Purpose: The purpose of this study is to investigate the current state of the home-based cancer patient management project of public health centers throughout the country. The results of the investigation is employed to identify obstacles to the execution of the program and, finally, to develop an efficient management program of home-based cancer patients. Methods: Data on the home-based cancer patient management project were collected and analyzed through visiting interviews or telephone interviews with 225 public health centers throughout the country for six months from July to December, 2006. Results: Obstacles to the present execution of the home-based cancer patient management project were identified. Some of them are : (1) patients' low trust in cancer patient management by local health centers, (2) absence of programs customized to local communities, (3) lack of personnel and vehicles for home-based cancer patient management, (4) lack of education program for personnel in charge of home-based cancer patient management, (5) problems in public health doctors, weak connection to private medical institutions, (6) absence of medical institutions and hospice facilities for cancer patients, and (7) non-standardized volunteer workers, so on. Considering all these problems, some effective management methods are proposed. The basic concept is to keep the autonomy and variety of the local helath centers. And based on this concept, three models of (1) public health center controlled model, (2) medical institutions and hospice facilities-entrusted model and (3) medical institutions and hospice facilities-cooperative model are developed. Conclusion: By adopting an adequate model among proposed three models, the public health centers are expected to achieve an efficient utilization of material resources and manpower. In addition, by inventing their own programs that are proper for the local societies, they can improve the home-based cancer patient management.
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.
Purpose: This study sought to provide basic information for the establishment of home care nursing system in cancer patients. Methods: Data were collected by the descriptive questionnaires consisting of 42 articles from five fields of nursing services. Patient's symptoms were investigated by the Korean version of EORTC QLQ-C30. Data were analysed using SPSS-PC 12.0. Results: Among the cancer patients (n=182), 40.1% had serious limitations on their usual lives. 74.7% had serious economic burdens. 79.7% agreed strongly with the necessity of home care nursing system, 74.2% were willing to use home care nursing, and 91.2% felt that home care nursing should be mandatory in cancer centers. There was no correlation between the frequency of symptoms or nursing items and the degree of home care nursing requirements. Digestive symptoms, symptoms requiring procedures, and symptoms to meet educational help displayed a high degree of requirement. Conclusion: Home care nursing should be activated for cancer patients as a bridge between hospital-based acute care and community-based chronic care which could increase the quality of care and reduce insurance related payments.
Purpose: As a part of the analysis of home-based cancer patients management of public health renters in cities, counties and districts across the nation, this study is to understand the degree of patient demands for that management and the degree and scope of the supply for the patient's demand. Methods: Developed the questionnaire which was constituted of degree of demand and supply for home-based cancer patient management and analyzed data centering on the frequencies and percentages by utilizing SPSS WIN 12.0. Results: The services provided through the home-based cancer patients management project include physical, emotional, spiritual and education/informative services. A survey was conducted for home-based cancer patients about these services, and its result showed that the degree of demand and supply was highest for emotional service, followed by education/informative service, spiritual service and physical service in the order of the demand-supply degree. When main items for each service were examined, it was found that: in the case of physical service, pain control was provided murk lower than its demand, while excretion disorder control and individual hygiene is provided murk more than its demand. In the case of emotional service, the degree of demand was overall higher than that of supply; spiritual service was provided appropriately to the degree of demand. Conclusion: This study examines the home-based canter patients management project of public health centers and compares and analyzes the degree of demand for patient services and the degree of services that are actually provided. The findings could be used as based data for the development of effective programs in future on the basis of actual demands of home-based cancer patients.
Journal of agricultural medicine and community health
/
v.36
no.4
/
pp.238-250
/
2011
Objectives: This study was performed to investigate the service needs of the beneficiaries who had enrolled in home-based management programs for cancer patients. Methods: From March to May 2009, 676 cancer patients who were registered in home-based cancer patient management programs were selected as subjects for this study. The data were collected using a questionnaire along with a face-to-face interview performed by officers in charge of the home-based care programs of 47 regional health centers. Fifteen patients were excluded due to incomplete data, leaving 661 subjects who were ultimately enrolled in the study. Results: The mean age of subjects was $64.0{\pm}2.5$ years, and males comprised 45.1% (298/661) of the sample. The results of factor analysis for service needs showed that there were five main categories and Cronbach's alpha ranged from 0.593 to 0.890 for each factor. The service needs categories in order of importance were social support, information and education, psychological problems, physical symptoms and household chores. The service needs scores were significantly different when subjects were stratified by age, habitation, religion and disease classification. When we divided the subjects into complete remission, under treatment and terminally ill groups, the needs scores of the terminally ill patient group were significantly higher than those of the other groups (p<0.001). Conclusions: Service provision based on patient and beneficiary needs could be an effective intervention to reduce the economic burden of cancer management and to improve the quality of life of cancer patients receiving home-based care. Therefore, it is recommended that individual cancer patient care programs be developed and administered according to patient age, habitation and disease severity.
Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.
Purpose: This study was conducted to assess needs at each end-of-life care stage and to analyze importance and difficulty of care needs for home care nursing among non-cancer patients. Methods: We used a retrospective design. Total eligible patients were 117 at the ages of 40 and over, who continuously received home care nursing throughout beginning, stable, and near death stages, and finally died at home from January 1, 2006 to December 31, 2006. Descriptive statistics, Cochran's Q test, Friedman's test were used for data analysis. Results: In the area of physical care, the care need for 'assistance for activities in daily life' was significantly highest in the beginning stage. The care need for 'aggravation or adverse changes in physical symptoms' was significantly increased in the near death stage. In the area of psychospiritual care, 'family's psychological burden' was revealed as having the highest rate of care needs in the every stage. Conclusion: Future intervention should consider assessing care needs in end-of-life care for non-cancer patients who are provided with home care nursing.
Purpose: The purpose of this study was to understand terminal cancer patient's experiences of home-based hospice care. Methods: The data were collected from July 2011 through September 2010. Data were collected from 10 terminal cancer patients who received home-based hospice care services and by using in-depth interview. The data were analyzed using Colaizzi's phenomenological method. Results: Data were classified by 25 themes comprising 14 theme clusters and five categories. The five categories were 'life quality deterioration', 'appreciation', 'acceptance of the rest of their lives', 'Prepared for death with religion', 'negative coping'. Conclusion: Systematic hospice care should be provided to understand life experience of patients with terminal cancer who receive home-based hospice care, to help them overcome negative experiences and grow a positive perspective.
Purpose: This study was done to develop and test a palliative care program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. Results: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. Conclusion: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.
Purpose: This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a χ2 test, Fisher's exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors' comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.
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