• Title/Summary/Keyword: Home-visit health care

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Effects of the Self-care Promotion Program for the Elderly in Home Health Nursing (재가노인을 위한 자가관리증진 프로그램의 효과)

  • Lee, Kyung Bok;Kim, Soon-Lae
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.21 no.2
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    • pp.156-165
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    • 2014
  • Purpose: This study aimed to investigate the effects of a program for increasing self-care with activities of daily living among the elderly living at home. Methods: The study adopted a non-equivalent control group pretest-posttest design. The number of participants were 30 in the experimental group and 30 in the control group. Participants were persons aged 65 years and above in Busan. The experimental group was provided with for 16 different types of self-care behaviors by family nurses who made weekly home visits to these participants. Each visit lasted for more than 30 minutes, and the visits were conducted for 12 weeks. The research instrument used in this study was a scale developed by Shimanouchi et al. (2003) which assessed self-care behavior, activities of daily living, and depression. Results: The experimental group showed an increase in self-care behavior compared to the control group. Time and group variables were also found to have an interaction effect on the daily living activity level. The experimental group showed an increase in the activities of daily living compared to the control group. Depression scores dropped from 9.4 to 5.8 in the experimental group and from 8.6 to 7.0 in the control group. Conclusion: We found that the self-care behavior program improved the levels of independence and activities of daily living among the elderly living at home.

A Consideration on the Instituting Home Health Care in Korea (우리나라 가정간호제도화 방안에 관한 고찰)

  • Yun, Soon-Nyoung;Hwang, Na-Mi;Hyun, Hye-Jin;Choi, Joung-Myoung;Kwon, Mi-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.2
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    • pp.5-18
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    • 1995
  • While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

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Awareness and using status on long-term care insurance and insurance benefits (노인 장기요양보험 이용실태 및 서비스내용에 대한 인식)

  • Jung, Jae-Yeon;Kim, Soo-Hwa;Kim, Young-Kyung;Ahn, Se-Youn;Yoo, Eun-Mi;Choi, Boo-Keun;Hwang, Yoon-Sook;Han, Su-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.3
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    • pp.373-381
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    • 2016
  • Objectives: The purpose of the study is to investigate the awareness toward use and service contents of long term care for the elderly. Methods: A self-reported questionnaire was completed by 296 adults from August 13 to October 20, 2014. The questionnaire consisted of general characteristics of the subjects, awareness toward long term care insurance for the elderly, awareness toward long term oral health care services, use of long term care service and use intention for the long term care insurance. Data were analyzed by SPSS 18.0 program. Results: Those who were aware of the long term care insurance accounted for 55.4 percent. Approximately 50 percent of the respondents recognized long term care service items, home visit care, home visit bathing, and home visit nursing. Most of the respondents had information of long term care services by way of mass media and direct contact. Only 13.4 percent of the respondents were aware of the oral health service in the long term care insurance. The subjects were aware of denture cleaning, oral cleaning and oral health education out of oral health service in order; and oral health services that needed to be offered were denture cleaning, oral health education and professional toothbrushing. They reported that dental hygienists were the most important manpower that offered the efficient oral health care services. They answered that professional manpower and financial support are required for oral health services. The positive thinking to long term care insurance accounted for 89.2 percent and 91.3 percent had use intention for oral health services. Conclusions: Many elderly people have mastication or dysphagic problems due to systemic diseases. Therefore, it is necessary to announce the long term care insurance and long term care services for the elderly people.

An Analysis of the Elderly Care and Management in Hospital-Based Home Care Agencies (노인대상 의료기관 가정간호사업의 운영실태)

  • Song, Chong-Rye;Kang, Im-Ok;Kim, Yun-Ok;Jo, Hea-Sook;Hwang, Moon-Sook
    • Research in Community and Public Health Nursing
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    • v.19 no.4
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    • pp.660-672
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    • 2008
  • Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

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A Decision-support System for Care Plan in Long-term Care Insurance (의사결정나무기법을 활용한 노인장기요양보험 표준급여모형 개발)

  • Han, Eun-Jeong;Lee, Jung-Suk;Kim, Dong-Geon;Kwon, Jinhee
    • The Korean Journal of Applied Statistics
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    • v.27 no.5
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    • pp.667-679
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    • 2014
  • National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

A Study of Home-visit Care Agencies' Perceptions and Attitudes toward Home and Community Long-term care Agency Quality Assessment (HCLA-QA) Program (방문요양기관의 재가장기요양기관평가에 대한 인식 및 태도)

  • Han, Eun-Jeong;Lee, Jung-Suk;Kwon, Jinhee
    • 한국노년학
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    • v.32 no.2
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    • pp.467-485
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    • 2012
  • National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.

