In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.
The Journal of Korean society of community based occupational therapy
/
v.8
no.3
/
pp.1-12
/
2018
Objective : This study conducted a preliminary study to develop a occupational therapy model focused on improving living functions within the community care system. Methods : From June to July, 2018, the literature on community care was researched, focusing on cases of Japan's Management Tool for Daily Life Performance (MTDLP), Sweden, United Kingdom, Germany and domestic S Elderly Care Centers and I Health Centers. Based on this information, a group of experts developed a occupational therapy model within the community care system. Results : Assessment tools such as occupation-based health promotional table, interest checklist, occupational goals for improving living functions, sheet for evaluation of living functions, survey of daily life time (weekday and weekend), and sheet for transition of living functions were developed to conduct evaluation for occupational therapy. The improving living functions program, analysis of activities based on ICF model, lifestyle redesign program, cognitive exercise therapy, the Lee Silverman Voice Treatment (LSVT), hospice, and home modification were also organized interventions already in place by occupational therapists. Conclusion : This study showed specific measures and models for the implementation of occupational therapy within community care systems. Occupational therapy is positioned as a specialized area that is essential to the client, and we look forward to the use of this model.
Journal of Korean Academy of Nursing Administration
/
v.18
no.1
/
pp.106-117
/
2012
Purpose: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. Methods: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. Results: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. Conclusion: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.
Purpose : This study, as the first year project of setting up a community based management system, was attempted for the cancer patients and their family to improve their quality of life; investigating and managing the cancer patients, educating volunteers and connecting the patients with the volunteers were performed. Method and result : The education of managing cancer patients for the volunteers was done once in lune for 2 days to the 80 volunteers. Questions about education effect, volunteer motivation and so on were made up. The survey showed, generally, education satisfaction level was high and a longer education and an intensive course were needed and was suggested that organizing a volunteer community be needed for the continuous further education and systematic management. As the result, after the public health center and volunteers deliberated, a volunteer community consisting of 4 teams, 28 members was organized, launched in Oct. and operated for the cancer patients and their family. For investigating and enrolling the patients, advertising on a local information paper, recommending of local doctors, publicizing by educating the heads of a subdivision of the city, the heads of a neighborhood association and the people in charge of the related local communities such as women's society, and surveying the community by volunteers were performed and the total, 41 patients were registered. Management of cancer patients was carried out by volunteers in a community and in a nursing school. A regional volunteers' community is composed of 23 members and they have worked 87 times, that is 3.8 times per capita on an average. The content of duties is attending the education (41.1%) the most. A volunteers' community of nursing students composed of 12 members have worked 135 times, that is 11.3 times per capita on an average. The content of duties - consulting with patients and home visiting (37.8 %) were the most and survey for investigating the cancer patients was the second. Conclusion : This study has the meaning that this is the guiding attempt in building a community based management system, and especially the achievement of this study is that a regional society organized a volunteer community for the cancer patients by itself and went into action for the cancer patients and their family. Furthermore, to activate this volunteering, it is necessary to keep managing volunteers and running continuing education or the intensive course of the volunteers. Indeed we should let the patients have good impression on this program through publicity and education for the residents to keep track of more cancer patients. For that, systematic and powerful cooperation of a self-administrative organization is required.
As the world's aging population increases, the aging problem in China, which has a huge population, has reached a serious situation. Therefore, this study intends to present the CCRC model of smart home care. Seven application factors of CCRC of smart home care and problems of CCRC of smart home care in China were derived through theoretical review and case analysis. Based on this, this study presented a value proposition for the 7 application elements of smart home care CCRC tailored to China's aging status and future technology demand. First, it improves the environmental atmosphere and increases the comfort of the spatial environment. Second, we value the physical and environmental safety of the elderly. Third, online convenience services are provided. Fourth, we guarantee the health and psychological health of the elderly. Fifth, it increases the efficiency of responding to unexpected situations. Sixth, predict the physical condition and surrounding environment of the elderly. Seventh, add more recreational rides. Through this, we expect to improve the quality of life by providing a safe and comfortable smart service environment for the elderly.
Purpose: The purpose of this study was to examine satisfaction with counseling in long-term care service, and to compare the scores of counseling satisfaction according to variables among beneficiaries of Korean long-term care services. Methods: Questionnaires were completed by 445 beneficiaries of long-term care insurance to measure satisfaction with counseling. Research design was cross-sectional descriptive design. Data were analyzed using descriptive statistics, t-test and ANOVA for evaluating differences in satisfaction with counseling according to variables including economic status, the level of long-term care insurance approval, duration of long term care service, and conditions of counseling. Results: The score of satisfaction with counseling was somewhat high as 71.67. The score of counselor's attitude was highest among the subcategories of satisfaction. The factors that influenced satisfaction with counseling were frequency and time of counseling (F=12.19, p<.001). Conclusion: Home-based individual counseling is necessary for the elderly who need long-term care service. The National Long-term Care Insurance Corporation should offer counseling and assistance to elders and their caregivers about long term care insurance.
Purpose: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs, Method: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. Result: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. Conclusion: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.
Purpose: The purpose of this study was to identify minimum datasets for ulcer assessment and to map the minimum datasets to paper-based nursing records for pressure ulcer care in homecare setting. Methods: To identify minimum datasets for pressure ulcer assessment, the authors reviewed four guidelines for pressure ulcer care. The content validity of the minimum datasets was assessed by three homecare nurse specialists. To map the minimum datasets to nursing records, the authors examined 107 pressure ulcer events derived from 45 pressure ulcer patients who received home nursing from two hospitals in Gyeonggi Province. Results: The minimum datasets for initial assessment were anatomical location, stage, size, tissue, exudate, condition of periwound skin, undermining, odor, and pain. 'Location' was recorded best, accounting for a complete recording rate of 98.1%. 'Exudate' and 'pain' showed the poorest record, accounting for 2.8% and 0%, respectively. The minimum datasets for progress assessment were wound size, tissue, and exudate, each accounted for 31.8%, 2.8%, and 4.7%, respectively. Conclusion: This study concluded that data on pressure ulcer assessment was not sufficient homecare and it can be improved by adopting minimum datasets as identified in this study.
Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.
Purpose: This study was to investigate the needs of health & community services among the disabled at home in rural areas. Methods: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. Results: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was $2.62{\pm}.79$: education services $(2.92{\pm}1.05)$; medical services $(2.81{\pm}.82)$ nursing care services $(2.75{\pm}1.08)$; connection services $(2.62{\pm}1.20)$;, housing services $(2.60{\pm}1.09)$; emotional services $(2.41{\pm}1.03)$; other services $(2.24{\pm}1.06)$; and support of self-sustenance service $(1.92{\pm}1.15)$. The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751. p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). Conclusion: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.
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