• Title/Summary/Keyword: Home Nursing Service

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A Study on Self Concept of Nursing Students. (간호대학생의 자아개념에 관한 연구)

  • Lim Nan Young;Jung Moon Hee;Choi Sun Ha
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.5-22
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    • 1991
  • This study was conducted to provide information of affective area in developing a nursing curriculum. The sample consisted of 38 sophomores and 43 seniors in Department of Nursing, College of Medicine, Han Yang University. Data were collected by using a structured questionnaire, which consisted of social, home and self control aspects in self concept. The results are summarized as follows; 1. CD In sophomore, as father's academic career were higher, the self concept In social aspects became higher. The students whose father's job was profesion and a white-collar job and who applied for nursing by force and were satisfied with their educational expenses had more positive self concept in social aspects. In senior, as their age were higher, the self concept in social aspects became higher. The students who had religion, recognized the visions of nursing, and were satisfied with their major, had more positive self concept in social aspects. In self concept in social aspects, home environment explained the major variable in sophomore. On the other side, the variable related to major was important in senior. (2) In sophomore, the students who were satisfied with educational expenses and their major had more positive self concept in home aspects. In senior, the students who counseled of their problems with their parents and recognized the visions of nursing had more positive self concept in home aspects. Counsel of their personal problem with their parents explained the most affective variable $(9.6\%)$ for self concept in home aspects in senior. But, it explained only $1.1\%$ of the variance for self concept in home aspects in sophomore. (3) In senior, the students who were unsatisfied with their educational expenses had more negative self concept in self control aspects. 2. There was no significant difference accord ing to the academic year m social, home and self control aspects. 3. The aspects with the highest positive perception of the self concept was home aspects. Self concept in social aspects was more positive perception than in self control aspects. Self concept in self control aspects was lower than in other aspects. 4. Significant relationship a revealed between social aspects and home aspects in sophomore. In senior, the positive correlation were found between social aspects and home aspects and between social aspects and self control aspects. In conclusion, the self concept m home aspects was more positive perception than in other aspects. It resulted from the fact that the nursing uniqueness was based on the spirit of humanity and service. But, when we consider social and self control aspects, good relationship between subjects and nurse is important in nursing, so it is desirable that nursing curriculum include human relationship program. Therefore. in order to strengthen positive self concept, professors and parents must pay attention to student's problems and counsel with then is required.

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Terminal Care in Nursing Homes (일 지역 요양시설의 임종돌봄서비스)

  • Kim, Jung Hee;Mun, Kyung Sook;Shin, Bok Soon;Jang, Eun A
    • Journal of Home Health Care Nursing
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    • v.22 no.2
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    • pp.216-227
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    • 2015
  • Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

Performance and Requirements of Visiting Nursing Care in Long-Term Care Insurance Using the OMAHA System (노인장기요양보험 방문간호서비스 수행도와 필요도 : 오마하시스템 문제분류체계를 이용하여)

  • Park, Sun A;Lim, Ji Young
    • Journal of Home Health Care Nursing
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    • v.24 no.2
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    • pp.181-188
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    • 2017
  • Purpose: The aim of this study was to compare between performance and requirements of visiting nursing care in long-term care insurance using the OMAHA system. Methods: The subjects were 72 nurses who had worked in a visiting nursing care center in long-term care insurance. Data were collected from December 5, 2016 to January 31, 2017 using self-recorded questionnaires. The collected data were analyzed using descriptive statistics and paired t-tests. Results: Four dimensions of the OMAHA system showed statistically significant differences between performance and requirements of visiting nursing care in long-term care insurance. The requirements of visiting nursing care were higher than was performance on all 40 items of the OMAHA system. The greatest difference was in environmental domain and then the psychosocial domain. Conclusion: Based on the results, we found that the environmental and psychosocial domains were the largest gap areas. Therefore, with the reality of elderly people living alone and the increase in elderly couples, active intervention connected with the community is needed in residential areas. Further, we suggest that the OMAHA system can be utilized as an integrated conceptual framework for developing and enhancing visiting nursing care in long-term care insurance.

