• Title/Summary/Keyword: Home care nursing need

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A Survey Of Infant Feeding Practices In Seoul, 1991. (영아의 수유 및 보충식에 대한 조사연구)

  • 김효진;박영숙
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.377-398
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    • 1993
  • A survey of infant practices was conducted to provide information on which to base planned nursing interventions. The subjects were a convenience sample of 168 mothers visiting out - patients departments of five general hospitals and one public health center in Seoul for immunizations or treatment for common colds for their infants from two to 12 months of age. Data collection was carried out from July 8th to September 30th, 1991 using a questionnaire of 84 questions, 31 on the type of feeding, 22 on supplementary feeding and 21 on demographic infer mation. The results are summarized as follows : 1) The type of feeding was primarily artificial feed-ing (63.1%), followed by mixed feeding (22%) and breast feeding (14.9%) of the 59 mothers expecting during pregnancy to breast feed, 54. 2% changed artificial feeding and 30.5% went on to breast feed as they had expected. For mothers expecting to continue breast feeding over seven months. only one infant was being breast fed for over seven months. 2) For the 106 mothers using artificial feeding, 70. 8% hed attempted breast feeding, 64% of them for less than a month. Breast milk had been suppressed by for medication (38.7%) : 34.9% had used no specia] means. 3) The major reasons for replacing breast feeding with artificial feeding were the infants' demand for more milk (47.2% ) and insufficient supply of breast milk (49.3%). 4) Most mixed feeding was started at the age of one to three months (59.5%). Only 34.4% gave an artificial feeding after breast feeding : most (46%) alternated breast feeding with artificial feeding. On the whole, the motive for mixed feeding was the lack of breast milk (70.3%). 5) Many mothers (81.8%) were adding vitamin or mineral supplements to artificial milk and 51.5% were adding something to faciliate digestion. As for the method of sterilizing milk bottles and nipples, 56% had sterilized them together in boiling water from the beginning : 27% were just washing the bottles after boiling only once initially when measuring artificial milk powder, 31. 5% of the mothers over filled the measuring spoon rather than to the level. 6) The mother's occupation was related to her way of feeding. Mothers at home full time did more breast feeding than mothers employed outside the home. (x²=5.72, p=〈0.05). 7) Most mothers began supplementary food, from three to four months (48.8%) : 11.2% began later than seven months. Supplementary food was given between milk feedings by 67.2% of the mothers : 19.2% gave it before a milk feeding. Some mothers(26.4%) made their own supplementary food : 19.2% used ready - made supplementary food products for convenience. Recommendations for nursing interventions included : 1. Prenatal education about the advantages of breast feeding and breast care, and home visits after delivery for counselling related to breast feeding. Correct preparation of artificial feeding methods need to be taught in both pre & postnatal periods. In addition, specific education about supplementary feeding needed. 2. Further research is indicated about the Perceived lack of supply of breast milk and about the effectiveness of nursing interventions to Promote breast feeding.

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A Trend of Research in Community Health Nursing (지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로-)

  • Lee, In-Sook;Kim, Yu-Na;Choi, Key-Won;Chin, Young-Ran
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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Analyses on the Mean Length of Stay of and the Income Effects due to Early Discharge of Car Accident Patients at General Hospital (3차 병원에 입원한 교통사고환자의 평균 재원기간과 조기퇴원시의 수입증대효과 분석연구)

  • Ryu, Ho-Sihn
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.70-79
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    • 1999
  • This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

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A Study on the Solution of Child Abuse Problems Appearing in Social Problems (사회문제에 나타난 아동학대문제의 해결방안에 관한 연구)

  • Kim, Duck-Sun
    • Industry Promotion Research
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    • v.3 no.2
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    • pp.41-51
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    • 2018
  • This study is to see the problem of child abuse as a social problem and sees that the society as a whole needs to find a solution and suggest solutions. The results of this study are as follows. First, legal supplement should be given priority. This can be solved through legal amendments to relevant laws and legislative amendments. Second, institutional complement should be done. Physical and psychological treatment is more urgent for school children than school education for victim child. In the future, children's welfare facilities should be expanded to include child counseling centers for children who are living in homes rather than nursing homes but who have problematic behaviors and treatment facilities for children who need professional treatment. Third, measures should be taken against abused children. Results of action for affected children include home care, separation protection, home return, and death.

Study on Laws related to the Scope of Both Medical Doctors' Practice in Korea (한의사와 의사의 업무 범위와 관련된 법령 고찰)

