• Title/Summary/Keyword: Home care nursing diagnosis

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Development of Dementia Care Model in a Community (지역사회 치매관리 모형 개발 : 광명시의 경우)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • Health Policy and Management
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    • v.9 no.1
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    • pp.30-71
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    • 1999
  • There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

A Survey on Pain and Self-Care Behavior of Patients with Chronic Arthritis (만성 관절염 환자의 통증과 자기간호행위 관련요인)

  • Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.206-213
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    • 2003
  • Purpose: This study was designed to explore pain and self-care behaviors and identify related variables in patients with chronic arthritis. Method: One hundred fifty patients with arthritis were recruited from two university based arthritis centers according to selection criteria. Collected data were analyzed using the SAS program to analyze the responses to the structured questionnaires of the study. Result: Most of the participants expressed pain and the intensity of the pain was moderate. There were significant differences according to age, educational level, diagnosis, duration of illness, number of affected joint, and use of complementary therapy. Self-care behavior scores were moderately high. The highest practice was for 'regular visits to the hospital', and the lowest for 'applying physical therapy at home'. The mean self-care behavior scores showed significant differences according to economic status and educational level. Pain scores showed no correlation with self-care behavior. Conclusion: Developing self-management programs for patients with chronic arthritis should focus on self-care skills which are applicable in the relief of pain and enhancement of knowledge. The skills are recommended not only for better health practices but also for enhancing the level of well-being and life satisfaction.

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Dietary Supplement use among Elderly Women with Self-perceived Musculoskeletal Problems (지각된 근골격계 문제를 가진 여성노인의 건강기능식품 이용행태)

  • Kim, In Kyung;Ko, Young Ji
    • Journal of Home Health Care Nursing
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    • v.20 no.1
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    • pp.24-32
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    • 2013
  • Purpose: This study aimed to clarify the characteristics of musculoskeletal problems in elderly Korean women and their actual and current use of dietary supplements by conducting a descriptive survey. Methods: The 1-month study began on April 3, 2012. A total of 150 elderly women from City D responded to the survey questionnaire used in this study. Results: Among the respondents, 55.3% used dietary supplements, although they had not consulted a physician for a definitive diagnosis of their condition but reported a self-perceived musculoskeletal problem instead. In addition, they engaged in healthy behaviors such as exercising and dietary supplement intake, without receiving any medical treatment. Compared with the nonusers, the dietary supplement users self-perceived a relatively more serious musculoskeletal problem (t =4.566, p<.001). Among the most commonly used supplements, multivitamins ranked first, followed by glucosamine and omega-3. Conclusion: Nurses should thoroughly monitor and maintain a positive attitude toward their patients' use of dietary supplements in order to appropriately educate them about the proper use of supplements.

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Evaluation of Visiting Nursing Services for the Vulnerable Family in Urban Community (도시지역 취약가구의 방문간호서비스 평가)

  • Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.15 no.1
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    • pp.56-66
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    • 2004
  • Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

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The Reaction and the Supporting Need for the Mother in Caring for their Chronicly III Child after Discharge (퇴원에 따른 만성 질환아 어머니의 반응과 환아 돌보기 지지 요구)