Development of Community Health Nursing Service Model: - Based on the Visiting Nurses Project in Seoul, Kyonggi, and Kang-won Area- (지역사회 간호 서비스 전달 체계 모형 개발 -가정방문서비스를 중심으로-)

  • Kim, Sung-Sil
    • Research in Community and Public Health Nursing
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    • v.12 no.2
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    • pp.361-374
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    • 2001
  • This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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An Investigation on the Status of Care-giving for the Demented Elderly and Desire for In-house Care Services (치매노인의 부양실태와 재가복지서비스 욕구조사)

  • Lee, Sui-Il;Kim, Ki-Tae;Jeong, Ihn-Sook;Park, Nam-Hee;Lee, Kyung-Nam;Kim, Mung-Soo;Kim, Jung-Soon
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.385-396
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    • 2003
  • Purpose: The purpose of this study is to examine the status of care-giving for the demented elderly and to find out the need of community in-house care services-day care services, short-term care services, home help services, and home care services. Method: It analyzed the data of 186 old people having dementia, and caregivers. Data were collected for five days, in September 2002. Results: The caregivers were mostly women and the burden for the care giving was high (87.5%). They used community care services, that is, day care services (26.5%), home care services (21.6%), home help services 00.8%), short-term care services (6.2%). Caregivers' age and education level were significant factors in the demand for day care services. Caregivers' education level was a statistically significant factor in the demand for short-term care services and home help services. Caregivers' age and education level were significant factors in the demand for home care services. Conclusions: It is necessary to expand the financial aid for the active implementation of daytime protection for dementia-patients under medical treatment at home and to promote patients' recovery. It is necessary to enhance home help services and home care services, and to establish many day care centers and short term care centers. Through this, it will prevent caregivers from becoming burnt out due to the burden of care giving.

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A Preliminary Study on the Classification of Visiting Nursing Service Recipients and the Development of Standardized Visiting Nursing Service Pathways Based on Public Health Center (대도시 보건소 동단위 방문간호 대상자의 군분류 및 표준 방문간호서비스 경로 개발을 위한 기초연구)

  • Hwang, Rah-Il;Ryu, Ho-Shin;Suk, Min-Hyun;Chin, Dal-Lae
    • Research in Community and Public Health Nursing
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    • v.16 no.4
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    • pp.381-391
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    • 2005
  • Purpose: The purpose of this research is to develop and classify district visiting nursing standards and to standardize visiting nursing service pathways. Method: This research was conducted as a focus group study and analyzed visiting nursing records. We surveyed 201 recipients at urban health centers, who were selected through convenient sampling, from April 2003 to November 2003. Result: First, visiting nursing service recipients were classified into four groups according to household and financial characteristics, existence of disease, ability of self-care, and existence of home care service needs. Standardized pathways of the selected items were assessment. nursing care plan, disease management and promotion of self-care ability for Level I (mean=12.2 visits). For Level II (7.3 visits) were offered assessment. disease management. health education. and health promotion services. For Level III (5.2 visits) were offered assessment. disease management. health education and health promotion services, and for Level IV (2.7 visits) were offered thorough assessment, education for self-care and health promotion. Conclusion: The visiting nursing service pathways identified in this research need to be developed further as basic materials applicable to quality assurance and agency evaluation. For this, we suggest repeated research and test to apply the derived standardized visiting nursing services pathways in visiting nursing programs.

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A Comparison of Cost between Home Care and Hospital Care - According to Subject′s General Characteristics - (뇌혈관질환자에서의 가정간호이용시와 병원입원시 비용 비교 - 대상자의 인구학적 특성을 중심으로 -)

  • 임지영
    • Journal of Korean Academy of Nursing
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    • v.33 no.2
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    • pp.246-255
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    • 2003
  • Purpose: This study was designed to compare direct cost and indirect cost between home care and hospital care according to subject's characteristics. Method: The subjects of this study were patients with cerebrovascular disease. They were 50 patients in six university hospitals and 49 in four home care centers. Data were collected by using two type of questionnaires and reviewing medical records, home care service records and medical-fee claims from April 4th to September 13th, 2001. Result: The results were as follows; First, there was a statistically significant difference of direct cost between home care and hospital care, however, there was not a statistically significant difference of indirect cost. Second, according to subject's characteristics, six variables had statistically significant differences; sex, age, marital status, economy, job and diagnosis. Conclusion: It was found that cost-saving effect of home care was affected by subject's characteristic factors. More study needs to be done to develop a more detailed selection criteria for home care subjects.

A Study on Home Care and Home Visiting Nursing in Japan (일본의 재가간호 및 방문간호 -새로운 개호보험제도의 실시를 앞두고-)

  • Kim, Jeung-Im
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.106-120
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    • 1999
  • Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

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The Follow-up Study of Changes in Frailty in Elderly Receiving Home Health Care of the Public Health Center

  • Lee, Dong Ok;Chin, Young Ran
    • Research in Community and Public Health Nursing
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    • v.30 no.4
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    • pp.528-538
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    • 2019
  • Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.