• Human Ecology Research
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• v.51 no.3
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• pp.275-284
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• 2013

The purpose of this study is to provide useful insights into community-level support services for family caregivers in Korea by comparing them with the services in the United States. Similar to most developed countries, life expectancy has led to rapid population aging in Korea over the last several decades. However, despite increased social needs of long-term care for the elderly, many elderly Koreans are still dependent on their family for the long-term care. Yet, existing support programs for family caregivers are very limited. As a result, family caregivers often suffer from a lack of financial resources and emotional support. In this study, we comprehensively review the extensive literature, including relevant studies and documents of community-level support services for family caregivers of the elderly at home in Korea and the United States. One of the most important differences is that compared to Korea, diverse services based on the law of NFCSP to support the family caregivers, such as counseling, organization of support group, and educating have been available in the United States since 2000. Additionally, the legal definition of family caregivers in the United State is broader than that in Korea, where family caregivers are limited to those who are related by blood or marriage. Therefore, more caregivers are eligible for support programs and benefit from the programs in the United States. The findings of the study suggest that policy makers in Korea should legislate for diverse and comprehensive services for family caregivers. Further, it is necessary to define legal terms for family caregivers more broadly to extend beneficiaries of the programs.

• Journal of Korean Academy of Nursing
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• v.34 no.1
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• pp.191-201
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• 2004

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

• Health Policy and Management
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• v.16 no.4
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• pp.112-127
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• 2006

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

• Research in Community and Public Health Nursing
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• v.30 no.3
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• pp.295-306
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• 2019

Purpose: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. Methods: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. Results: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). Conclusion: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.

• Journal of Home Health Care Nursing
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• v.7 no.1
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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.

• Child Health Nursing Research
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• v.26 no.3
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• pp.366-375
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• 2020

Purpose: This study was conducted to evaluate the efficacy of a community-based follow-up program on parenting stress, parenting efficacy, and coping among parents with premature infants. Methods: A non-equivalent control group pre-post quasi-experimental design was used. This program consisted of structured home visits and self-help group meetings for 6 months. The experimental group (n=29) received visits by an experienced neonatal intensive care unit (NICU) nurse and the control group (n=27) was visited by a visiting nurse. Data were analyzed using the χ² test, t-test, and analysis of covariance. Results: Parents' coping behavior significantly differed in the experimental group compared to the control group (t=3.14, p=.003). In particular, coping subscale I, for maintaining the family situation (t=2.63, p=.011), and subscale III, for understanding the infant's medical situation (t=4.30, p<.001), showed significant differences in the experimental group. There were no significant between-group differences in parenting stress or parenting efficacy. Conclusion: The findings of this study suggest that home visits by an experienced NICU nurse provided through a community-based follow-up program were an effective intervention to improve coping behavior among parents with premature infants.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.109-119
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• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Journal of Korean society of Dental Hygiene
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• v.23 no.2
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• pp.91-103
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• 2023

Objectives: This case study was conducted to assess changes in the concentration of volatile sulfur compounds (VSCs) of older adults following home oral health care interventions based on community care. Methods: The participants were three elderly people with the halitosis. An oral health intervention programs including oral massage, oral hygiene care, and oral muscle training strenghtening were conducted for 12 weeks. Halitosis was measured using an oral malodor-checking device. Results: The program showed positive effects on changes in halitosis. The concentration of VSCs of the first case decreased rapidly from 44.5 Refres Oral Volume (ROV) on pre-test to 15.5 ROV on the first post-test. In the second case, the score decreased from 14.5 ROV on pre-test to 12 ROV on 2nd post-test. In the third case, the score decreased slightly from 6.5 ROV on pre-test to 6 ROV on the first post-test. Conclusions: Oral health care interventions contributed to decreasing the concentration of VSCs and improving the quality of life of older adults. The active promotion and customization of these programs are required.

• Journal of Home Health Care Nursing
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• v.23 no.2
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• pp.121-128
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• 2016

Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.

• Journal of Korean Critical Care Nursing
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• v.13 no.1
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• pp.63-75
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• 2020

Purpose : The purpose of this study was to review mobile health (mHealth) interventions based on studies from online databases for community-dwelling patients with heart diseases. Methods : Six databases (RISS, KISS, PubMed, CINAHL, EMBASE, and SCOPUS) were searched to select studies conducted from January 1 to September 30, 2010. After this, quality appraisals were carried out using the Scottish Intercollegiate Guidelines Network checklist and a total of 11 studies were selected. Results : The selected 11 studies included 7 randomized controlled studies, 1 quasi-experimental study and 3 pilot studies. The main components of mHealth interventions included symptom monitoring at home, provisions for individualized messages for health management using text messaging, telephone or smart phone applications, and running websites for symptom monitoring or health education. Intervention periods varied from 6 weeks to 12 months. The findings of the studies suggested that the mHealth interventions were effective in improving self-management of heart diseases, quality of life, and decreasing symptoms. Conclusions : The results of the review suggested that mHealth interventions had positive effects on community-dwelling patients with heart diseases. More mHealth intervention studies need to be conducted in Korea to aid community-dwelling patients with heart diseases.