  • Chai, Hyun-Yi
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.50-61
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    • 2001
  • With the improvement of current medicine, the number of the chronicly ill children are increasing. The illness of the child drives all of the family to despair. especially it is a burden on the mother who takes care of the ill child. She's faced with many emergencies and feels powerless. The home care for a child is for finding a child's problems early and mediating them. The purpose of this study was to investigate the mother's reaction following their chronicly ill child's discharge and to investigate the supporting needs for caring for an ill child. The subjects of this study were mothers with a chronicly ill child being discharged from a general hospital in Seoul and the data was collected from July 20 to September 30. Data was collected by using questionnaires which were developed by the researcher. (The questionnaires were composed of the average 5 points - Likert's method). The Mother's reaction means that the higher the score, the more negative the mother's thoughts about discharge are. Supporting need for caring for ill an child means that the higher the score, the higher the demand of nursing is. The statistical analysis used the SPSS program for t-test. ANOVA, and Pearson Correlation. The results of this study were as follows: 1. The mother's reaction scores following discharge were the lowest. 19 and the highest 72 so that the total average was 43.15. The answer, 'I worry that my baby will be troubled with illness again after discharge gained the high points (3.94 of 5 points). The answer. 'The discharge of my baby makes me gloomy' gained 2.05-it was the lowest points. Their were significant differences according to religion (p=.006). salary (p=.050). the burden of the medical fee (p = .005) and caregiver (p=.027). 2. Supporting Need for caring for ill an child was the lowest 15 and the highest 67. the total average was 47.87. The answer. 'I'd be glad to get a person whom I could always get counsel about the health of my baby with' scored the high point (average 4.04 of 5). The answer. 'Caring for my baby at home makes me exhausted' gained the lowest point. 2.49. Their were significant differences according to religion (p=.019) and diagnosis (p=.019). 3. The relationship between the reaction of the mother and supporting need for caring for an ill child was a positive correlation (r=0.585). In conclusion. this study revealed that mothers weren't positive about their chronicly ill child's discharge and they wanted to get support for caring for an ill child. Through this study. I proposed that the program to support the chronicly ill child at home and home care by continuous counselling after discharge should be develop.

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Factors Influencing Urinary Incontinence Quality of Life among Elderly Women in Home Visiting Healthcare Services (방문건강관리 대상 여성노인의 요실금 유병과 삶의 질 영향요인)

  • So, Aeyoung;Park, Sunah
    • Research in Community and Public Health Nursing
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    • v.32 no.3
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    • pp.243-253
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    • 2021
  • Purpose: The purpose of this study is to identify factors affecting the urinary incontinence (UI) prevalence and the quality of life among elderly adult women who are subject to home visiting healthcare services. Methods: A cross-sectional study was conducted with 400 women aged 60 or over who were registered for home health care services at one health center in Gangwon-do. Data were collected using a structured questionnaire consisting of UI severity, UI type, and the quality of life. The UI severity was assessed using International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF), the quality of life using Incontinence Quality of Life (I-QOL), and type of UI using Questionnaire for Urinary Incontinence Diagnosis (QUID). The data were analyzed by using x2 test, independent t-test, one-way ANOVA, Pearson's Correlation, binary logistic, and multiple lineal regression. Results: The prevalence of UI is 51.7%. The mean score of ICIQ-SF was 9.70±4.04 for women with UI and 0.04±0.51 for women without UI (t=-33.67, p<.001). As the frequency of day time urination (OR=1.34), the subjective health status (OR=1.45), and the educational status (OR=0.90) were higher, the risk of UI prevalence was the higher. The factors affecting I-QOL were ICIQ-SF score, mixed UI, subjective health status, and nighttime urination (adjusted R2=.61). Conclusion: The results of this study showed that UI severity, mixed UI, subjective health status, and day time urination affected the quality of life. It suggests that the assessment for the severity and type of UI be needed to prevent UI or improve the quality of life of UI vulnerable elderly adult women.

A Study of Family Caregiver's Burden for the Terminally III Patients (지역사회 말기질환자 가족 부담감에 관한 연구)

  • Han, Sung-Suk;Ro, You-Ja;Yang, Soo;Yoo, Yang-Sook;Kim, Sek-Il;Hwang, Hee-Hyung
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.58-72
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    • 2003
  • The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,

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The Educational Needs of Mothers of Nephrotic Syndrome Patients and the Degree of the Importance of Educational Activity Perceived by Nurses (신증후군 환아 어머니의 교육요구와 간호사가 인지한 교육활동의 중요도에 관한 탐색적 연구)

