• 대한간호학회지
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• 제39권4호
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• pp.528-538
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• 2009

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.

• 대한간호학회지
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• 제28권4호
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

• 종양간호연구
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• 제10권2호
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• pp.218-230
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• 2010

Purpose: This study was conducted to develop the telecommunication guideline that was possible to make the immediate, logical decisions and to evaluate the possibility of the use by verifying it from the specialists' group. Methods: Telecommunication guideline was designed with selected six symptoms which were pain, dyspnea, nausea/vomiting, diarrhea, fever, and cough based on the results of literature. Results: This study showed that the patients understood well about the contents of the questions, examination, and education. Also, 85% of them fulfilled the guidelines of the adjustment and more of them were satisfied with the results shown to all of them compared to the previous telecommunication. And 95% of them replied that the information from the telecommunication was more useful than any other information sources related to the information of cancer and self management that were used previously. Conclusion: The telecommunication was considered to complement the weakness during the time the cancer patients spent at home after the treatments. Also, it was expected to be a role as an immediate and comprehensive method of decision making and a passage for information supply which was considered the specialty of individual patient related to an inquiry of the self management.

• 가정∙방문간호학회지
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• 제12권1권
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• 임상간호연구
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• 제18권3호
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• pp.368-380
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• 2012

Purpose: The purpose of this study was to evaluate the effects of a home-based video exercise program on cancer-related fatigue, physiological and psychological status in patients with colon and rectal cancers undergoing chemotherapy. Methods: The study design was a non-equivalent control group non-synchronized design. Data were collected from patients with colo-rectal cancers in Yonsei cancer center from July 5th to October 31st in 2011. There were 40 participants; 20 in the experimental group and 20 in the control group. The structured questionnaire was used to measure fatigue, physical function and emotional status. Data were analyzed using SPSS 18.0 and a chi-squre test, Fisher's exact test, Mann-Whitney U test and Wilcoxon signed- rank test were conducted to examine the homogeneity and the research hypotheses. Results: There was a statistically significant difference in White Blood Cell count in the experimental group compared with that of the control group. The exercise group showed a slight decrease of White Blood Cell count compared with that of the control group after 4 week program (z=-2.935, p=.003). However, there were no significant differences in fatigue, physiological and psychological status between the two groups. Conclusion: In this study, the developed video exercise program was effective in markedly slightly decreasing White Blood Cell count in patients with colo-rectal cancers undergoing chemotherapy. Therefore, utilizing the video exercise program can be an useful method to promote health among patients with cancer in clinical practice.

• 재활간호학회지
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• 제16권1호
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• pp.37-46
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• 2013

Purpose: This study was to identify the effects of a nurse-led education program using computerized animation video for post-operative colon cancer patients. Methods: a total of 163 patients and 51 nurses were participated in this study. With a non-equivalent control group post-test design, patients were divided into three groups (77 got traditional education, 46 were applying brochure, 40 were watching video). Twelve-item animation video and brochure about the management after discharge for post-operative colon cancer patients were developed based on patient survey and the items of Korea Healthcare Accreditation. Results: The computerized video watching group had better satisfaction than the others, but there was no significant difference about comprehension. When video was applied, satisfaction, usefulness, application, and perceived patients' comprehension of nurses were all increased. Conclusion: This video education program was developed by nurses and it had a special thing for patient to access the same program even after discharge using the authorization system. It would be helpful for nurses to be more concentrated on the direct care for hospitalized patients as well as for patients to provide self-care at home. This program would be adjusted into more various diseases and settings.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.482-490
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• 1999

본 연구의 결과를 요약하면 다음과 같다. 1. 1986년부터 1992년까지 강화지역 주민 중 총 992명의 암 환자가 등록되었고, 이중 남자가 605명(60.9%), 여자가 387명(39.1%)이었다. 2. 세계표준인구로 연령교정한 발생률은 연간 인구 10만명당 남자에서 위암이 65.9, 폐암 33.8, 간암 27.7, 식도암 10.2, 직장암 8.3의 순으로, 여자에서는 위암 25.0, 자궁경부암 21.8, 폐암 8.4, 간암 7.7, 유방암 7.1의 순으로 높았다. 3. 세계표준인구로 연령교정한 주요 암의 부위별 발생률을 1983-1987년과 1988-1992년의 미국 LA지역 한인(韓人), 1988-1992년의 일본 오사카, 중국 상하이의 암 발생률과 비교한 결과 남자에서 가장 많이 발생되는 암은 강화와 1983-1987년 사이의 LA한인, 오사카에서는 위암이었으나 상하이, 1988-1992년의 LA한인에서는 폐암이었다. 여자에서 가장 많이 발생되는 암은 강화와 1983-1987년 사이의 LA 한인, 오사카에서는 남자와 마찬가지로 위암이었으나 상하이, 1988-1992년 사이의 LA한인에서는 유방암이었다. 4. 강화지역의 전체 부위 연령표준화 암발생률은 남자에서는 45세 이후 증가 하다가 75세 이후 감소하는 양상을 띄고 있고, 여자에서는 30세 이후 증가하다가 45세에서 약간 감소한 후 65세까지 증가하고, 75세 이후 감소하는 양상을 보인다.

• 대한간호학회지
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• 제30권6호
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• 가정∙방문간호학회지
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• 제3권
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• pp.86-97
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• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.

• 한국보건간호학회지
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• 제19권2호
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• pp.229-240
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• 2005

Purpose: To evaluate every step of the cancer screening program. Method: 146 of 233 health centers participated in this study. Data were collected by mailing questionnaires between December 2002 and January 2003. The response rate was 65.5%. Result: The government cancer screening program was directed by a variety of departments of the health centers. 41.1% of persons in charges were nurses. 41.3% of the health centers received a list of the appropriate person from the National Health Insurance Cooperation within one or two months. 26.1% of health centers received ??? after five month from when the program started. All the health centers advertised their services, and most of them used mail and mass media 56.4%, used other institute's materials, and 72.2% of them used the government's materials. 76.7% of the heath centers recommended secondary health screening to the persons who had positive results at the first screening. 71.6% of the health centers ascertained the patients with cancer who were diagnosed at secondary screenings. 67.9% of the health centers had registered home-based cancer patients at the health center. 137 out of 146 health centers had a local institute for cancer screening; an average of 4.9 institutes had cancer screening. 80.1% of the persons in charge of the programs felt they needed this program, but 80.8% of them thought the program should be modified. Conclusion: Organized and standardized programs are needed to promote the efficiency of National Cancer Screening Program.