• 제목/요약/키워드: Home Health

검색결과 4,080건 처리시간 0.031초

노인장기요양 재가서비스 이용자의 시설 입소 영향 요인 (Factors Related to Nursing Home Institutionalization of Elderly using Home Care Services)

  • 한은정;황라일;이정석
    • 한국보건간호학회지
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    • 제30권3호
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    • pp.512-525
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    • 2016
  • Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

재가방문 요양보호사의 건강정보 이해력, 자기효능감이 서비스의 질에 미치는 영향 (The Effect of Health Literacy and Self-efficacy on the Quality of Care Service for Home Visitor Care Workers)

  • 고은정;김현경
    • 가정∙방문간호학회지
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    • 제28권3호
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    • pp.276-284
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    • 2021
  • Purpose: This descriptive research study aimed to identify the effect of the health literacy and self-efficacy on the quality of care service of home visitor care workers. Methods: The participants were 124 home visitor care workers who had worked for more than six months at one of the five home-based welfare centers located in D metropolitan city. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis using the SPSS program. Results: The quality of care service differed significantly by age (F=-1.03, p<.001), career (F=5.09, p=.002), and education status (F=9.57, p<.001). A statistically significant positive relationship was observed between the quality of care service and self-efficacy (r=.63, p<.001). A total of 55.3% of the variance of quality of care service was explained by age and self-efficacy. Conclusion: Based on the results, it is necessary to develop and prepare programs that can increase the self-efficacy of home visitor care workers through a nursing approach to improve the quality of life of elderly.

재가 장기요양노인 가족수발자의 건강 관련 삶의 질 영향요인 (Factors associated with Health-related Quality of Life among Family Caregivers of Elders Receiving Home Care Services)

  • 김은영;여정희
    • 지역사회간호학회지
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    • 제23권2호
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    • pp.117-126
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    • 2012
  • Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

시뮬레이션을 적용한 방문건강관리 실습교육 프로그램이 방문간호 지식, 문제해결 능력, 임상수행 능력에 미치는 효과 (The Effects of the Home Health Nursing Practical Education Program Applying Simulation on Knowledge related Home Health Nursing, Problem-solving Ability, and Clinical Competency)

  • 김미한;하영선;나윤주
    • 디지털융복합연구
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    • 제19권12호
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    • pp.605-616
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    • 2021
  • 본 연구는 간호대학생들을 대상으로 시뮬레이션을 적용한 방문건강관리 실습교육 프로그램을 적용한 효과를 확인하기 위해 실시되었다. 일개 간호대학생 60명에게 비동등성 대조군 유사 실험연구를 수행하였고, 개발한 시뮬레이션을 적용한 방문건강관리 실습교육 프로그램을 2주간 실시하였다. 자료 수집 기간은 2021년 3월 29일부터 5월 7일이며, 수집된 자료는 SPSS PC+ 19.0을 사용하여 분석을 수행하였다. 효과 검증한 결과 방문간호 지식, 문제해결 능력, 임상 수행 능력에서 유의한 차이가 있는 것으로 나타났다. 본 연구에서 개발된 시뮬레이션을 적용한 방문건강관리 실습교육 프로그램은 간호대학생의 방문간호지식, 문제해결 능력을 높이고 임상수행 능력을 높여 방문건강관리를 수행할 수 있는 역량이 증진됨을 확인하였다.

가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교 (A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients.)

  • 김용순;임영신;전춘영;이정자;박지원
    • 대한간호
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    • 제29권2호
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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가정간호행위 업무량의 상대적 가치 측정에 관한 연구 (Workload Measurement of Home Health Care Nurses상 Services using Relative Value Units)

  • 이태화;박정숙;김인숙
    • 대한간호학회지
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    • 제30권6호
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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.

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재가 복지 봉사 사업의 가정 간호 사업연계 필요 조사 (Study on Effective Utilization Strategies of the Home Health Care Program in the Community Care Service of Welfare Policy)

  • 김성실
    • 지역사회간호학회지
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    • 제7권2호
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    • pp.183-202
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    • 1996
  • This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

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치과위생사의 재가방문 구강건강관리 중재 활동을 위한 프로토콜 고찰 (Oral health care intervention protocol for older adults at home in dental hygienists: a narrative literature review)

  • 장종화
    • 한국치위생학회지
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    • 제23권5호
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    • pp.333-341
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    • 2023
  • Objectives: This study aims to propose a standard protocol for oral health care intervention activities by dental hygienists. Methods: A narrative literature review of home visit oral health care intervention activities reported in Cheonan, South Korea was conducted to enable the proposal of a standard home visit protocol for dental hygienists in the context of community care. Results: Oral health management intervention activities contributed to improving the quality of life, as well as the oral health, of older adults living at home. This was a result of applying a protocol consisting of oral observation, oral massage, expert oral hygiene management, oral muscle function training, and final stages. Conclusions: The visiting oral health intervention protocol was effective in resolving oral health problems of older adults. In the future, customized programs and reimbursement systems should be developed to promote oral health care for older adults that can be provided at home.

가정간호대상자의 삶의 질에 영향을 미치는 요인 (A Study on the Quality of Life for Home Care Nursing Patient)

  • 곽경선;정혜선
    • 가정∙방문간호학회지
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    • 제12권1권
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    • pp.136-154
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    • 2005
  • Purpose : This study purposed to conduct a comprehensive survey of home care nursing clients' quality of life based on the PRECEDE model. Method : This study selected 74 home care nursing clients registered at a university hospital in Incheon and performed face-to-face interviews by structured questionnaire. The research period was two months from the $2^{nd}$ of February to the $30^{th}$ of March in 2004. Result : According to the result of assessment at each stage of the PRECEDE model, home care nursing clients' quality of life was 13.88 out of 25 points, health level 15.22 out of 21, abilities to perform activities of daily living 29.26 out of 100, cognitive abilities 16.00 out of 30, social support 13.68 out of 20, and satisfaction with home care nursing service 33.26 out of 40. According to the result of stepwise regression in order to identify factors influencing home care nursing clients' quality of life, social support and abilities of daily living were found to be significant variables among the characteristics of each assessment stage. Conclusion : It is necessary to develop nursing intervention strategies for strengthening social support and enhancing abilities to perform activities of daily living in order to improve home nursing clients' quality of life.

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