• Title/Summary/Keyword: Home hospice

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A Study on the Development of Guidelines on Visiting Nursing Services for the Management of Hypertension Patients in the Rural Areas of Korea

  • Jung, Moon-Hee;Han, Myung-Hwa-Han
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.133-145
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    • 2000
  • This study aims to develop some guidelines on visiting nursing services for the management of hypertension patients at home in the rural areas of Korea. Firstly, in-depth interviews were given to the eight staff in charge of visiting nursing services in the rural health centers from June 1, 1999 to August 30, 1999. And then, their five patients with hypertension were under participatory observation. At the same time, literature review was conducted. Through those methods, some preliminary items were derived and the initial guidelines were drawn up. They were referred to ten experts, so that their validity was tested with Delphi Technique. Through the verification of their validity, they were complemented into the final ones. The total number of the items in the final guidelines was 22. By areas, they could be categorized as follows; eight items as skilled nursing care, five as general nursing care, three as guidance for diet, two as guidance for exercise, one as hospice care, and one as connection with social welfare services. By methods of activities, 13 items were classified as assessment, two as intervention, two as demonstration, and 17 as explanation. On the basis of the guidelines, nursing services are recommended to be divided and performed; general nursing activities by nurse aids and skilled nursing activities by public health nurses.

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Health Care Needs and Health Problems of the Subjects in a Health Center (보건소 방문간호 대상자의 건강문제와 방문간호 요구)

  • Kim, Soon-Lae;Lee, Kyeong Yeao
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.103-108
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    • 1999
  • In order to investigate the basic data for the visiting nursing care plan of Health Center in Korea, the questionnaire survey in regard to health care needs and health problems of the subjects with visiting nursing care was carried out on 131 subjects with visiting nursing care. The results were as follows : 1. The subjects consisted of 38.2% in male and 61.8% in female. 77.1% of the subjects had no job. 2. In the health problem, the subjects symptoms were 31.2% of hypertension, 20.6% of arthritis, and 19.1% of diabetes and other chronical illness. Utilization of medical care facilities were 61.8% of private clinics or general hospitals and 29.0% of Health Center. 3. 10 areas of health care needs that subjects wanted were disease management(19.5%), demand for welfare concerns(15.7%), health promotion and disease prevention(14.2%), information for medical institution(12.3%), health management for the aged(10.8%), hospice care(8.0%), prevention of dementia(8.0%), care for mental hygiene(6.7%), management for drinking, smoking and drug abuse(3.3%), home care nursing and rehabilitation nursing(1.2%).

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A Study on Intensive Major Course of Department of Nursing in College (전문대학 간호과 전공심화과정 운영방안)

  • Park, Song-Ja;Je, Mi-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.64-74
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    • 2004
  • This study was conducted to investigate what contents nurses want in the intensive major course of junior nursing college. Data were collected for four months from October 2002 to February 2003 by structured questionnaires. Subjects were 240 registered nurses in working at five hospitals and four public health centers and elementary or middle schools in the capital and its suburbs and country. The collected data were analyzed using SPSS 8.0 program. The results of this study were summarized as follows : 1. Nurses working at hospitals want the programs which involve the contents as follows : emergency nursing/CPR, infection control, critical care, caner pt. care, pain control, hospice, pulmonary disease pt. care, analysis of lab. exam, heart disease pt. care, chronic disease pt. care, DM pt. care, digestive-system disease pt. care, nervous-system disease pt. care, elderly pt. care, immune-system disease pt. care, endocrine-system disease pt. care. 2. Nurses working at public health centers want the programs which involve the contents as follows : home nursing, family nursing, management of DM, HT, degenerative disease, and chronic liver disease, elderly pt. care, health education, maternity nursing, rehabilitation nursing. 3. Nurses working at elementary or middle schools want the programs which involve the contents as follows : prevention of drug abuse or misuse, sex education and consultation, health education, consultation technique, emergency care, prevention of child obesity, prevention and management of adult disease in children, teaching method, method of school health room management.

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End of life Nursing Care Through a Visiting Nurse in Long-Term Care Insurance: A Case Report using the OMAHA System (방문간호사의 생애말기 환자 간호사례: 오마하시스템을 활용하여)

  • Song, Yeon Yi;Park, Eun Jin
    • Journal of Korean Academy of Rural Health Nursing
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    • v.16 no.2
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    • pp.60-68
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    • 2021
  • Purpose: This case report was attempted to present the process of the end of life nursing care provided by the visiting nurse. Methods: The subject was a person who was decided the long-term care Grade 1 and received a visiting nursing service, and the service was terminated on the death, and then was selected as a case with the consent of his family. The data were collected through long-term care benefit provision records and interviews with the visiting nurse. The nursing process was presented by applying the Omaha System. Results: The subject had digestion-hydration problems and respiration problems in the physiological domain, and the problems of role change, caretaking/parenting, spirituality, and grief in the psychosocial domain were identified. Depending on the problem, the end of life nursing care was provided to the subject and family members through activities on physical symptoms/signs, dietary management, end-life care, and coping skills. Conclusion: We expect that if the visiting nurse provides anticipatory guidance on the death process, the subject will be able to prepare for death comfortably with the family at home instead of vague fear of death.

The Demand for Home Nursing Care of Hospital Inpatients in Brain-Spine and Musculoskeletal Diseases (종합병원의 뇌.척수.근골격계 입원환자의 가정간호요구)

  • Kim, Sang-Soon;Kim, Gui-Jae
    • Journal of Home Health Care Nursing
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    • v.1
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    • pp.57-70
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    • 1993
  • This study was carried out to investigate agreement, content and demand for home nursing care of hospital inpatients in brain, spain and musculoskeletal diseases .The data was collected by interviewing with 242 patients who were hospitalized in university hospital on Taegu, from September 6,60 October 9, 1993. Of 242 patients, 66.1% agreed to home nusing care system and rate of agreement was highest between 30 years to 49 years of age as 75.5%, in middle urban area residents as 75.9% and was lowest in medicaid as 40.0% in general chareacteristics. The rate of agreement according to type of diagnosis was highest inpatients with spinal diseases as 75.6% according to functional status was the highest in patients who had daily living activity freely as 69.4% according to prognosis in patients at terminal stage as 80.0% and the rate of agreement to home nursing care of patients who wanted early discharege was 73.9%. The first-ranking reasom of agreement to home nursing care was asking for continuous relationship with doctor as 37.3% and there was statistically significant difference in reasons of agreement to home nursing care according to functional status of patients. The first-ranking reason of eary discharge among patients who wanted early discharge(74.8%) was because of long time stay in hospital. Among 23 items of nursing activity that patient wanted, the first-ranking item was recovery promotion, prevention of complication, education and counseling for health as 76.4%, drug management was 2nd-ranking item as 62.1% and the third was regular checking of vital signs as 55.9%. The lowest item of demand for home unring care was hospice care(3.9%) and airway keep(9.1%).

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The Group Counseling Program for Terminal Cancer Patients and their Family Members in the Seoul National University Hospital (말기 암환자와 가족을 위한 집단상담 프로그램 - 서울대학교병원 경험의 분석-)

  • Lee, Young-Sook;Heo, Dae-Seog;Yun, Young-Ho;Kim, Hyun-Sook;Choi, Kyung-Sook;Yun, Yeo-Jung
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.56-64
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    • 1998
  • Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

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Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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The Impact of Childhood Cancer on The Korean Family (암 환아 발생이 가족에게 미치는 영향에 관한 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.636-652
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    • 1992
  • This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.