• 가정∙방문간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• 한국보건간호학회지
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• 제16권1호
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• pp.77-94
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• 2002

This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

• 대한간호학회지
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• 제13권1호
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• pp.34-41
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• 1983

This study was concerned with the investigation of the relationship between the degree of family incongruence about family environment and the occurrence of juvenile delinquency using Family Environmental Scale (F.E.S) designed by Rudolf Moos. The study employed the control group design using the interview and questionnaire through home visiting. The control group sample consisted of 44 families from a middle socioeconomic S Dong community setting and the experimental group sample consisted of 30 families of juve nile from Juvenile Training School in Seoul, Total sample size was 321. Data for this study was collected over a period of three months from the end of Nov. 1982 to the beginning of Feb. 1983, after pretest. To analize the data, t-test was used. The result of this study was as follows; 1. The experimental groups' incongruence score was 18.8598 as compared to the control groups' score of 14.8598. The differences were statistically significant at .001 level, and the hygothesis was supported. 2. The experimental group had higher incongruence scores as compared to the control group of three dimensions, the differences were statistically significant at .05 level. The experimental group had higher incongruence scores than the control group on 6 subscales, namely, cohesion, expressiveness, conflict, achievement orientation, moral-religious emphasis and organization. The differences were statistically significant at. 05 level.

• 지역사회간호학회지
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• 제21권4호
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• pp.502-511
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• 2010

Purpose: The purpose of this study was to investigate the influencing factors of influenza vaccination in the elderly participating in lifetime transitional health examination. Methods: This study was a secondary analysis of data collected from lifetime transitional health examination (for 66-year-old people) conducted by the National Health Insurance Corporation (NHIC) from January 1 to December 31, 2008. Questionnaires were received from NHIC to obtain information regarding gender, chronic diseases, health-related behaviors, and ADL. A total of 255,333 participants who responded all the questions in the questionnaire were included in the analysis. Collected data were analyzed by descriptive statistics, ${\chi}^2$ test, and multiple logistic regression. Results: The influenza vaccine coverage rate in 66-year-old people was 66.1%. The influenza vaccine coverage rate was higher in female elders and those with hypertension, diabetes, heart disease or past smoking, and lower in those with stroke, current smoking, drinking, no-exercise or ADL-dependency. Conclusion: Strategies for improving the influenza vaccination coverage rate in the elderly are needed. The strategies should give priority to the elderly with current smoking, drinking, and no-exercise, and home visiting programs are needed for the elderly with stroke and ADL-dependency.

• 농촌지도와개발
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• 제8권2호
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• pp.223-234
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• 2001

The community consciousness used to be the core of the social capital in rural Korea, and there used to be a long tradition of mutual trust and cooperation in rural village community in Korea. However, recent trends in rapid urbanization or de-ruralization may affected community consciousness and social capital in rural society in Korea. The social capital has been existed in terms of mutual trust, commonly shared norms, and cooperative behavior in farm work and daily life of rural people. Commonly shared norms and networks have accelerated social effectiveness and promoted cooperative work as well as moral and spiritual aspects of rural society. Social capital in terms of community consciousness, participation of village work, visit and invitation of the neighborhood, and participation in various village group and networks were suveyed in JanggogRi, Jori Myun, Paju city, Gyeonggi province. The data collected from 65 persons, and the major findings of the study were as follow; The respondents responded that the community consciousness of de-rural area decreased in general with a few exception in the groups of alumni, family, religion and voluntary society. Social capital in terms of participation of village work, visiting the neighbors and voting increased slightly. Further research on social capital should be conducted to strengthen community consciousness, and various measures to increase the social capital should be adopted for livable community development.

• 한국보건간호학회지
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• 제30권2호
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• pp.300-310
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• 2016

Purpose: The purpose of this study was to understand the role of community health nurse through a nurse practitioner of primary health care post. Methods: An assay, 'Even if we were allowed to look at', written by a nurse practitioner of primary health care post was analyzed with the contents analysis method. Results: In the assay, we checked the following roles: client-oriented, delivery-oriented, and population-oriented roles described and classified by Clark. In particular, direct care such as in-patient care, home visiting nursing care, and drug prescription was frequently performed. Moreover, community health nurse has been listening, counselling, expressing sympathy, and advocating vulnerable elderly people economically and psychologically. Conclusion: The assay gave us a better understanding of the role of community health nurse, and we need more assays delineating the role of community health nurse in others setting as well primary health care post.

