• 제목/요약/키워드: Home and Community Based Care

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대학연계형 연속보호체계형 노인주거환경의 서비스 및 프로그램 운영 분석 연구 - 미국의 사례를 중심으로 - (An Analysis of University-based Continuing Care Retirement Communities' Services and Programs Management - With a Focus on Three Cases in the United States -)

  • 김미희
    • 한국주거학회논문집
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    • 제28권2호
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    • pp.75-83
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    • 2017
  • This study aimed to identify services and social and leasure programs that will be needed for helping senior residents to be aging healthfully and comfortably in the university-based continuing care retirement community (UBRC). This study conducted case study targeting three representative university-based CCRCs in the east area of United States such as Oak Hammock (OH) at Florida state, Kendal at Lexington (KL) and The Collonades (C) at Virginia state. There were three types of services in the UBRC, which were meal services, healthcare services, and personal services. Those services were different from the level of care such as independent living, assisted living, nursing home and memory care. Meal services and personal services were very similar among three UBRC, whereas healthcare services of OH were higher level of quality and diversity than the others. The social and leisure programs were categorized in-house programs, university outreach program and intergenerational programs between residents and students attending to related university. In-house programs and university outreach program were almost similar among three UBRC, whereas intergenerational programs of OH were well organized and actively operated than the others. This study results are expected to provides essential information for the development of Korean style services and programs of university-based CCRCs in the future.

노인전담 방문간호사 교육 프로그램 개발 및 평가 (Development and Evaluation of Geriatric Visiting Nurses' Educational Program)

  • 백희정
    • 가정∙방문간호학회지
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    • 제25권3호
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    • pp.240-248
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    • 2018
  • Purpose: The purpose of this study was to evaluate the validity of an educational program developed for geriatric visiting nurses in Seoul by assessing their satisfaction level and level of learning goal achievement. Methods: This descriptive research study was conducted to develop, implement, and evaluate the educational program in accordance with the ADDIE Instructional System Model. Participants were 170 nurses hired for the 2016 Seoul Metropolitan Government visiting service for older people. Based on Kirkpatrick's Training Evaluation Model, reaction and learning evaluations were conducted during and after the educational program. Data were analyzed using descriptive statistics. Results: The developed educational program consisted of basic and professional courses. The evaluations showed that participants were highly satisfied with the lectures and field placement. Over 90% of the participants achieved the learning achievement goals. Conclusion: The program developed for geriatric visiting nurses in Seoul is considered a valid educational program because of the participants' high levels of satisfaction and academic achievement.

영유아 건강증진을 위한 지역사회 간호센터 모형 구축 (Development of A Community-Based Nursing Center Model: Focused on Health Promotion of Infant & Toddler)

  • 오가실;김의숙;김인숙;서미혜;함옥경;김광숙;;조원정
    • 지역사회간호학회지
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    • 제13권4호
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    • pp.795-807
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    • 2002
  • Objectives: The purpose of this study was to develop a community-based nursing center model that can provide health promotion for infants and toddlers as well as a research and practice site for nursing faculty and students. Methods: Review of current health care system and health promotion programs, and workshops with brain-storming were carried out to identify needy areas of services to be provided by the nursing center. Finally, the community nursing center model was developed through expert consultation and filed visits. Results: The services and programs were developed for infants and toddlers residing in Seoul area. These services and programs include growth and developmental screening, environment and health problem assessment, infant stimulation and parent education, and self-help group. Full-time and part-time staff nurses and nurse practitioners will provide those services and offer home visiting if needed. Database system, health information system, and trainers' training programs were developed as well. Conclusion: The nursing center model developed in this study will ensure clients direct access to nursing care and increase of autonomy and accountability of nursing practices. The nursing center model focused on disease prevention and health promotion will enhance the quality of life of the infants, toddlers and their families as well as to decrease national health care expenditure.

