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.
Park, Nam-Hee;Jang, Rang;Kim, Jung-Young;Kim, Myoung-Soo
Research in Community and Public Health Nursing
/
v.23
no.1
/
pp.71-81
/
2012
Purpose: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. Methods: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. Results: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as $8.88{\pm}3.20$ and $7.08{\pm}2.92$, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. Conclusion: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.
Purpose: This study aims to compare health status and health behavior among the hypertension group, the DM group, and the hypertension-DM group for aged clients of customized home visiting health care services. Methods: This study was conducted as cross-sectional research. The subjects of this study were 2,235 aged people over 65 living in J City. Data were collected using structured questionnaires and measurements. The collected data were analyzed using the SPSS/WIN 12.0 program, and descriptive statistics, $x^2$ test, t-test and ANOVA were used for the analyses. Results: BP and glucose control showed a significant difference among the groups. BMI and waist circumference were significantly higher in the hypertension-DM group than in the other groups. Stroke, arthritis, and perceived health status were significantly different among the three groups. Depression was high, but not significantly different among the groups. Smoking and drinking were not significantly different among the groups. Physical activity was very low, especially in the hypertension group. Medication was high, especially in the hypertension-DM group. Conclusion: It is necessary to consider care plans for the hypertension-DM group, and educate the group for care management. Also, depression and physical activity programs are needed for the age.
The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.
Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.
Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.
Purpose: This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center. Method: The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done. Result: The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year. Conclusion: This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.
Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.
Purpose: This study examined the legal basis related to a physical therapist's home-based rehabilitation. Methods: The policy data were referenced to the comprehensive plan for national health promotion and the guidebook Community Health Promotion Project issued by the Korea Health Promotion Institute and other institutes. The legal data were referenced to the Bill information system on the National Assembly website. Results: The physical therapist's home-based rehabilitation did not have a legal basis in the community-based rehabilitation project (CBR) of the HP 2020 project. On the other hand, according to the Home health care part of the community health promotion project that began in 2013, physical therapists were allowed to play a role from 2020 under Article 16-2 (Public Officials in Exclusive Charge of Visiting Health Management) of the REGIONAL PUBLIC HEALTH ACT. Conclusion: Policies and laws are being developed in the field of healthcare, but the necessary policies and laws in the field of rehabilitation are still insufficient. A bill to rehabilitate in a variety of fields and spaces by modifying the scope of work of physical therapists will be needed.
Purpose: The purpose of this study is to understand nursing students' experiences during clinical practice at a public health center. Method: This research used narrative inquiry far data collection. From April 2005 to June 2006, data collection was conducted by open-ended interview, questionnaire and close observation. The participants, who were student nurses, were willing to take part in this study. Results: On the basis of these data, the experiences of clinical practice at public health center were: 1) when the student nurses begin clinical practice at public health centers for the first time, most of the students feel fearful, nervous and stressed. They also mentioned having a hard time being polite to clients and the staff. 2) The students had new experiences at the health public center compared with clinical practice. Especially, the student nurses who were determined to be good nurses were doing home visiting care service. Not only did they have the opportunity to confirm their identity as nurses, but also the students change their career course from clinical nursing to public health nursing. 4) They reflected on themselves after home visiting care service. Conclusion: On the basis of these findings, the following recommendations are made. 1) Data collection and analysis are needed, net only through the narrative method, but also through other various qualitative methods. 2) Comparative study is necessary to enhance clinical experiences through the analysis of the interfering factors and the original experiences.
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