• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.64-80
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• 2005

The objectives of this study were to identify factors associated with unexpected revisit to an emergency medical center (EMC) located in Seoul and to examine reasons for revisit. During March, June, September and December, 2002, a total of 168 patients had unexpected revisits to the EMC within 48 hours of a previous discharge. As a 1:1 matched control, we included 136 patients who: discharged from the EMC during the same time period: did not return to the EMC; had the same diagnosis and age(${\pm}5$) with the case. In this study, factors associated with unexpected revisits were defined as characteristics of a previous discharge, which were classified into three: sociodemographic, EMC visit-related, and discharge management factors. Reasons for revisit were categorized into disease, physician, patients, and system-related factors. Data were collected by medical chart review with assistance from clinicians of the EMC. Logistic regression results showed that patients who headed home after discharge without follow-up schedule had a 27.6 times higher risk of revisiting EMC than those who were hospitalized following EMC visit. Patients discharged on his own will had a 5.9 times higher risk of revisiting than those discharged following physician's advice. Patients requiring continual observation at the time of discharge were more likely to revisit by 8.7 times than those discharged with improved condition. About 69.13% of the revisits were due to disease-related factors, followed by 13.90% due to patient-related factors, 8.64% due to system-related factors, and 8.34% due to physician-related factors. It appears that the most significant factors influencing revisits are discharge management factors such as patient's condition at discharge, whether the discharge was accorded with physician's advice, and whether returning home without follow-up schedule. Therefore, appropriate discharge management is necessary to prevent EMC revisit.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.33-54
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• 1981

The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.31 no.4
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• pp.531-539
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• 2021

Objectives: The purpose of this study is to understand the effect of infection anxiety about COVID-19 perceived by home appliance installers and repair technicians on work stress. Methods: To collect data, the purpose of the study was explained through the labor union of domestic home appliance service companies, and a survey was conducted through mobile to 286 home appliance installers and repair technicians who agreed to the survey. Results: As a result of the analysis, it was found that age, fatigue, work satisfaction, visit time, and Corona 19 infection anxiety had a significant effect on work stress. In other words, the higher the age, the higher the fatigue, the lower the job satisfaction, the higher the work stress was when the visit time was more than 30 minutes, and the higher the Corona 19 infection anxiety, the higher the work stress. Conclusions: Based on the results of this study, the following suggestions are made. First, in order to prevent work stress, we propose the development of a workplace health care program that can solve fatigue. Second, it is necessary to prepare a working environment and provide institutional support to reduce work stress by increasing Job satisfaction. Third, a workplace quarantine measures is needed to prevent infection for essential-workers who do face-to-face work in preparation for possible infectious diseases in the future.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.15-20
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• 2011

A person with neurological disorder is defined as a person with limitation of ambulation or basic life activity due to the cerebral palsy or traumatic brain damage, stroke. Recently, the DMFT of the children with neurological disorders is similar or lower than the DMFT of the children with no disability. But, this article is about the severe-early childhood caries in children with grade 1 neurological disorder. It is supposed that the primary motor impairment and secondary physical weakness, frequent hospitalization, sugar- rich food and drugs, lack of oral care, delayed dental visit made high caries susceptibility. In case of treatment of the children with severe neurological disorders, dentists should make a thorough caries preventive plan based on individualized caries risk assessment. Also parents and medical doctors should recognize the importance of oral care and do the early dental visit and home care.

• Journal of Hospice and Palliative Care
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• v.18 no.4
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• pp.329-334
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• 2015

Purpose: This study was aimed at analyzing the characteristics and symptoms in home-based hospice-palliative care (HBHPC) patients registered at local public health centers. Methods: A retrospective study was performed; Data of 144 HBHPC patients registered at six public health centers in Pusan City were analyzed, including their initial visit records (registration cards, initial pain evaluation and symptom evaluation). Results: The average age of the patients was 67.7 years old. Among all, 46.2% of the patient lived alone, and 65% had middle school education or lower. The most popular (36.3%) religion was Buddhism, and 47.5% received medical assistance from the government. The most frequent diagnosis was lung cancer followed by stomach cancer and liver cancer in that order. Of all, 48.9% were functionally too weak to lead a daily life, 39.6% were under cancer treatment when registered at the public health center, and 84.5% were aware of the fact that they have reached the terminal phase. Moreover, 83.6% complained about pain, and the pain level was moderate or severe in 36.5% of them. Besides pain, fatigue was the most complained symptom (84.7%), and 49.3% of them rated their fatigue as moderate or severe. Conclusion: Most of the HBHPC patients were socio-economically underprivileged and complained about moderate or worse pain and symptoms. Therefore, it appears necessary to develop an integrated strategy that is tailored for each patient reflecting their characteristics.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.13-29
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• 2002

The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

• Journal of Korean Public Health Nursing
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• v.12 no.1
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• pp.132-146
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• 1998

This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

• Korean Journal of Biological Psychiatry
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• v.25 no.3
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• pp.72-78
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• 2018

Objectives The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. Methods A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. Results The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). Conclusions We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.1
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• pp.112-135
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• 2021

Objectives : To report a case of drug-induced xerostomia treated with Integrative Korean Medicine Visiting Care Service of a Public Health Center. Methods : Home visit treatment and telemedicine were provided by public health doctor(Korean medicine doctor) for person with physical disability who were diagnosed with Behcet's Disease. Palmul-tang(PMT) soft extract was provided steadily 3 times a day for 6 months, and acupuncture, electro-acupuncture, and electro-moxibustion were provided irregularly 6 times for 6 months. Yin-deficiency questionnaire(YDQ), oral health impact profile-14(OHIP-14), oral pain visual analogue scale(VAS), and xerostomia inventory(XI) were used 3 times(baseline, intermediate and termination) to evaluate the changes. Results : YDQ decreased from 620 to 375, OHIP-14 decreased from 34 to 6, VAS decreased from 70 to 40, and XI decreased from 44 to 34. Four scales all gradually decreased. Conclusions : Integrative Korean Medicine Treatments in health insurance including PMT soft extract through home visit treatment can improve drug-induced xerostomia and Quality of life(QoL) of person with disabilities.