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재가 방문구강관리 중재에 의한 시청각장애 노인의 구강건강상태 변화 (Changes in the oral health status of older adults with visual and hearing impairments through home oral health care intervention: a case report)

  • 윤해수;정민숙;장종화
    • 한국치위생학회지
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    • 제23권1호
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    • pp.13-23
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    • 2023
  • Objectives: This case study was conducted to assess the changes in the oral health status of older individuals with hearing and visual impairments through home oral health care based on community care. Methods: The participants were two older adults with hearing and visual impairments. Through home visits, an oral health intervention program, including oral hygiene care and training on strengthening of oral function, was conducted once a week for 5 months. Dental hygienists performed special oral health interventions such as dental plaque control through individual tooth brushing and interdental care, training on strengthening of intraoral and extraoral muscle function, and denture care for the individuals with visual-hearing impairments. Results: The overall periodontal health status and oral muscle function improved in older adults with hearing and visual impairments. In the case of the visually impaired individuals, changes in the oral health status were oral mucosal moisture (30.1 and 37.2 points before and after intervention, respectively), salivary secretion (3.5 and 4.0 cm before and after intervention, respectively), and maximum tongue pressure (20.5 and 26.2 kPa before and after intervention, respectively). Changes in the oral health status of the hearing impaired individuals increased from 28.3 points before the intervention to 38.4 points after the intervention, and the maximum tongue pressure increased from 1.85 kPa to 23.5 kPa after the intervention. Conclusions: Oral health intervention activities contributed to improving the periodontal health and oral function of older adults with hearing and visual impairments. To improve their overall and oral health, it is necessary to prepare measures to activate customized oral health intervention programs.

방문간호서비스의 직무특성이 방문보건인력의 심리적 임파워먼트에 미치는 영향 (The Effect of Job Characteristics on Emotional Empowerment in Visiting Health Personnel)

  • 임지영;김인아;김지윤
    • 가정∙방문간호학회지
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    • 제15권1호
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    • pp.14-21
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    • 2008
  • Purpose: The aim of this study was to analyze the effects of job characteristics on emotional empowerment in visiting health personnel. Methods: Subjects were recruited in ten community health care centers in one directorial area. Data collection was done using a self-report questionnaire. Job characteristics of visiting healthcare personnel were measured using the questionnaire developed by Kang (2006), based on Hackman & Oldham (1975). Emotional empowerment was measured using the questionnaire developed by Kang (2006), based on Spreitzer (1995). Results: First, the score of job characteristics was revealed to be 3.51 points the task significance was high, and the feedback was low. Second, the level of emotional empowerment was revealed to be 3.78 points the meaning was high, and the impact was low. Third, the prediction power of job characteristics on emotional empowerment was 34% autonomy, task identity, and task significance were identified as statistically significant predictive factors. Conclusion: The job characteristics of visiting healthcare personnel are highly correlated with emotional empowerment. Autonomy, task identity, and task significance are predictive factors of emotional empowerment. These results can be used to develop more effective job planning for increasing organizational effectiveness in visiting healthcare personnel.

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재활교육이 보건간호사의 재활에 대한 지식, 태도, 실천에 미치는 효과 연구 (A Study on the Effect that Rehabilitation Education Influence on the Knowledge Attitude and Practice of Public Health Nurse)

  • 조계숙;유인자;배정희;이영자
    • 대한간호
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    • 제36권5호
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    • pp.63-73
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    • 1998
  • The home visiting health nurses are important man-power who can serve various and persistent rehabilitation care to disabled person in community. The Community Based Rehabilition project(CBR) of national rehabilition center have been carried out from 1995. As a part of that project national health center performed rehabilition education program for home visiting health nurses. The purpose of this study is to analysis the effect of this education. In the first stage all of those groups were educated for two weeks in national rehabilitation center. But only two group nurses, one is in a urban and the other in a rural community, have been educated continually in the field through discussing rehabilitation care case study. The data in this study were gathered from three group healh nurses and analysed by SAS computer program. The results about knowledge, attitude and practice changes of the three group nurses were as follows. 1. In the pre education state the mean point of all nurses' attitude for rehabilition was 59, but in the post education state that was 90. The difference between pre and post attitude is very significant(t=-14.1. p<0.0001l). 2. In the pre education state the mean point of all nurses' knowledge for rehabilition was 45, but in the post education state that was 78. The difference between pre and post knowledge is very significant(t=-12.7, p<0.000l). 3. In the pre education state the mean point of all nurses' practice for rehabilition care was 37, but in the post education state that was 62. The difference between pre and post practice is very significant(t=-7.3, p<0.000l). 4. In practice point, the two group nurses who have been educated continuously were superior to the other(t=-3.9. p<0.00l). 5. All points between the urban and rural nurses were no significant differences(p>0.l). 6. All changes of the attitude, knowledge and practice did not affected by age(F=0.58, p>0.l). professional career(F=O.61, p>0.l), educational background(F=0.97, p>0.l).

