• 한국노년학
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• 제31권2호
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• pp.371-380
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• 2011

본 연구는 노인장기요양보험제도 도입 전후 의료기관 가정간호사업소 수 및 이용량 변화를 파악하고자 하였다. 건강보험심사평가원으로부터 노인장기요양보험제도 도입 직전 1년(2007.7.1~2008.6.30)과 제도도입 후 혼란기인 6개월 후 1년(2009.1.1-12.30)간 의료기관 가정간호 기본방문료(AN100)가 청구된 자료를 받아 분석하였다. 노인장기요양보험제도 도입 후, 약 40개 의료기관 가정간호사업소가 문을 닫았고, 사업소가 한 곳도 없는 시군구가 전체 시군구 중 53%에서 59%로 증가하였다. 또한, 노인의 의료기관 가정간호 이용은 물론(이용자수 13.4% 감소, 방문건수 20.9% 감소), 비노인의 이용도 감소하였다(이용자수 3.5% 감소, 방문건수 3.9% 감소). 비노인의 가정간호 이용감소는 가정방문 간호사업소의 감소로 가정간호에 대한 접근이 낮아져 나타난 결과로 유추할 수 있다. 가정간호사업소 당 총 수입액은 2009년 1년간 평균 121,850천원으로 최소 인력인 가정전문간호사 2인의 인건비를 감안하면 수익이 크지 않은 것으로 확인되었다. 이 연구결과를 통해 노인의 의료기관 가정 간호 이용감소는 노인장기요양보험 방문간호로 대체된다고 하더라도, 비노인의 가정간호 접근성을 높이기 위해서는 의료기관 가정간호사업소를 확대할 필요가 있다.

• 가정∙방문간호학회지
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• 제8권2호
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• 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.

• 가정∙방문간호학회지
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• 제2권
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• pp.52-59
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• 1995

This Study was done to examine the home health care service provided by home care nurses and the level of client satisfaction. Data were collected from 60 clients who received services from a home care center. The tool for measurement of satisfaction was composed 13 items and was 3 score scale. The results of this study are summarized as follows ; 1. By the disease pattern, subjects were distributed into cardiovascuvr disease(73.5%), digestire disease(10.2%), endocrine disease (6.1%), Senile dementia(6.1%) and the others(4.0%). 2. By the disease pattern, provided home health care services were follows; In cardiovascular disease and digestire disease, direct nursing service, education and physical assessment were provided every time. In senile dementia, direct nursing services were mainly provided and transfer and medication were rarely provided. 3. The level of satisfaction on provided home health services was high; mean score was 2.4 out of 3.

• 가정∙방문간호학회지
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• 제4권
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• pp.41-52
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• 1997

The purpose of this study is to identify the domestic research results related to the outcomes of home care services for 1981-1996. 12 studies were analized by the characteristics of the subjects, home care services provided, and outcome variables and tools during the period of Apirl-June, 1997. The results were as follows: the subjects of 8 studies conducted before 1993 were discharged patients comparing to early discharged patients of 2 studies conducted after 1994. The main home care service delivered to the clients and their families were education before 1993. The outcome variables were used the level of sat. isfaction of home care services, quality of care, cost-effectveness, health status, quality of life, and self -care ability. A variable, health status, were mainly measured by the global outcome measures such as quality of life, health hehelief, health perception, activity of daily living, health management pattern but also foused outcome measures that could be specified by the medical diagnoses.

• 한국보건간호학회지
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• 제24권2호
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• pp.211-225
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• 2010

Purpose: This comparative study analyzed information systems including manpower, contents of service, clients, and costs among four nations. Methods: A literature review of relevant publications from Korea, United States, Japan, and Germany supported the use of several plans to activate home nursing care services under the long-term care insurance system in Korea. Results: Korean home nursing care services require quality improvements. The results indicated that a rule is necessary that rations simple visiting service and home nursing care services under the long-term care insurance system, that an integrated management system for elderly care is required, and that the revised delivery of services needs to establish and reflect on various factors to estimate the value in a home visiting nursing care cost system. Conclusion: The data should be valuable in establishment of home nursing care services under the long-term insurance system in Korea.

