• Journal of Home Health Care Nursing
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• v.6
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect 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 of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records 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 tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• Journal of the Korean Home Economics Association
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• v.46 no.8
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• pp.85-95
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• 2008

This study examined the revictimization of wives from repeated husband violence and how that affected their depression. It also explored whether social support networks can have moderating effects. Sixty-four wives participated in the research group, 72.3% of whom had experienced repeated verbal violence, and 29.2% experienced repeated physical violence since their husbands participated in the correction and rehabilitation program for family violence perpetrators. Revictimization from repeated husband-to-wife violence was proven to significantly influence wife depression. To moderate the harmful effects of repeated domestic violence on depression, social support networks were observed to provide protective reinforcements. However, the findings of this study did not support the notion that social support networks have moderating effects on wife depression, while a strong negative relationship was established between professional networks of social support networks. Based on these results, the research discussion here advocates for an intervention that promotes psychological health to wives who are exposed to repeated domestic violence.

• Design Convergence Study
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• v.17 no.3
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• pp.1-19
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• 2018

Hand rehabilitation training tools are used in hospitals and at home for patients and users who require recovery of disabled hands and improvement in overall hand function. However, existing training tools are not organized into a progressive system, and they lead to repeatability operations over a period of time. As a result, patients feel free and cannot be motivated by rehabilitation, and continuous rehabilitation training is difficult. Based on this argument, the study combines one of the elements of the game called the "Cat's cradle" to enable the user to feel achievement through play and to achieve natural rehabilitation through unconsciousness. After examining the characteristics of the tool, the user's environment, the relevance of the Cat's cradle game to the training tool and to the patient's continued rehabilitation was established. And design elements were derived through professional interviews. Later, design guidelines and prototypes have been created to complement the problems associated with guidelines and prototypes by conducting usability testing and design element assessment.

• Research in Community and Public Health Nursing
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• v.22 no.2
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• pp.192-203
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• 2011

Purpose: This study was conducted to develop and assess the feasibility of an upper extremity exercise program based on Patterned Sensory Enhancement (PSE) for home-bound stroke patients by measuring the level of upper extremity function, depression, and interpersonal relationship. Methods: The experiments were performed on stroke patients at three different rehabilitation centers in Incheon City. Twenty patients participated in the experimental group or in the control group. The program was executed three times a week for 6 weeks. Data were collected from August to October, 2006. Manual Function Test was used to quantify and evaluate upper extremity function. The depression level and the effectiveness of interpersonal relationship were quantified and measured using CES-D and Relationship Change Scale, respectively. Results: The effectiveness of upper extremity function of stroke patients who participated in the PSE upper extremity exercise program was higher than that of non-participating patients. The depression level decreased and interpersonal relationship improved in the stroke patients who participated in this program compared to those who did not. Conclusion: These findings prove that the PSE upper extremity exercise program for home-bound stroke patients was an effective strategy for enhancing upper extremity function, decreasing the depression level, and improving interpersonal relationships.

• The Journal of the Korea Contents Association
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• v.13 no.8
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• pp.324-333
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• 2013

The purpose of this study was to investigate the need of home modification for outpatient with stroke and spinal cord injury. The subjects of this study were 54 outpatients who have experience in rehabilitation therapy at hospitals in Seoul and Gyeonggi-do. A questionnaire was distributed and collected form January 2th to February 4th, 2012. Descriptive statistics and $x^2$-test were used to analyze data. There were statistically significant difference in stairs of access, in width of front door, in bathroom, space of room according diagnosis. There were statistically significant difference in light of sensor, tissue holder and socket cover in bathroom for the comparison of demands for home modification by living type. There were statistically significant difference in width and threshold of front door, tissue holder and towel bar, nonslip floor in bathroom, space and table, chair of kitchen, space and threshold of porch, light for the comparison of demands for home modification according score of MBI. Based on the results of the survey, needs of home modification is different according disability level, diagnosis, living type, ADL performance. The results of this study show a need for the further occupational therapy of home modification and supporting policies in home modification.

• Clinical Pain
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• v.16 no.1
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• pp.20-25
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• 2017

Objective: To find that the patients who conducted home self-exercise in conjunction with intra-articular corticosteroid injection will have better improvement in subacromial subdeltoid (SASD) bursitis symptoms than those who received only an injection. Method: A prospective, nonrandomized, comparison study was conducted in outpatient rehabilitation clinic in a tertiary university hospital. Patients diagnosed with SASD bursitis with physical examination and ultrasound evaluation were included and received ultrasound guided injection (UGI). Patients were divided into two groups according to the compliance of self-exercise: UGI-exercise group and UGI only group. Visual analog scale (VAS) was checked before, at 3 weeks, 3 months, and 6 months after the UGI. A patient's global impression of change (PGIC) survey was made at 3 months after the UGI. Results: A total of 82 patients with SASD bursitis were included. At 3 weeks after the injection, the mean VAS for the UGI-exercise group was 2.6 ± 1.7 and for UGI only group was 1.9 ± 1.3 (p=0.030). At 3 months after the injection, the mean VAS for the UGI-exercise group was 4.0 ± 1.3 and for UGI only group was 5.4 ± 1.4 (p<0.001). Conclusion: We concluded that home-based self-exercise of the shoulder provides an additional benefit for pain alleviation possibly with prolonging the effect of injection in SASD bursitis.

