Purpose: Competency is a key foundation of the nursing education curriculum and a baseline element of nursing practice. The purpose of this study was to explore the competencies of community health nurses in a maternal early childhood sustained home-visiting program based on nurses' field experiences. Methods: The participants were 21 nurses who had more than 1 year of experience in this program. Reflective interviews were performed; lasting 1 hour per nurse, on August 18, 2016, and the collected data were analyzed using qualitative directed content analysis. Results: Twenty-four themes were extracted for 9 competencies. The major themes included implementing a long-term relationship-based approach, providing client-led service rather than expert-led service, helping mothers with psychosocial difficulties, and applying skills in a practical manner in the home environment. Conclusion: In order to develop a home-visiting program as part of maternal-early childhood nursing practice, nurses should develop competencies that help them make significant and positive interventions. Results indicate that the curriculum for community health nurses should be changed to improve competencies in building relationships with clients and to focus on the application of skills in specific cases and in clinical practice.
The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.
The purpose of this study was to evaluate appropriateness of home health care travel cost. For the evaluation, investigated the operating costs of vehicles used by home care nurses and then were components of home care nurses's annual salaries. Travel costs were then calculated based on actual travel expenses of home health care service. Actual data of 23 hospital-based home care agencies between July, 2002 to December, 2002 were collected for the analysis of the travel costs. The results of this study are : 1) For home visit, 65% of home care agencies turned out to be using only hospital owned cars, and 17.1% be depending purely on home care nurses' cars. On average, 1.9 cars used for home visit. 2) Out of 89 agencies, 23 agencies responded to the travel cost survey. Total maintenance cost of a car per month was 381,457 won. 3) Average per visit personal expenses of home care nurses during travel time turned out to be 7,124won assuming 8 working hours per day, 4 visits per day, and 30 minuets of travel time for each visit. 4) Total home health care travel cost per visit was 12,069 won, which was the sum of actually paid travel cost of 4,945 won and personal expenses during travel time of 7,124. In conclusion. we reckon that current compensation price of home care nurses' travel is inappropriate because total home health care travel costs of 12,069 won per visit turned out to be 2.1 times of currently prevailing standard compensation price of 5,830 per visit.
There are three main purposes in this study. First, we project the number of elderly dementia population in the future based on the projection of the elderly population in the Kyungpook area. Second, the demands of home-based care service and facility-based care for the elderly dementia are estimated. Thirdly, some policy implications for the improvement of welfare services for the elderly dementia are addressed. The findings of this study are as follows. Considering the size of the elderly dementia population, facilities for the elderly dementia are extremely insufficient and most of the elderly dementia patients rely heavily on home-based care. Although we expect that there will be a rapid increase in the number of the elderly dementia in the next two decades, the social welfare services for them in the future are very unreliable. Home nursing for the demented elderly needs to be recognized by law and financed by the government. In this context, we address some issues regarding the rapid growth of the elderly dementia population in the future and social welfare services for them as well. Finally we suggest some policy implications regarding this matter.
As the health of people is a integral element of the public well-being, the government adopted and put the home visiting nurse system into practice from Jan. 1990, so that the public might get the necessary health service at the low cost and at home. Thus, it resulted in a rapid increase of the public need for the quality of life. The increasing demand for home care created a necessity for an increased man-power like home care nurse. Since the demand of the publics‘ home care has increased, Seoul Nurses’ Association, one of the branches of Korean Nurses Association has developed for the project team of Home Visiting Nurses Activities. The purpose of this study will analyzed and classified home nursing care activities of home visiting nurse according to the criteria of nursing diagnosis Korean Nurses‘ Association. The subject of the study was 54 patients in 1993 and 148 patients in 1994. All patients received home care at home from visiting nurses were living in Seoul city. The results of the study were as follows; 1) With regard to the nursing diagnosis, 24 items were classified. 2) The patients and families wanted to increase the number of time for home visiting. 3) Main sources of request to visit the patients at home were mainly from the families through nurses or doctors who cared for the patients. 4) In comparison of the characteristics visiting activities between 1993 and 1994, the number of the classification of nursing diagnosis and the number of visiting activities in 1994 were relatively increased than the outcomes in 1993.
Purpose: This study aimed to provide basic data necessary to develop education programs and educational services for home care by investigating the degree of patient and family education among home health care nurses. Methods: Data collection was carried out with 145 people from 47 institutions that agreed to participate in the research. A total of 128 questionnaires were received, of which 122 were analyzed. Data were analyzed using SPSS 12.0. Results: The item on which education was most frequently delivered was intravenous injection speed control (66.4%), whereas the item requiring the longest teaching period was pressure ulcer care. The average degree of impediment perceived by home care nurses was 2.82 out of 5. Conclusion: Medical institutions should develop educational materials and programs that reflect the characteristics and degree of home health care needed. Repeated research, including that by medical institutions, on the degree and impeding factors related to patient and family education performance of home health care nurses should be conducted. Moreover, medical institutions should investigate the nursing and educational needs of patients and families who received home health care service.
Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.
In this paper, we checked health problems of outpatients who suffered from cancer, apoplexy, and arthritis. After accessing each patients condition, in order to alleviate their sufferings, we introduced several methods of aroma therapy as a holistic approach to these health problems. Aromatherapy, which can be defined as a nature-friendly complementary / alternative method, has its great merit in its easy way of treatment by the family member of patient or patient himself. Recently, it was scientifically proved that aroma therapy has various curative effects. The easiness of applying aroma therapy is full of suggestions concerned with the future of nursing science. Recently, in the domain of home care nursing, there happened a fundamental change in its structure: a change from the supplier/professional-centered to the consumer/patient-centered one. With this change, home care nursing as a cherished desire of nursing science obtained its legal ground in the established medical programs and, in the same context, patients came to have the chance to receive demanded medical services in their home without going through complicated hospital admission procedures. Considering the future status of home care nursing as a major contributor in the consumer-centered structure of medical health service, aroma therapy as a complementary/alternative method is expected to contribute not only to establishing more effective structure of health service supply but also to resolving chronic health problem of outpatients.
The purpose of this study is to estimate the population requiring nursing home services among elderly people in Korea. This study identifies the need of nursing home services determined by health care professionals and estimates the proportion of elderly people requiring nursing home service according to the admission criteria. Surveys were conducted on health care professionals including medical doctors, home care nurses, and nurse practitioners. They were asked to assess nursing home need based on four content areas: Physical function (Activities of Daily Living), chronic disease, Physical symptoms (incontinence), mobility, eating, and sensory function. Based on the professionally determined need criteria the proportion of elderly people requiring nursing home services was estimated using secondary data from the 1994 Survey on the Living Status of the Korean Elderly. The number of study subjects to estimate nursing home need who were 60 and older totaled 2,058. The most important factor contributing to the admission eligibility criteria was the elderly living alone. Other factors related were the elderly being unable or having difficulty carrying out activities, and having insufficient help from other our activities, and having insufficient help from other members of the household. Using only physical function, the proportion of elderly people requiring nursing home was $8{\sim}9%$. When only chronic disease was used, proportions varied widely; for the doctor's group, the proportion was over 30%. Using all areas, the proportions of elderly people requiring nursing home were between 13% and 38%. The estimate using chronic disease and physical function was similar to the on using all areas.
Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.
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