A Study of Hospital-based Home-Visit Nutrition Education Needs of Patients at Discharge (퇴원환자의 병원중심 방문영양지도 요구도 조사)

  • Ahn, Su Mi
    • Korean Journal of Community Nutrition
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    • v.19 no.4
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    • pp.386-400
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    • 2014
  • Objectives: The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. Methods: Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. Results: Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01).

An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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Relationships Among Musculoskeletal Problems, Sleep Problems, and Self-Rated Mental Health of Home-Care Workers: Focusing on the Mediating Effect of Sleep Problems (방문 돌봄 노동자의 근골격계 자각증상, 수면문제와 주관적 정신건강 간의 관련성: 수면문제의 매개효과를 중심으로)

  • Yang, Ju Hyeon;Lee, Eun Jung;Jung, Inok;Park, Bohyun
    • Korean Journal of Occupational Health Nursing
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    • v.31 no.1
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    • pp.11-21
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    • 2022
  • Purpose: This study aimed to identify the relationship among musculoskeletal problems, sleep problems, and self-rated mental health of home-care workers. Methods: Data were collected from 447 home-care workers spanning three occupation types: life supporters for the elderly, home-visit caregivers, and life supporters for the disabled. Musculoskeletal problems, sleep problems, and self-rated mental health were assessed using structured questionnaires. Factors affecting self-rated mental health were analyzed using multiple regression. SPSS was used to test the mediating effects of sleep problems on musculoskeletal problems and self-rated mental health. Results: Among the general characteristics, the variables that showed significant differences in musculoskeletal problems were monthly income level, caring-related career duration, weekly working hours, and occupation type; and the variable that showed significant differences in self-rated mental health was occupation type. Among the occupation types, supporters for the disabled had the most musculoskeletal problems and the lowest self-rated mental health. Musculoskeletal problems among home-care workers had a direct negative effect on self-rated mental health and indirect negative effects on sleep problems. Conclusion: Measures are needed to reduce the differences in working conditions and health status among the occupation types of home-care workers. Considering the relevance between the health issues of home-care workers, the development of a carefully designed health promotion strategy is required.

A Study on Effectiveness of the Home Care Services for the Low Income Inhabitants (일부 지역사회 저소득층 주민을 대상으로 한 가정간호사업의 효과에 관한 연구)

  • Lee Kunja;Kim Myongsoon;Yang Younghee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.70-107
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    • 1992
  • This study was intended to assess the need of home nursing care and analyze the effect of home nursing care, and find out the problems during the performance of home nursing care for the chronic patients among the low-income people in urban area. Data collection by interview was carried out from Nov. 1991 to Jul. 1992. The main results were as follows; 1) Total subjects for the need assessment of home nursing care were 123 households wi th 488 persons in a urban poor area. Over half of households $(57.7\%)$ was teenage family. The overall living conditions were poor and the average monthly income was 580 thousands won. $74.8\%$ of subjects was covered by medical care insurance and only $4.7\%$ was covered by public assistance. The morbidity rate was $8.2\%$ among 488 subjects and $27.5\%$ of them was not treated at all, $30\%$ was treated in utilizing pharmacies or local clinics. 2) The subjects of home nursing care were 46 with Hypertension or DM who agreeded the participation of study among registered patients at a public health center in Incheon. Home visiting was performed at intervals per one month for one year. Most of them were the elder(mean age=61 years) and long term patients(7.8 years continued). Home nursing care was effective. That is, blood pressure(including systolic and diastolic pressure) was significantly reduced (t(n=22)=2.31, P=.031, t(n=24)=4.16, P=.000 respectively) and knowledge of disease(t(N=46)=-7.63, P=.000), attitude of disease (t(N =46) = -4.92, P=.000), and self-care(t(N =46) = -4.89, P= .000) were significantly improved through home nursing care. But there was no difference in blood sugar for diabetics between the beginning and the end of visits. At the beginning of visit for home nursing care, sex$(\beta=-0414,\;t=-3.012)$ and nursing need({3=.310, t=2.164) were influencing self-care, and duration of disease$(\beta=.297,\;t=2.106)$ and nursing need $(\beta=.385, t=20417)$ were influencing blood pressure, blood sugar level. Namely, the subjects who were male and had higher nursing need showed better self-care and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. At the end of visit for home nursing care after one year, the blood pressure and blood sugar level was influenced by age $(\beta.320,\;t= 2.242)$, duration of disease ($(\beta.352,\;t= 2.395)$ and nursing need $(\beta=.350,\;t=2.623)$ and self-care had no influencing factor. The higher age and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. 3) The problems that were found out during the performance of home nursing care were the absent of useful protocols for services and the clear evaluation base, and the difficulty of teaching elders who were the major part of our subjects.

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