The purpose of this study was to 1) identify the current management status of the Visiting Health Care Services (VHCS) and 2) to analyze the workload of the staff in the VHCS located in the Public Health Centers (PHCs) in the urban and rural areas. Method: A descriptive research design and a prospective, time and motion research design were used. A total of 18 PHCs in Gangwon Province participated in this study. A questionnaire and semi-structured observational sheet were utilized. A total of 650 self report records of the work load from the VHCS personnel were collected for a 10 day period at each of the 18 PHCs. A descriptive analysis was then done. Results: The major results were as follows. 1) The VHCS staff (nurses and nurse aids) was being assigned additional work such as maternal health care, chronic disease care, mental health care and health promotion on top of their VHCS duties. 2) The average number of home visits per client during the past year was 5.8. More specifically, the clients in the severe dependent group received an average of 27.1 visits, those clients in the moderate dependent group received 14.0 visits those clients in the slightly dependent group received 5.0 visits and those clients in the self-care group received 1.6 visits. 3) The time required for the work duties of the VHCS staff totaled 488 minutes per day. The percentage of time for home visits was only 17.4%, and this didn't include travel time. Conclusion: The main problems of VHCS were identified as a lack of personnel and a lack of time for the home visits. Strategies that are directed at the construction of a better infrastructure for VHCS are needed.
Purpose: The purpose of the study was to analyze the ADL, IADL and cognitive function of low-income elderly who are receiving the visiting nurse service in the community. Method: Study participant were 2,413 community-dwelling elderly who live in S City. The data were collected from 5th Jan. to 28th Feb. 2006. The cross-sectional descriptive survey was done using a structured questionnaire through interviews by visiting nurses. Result: The average scores of ADL and IADL was respectively high, which indicates a relatively independent everyday life. However, the score of cognitive function was 21.87(normal range is over 23). There was a significantly positive correlation among ADL, IADL and cognitive function with the pearson correlation coefficients. Conclusion: It is concluded that elder subjects who are women, old aged, and live alone should be watched carefully for the cognitive impairment. In addition, the government should apply early detection and management system for cognitive impaired people who live in the community.
The home visiting health nurses are important man-power who can serve various and persistent rehabilitation care to disabled person in community. The Community Based Rehabilition project(CBR) of national rehabilition center have been carried out from 1995. As a part of that project national health center performed rehabilition education program for home visiting health nurses. The purpose of this study is to analysis the effect of this education. In the first stage all of those groups were educated for two weeks in national rehabilitation center. But only two group nurses, one is in a urban and the other in a rural community, have been educated continually in the field through discussing rehabilitation care case study. The data in this study were gathered from three group healh nurses and analysed by SAS computer program. The results about knowledge, attitude and practice changes of the three group nurses were as follows. 1. In the pre education state the mean point of all nurses' attitude for rehabilition was 59, but in the post education state that was 90. The difference between pre and post attitude is very significant(t=-14.1. p<0.0001l). 2. In the pre education state the mean point of all nurses' knowledge for rehabilition was 45, but in the post education state that was 78. The difference between pre and post knowledge is very significant(t=-12.7, p<0.000l). 3. In the pre education state the mean point of all nurses' practice for rehabilition care was 37, but in the post education state that was 62. The difference between pre and post practice is very significant(t=-7.3, p<0.000l). 4. In practice point, the two group nurses who have been educated continuously were superior to the other(t=-3.9. p<0.00l). 5. All points between the urban and rural nurses were no significant differences(p>0.l). 6. All changes of the attitude, knowledge and practice did not affected by age(F=0.58, p>0.l). professional career(F=O.61, p>0.l), educational background(F=0.97, p>0.l).
Purpose: The purpose of this study was to develop a job stress scale for hospital-based home care nurses in Korea. The process was construction of the conceptual framework, development of the preliminary items, verification of the content validity, item analysis and test of the reliability. The preliminary items were based on literature review and in-depth interviews with home care nurses. As a result, eight categories and sixty items were selected. These were reviewed by seven specialists for content validity and finally fifty one items were chosen. Data was collected from 180 home care nurses who were engaged in 87 hospitals from August to September 2003. The result of item analysis one was excepted, The final item count was 50. Categories were as follows: overload work(8 items), lack of specialized knowledge and technique(5 items), ethical dilemma(4 items), role conflict(5 items), interpersonal relationships(6 items), visiting home environment(9 items), driving conditions(4 items) and lack of administrative support(9 items), The reliability of the scale by Cronbach's alpha was .948 and the domain's reliability ranged from .649 to .841. The result of this study could be used to measure the job stress of home care nurses. However, for further validity and reliability, repeated studies will be necessary.
Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.
The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.
The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.
본 연구의 목적은 방문간호사의 이직의도와 직무만족도와의 관련성과 이직의도의 예측요인을 분석하여 맞춤형 방문건강관리사업의 안정적인 정착과 활성화에 도움이 되고자 시도되었다. 조사대상자는 대구시와 경상북도의 방문간호사를 대상으로 총 237명의 조사결과를 최종적으로 활용하였다. 방문간호사의 이직의도는 3.12점(5점 만점)이었고 직무만족도는 2.41점(4점 만점) 이었다. 직무만족도 하위영역에서는 운영요인의 점수가 가장 낮았고, 인간관계요인 점수가 가장 높았다. 방문간호사의 이직의도와 관련이 있는 일반적인 특성은 결혼상태, 종교, 방문건강관리업무 근무경력, 고용형태, 근무지역이었으며, 이직의도와 직무만족도간에는 부적인 상관관계를 보여주었다. 이직의도를 설명하는 주요변수로는 직무만족도, 결혼상태, 고용형태로 나타났고, 방문간호사 이직의도를 19.8% 설명하였다. 방문간호사들의 이직의도를 감소시키기 위해서는 직업 만족도 향상 방안과 각 지자체마다 방문간호사의 연속고용이 보장될 수 있도록 실효성 있는 제도적 장치 마련이 이루어져야 할 것이며, 이로 인해 방문보건사업의 정립과 함께 질적인 성과도 향상될 수 있을 것이다.
The purpose of is study deals with the physical therapy and the delivery system of public health center, as a center, in community based rehabilitation and delivery system. We hope that the system of physical therapy of public health center in community based rehabilitation spreads all over the country and contributes to the promotion of national health and social welfare. There are many public health center in the country because it can serve inhabitants with the medical benefits in the Erst line. public health center continuously provides poor inhabitants who cant pay medical expenses care of health. It has the public health center branches that take care of inhabitants who live a remote village and hiterland. Additionally, many people want to receive physical therapy. Therefore, the physical therapy of public health center becomes the central paint in community based rehabilitation so that we supply the inhabitants with superior rehabilitation service. We can approach them as a team that be constituted with physical therapist speech therapist, psychologist, nurse, social work. Also the role of physical therapist is divided into two parts, which are home visiting part that individually takes can of patients nod public health part that takes care of patient, family, home, community. We connect with both self-governing body and the government so that we may receive government subsidies. Also, we must prepare regular school education for community based rehabilitation
The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.