• Journal of Korean Public Health Nursing
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• v.15 no.1
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• pp.27-41
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• 2001

The purpose of this study was to discern the level of satisfaction of postpartum care in hospitals. the level of importance of traditional postpartum care and the need for home health care for postpartum women. The study's design was to obtain data needed to develop a community-based postpartum care program and to improve the quality of nursing for postpartum care recipients. Data for the study was collected from 1 March to 31 June 2000 from 116 postpartum care recipients treated in Chung-Buk, Korea. Data analysis consisted of frequency, percentage, t-test, and ANOVA. using SPSS win program. The results the of analysis were as follows: 1) The level of satisfaction of postpartum care in the hospital (mean 1.31) was very low. The most laudable items of nursing care by category were: moderate satisfaction with 'perineal wound care' (2.04) and 'afterpain observation'(2.09). The overall level of satisfaction of postpartum care in the hospital. however, was very low. 2) Among other items of postpartum care in the hospital, 'postpartum exercise' $(25.9\%)$. 'assessment and support for postpartum depression' $(25.9\%)$, 'operation wound care for women who underwent Caesarean sections' $(24.5\%)$. and 'contraception and family planning' $(20.4\%)$ showed a need for home health care for postpartum care recipients above $20\%$. 3) The level of importance of traditional postpartum care (Sanhujori) was relatively high (mean 2.72). The importance of Sanhujori by category was as followed: 'the fourth principle: protecting the body from harmful strains' was the highest (2.88), 'the third principle: eating well', 'the first principle: invigorating the body by augmenting heat and avoiding cold', 'the second principle: resting without working', 'the fifth principle: keeping clean' and 'the sixth principle: handling with the whole heart' showed 2.85, 2.80, 2.70, 2.51 and 2.46 respectively. 4) The need for home health care with Sanhujori was very low. 5) The relationship between demographic factors and the level of satisfaction with postpartum care in the hospital was as follows: the satisfaction levels were significantly different among' delivery frequency' and 'health status' alteration after delivery'. 6) The relationship between demographic factors and the importance of the Sanhujori category was as follows: There were no significant differences in the level of importance of the first and the forth principle of Sanhujori. The level of importance of the second principle of Sanhujori was significantly different among 'income' and 'family type'. The level of importance of the third principle of Sanhujori was significantly different among 'having a boy'. The level of importance of the fifth principle of Sanhujori was significantly different among 'income' and 'feeding type'. The level of importance of the sixth principle of Sanhujori was significantly different among 'education background' and 'feeding type'. In conclusion. the findings of this study illustrate the nursing needs of postpartum care recipients. It provides a challenge to caregivers in the healthcare industry to develop a continuous postpartum care program and integrative postpartum care system that embodies the oriental and western paradigm for the promotion of women's health.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.26 no.1
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• pp.91-101
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• 2019

Purpose: The purpose of this study was to identify factors associated with stress related to home mechanical ventilator (HMV) care in general ward nurses. Methods: The study participants were 110 general ward nurses. Data on participant characteristics, level of knowledge, education needs, coping ability in emergency situations, confidence, and stress were collected from August 1 to 30, 2018 using a structured questionnaire by web-based surveys. Data were analyzed using SPSS/WIN 20.0 for descriptive statistics and independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis. Results: Significant factors associated with stress related to HMV care were ward career, intensive care unit (ICU) career, intensive care room (ICR) career, education experience, and satisfaction level of HMV education. Stress had negative correlations with confidence and positive correlations with education needs. The determining factors affecting stress related to HMV care in the general ward were confidence (${\beta}=-.31$, p=.004), ICR career (${\beta}=-.27$, p<.001), education needs (${\beta}=.24$, p=.005), education frequency (${\beta}=-.18$, p=.040), and ICU career (${\beta}=-.18$, p=.025); their explanation power was about 41.8%. Conclusions: It is necessary to develop HMV care training manuals and guidelines and consider ICU or ICR careers for patient safety.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.507-516
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• 2000

This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

• Journal of Korean Academic Society 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.

• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Health Policy and Management
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• v.30 no.1
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• pp.100-111
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• 2020

Background: Few studies have examined the performance of the public long-term care insurance (LTCI) from the perspective of geographic equity. This study investigated regional variations and associated factors in the supply and utilization of nursing home care within and also between Japan and Korea. Methods: A comparative dataset was developed by extracting data from 2013-2015 LTCI statistics yearbooks and Organization for Economic Cooperation and Development regional statistics, as well as other comparable data in Japan and Korea. The unit of analysis was the prefecture in Japan and the province in Korea. We computed variation indices and conducted regression analyses for regional variations within each country and decomposition analyses to examine the variations between the countries. Results: The overall regional supply and use of nursing home care were higher in Japan, but the regional variations in Korea were larger than in Japan. In both countries, the nursing home supply was negatively associated with the proportion of older people with independent living. Nursing home use was also negatively associated with the supply of hospital beds and home care agencies in Korea; the relationship was the opposite in Japan, however. The country-based differences were more likely to be explained by differences in the distributions of the variables included in the analytical model than country-specific characteristics. Conclusion: Regional-level nursing home supply and use were unequal in both countries, and the contributing factors were not the same. Policy efforts are needed to advance regional equality in long-term care (LTC) and collaboration between health and LTC institutions for frail older people, especially in Korea.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.13 no.1
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• pp.24-32
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• 2006

The purpose of this study is to predict the degree of taking the complementary & alternative therapy in the home care nursing service and provide basic data for the application of it. To accomplish this, degree of general recognition of the complementary & alternative therapy, experiences, degree of concern, applicability of the therapy, and educational need should be studied. This study is a descriptive research survey on the home care nurses working at 73 medical centers out of 125 nationwide who provide hospital based home nursing care. The data was collected from Sep. 20, to Oct. 20, 2004 by ChoiHeyran's questionaries (2002). The data was analyzed by the frequency and the percentage. The results of this study are as follows ; 1. The degree of pre-cognition on the complementary & alternative therapy is very high. Information about the therapy was mostly obtained through medias. Home care nurses understand that he desirable treatment is to practice medical treatment and complementary & alternative therapy simultaneously. While 50% of them have already practiced complementary & alternative therapy among their patients. The most commonly used therapy is Acupressure. And Home care nurses have open and positive attitudes about the complementary & alternative therapy as to answer they aye ready to recommend it to their patients. 2. Over half of the Home care nurses met patients taking complementary & alternative therapy. 94.5% of them think scientific diagnosis on the effect of the therapy. advice from the doctor. and the special working staff is required to apply it on to the home care nursing. 3. 68.5% of the Home care nurses have taken education on the therapy through general comprehensive instructions and supplementary. Most of them want to have a opportunity education on the therapy because they want to provide comprehensive nursing and diversified nursing service. The preferred educations are Hand acupuncture, Acupressure & Massage and Aromatherapy, in that order. Based on the above results, the followings are recommended. 1. A study that stipulates the types, applications, and efficiency assessment of the complementary & alternative therapy practiced by Home care nurses in the home care nursing care procedure. And systematic and scientific nursing intervention be developed.

• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.3
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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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.1
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• pp.50-67
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• 1996

Home nursing interventions based on nursing diagnosis were implemented to the patient who are discharged from one hospital often the treatment for chronic neuromuscular system problem, and its effects were studied. The purpose of this study was to find out the effectiveness of hospital bouned home nursing provided by hospital nurses and to categorize home nursing diagnosis and its interventions. Data from experimental group patients were collected at three different time ; at the time of discharge, two weeks after discharge and our weeks after discharge. Data from controll group patients were collected twice ; the first one at the time of discharge, and the other one four weeks after discharge. For this study nursing assessment and intervention booklet developed by the research team. There were no significant decrease of the number of nursing problems and life satis-faction. But daily activity level of patients showed the signs of significant improvement at the time of four weeks after discharge. Results of this study indicates that home nursing intervention based on nursing diagnosis provided the patients with noticeable difference in health maintanance, impairment of physical mobility, potential for infection, impaired home marntenance management, health seeking behavior, chronic pain, disuse syndrome, impaired skin integrity.