• 가정∙방문간호학회지
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• 제4권
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• pp.86-100
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• 1997

The purpose of the study is to evaluate the community rehabilitation program of the two Public Health Center. Data were collected from the 138 clients who received rehabilitation services from visiting public health nurses. Data were analysed by SAS computer program. The result were as follows. 1. The clients have been average 7years disabled state until public health nurse visit them. 78.3% of them can't advance rehabilitation process because of insufficient family or social support. 2. The clients' burden due to their family's help was average 80.0 and that due to economic distresst was average 76.0. That factors were same that interfere rehabilitation process. 3. The clients needed exercise and modality therapy(78.2), economic support(76.0) and rehablitation advices (64.0). The needs of welfare benefit, medical service and social participation were 68.0, 61.5 and 54.5. 4. The pulblic health nurse visited the clients 2.3 time every month. And they have served emotional support (95.7%, exercise therapy (94.9%), family education(82.6%) and blood pressure management (71.7%), One client have received average 60% of the medical rehabilitation services and 27% of the refer services. 5. The rehabilitation effects of clients' attitude, knowledge and practice were 73.3, 81.0 and 68.7. The physical rehabilitation effect was 70.0. After receving rehabilitation services, the clients' preforrence to pulblic health center was 82.0. 6. The clients hopped that public health nurse visit them earlier (80.0). On the basis of this results, the following suggestions are proposed. 1. The pulblic health center is important institution in community rehabilition program, and every pulblic health center must participate in this program. 2. Various strateges have to be tryed and analysed to improve the visiting nurses' rehabilitation services. 3. For successful community rehabilitation, social welfare rehabilitation program must be developed and correlated with that of the pulblic helth center.

• 지역사회간호학회지
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• 제14권1호
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• 지역사회간호학회지
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• 제14권2호
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• pp.299-311
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• 2003

Purpose: This is a phenomenological study to describe the experiences of nursing students on home visiting nursing service as a community nursing practice. Method: Individual interviews were conducted on subjective experiences of 17 nursing students. Data were analyzed through Colaizzi's method in which meaningful statements were extracted and these were clustered into 6 themes. Result: The nursing students started practice with anxiety and expectation at the same time. They were frightened at the clients' inferior environment and their level of loneliness. They also felt pity and experienced complicated feelings for the clients. However, the home visiting practice was a chance for them to discard prejudice on the clients. Positive experiences on visiting nursing practice reported by the nursing students included lively interactions between nurses and the clients, and variable provision of primary nursing care. However, facts such as much limited visiting time, non-professional and limited scope of practice were reported as negative experiences. They felt both worthiness of the home visit service and restricted self-capability at the same time through the practice. They also felt sorry for the clients because the home visit services were carried out during limited time period. Regardless of this, the home visit experience provided them an opportunity of self-growth. This self-growth includes increased awareness of issues for elderly, building of self-identity as a nursing student, self-reflection, and realization of the value of family. Conclusion: This study may provide data for better understanding of nursing students experiences of home visiting nursing services. However, more study on the barriers of their community health practice is needed in the future. Moreover, it is needed to establish desirable practice environment through the collaborative relationships between the university and staffs in the public health center.

• 한국콘텐츠학회논문지
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• 제15권4호
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• pp.234-245
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• 2015

본 연구는 방문 요양보호사의 대인관계가 직무만족에 미치는 영향을 알아보기 위한 것으로, 방문 요양보호사들의 대인관계는 대인서비스적 업무 특성을 고려하여 수급자, 보호자, 동료, 기관장과의 관계로 구분하였다. 대전광역시의 방문요양서비스 제공기관에 근무하는 요양보호사 336명을 연구대상으로 하였으며, 수집된 자료는 SPSS 22.0프로그램을 이용하여 신뢰도분석, 빈도분석, 상관관계분석, 위계적 회귀분석을 실시하였다. 최종 분석 결과, 인구사회학적 특성의 영향력은 유의미하지 않았으나, 업무수행관련 특성 중 업무비중 우선순위, 이직경험, 직업선택이유는 직무만족에 유의미한 영향을 주는 것으로 나타났다. 특히 보호자와의 관계를 제외한 대인관계 요인은 영향력이 가장 큰 변수로서 직무만족에 유의미한 영향을 미치는 것으로 나타났다. 영향력은 기관장과의 관계, 수급자와의 관계, 동료와의 관계 순으로 컸으며, 관계가 좋을수록 직무만족도가 높았다. 본 연구결과는 방문 요양보호사의 직무만족을 향상시키기 위해, 기관 내외적으로 원만한 대인관계를 형성 할 수 있는 환경을 조성할 필요가 있음을 보여주고 있다.