  • Sung Mi Hae;Jung Yun
    • Child Health Nursing Research
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    • v.3 no.2
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    • pp.169-177
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    • 1997
  • This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients and the degree of the importance of educational activity perceived by nurses who look after nephrotic syndrome patients. The study subjects were composed of 60 mothers & 63 nurses of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from Mar. in 1997 to July 1997. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. The data analysis was done by SAS. t-test, and ANOVA were done to determine the effect of general characteristics of subjects on their educational needs. T-test was done to measure relations between the degree of educational needs and importance of educational activity. The results were as follows. 1. The Educational needs of mothers ranked as the highest in home care. 2. In character of mothers, the degree of education, economic state, the number of child and occupation was significant in statistically. 3. The importance of educational activity of nurses ranked the highest in diagnosis and treatment of the disease. 4. The educational needs of nephrotic syn. children' mother and importance of nurses were different in diagnosis and treatment of the disease and home care. On the basis of these results, we suggest as follows. 1. It is proposed that nurses use these results of the study actively for the educational program for Nephrotic Syndrome patients and their mothers. 2. It is suggested to make a comparative study of the degree of nurses' understanding of the importance on educational items with the instruments of this study.

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The Factors affecting Burdens and Quality of Life of the Family Caregivers of Patients with Rare and Incurable Diseases Using Home Ventilators (가정용 인공호흡기를 적용한 희귀·난치성질환자를 돌보는 가족간호자의 부담감과 삶의 질 영향요인)

  • Hwang, Moon Sook;Lee, Mi Kyoung;Song, Jeong Rye
    • Korean Journal of Adult Nursing
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    • v.26 no.2
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    • pp.191-202
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    • 2014
  • Purpose: This study was aimed to survey the actual caregiving conditions of family caregivers who are caring patients with rare and incurable diseases using home ventilators at home, and to clarify any factors affecting their burdens and quality of life. Methods: A questionnaire survey was performed by the 159 subjects, and the questionnaires contained the actual conditions of caregiving activities, and caregiver's burdens and quality of life. The collected data was analyzed by ANOVA, Pearson's correlation, and stepwise linear regressions. Results: The mean of burden scores was 3.55 out of 5, and influencing variables included the relationships with patient (spouse), respite (moderate), health status, and diagnosis (non ALS), with the explanatory power of 30.0%. The mean of the quality of life was 2.58 point, and the influencing variables included burdens, health status, and respite (enough), with the explanatory power of 39.0%. Conclusion: In order to improve the quality of life among family caregivers caring for patients with using a home ventilator, it is required to develop strategies for reducing caregiving burdens as well as to introduce family respite welfare systems to family caregivers.

Overcoming Experiences of Family Members Caring for Elderly Patients with Dementia at Home (재가 치매 노인환자를 돌보는 가족원의 극복 경험)

  • Sung, Mi Ra;Yi, Myungsun;Lee, Dong Young;Jang, Hye Young
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.389-398
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    • 2013
  • Purpose: The purpose of the study was to understand and describe the overcoming experiences of family members caring for elderly patients with dementia at home. Methods: Data came from autobiographies on the overcoming experiences of caregiving from 31 participants, who had submitted the autobiographies to a public contest held by the Seoul Metropolitan Center for Dementia in 2012. Data were analyzed using qualitative content analysis. Results: Four overcoming stages emerged from the analysis: confronting stage; challenging stage; integrating stage; and transcendental stage, representing transformation of experiences from frustration and suffering to happiness and new hope in life. The confronting stage illustrates severe negative feelings and exhaustion occurring after the diagnosis of dementia. The challenging stage signifies major driving forces in taking good care of their patients. It includes tender loving memories about the patients as well as family and social supports. The integrating stage shows genuine empathy for the patients' situation and the happiness of 'here and now', while the transcendental stage represents new hope in the future. Conclusion: Health professionals need to support caregivers to find true meaning of caring and happiness in everyday life, while providing specific information on dementia care and relieving various negative feelings.