To evaluate the effects of planned visiting nursing services for homebound disabled persons in the community who have had a cerebrovascular accident Methods: One group pre-test and post-test research deign was applied to 61 disabled persons who were undergoing rehabilitation with visiting nursing services to evaluate the effects on the health status (SF-36) and activity daily living (ADL/IADL) from March to August, 2001. Results: The health status score by SF-36 of homebound disabled people was significantly improved; the average score was 28.56$\pm$21.24 before service, 34.29$\pm$22.30 at 3 months after, and 40.84$\pm$=27.41 at 6 months after. The activity daily living score by OASIS II was also significantly increased (z= -6.09, p=.000; z= -6.04, p= .000) at 3 months and 6 months after home visiting nursing services. Conclusion: The strategy plan for developing a visiting nursing service in health centers should be prepared to develop community based rehabilitation (CBR) programs as well as to improve the level of health status and ADL/IADL for homebound disabled people in the community.
Purpose: This study was designed to define the roles, tasks, and activities of home visiting nurses aimed at enhancing the quality of nursing care under the long-term care insurance regulation for the elderly introduced on July 1, 2008 in Korea. Methods: A review of domestic and foreign literature was used to formulate the proposed roles, tasks, and activities of visiting nurses, which were subsequently modified and complemented by the agreement of home visiting nurse experts and acceptance of 127 nurses. Data was collected from 04 June - 17 September 2008 and analyzed concerning frequency and percentile using SPSS ver. 15.0. Results: The established functions of home visiting nurses were direct nursing service provider, case manager, patient educator, decision maker, care coordinator, and research worker. These functions involved 27 different tasks and 167 activities. Conclusion: The roles, tasks, and activities of visiting nurses, established based upon the guidelines of the Long-term Care Insurance Act for the elderly, were verified for their applicability by nurses involved in home care delivery. These parameters will provide a useful tool in developing an assessment to enhance the quality of home-based care for the elderly in Korea.
As same time of starting on the Korean Long-term Care Insurance System, the government developed a program to train new qualification of long-term care workers. The number of enrolled long-term care workers are 950,000 persons in 2010. Mostly they are working in home based care work places such as home visit care centers and home visit bathing centers covered insurance. The purpose of this study is to understand the difference of task performance requirement according to long-term care workers' responsibilities which divided into home visiting care and home visiting bathing. The comparison analysis was conducted to task performance requirement in basic management, safety management, administration management, practical services. Key result was found that task performance requirement of long-term care workers whose responsibilities are home visiting care were more higher than the home visiting bathing. Finally, To improve quality of home visiting care and home visiting bathing, it is necessary to provide the fields based continuing education and reflect new reimburse system.
Purpose: This study was conducted to survey children's health status and need of customized visiting health care services in one province. Methods: The participants in this study were 237 caregivers of infants and preschoolers. Data were collected at the participant's home or public health center. Results: Many of the children did not receive developmental screening tests or dental examinations. In the beneficiary group, the prenatal checkup rate and children's vaccination rate were lower, and caregivers had more health problems than the other groups. On the assessment of home safety, unsafe conditions were more frequently found in the beneficiary group. The caregivers in the beneficiary group showed lower child rearing confidence than the other groups, and wanted customized visiting health care services most in the areas of developmental screening, regular health check-up and counseling, nutritional supplementation, and oral health care. Conclusion: These results indicate that it is necessary for children and parents in poverty to be provided with professional home visiting interventions for the promotion of child health and prevention of developmental problems and diseases. These findings can be used for developing future customized visiting health care service programs for infants and children in this community area.
Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.
Purpose: This is a phenomenological study to describe the experiences of nursing students on home visiting nursing service as a community nursing practice. Method: Individual interviews were conducted on subjective experiences of 17 nursing students. Data were analyzed through Colaizzi's method in which meaningful statements were extracted and these were clustered into 6 themes. Result: The nursing students started practice with anxiety and expectation at the same time. They were frightened at the clients' inferior environment and their level of loneliness. They also felt pity and experienced complicated feelings for the clients. However, the home visiting practice was a chance for them to discard prejudice on the clients. Positive experiences on visiting nursing practice reported by the nursing students included lively interactions between nurses and the clients, and variable provision of primary nursing care. However, facts such as much limited visiting time, non-professional and limited scope of practice were reported as negative experiences. They felt both worthiness of the home visit service and restricted self-capability at the same time through the practice. They also felt sorry for the clients because the home visit services were carried out during limited time period. Regardless of this, the home visit experience provided them an opportunity of self-growth. This self-growth includes increased awareness of issues for elderly, building of self-identity as a nursing student, self-reflection, and realization of the value of family. Conclusion: This study may provide data for better understanding of nursing students experiences of home visiting nursing services. However, more study on the barriers of their community health practice is needed in the future. Moreover, it is needed to establish desirable practice environment through the collaborative relationships between the university and staffs in the public health center.
Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.
This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.
Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.
Purpose: The purpose of this study is to analyze the home-stay disability's activity, as well as the participation domains and the environment factor domains of international classification of functioning (ICF), in order to examine the effect of the home visiting physical therapy and the disability's activity. Methods: A total of 211 home-stay disabled subjects with brain lesions or crippled disorder, living in 5 cities and districts of Jeollanam-do, underwent 90 minutes of home visiting physical therapy per week during a 6-month period, and using the ICF checklist, evaluated the subject's activity and participation domains and environmental factor domains. Results: The performance qualifier showed a significant statistical change in the movement, self-care, domestic life, interpersonal interactions and relationships, community, society and civic life domains (p<0.05); and the capacity qualifier showed a significant change only in the mobility domains in the before and after of the home visiting physical therapy (p<0.05). The barrier factor in the order of services, systems and policies domains, product and technology domains, and attitude domains it influenced significantly in the performance (p<0.05), and in the facilitator factor in the order of product and technology domains, support and relationships domains, services, systems and policies domains it influenced significantly in the performance of the disabled (p<0.05). Conclusion: The visiting physical therapy can help in the improvement of the activity and participation of the home-stay disabled subjects, and for the accurate evaluation of the home-stay disabled subjects, it is considered that an evaluation including various environmental factors, such as ICF, must be fulfilled.
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