• Journal of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect 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 of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records 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 tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.28-38
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• 2000

Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.

• Journal of Home Health Care Nursing
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• v.23 no.2
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• pp.147-154
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• 2016

Purpose: This study aimed to develop and apply simulation-based education, and to verify the effects of this type of education on nursing students' presence in education, systems thinking, and proactivity in problem solving. Method: Subjects were 69 senior college students recruited through convenient sampling. This study used a one-group pre-posttest quasi-experimental design. A structured survey was administered a week before and after provision of the simulation-based education once a week for 4 weeks. Data were analyzed using descriptive statistics and t-tests. Results: Teaching presence increased after the educational intervention; instructional design and organization, and aspect of direct facilitation subscales improved. Learning presence increased after the educational intervention; although cognitive presence did not change, emotional presence increased. With regard to emotional presence, perception and expression of one's emotional status increased, although emotional management did not change. Moreover, systems thinking increased. Among the subscales, team learning showed an increase after the educational intervention. However, there was no significant difference in proactivity in problem solving, although it showed an increase after the educational intervention. Conclusion: Based on the aforementioned study results, there is need to establish educational environments for qualitative teaching and learning presence, and devise strategies to increase learning effects with various teaching methods and type of content.

• Journal of Home Health Care Nursing
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• v.30 no.3
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• pp.264-275
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• 2023

Purpose: The aim of this study was to examine the influence of second victim experiences following patient safety incidents and positive psychological capital on the intention to remain among advanced beginner nurses working at tertiary hospitals. Methods: The participants were 179 nurses with a clinical experience of 13 to 36 months at two tertiary hospitals. We collected data using questionnaires related to second victim experiences, positive psychological capital, and intention to remain. Data were analyzed using descriptive statistics, independent t-test, a one-way analysis of variance (ANOVA), Scheffé test, Pearson correlation, and hierarchical regression analysis. Results: The intention to remain in advanced beginner nurses was negatively correlated with second victim experiences and positively correlated with positive psychological capital. A hierarchical multiple regression model with control variables (subjective job satisfaction and self-assessed work proficiency), psychological capital, and second victim experience accounted for 26% of the factors that influenced advanced beginner nurses' intention to remain. Among the related factors, the most influential was subjective job satisfaction. Second victim experience and positive psychological capital also influenced the advanced beginner nurses' intention to remain. Conclusion: The results of this study suggest a need to develop a program that helps promote intention to remain for nurses at the advanced beginner stage by minimizing second victim experiences and improving positive psychological capital and the work environment.

• Journal of Korean Academy of Rural Health Nursing
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• v.6 no.1
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• pp.15-22
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• 2011

Purpose: The purpose of this study was to analyze the present status of institutionalized persons and personnel of nursing homes for elders. Method: A survey questionnaire was distributed to 520 nursing homes nationwide, of which 308 nursing homes responded by completing the questionnaire. The data were collected from November 1 to November 14, 2008. The data were analyzed with descriptive statistics. Results: Most home care facilities were situated in small or medium sized cities (46.8%, 56.6% respectively). About half of the nursing homes had 50-99 institutionalized persons (43.4~42.5%). Most of the nursing homes were operated by social welfare ownership. Average number of institutionalized persons was 41.7 and operation ratio of facilities was 93.9%. For severity of problems, 30% of institutionalized persons were assessed as third grade indicating mid-point severity. The average number of personnel was 18.6. The number of full-time positions was greater than that of part-time positions. The average income for the director was 2,600,000 Korean won, for nurses, 2,000,000, for social workers, 1,940,000, for physical therapists, 1,820,000, and for care workers, 1,560,000. Conclusion: Strategies need to be developed to maximize the value of the existing workforce without impacting on the quality of care delivered.

• Korean Journal of Adult Nursing
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• v.19 no.3
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• pp.495-507
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• 2007

Purpose: This critical ethnography was performed to explore the experiences of nurses who are working with patients in an industrial disaster hospital. During the research process, I focused on the experiences of conflict in caring patients. Methods: Data for the study came from 13 informants with their corresponding patients through interview and observation from March 2002 to February 2004. The data was examined line by line; then compared and contrasted based on a critical discourse analysis. Results: Nurses' conflicts came from discrepancies of the world views from that of the patients. Such conflicts arose because of various issues as follows: Worker as an individual vs patients, nurse as young women vs the medical profession, hospital as an extended home vs health care setting, and hospitalization as a means to enhance work capacity vs a means of treatment. Conclusion: We need more study on the development of adaptive strategy for the nurses to overcome conflicts during their nursing career. Developing a nurses' and patient role intervention program is needed.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.2
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• pp.79-88
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• 2018

Purpose: The purpose of this study was to identify the factors that affect quality of life in elderly people with dementia. Methods: The participants for this descriptive correlational study were 97 elderly patients with dementia who were attending a daycare center or were being cared for at home. Data were collected from the participants using the Mini-Mental Status Examination-Dementia Scale, the Geriatric Depression Scale (Short Form), Activity of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) Scale. Results: There were statistically significant differences in quality of life of elders with dementia according to mobility, using dementia day-care center, and cohabitation. In multiple regression analysis, depression, activity of daily of living, using dementia day-care centers and cohabitation were significant predictors of quality of life and the four variables explained 60% of the variance in quality of life. Conclusion: Findings indicate that to enhance the quality of life for elders with dementia, depression needs to be decreased and regular use of daycare service recommended. Further, various programs enhancing physical ability need to be developed and used with these elders.

• Perspectives in Nursing Science
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• v.18 no.1
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• pp.10-15
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• 2021

Purpose: The purpose of this study is to evaluate the current status of discharge education and nursing needs of children after musculoskeletal surgery. Methods: The literature from research databases was reviewed and analyzed (using PubMed, RISS review, KISS, and Dbpia). Results: Children who have undergone musculoskeletal surgery face physical challenges due to the effects of splints and immobilization, and experience pain for a long time. Therefore, home care after discharge is of paramount importance in these cases. The discharge education needs of each patient vary with regard to the topic and period. Discharge education should be systematic and consistent, with an emphasis on understanding the needs of the patients and parents. Conclusion: While there are studies on the nursing needs of adult musculoskeletal surgery patients at discharge, studies on discharge nursing needs in children who have undergone musculoskeletal surgery are still insufficient. It is necessary to specifically identify the educational needs of parents of children undergoing musculoskeletal surgery. Interventions that improve the voluntary participation of patients and parents in active self-care need to be developed.

• 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.