Majority of the seniors living in nursing homes suffer from persistent chronic pain, which may cause depression and compromised quality of life if untreated. The environment should support them to lift their focus from current pain and worries to the positive feelings and the delight of life. The purpose of this research is to classify the healing environment elements for positive distraction, and analyze 6 international cases to see the current situation. The elements were categorized as follows, based on literature review from both healing spaces and elderly care field: spatial elements(view, natural elements, artificial elements, exercise space, garden), psychological elements(grooming area, space for privacy, meal/drink area, elements for recollection, religious space), social elements(common living area, activity/hoppy room, family/visitor area, information area, local community program space). Analysis on 6 facilities showed that each elements were reflected to designed relatively well. New inventions from workers who think distraction is important were also introduced. Healing environment for positive distraction requires delicate touch, derived from understanding characteristics and situation of the residing elderly individuals. Technology update is also significant, from audio books to virtual reality devices, since cultural life of nursing home is far behind from what the others enjoy now.
The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.
Joung, Se Ho;Lee, Jung Woo;Bae, Da Young;Kim, Yoo Kyung
Journal of Korean Home Economics Education Association
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v.33
no.1
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pp.151-167
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2021
This study reports on the development of a dietary education program for Korean young adults in single-person households. The 7th National Health and Nutrition Survey (2016-2018) was used to compare and analyze the dietary behavior of single-person households and multi-person households, and an online survey was conducted on 350 young adults (age 19-39 years) living in Seoul. According to the analysis, single-person households had higher rates of breakfast and eating out than multi-person households, and significantly lower average intake of energy and nutrients (p<0.05). In particular, in the case of single-person households, the lower the frequency of cooking at home, the higher the rate of breakfast and the higher the frequency of eating out and delivery food (p<0.05). Based on the survey, a dietary education program for young adults single-person households was developed by applying the DESIGN six-step procedure and social cognitive theory as a conceptual model. The first session consisted of the health and economic benefits of home-cooked meals, the second session of the importance of the breakfast and the effect of exercise in life, the third session of the importance of balanced nutrition and the principles of a healthy diet, the fourth session of food safety and storage, and the fifth session of social dining. Each session was composed of a combination of theoretical lectures to motivate 'more making and eating healthy home-cooked meals' and cooking practice for improving behavioral performance.
Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. Results: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). Conclusions: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.
Journal of Korean Academy of Fundamentals of Nursing
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v.8
no.1
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pp.81-94
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2001
The purpose of this study was to identify levels of activity of daily living, self-efficacy. stroke specific quality of life and need for self-help management program for patients with hemiplegia in the home. Data were collected from June to November, 2000 and subjects were 88 poststroke patients who lived in Seoul and Kyunggi-do. The questionnaire consisted of 5 scales: activities of daily living, self-efficacy, stroke specific qulaity of life and need for a self-help management program. Data were analyzed using frequencies, percent, paired t-test, and Pearson's correlation coefficient with the SAS(version 6.12) program. The results are as follows ; 1) Most of subjects were Partially independent in ADL, but they needed assist once to do dressing, bathing meal preparation and house keeping work. 2) The mean self-efficacy score was 54.89(range : 1 to 80) and the individual differences were large. 3) Subjects responded that they were satisfied on the stroke specific quality of life scale totaled 65.8%. This value is comparatively low, especially for social role(51.4%), family functioning(58.3%) and mood (62.2%). 4) The highest needs for self-help management programs were for physical therapy, stress management, and range of motion exercise and the lowest needs were for elimination management and training, family counseling, and speech therapy. 5) On the demographic variables, sex showed significant differences for the dependent variables. Females had higher scores than males for IADL, self-efficacy, stroke-specific quality of life, and need for self-help management. 6) Age had high negative correlation with ADL, self-efficacy and stroke specific quality of life. Age was also correlated with need for self-help management. In conclusion, there was a high correlation for ADL, Self-efficacy and Quality of life in poststroke patients of home. The patient with a stroke also had a strong need for self-help management programs especially physical therapy and stress management. Therefore rehabilitation programs based on self-efficacy enhancement need to be developed in order to promote independent living for patients with hemiplegia.
The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.
The purpose of this study is to see difference based on age, sex, sociometric ststus for perceived competence of children and difference about perception of responsibilities degree of parents of these children. the content of study as follows. 1. How is the difference about perceived competence of children based on age, sex, sociometric status. 2. How is the difference about perception of responsibilities of children based on age, sex, sociometric status. 3. How is the relationship between father and mother. The subject of this study is children and their parents of 126 persons of the third grade, sixth grade of S elementary school, the second grade of S middle school, the second grade of S girls' middle school which are located in Pusan city. This study used a peer nomination among sociometric assesment method as sociolity assessment means, self-perception profile for children of Harter(1985) as perceived competence assessment means of children and used self-perception profile for children which amends fits for parents. the collected data are managed by SPSS/PC+ program. We analyze three-way ANOVA to verify study question No, one, two, analyze t-verification and Pearson's product moment correlations to verify study question No. three. The result of this study as follows. First, in investigating difference about perceived compretence of children based on age, sex, sociometric status, we can see that children perceive high, self-ability for low ages. Also, boys than girls, popular children than rejected children, neglected children perceive high self-ability. Second, in investigating difference about perception of responsibilities of children based on age, sex, sociometric status, we can see that mother perceive responsibilities in learning sphere, exercise sphere, the whole self-value sphere and father perceive responsibility only in social sphere. Third, in investigating relation between perception of responsibilities of father and mother, this shows that difference between perception of responsibilities of father and mother is not showed ane have (+) interrelation of r=.46(P<.001) between perception of responsibilities of father and perception of responsibilities of mother.
This study is aimed at developing a cardiac rehabilitation program and enlightening the effects of the program on patient's health behavior compliance, cardiovascular functional capacity, and quality of life. Using a quasi-experimental approach the nonequivalent control group pretest - posttest design was accepted for this study. The subjects of this study consisted of 55 patients with ischemic heart disease at the Cardiac Center of 'G' Hospital located in Inchon from May 1, 1998 to April 30, 1999. The patients were divided into two groups: the experimental group, which participated in the cardiac program with 30 patients and 25 patients of a control group were not involved in the program. There were two phases in the cardiac rehabilitation program: the first phase was a team approach education. It focused on reducing the risk of ischemic heart problems. The second phase was individual training by using a home based exercise program, which was comprised of 8 weeks, three sessions per week, 40-60 minutes per session, and followed by consultation. Every session involved 20-40 minutes of aerobic exercise at 40-60% of heart rate reserve, 11∼13 RPE and 10 minutes of warm-up and 10 minutes of cool-down exercises. The experimental tools for the study were the health behavior compliance scale developed by Lee, Yoon-hee (1992), and quality of life scale developed by McGirr et al.(1990). RPPsubmax were measured by the treadmill. The collected data was processed by SPSS and analyzed by χ²test and t-test. The results of this study were as follows: 1. The health behavior compliance in experimental group was significantly increased (t=5.091, p=.000) when compared to the control group. 2. RPPsubmax also decreased significantly in the experimental group when compared to the control group(t=-2.109, p=.040). 3. The quality of life significantly improved in the experimental group (t=3.853, p=.000) as compared to the control group. As the above results of this study revealed, the effectiveness of the cardiac rehabilitation program of the study was confirmed. It increased the health behavior compliance for reducing the risk of further coronary events, enhanced the cardiovascular functional capacity, and eventually improved the patient's quality of life.
Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.
Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
Journal of Korean Academic Society 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.
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