The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.
Journal of agricultural medicine and community health
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v.32
no.1
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pp.27-39
/
2007
Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.
It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.
Kim, Yong-Soon;Park, Jee-Won;Bang, Kyung-Sook;Jung, Soon-Re;Woo, Hea-Suk;Lee, Hea-Jung;Jang, Hyeon-Soon
Research in Community and Public Health Nursing
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v.13
no.2
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pp.280-291
/
2002
Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.
Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.
Purpose: The purpose of this study was to identify the health status and request of community residents. This study is part of development of efficient health life enhancement programs. Methods: The subjects of this study were 586 households in a rural community and well-trained interviewers visited every household in the designated area and individually interviewed heads of households for general information and health service utilization. The data were collected using a questionnaire for seven months from March 25 to September 24, 2002. The data were analyzed using frequency. percentage by SPSSWIN (v 10.0). Results: 1. 58.9% of subjects were above sixty, and 60.8% of them were women. 2. The most serious problems they identified were health problems (45.6%), and the second was(##-was+were) economic problems(22.0%). 3. Almost half of the study population regarded themselves as healthy (46.2%). The types of illness they had were neuralgia, arthritis, hypertension, diabetes, and heart disease. 4. Most of the study population answered that they didn't do anything special for health enhancement. 5. Among medical facilities, hospitals or medical clinics (55.3%) were most commonly utilized when they were sick. 6. The highest request of the subjects was 'Home visiting service (45.4%)', and 'free treatment connected to the service of hospitals' was the second. What they needed most regarding health enhancement programs in health life enhancement centers was 'free health examination (58.2%), and heath education programs (57.7%). 7. As a result of investigating the subjects' demand for nursing services in health life enhancement center, 'the clinical examination' was the most requested, and next was 'blood pressure check', 'emergency treatment', and 'rehabilitation service', in that order.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.8
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pp.485-491
/
2016
The purpose of this study was to identify the effects of a visiting exercise program for physical activity promotion on physical (grip strength, static balance) and psychological (depression, perceived health status) function of frail elderly patients receiving home visiting service care. Subjects included a total of 49 patients; 24 in the control group and 25 in the experimental group. The visiting exercise program was carried out 16 times for 8 weeks. The collected data were analyzed by ${\chi}^2-test$ and t-test using SPSS/WIN 21.0 program. There was a significant improvement in the left grip strength (t=2.19, p<.000), right grip strength (t=5.07, p=.032), static balance (t=3.98, p=.050), and depression (t=-8.83, p=.009) in the experimental group compared with the control group. The visiting exercise program for physical activity promotion was effective on physical and psychological functions for frail elderly patients receiving home visiting service care. Further research is needed in a longitudinal study incorporating various centers to examine the maintenance of such effects.
Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.
Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
Journal of Home Health Care Nursing
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v.7
no.1
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pp.58-72
/
2000
This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting 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 the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical 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 test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.
Kim, Hye-Kyeong;Lee, Yun-Hee;Moon, Sun-Young;Kwon, Eun-Joo
Korean Journal of Health Education and Promotion
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v.24
no.4
/
pp.65-85
/
2007
Objectives: The purpose of this study was to identify the major health problems of poor children, and to provide basic information for developing health care program for low income children in underserved area. Methods: Health data were collected through medical examination(KAHP Social Welfare Service) and analysed for 3,081 poor children in 106 local children's centers nationwide. Results: 1. The mean height and weight of poor children were lower than those of nonpoor children. The differences were increased by age. 2. The rate of relative low weight was higher in poor children than in nonpoor children. On the contrary, The obesity rate was higher in nonpoor children than in poor children. 3. Poor children were more likely to have vision problem, anemia, high blood pressure, and oral health problems than nonpoor children. 4. The Health problems of children were the most serious in single father family. Conclusion: In order to improve children's health status, health promotion program for poor children should be developed and implemented. Health promotion program should include activities including regular health examination, home visiting, nutrition support, managed health care, health counseling and education. And the community support network was suggested for the efficacy of the program, including home, school and community.
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