were decreased from 5.98% to 4.76%. The proportions of health care expenditure for 3 years to come were predicted to 4.75% in 1994, 4.67% in 1995, and 4.63% in 1996 by the time-series analysis. That is, it was predicted that they would be decreasing slowly. The product elasticity of health care expenditure was less than 1 in the multiple regression analysis. so the health care is normal good rather than superior good. Therefore, it seems that the household economy is able to bear the expense pursuing the improvement of quality of health care by actualizing the medical insurance fee.

• Perspectives in Nursing Science
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• 제16권1호
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• pp.35-44
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• 2019

Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.

• 가족자원경영과 정책
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• 제13권1호
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• pp.147-168
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• 2009

The purpose of this study is to research support systems of the community child care services for optimum work-family balance. For this purpose, the questionnaire to be completed combined four areas: the workplace, school, community and home. Then questions concerning demographic factors and community-related aspects were analysed for this article. After analyzing 197 questionnaires, supplementary questions were asked, by interview to 10 samples. Full-time working wives (eg. working from 9am to 6pm) who have 1 or more children under 10 years old, living in Seoul and Gyeonggi province were collected as samples. The results were as follows: First, child care from family and relatives, and community services was properly used during the week, but dual working parents took complete charge of child care on Saturdays. Second, emergency child care was usually provided by the family, while relatives and community child care services were used less. Third, parents spent 17% of their monthly income on total child care expenditure. Fourth, community child care services were not used often, but the level of satisfaction with them was very high. Finally, they used relatives' services for safety reasons and community services for location, and only based on informed decisions. Therefore, Saturday child care programmes need to be initiated to help physically and mentally tired parents, with more general provision of positive and diverse public support systems.

• 한국치위생학회지
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• 제19권4호
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• pp.601-614
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• 2019

Objectives: The purpose of this study was to investigate the present conditions and problems of oral health care in senior citizens with dementia using a qualitative research method, through focused group interviews. Methods: Data was collected for approximately one month from May 2019. The subjects were divided into two groups: care workers and family caregivers. Fifteen participants were included in the study. Results: In-depth interviews with the care workers revealed the following three categories: characteristics of senile dementia patients, oral health care in senile dementia patients, and oral health care education. In-depth interviews with the family caregivers revealed the following four categories: characteristics of senile dementia patients, oral health care in senile dementia patients, oral health care education, and burden of care. The central themes common to both the care workers and family caregivers were the challenges owing to the characteristics of senile dementia patients, poor health condition of the senile dementia patients, difficulty in oral health care of the senile dementia patients, the desire to receive oral health care education and related information, and to access the information more easily. Additional central themes specific to the care workers were, the applicability of the intervention programs, variability between the facilities, and the problems of oral health care education. An additional central theme specific to the family caregivers was the burden of care. Conclusions: It is necessary to provide oral health care education and information to care workers and family caregivers of senile dementia patients, and to manage and support the dental health professionals ready to care for senile dementia patients. In addition, support to the family caregivers should not be limited only to the financial aspects, but also consider the psychological and emotional difficulties.

• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.252-255
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• 2020

This article aims to discuss the barriers hindering cancer patients from receiving early palliative care, which has been demonstrated to be more effective in improving quality of life and controlling symptoms. Specifically, there are barriers in four aspects of delivering early palliative care. First, the difficulty of starting discussions about early palliative care and the lack of adequate appointment time can impede communication between oncologists and patients and their family members. Second, determining the timing of referral and deciding upon and applying a standard for referral can be barriers in the process of referral from oncology to palliative care. Third, palliative care patients and their family members can face difficulties regarding in what format and by whom the services will be delivered. Fourth, biases, misinformation, and inaccurate beliefs can be barriers in the process of patients and their family members accepting care. In order to facilitate early palliative care, research and policy regarding these barriers are necessary, along with efforts made by medical staff.

• 아동학회지
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• 제13권2호
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• pp.129-144
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• 1992

The purpose of this study was to investigate the current status of family child care. The status of family child care was explored in terms of general characteristics, program quality, and child behavior. The subjects were 17 family child care and their 102 children and 60 parents. Harms & Clifford's (1989) FDCRS(Family Day Care Rating Scale) was used to measure program quality. Child behavior was recorded by time sampling in two 30 min observations during the free play session in each facility. A questionnaire for caregiver and parents was used to investigate general characteristics. The data were analysed by frequency, percentage, and Pearson's r. Results showed that (1) a wide range of variable accounted for the general characteristics of family child care, (2) the level of program quality as rated by the FDCRS was below mid-point, (3) children engaged in solitary behavior much more than in peer interactions or caregiver-child interactions.

• Journal of Hospice and Palliative Care
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• 제23권4호
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• pp.183-197
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• 2020

Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

• 한국사회정책
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• 제20권2호
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• pp.97-129
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• 2013

본 연구는 한국의 노인장기요양보험제도에서 자연발생적으로 등장한 '가족요양보호사'에 대해 조사하고 분석하였다. 2012년 기준 방문요양급여의 38.4%가 노인이용자와 가족관계인 요양보호사에 의해 청구되었다. 가족의 돌봄부담을 경감하기 위해 도입한 노인장기요양보험제도에서 가족들은 왜 스스로 요양보호사가 되어 가족돌봄을 유지하는가? 본 연구에서 가족요양보호사 현상은 의도하지 않은 정책결과에 대한 규범적 분석의 대상이 아니라 정책과 정책대상의 욕구가 충돌하는 지점으로 포착되고 탐구되었다. 가족요양보호사를 선택한 가족돌봄자 10명의 사례를 선정하여 심층인터뷰를 진행하였고, 이 자료를 토대로 가족요양보호사의 발생 원인과 가족요양보호사가 받는 급여의 성격을 어떻게 인식하는지를 분석하였다. 연구결과, 생계와 돌봄을 동시에 해결해야 하는 노인가구 가족돌봄자에 의한 선택, 전통적인 가족부양의 연장선에서 이루어지는 부가적인 선택, 제도 안에서 수용되지 않는 서비스를 위한 선택이라는 세 가지 원인이 발견되었다. 연구결과는 노인가구의 소득과 서비스의 통합적 개선방안, 노인장기요양보험제도와 호혜적인 가족돌봄지원 정책의 필요성, 재가서비스의 종류와 내용의 다양화라는 제도적 개선과제를 제시하고 있다.

• 중환자간호학회지
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• 제4권1호
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• pp.51-63
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• 2011

Purpose: This study aimed to examine the effects of extended family visiting hours in the intensive care unit (ICU). Methods: The subjects were 168 ICU patients and their family members. Two 30-minute visits a day were allowed to the control group according to current policy, while four 30-minute visits a day were allowed to the experimental group. Patients' state anxiety was measured at the first day of ICU admission, and on the third day of ICU admission patients' anxiety and family satisfaction were measured. For the infection rate, comparison was made between the experimental and control data-collecting periods. Results: The patients' state anxiety significantly decreased in the experimental group. Family satisfaction of experimental group was significantly higher than that of control group. There was no significant difference in the infection rate. Nurses positively evaluated extension of visiting hours because it could stabilize patients, reduce the number of arrangements for additional visits, and help establish trust relationship with families. Conclusion: Extended family visiting hours in the ICU reduced patients' anxiety and improved family satisfaction but had no effect on the infection rate. Extended family visiting hours in the ICU is expected to improve the quality of critical care.