Kim, Jung-Soon;Ko, Young-Hee;Kim, Dae-Suk;Kim, Jeung-Hwa;Shin, Jae-Shin;Lee, Jil-Ja;Jeong, Ihn-Sook;Hwang, Sun-Kyung
Journal of Home Health Care Nursing
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v.8
no.2
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pp.148-158
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2001
Purpose: This study is to investigate the attitudes on the Home Health Care among the physicians and nurses in P University. Method: Data were gathered from 71 physicians and 264 nurses. working at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and Fisher exact test. Results: 1) As to the previous information about home health care program, those who have been familiar to it were 100% of physicians, and 99.6% of nurses, and 39% of the physicians and 66.1% of the nurses. were found to have responded with right answers, 2) As to the acceptance of the home health care program, 87% of physicians and 98.5% of nurses were found to be positive and there showed a significant difference(p= .019), 3) The main reasons for accepting the system were: the alleviation of the family burden of time, the maintenance of continuity of care, and the reasons for opposing the system were incomplete legal assurance. the possibility of providing illegal medical services. 4) The physician's intention rate of patient referrals to home care program reveled 49.2%. 5) According to the services related to Home Health Care. the orders of acceptance rates were medical tests related services (77.8%, 92%); therapeutic nursing interventions(69.0%, 88.2%): and services for medication(68.3%, 82.5%) among physicians and nurses. respectively. Conclusion: For the stabilization and successful implementation of home health care system. it should be accompanied with education for physicians about home care. setting specific laws and regulations for home care. legal assurance of home care business. outcome research for home care recipients. and support systems of hospital administration.
This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.
Purpose: The purpose of this study was to identify the needs of family caregivers of home care patients. Methods: A total of 40 caregivers had been selected from a hospital-based home care agency in Gyunggi province. The instrument developed by Hileman, Lackey, & Hassanein(1992) was modified to 55 items and used in this study. The instrument consists of 6 categories: informational, household, patient care, personal, spiritual, and psychological needs. Out of 29 analysed with descriptive statistics, Mann-Whitney U test, and Spearman correlation test using SPSS 14.0. Results: Most caregivers were females, with a mean age of $60.0{\pm}15.5$, 32.1% were spouses, and 92.9% were living with patients. Patient's activities of daily living score was very low, and 44% of patients had cerebrovascular disease. Caregiver's needs were moderate, and the greatest being personal need. There was a significant difference between caregiver's monthly income and needs. Conclusion: Home care nurses need to teach and support family caregivers with specific programs and services to meet the identified and unmet needs of caregivers of home care patients. In-home respite and institutional respite are recommended for family caregivers taking care of patients with chronic disease.
Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.
The rapid increase in the number of patients with chronic diseases is an important public healthcare issue in many countries, which accelerates many studies on a healthcare system that can, whenever and wherever, extract and process patient data. A patient with a chronic disease conducts self-management in an out-of-hospital environment, particularly in an at-home environment, so it is important to provide integrated and personalized healthcare services for effective care. To help provide effective care for chronic disease patients, we propose a service flow and a new cloud-based personalized healthcare system architecture supporting both at-home and at-hospital environments. The system considers the different characteristics of at-hospital and at-home environments, and it provides various chronic disease care services. A prototype implementation and a predicted cost model are provided to show the effectiveness of the system. The proposed personalized healthcare system can support cost-effective disease care in an at-hospital environment and personalized self-management of chronic disease in an at-home environment.
Purpose: The purpose of this study was to suggest the projected workforce of home health care specialists in Korea. Method: Need model. ratio methods and expert opinion were used for projecting the number of home health care specialists. Result: 1) In 2002. there are 13 programs which offer one year home health specialist training. From those programs. they produced 3860 registered home health care specialists. 2) In 2002. there are 89 hospitalbased home health service units and 220 active home health care specialists. 3) In case of hospital- based home health service. average of 4 services per month for average of 3 months was assumed as workforce standard. 4) In case of community-based home health service. average of 4 services per month for 12 months was assumed as workforce standard. 5) The number of home health care specialists required to meet the demands for home health care population in 2000 and 2005 was estimated at minimum of 20.361 to maximum of 31.360 and 21.989 to 34.080. respectively. Conclusion: Community home health care agencies are needed to meet the demands of home health care.
Purpose: The purpose of this study was to identify the extent to which in-hospital-based home health nurses' perceptions and anxiety about death following terminal care, affects their attitudes toward terminal care. Methods: The subjects were 128 advanced practice nurses working in hospital-based facilities for home health care, located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from May 3, 2019, to June 3, 2019, using structured questionnaires, on terminal care and related variables based on the literature. Data were analyzed by performing the Student's t-test, one-way ANOVA, Pearson's correlation, and multivariable stepwise regression using the SPSS Version 25.0 program. Results: The scores of the attitudes toward terminal care of home health care nurses was 3.25 points out of a possible 4 points. Factors affecting nurses' attitudes toward terminal care were their concern about death(β=0.45, p<0.001), religion(β=-0.26, p=0.001) and the anxiety of others about dying(β=-0.23, p=0.003), which explained 32.0% of the observed variance concerning the factors affecting nurses' attitudes toward terminal care. Conclusion: Through this study, concern about death, anxiety about how other people process dying, and religion, were found to be associated factors. The more concerned the nurses were about death and the less their anxiety about how others process dying, the better the home health care nurses' attitude toward implementing terminal care.
Purpose : This study purposed to conduct a comprehensive survey of home care nursing clients' quality of life based on the PRECEDE model. Method : This study selected 74 home care nursing clients registered at a university hospital in Incheon and performed face-to-face interviews by structured questionnaire. The research period was two months from the $2^{nd}$ of February to the $30^{th}$ of March in 2004. Result : According to the result of assessment at each stage of the PRECEDE model, home care nursing clients' quality of life was 13.88 out of 25 points, health level 15.22 out of 21, abilities to perform activities of daily living 29.26 out of 100, cognitive abilities 16.00 out of 30, social support 13.68 out of 20, and satisfaction with home care nursing service 33.26 out of 40. According to the result of stepwise regression in order to identify factors influencing home care nursing clients' quality of life, social support and abilities of daily living were found to be significant variables among the characteristics of each assessment stage. Conclusion : It is necessary to develop nursing intervention strategies for strengthening social support and enhancing abilities to perform activities of daily living in order to improve home nursing clients' quality of life.
This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.
Lee, Mi Kyoung;Song, Chong Rye;Oh, Eun Kyung;Yoon, Young Mi
Journal of Home Health Care Nursing
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v.24
no.2
/
pp.210-220
/
2017
Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.
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