  • Park, Yu Lee;Kang, Yeonseok;Baek, Kyung Hee;Ra, Sewhan
    • Journal of Society of Preventive Korean Medicine
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    • v.18 no.3
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    • pp.91-104
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    • 2014
  • Objective : This study aims to compare the scope of practice of Korean Medicine doctors and western medicine doctors based on laws related to medical practice Method : We searched for laws related to medical practice using terminologies such as "Korean Medical practice", "Korean Medicine", "Principles of Korean Medicine", "western medicine", "Korean Medicine doctor", "western medicine doctor" at the national law information center(http://law.go.kr/main.html). Results : We categorized the laws we found into four categories: diagnosis, treatment, prescription, and all the other areas including public health. In diagnosis, both Korean Medicine doctors and western medicine doctors have a right to issue medical certificates including birth and death. However, diagnosis of a few specific diseases is allowed only to western medicine doctors. In treatment, laws related to emergency medicine and nursing at home were searched. Korean Medicine doctors and western medicine doctors are emergency care providers; however, most of emergency medicine can be done by western medicine doctors. In prescription, the scope of practice is divided by herbal medicine and western medicine. Finally, as public health professionals, both of them need to do lots of public health works. However, in some area such as vaccination, maternal and child health care, and industrial health, only western medicine doctors can practice. Conclusion : This study suggests that, in diagnosis, treatment, prescription, and all the other areas including public health, the scope of practice of Korean Medicine doctors and western medicine doctors has huge difference. There is also lack of consistency in current law, and some laws do not reflect current health care system and health care services.

A Study on the Awareness & Preferences about the Nursing Homes (노인요양시설에 대한 고령자 인식 및 시설 내부 색채선호 경향에 관한 연구)

  • Jeong, Mu Lin;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.29
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    • pp.319-331
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    • 2017
  • South Korea has entered the age of aging society since the elderly population over 65 reached 13.1% in 2015. This increase rate is the fastest in the OECD members. as a part of the precaution, the Korean government has enforced the long term care insurance from July 2008 and the increase of related nursing homes until 2015 was 220.2% which is rapid and quantitative. It was natural that quantitative expansion leads to qualitative improvement. With regard to service environment conditions, color environment draws attention as one of the most effective measures. color environment supports nursing home's spatial functions and the aged class is subject to the research as the potential customers. This study aims to understand color environment, conduct surveys for color preference and attitude toward color environment, and suggest directions for color environment plan. The ultimate goal is to improve the quality of Korean nursing home environment. It studied definition, state, color environment and space functions of nursing homes as well as the preceding researches. With 100 people over 60s in Busan and Gyeongnam area (52 male and 48 female), the survey examined attitudes for color environment and color preference by space functions in nursing home. The research method is as follows. First, as a result of the consciousness survey on color environment in elderly nursing home, it considers service (37%), medical service (20%), and location (19%) heavily in order. color environment plan is not recognized significantly. However, the need of indoor color plan in the elderly nursing homes has "agree (32%) and "strongly agree (25%), which suggests that color introduction is required to the nursing homes. Second, the indoor coloration for the elderly nursing homes has various color preferences. The color preference order for bedroom was R, P, and G but this order changes in nursing space (program room) to G, R, and Y. The communal space such as lobby prefers R, G and Y in order. R color was preferred in general.

A Study of a Pattern of the Stress Perceived by Stroke Patients through the Rehabilitative Process (뇌졸중 환자의 재활과정에 따른 스트레스 변화 양상)

  • Lee, Jung-Min
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.82-98
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    • 1997
  • The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

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Effects on the Functional Status Changes of LTC(Long-Term-Care) Services (노인장기요양보험 급여이용이 기능상태 변화에 미치는 영향)

  • Hyun, Kyung-Rae;Lee, Sun-Mi
    • 한국노년학
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    • v.32 no.2
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    • pp.593-609
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    • 2012
  • The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.

A Study on the Change of Primipara's Mother - Infant Interactional process (모아상호작용과정의 진행양상에 관한 연구)

  • Cho, Mi-Young
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.5-27
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    • 1995
  • One of the important tasks for new parents, especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the health development of the child and the well-being of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. The purpose of this longitudinal descriptive correlational study is to investigate the changes of the mother - infant interactions from postpartum 1 day to postpartum 8weeks of the transition to parenthood. The aim was to contribute to the development of theoretical under standing on which to base care toward promoting the quality of maternal - infant interaction. Data were collect ed directly by the investigator and at rained from Jul, 1, 1990 to Jun 8, 1991, Subjects were a random sample of 44 mothers, 44 who had a normal delivery (but with out other perinatal complications) at four general hospitals in Seoul. Instruments used were the Stainton Parent-infant Interaction Scale (1981). The first observations were made in the delivery room, followed by day 1, day 2, day 3 and 2 weeks, 4 weeks, 6 weeks and 8 weeks after, birth, for a total of 8 contacts. Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was don by computer using as SPSS program and included, Paired t-test, t-test and Pearson Correlation coefficient ; the results were as follows. 1. The daily maternal-infant interaction score for the initial contact ofter birth to 8 weeks postpartum had the lowest average score 5.21 and the highest 8.02(in a range of 0-10). This subject group of mothers needed Extra nursing supporting to promote their maternal-infant interaction. 2. The daily scores for the maternal-infant interaction tended to rise, showing a gradual improvement over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day (p=0.000) and from the fourth to sixth weeks ofter birth.(p=0.000) 3. When the seven items of maternal-infant interaction were evaluated items of maternal-infant inter action were evaluated separately, "Care taking for the baby" had the highest average score, 1.60(in a range of 0-2) and "Speaks to baby" the lowest, 0.8. All items, suggested the subjects' need of nursing intervention to promote maternal-infant interaction 4. There were positive correlations between certain general characteristics, namely, both a higher economic status (p=0.027) and breast feeding (p=0.021) and maternal-infant interaction.

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