• Tuberculosis and Respiratory Diseases
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• v.52 no.6
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• pp.597-607
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• 2002

Background : Even though it is well known that pulmonary rehabilitation (PR) improves exercise capacity, and the quality of life, in patients with chronic lung diseases, not many patients can attend hospital based intensive PR in Korea. The purpose of this study was to develop a method for a home-based PR program, and study its effectiveness. Materials and Methods : Twenty patients with chronic lung diseases were randomly divided into two groups : a home PR group comprising of 10 male patients, with a mean age of 70 years, and a control group comprising of 10 male patients, with a mean age of 65 years. We developed exercise programs, depending on the exercise capacity of each patient, which were easy to do at home. The PR program consisted of a 12 week period of enforced aerobic (mostly walking) and muscle strengthening exercises, as prescribed by the exercise specialist, in accordance with the functional capacity of the patient. In addition to the education, nutritional and psychiatric consultation was undertaken, and respiratory muscle training arranged. Patients visited hospital every 2 weeks for evaluation and exercise prescription. Results : All patients finished the 12 week course of therapy. Following the home PR, the endurance times and work capacity of the upper and lower extremities were significantly increased in the treatment group in comparison to the controls. The six minute working (Eds note:should) 'working' read "walking"?) distance was increased from $465{\pm}60m$ to $508{\pm}37m$ and the maximal inspiratory pressure from $72.8{\pm}27.2cmH_2O$ to $91.4{\pm}30.9cmH_2O$. The quality of life, as assessed by St Georges Respiratory Questionnaire (SGRQ), was also improved following PR. (Eds note:do you have figures for before and after, and a reference for the SGRQ?i.e. for the main paper.) Conclusion : The home PR program we developed seemed to be applicable, and effective, to most of the patients with chronic lung diseases in this study.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.257-270
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• 1999

The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

• Physical Therapy Korea
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• v.20 no.3
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• pp.62-73
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• 2013

Pediatric home-based physical therapy (PHBPT) provides professional rehabilitation programs at the patient's home, where the activities of daily life are actually performed. PHBPT also allows to avoid the difficulties of transporting children with disabilities to the clinic. Despite these advantages, PHBPT is not yet widely practiced in Korea. There is little objective information regarding the opinions of the main stakeholders on PHBPT. To investigate the awareness and demand of PHBPT among the main stakeholders, 41 pediatric physical therapists (PT) (of 60 contacted) were recruited from different regions of Korea on the basis of the regional population distribution. The recruited PTs completed their questionnaires and also participated in collecting questionnaires from 35 medical doctors (MD) with whom they worked and from randomly selected 201 parents of children with disabilities recruited. The overall response rate was 85.5%. The awareness of PHBPT differed between PTs (95.1%) and parents (67.2%) (p<.001). The survey showed that 82.9% of MDs had at least heard about PHBPT. Significantly more parents (83.5%) than MDs (57.1%), and 70.0% of PTs, wanted to start PHBPT service immediately (p<.001). Significantly more parents (90.0%) than PTs (73.2%) were willing to participate in PHBPT (p<.001). Opinions on the details of policies and procedures (i.e., necessity for prescription, treatment cost, and treatment frequency) differed among the respondent groups, but all favored a minimal qualification of 6~10 years of pediatric experience and a treatment session duration of 1 hour. These findings provide objective information to support health service administrators to understand the current demand and develop feasible policies and procedures of PHBPT in Korea.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.1
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• pp.39-49
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• 2020

Objective : The aim of this study was to investigate the care burden and life quality in family caregivers of community-dwelling patients using home mechanical ventilator(HMV) in Yeognam region. Methods : Survey performed to family caregivers of the patients using HMV in Yeognam region, Korea. The questionnaire is composed with patient care and the burden on caring. Korean version of Short Form Zarit Burden Interview(K-ZBI-12) and 3-Level version of EuroQol-5 Dimension applying Korean weight(KEQ-5D-3L) were also investigated. Statistical significance was accepted for p<.05. Results : A total 98 out of 150 questionnaires were analyzed. The K-ZBI-12(33.08±10.34) had a correlation with KEQ-5D-3L(0.71±0.25) negatively(p=.038). Patients' age, duration of HMV, financial burden and professional caregivers' care time had correlations with K-ZBI-12 positively(p<.05). KEQ-5D-3L correlated duration of HMV negatively(p=.017). Invasive ventilator group had lower KEQ-5D-3L than the non-invasive ventilator group(p=.008). K-ZBI-12 was lower in more than one caregiver care of patients than in one(p=.001). Conclusion : This study revealed high care burden and low quality of life in family caregivers of the patients with HMV in Yeongnam region, Korea. Efforts are needed to continually identify the needs of patients and their families, and the socioeconomic support and medical services associated with HMV.