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서울시 자치구 건강가정지원센터 이용자의 가족건강성 및 프로그램 요구도 (Family Strengths and Program Needs of Seoul Local Healthy Family Support Center Participants)

  • 손서희;계선자
    • 가정과삶의질연구
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    • 제32권6호
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    • pp.19-30
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    • 2014
  • The purpose of this study was to identify the relationships between Healthy Family Support Center (HFSC) program participation and family strengths and program needs based on HFSC participants' individual, family, and community characteristics. A total of 695 HFSC participants who were married and had participated in HFSC programs were recruited through 25 local HFSCs in Seoul. A multiple regression method was conducted for data analysis. The major findings are as follows. Family strengths was related to the variables of age, education, monthly household income, and participation in family counseling and sharing family care programs. In terms of program needs, the variables of marital conflict, difficulty in care, financial distress, family strengths, and family-friendly community were associated with HFSC program needs while participants' socio-demographic characteristics were not related to program needs. This study highlights that HFSC programs have different target populations considering that the level of family strengths was different among the various programs' participants. In addition, program needs are different depending upon the HFSC participants' experiences in the family and community. These findings suggest that it is important to consider participants' family and community characteristics as well as participants' socio-demographic characteristics to provide appropriate programs for all HFSC participants.

서울시 보건소 방문간호 수요.공급 추계 (An Estimation on the Need and Supply for Visiting Nursing Services of Health Center in Seoul)

  • 명재일;황라일;유호신
    • 지역사회간호학회지
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    • 제14권4호
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    • pp.587-597
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    • 2003
  • Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.

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이중차이분석을 활용한 노인장기요양보험제도의 방문간호서비스 효과 (The Effects of Visiting Nursing Services in Long-term Care Insurance: A Difference-in-Difference Analysis)

  • 김지은;이인숙
    • 지역사회간호학회지
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    • 제26권2호
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    • pp.89-99
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    • 2015
  • Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

An Improved Particle Swarm Optimization Algorithm for Care Worker Scheduling

  • Akjiratikarl, Chananes;Yenradee, Pisal;Drake, Paul R.
    • Industrial Engineering and Management Systems
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    • 제7권2호
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    • pp.171-181
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    • 2008
  • Home care, known also as domiciliary care, is part of the community care service that is a responsibility of the local government authorities in the UK as well as many other countries around the world. The aim is to provide the care and support needed to assist people, particularly older people, people with physical or learning disabilities and people who need assistance due to illness to live as independently as possible in their own homes. It is performed primarily by care workers visiting clients' homes where they provide help with daily activities. This paper is concerned with the dispatching of care workers to clients in an efficient manner. The optimized routine for each care worker determines a schedule to achieve the minimum total cost (in terms of distance traveled) without violating the capacity and time window constraints. A collaborative population-based meta-heuristic called Particle Swarm Optimization (PSO) is applied to solve the problem. A particle is defined as a multi-dimensional point in space which represents the corresponding schedule for care workers and their clients. Each dimension of a particle represents a care activity and the corresponding, allocated care worker. The continuous position value of each dimension determines the care worker to be assigned and also the assignment priority. A heuristic assignment scheme is specially designed to transform the continuous position value to the discrete job schedule. This job schedule represents the potential feasible solution to the problem. The Earliest Start Time Priority with Minimum Distance Assignment (ESTPMDA) technique is developed for generating an initial solution which guides the search direction of the particle. Local improvement procedures (LIP), insertion and swap, are embedded in the PSO algorithm in order to further improve the quality of the solution. The proposed methodology is implemented, tested, and compared with existing solutions for some 'real' problem instances.