• 한국농촌건축학회논문집
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• 제17권4호
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• pp.83-90
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• 2015

The equalization policy needs various factors-standardization of educational environment, standardization of learning method, standardization of teacher ability, etc. Especially the standardization of educational environment is the base of various factors. But the recent educational environment condition of high school is not equal. The purpose of this study is to provide basic data for equal learning environment condition in high school applying departmentalized classroom system. This study has progressed through analyzing on 9 remodelling case of high school in Gangwon-Do. The method of this study is visiting high schools that operate the system, grasping the condition for environment composition, and investigating and analyzing practical use of the environment. The results of this study are summarized as follows: 1) The space compositions for departmentalized classroom system are generally desirable, but some schools take irrational space composition, especially on home base-teacher laboratory, classroom-teacher laboratory. 2) The space area distributions are different in every school. This result is based on not taking standard criterion on space area distribution.

• 성인간호학회지
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• 제18권5호
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• pp.809-818
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• 2006

Purpose: The purpose of this study was to evaluate the effect of antioxidant vitamins and magnesium supplementation on fasting blood glucose and lipids in patients with type 2 diabetes. Methods: This study is a unequivalent control group pretest-posttest design. Seventyone subjects with type 2 diabetes who were recruited from home visiting clients of a public health center, completed the trial. The experimental group entered a 12-week treatment period with antioxidant vitamins and magnesium and the control group with no antioxidant vitamins and magnesium. Results: Serum level of fasting blood glucose decreased from $134.7mg/d{\ell}$ to $125.0mg/d{\ell}$ and total-cholesterol decreased from $215.5mg/d{\ell}$ to $198.2mg/d{\ell}$ in the experimental group. No changes in fasting blood glucose and total-cholesterol were demonstrated in the control group. Conclusions: A short-term supplementation with antioxidant vitamins and magnesium can reduce fasting blood glucose and total-cholesterol in patients with type 2 diabetes. The continuous effect of this supplementation and the beneficial effect on the prevention of diabetes complication still needs to be demonstrated.

• 지역사회간호학회지
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• 제29권3호
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• pp.335-348
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• 2018

Purpose: This study has been conducted to develop and examine a health promotion empowerment program using a lay health leader for frail elderly. Methods: The research was organized in a nonequivalent control group pre-post test design. Data collection was performed from August 18 to October 8, 2015. The subjects included 76 frail elders aged over 65 registered in home visiting services (Experimental group=39, Control group=37). A health promotion empowerment program using a resident volunteer as a lay health leader was run for 8 weeks. Health factors (health promotion behavior, perceived health status and frailty) and empowerment factors (empowerment, social participation) were assessed. The data were analyzed by using the SPSS/WIN 18.0 program. Results: After the program, health promotion behavior, perceived health status and social participation increased in the experimental group more significantly than in the control group, but frailty decreased in the experimental group greater than in the control group. Conclusion: The health promotion empowerment program using a resident volunteer as a lay health leader was effective. Therefore, the health promotion empowerment program needs to be expanded to other frail elders. Also, a health leader should be recommended as a public health resource and systematically managed.

• 한국보건간호학회지
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• 제17권2호
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• pp.287-298
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• 2003

This study was conducted to identify the health care utilization, health care costs, and potential health care demands of the disabled in the Medicaid Aid beneficiaries. This study focused on the heath care costs not included in the medical aid allowance such as transportation, informal nursing costs, and ambulatory aids etc. Participants were the 864 subjects who were beneficiaries of the National Medical Aid program living in 10 district of Korea. A questionnaires were distributed to the disabled in the Medical Aid beneficiaries during August to September, 2001 through public offices. Data were collected through a home visiting by social workers working in public offices. Direct and indirect medical costs expended for one month by the participating disabled were examined. They expended 110.748 won $({\$}100)$ for heath care costs, which was not included in the medical aid allowance during the month. The disabled with cerebral diseases or who have level 4 disability expended more health care costs compare to those with other diseases. Gradual expansion of medical aid allowance for the disabled is recommended to alleviate economic burden of the disabled and their family.