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A Study on the recognition and Attitude of Home Health Nursing System (가정간호사 제도에 대한 인식 및 태도 조사연구)

  • Lee Sung Ja
    • 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).

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A study on the present situation of the treatment services provided by alcohol addiction specialized hospitals (알코올중독전문병원의 서비스 제공 현황에 관한 연구)

  • Cho, Hyun;Yoo, Jin-Yeong;Lee, Ji-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.8
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    • pp.3547-3554
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    • 2011
  • The aim of this study is to take hold of the present situation as well as the perspective of the domestic alcohol specialized hospitals. The structured questionnaire was prepared to understand the type of services, manpower and systematic programs. Among eight hospitals that stand for the alcohol addiction specialized hospitals, six hospitals agreed to participate in the survey, which was made from Jun. 17 to July 15, 2010. The average number of beds of the surveyed hospitals was 208. They were mostly private ones(66.7%), located in urban area(50%), and had experiences of alcohol treatment less than five years(50%). While all of them practiced both the inpatient and outpatient services, only 33% provided the systematic outpatient program that was at least 2 or 3 hours per week. All hospitals practiced the physical and individual psychological evaluations, but only 16.1% had the daytime programs. The beds of protective ward were 72% of all beds, and the beds of night and day occupied 7.6% and 2.6% respectively. It was found that although the average number of mental health social worker and mental health nurse was larger than that required in the regulation of mental health law there are significant deviations between hospitals. However, the manpower of psychiatrists and nurses were comparatively large. The first problem indicated by clinical experts was the patient's refusal of care, which results in an inefficiency in the treatment. The next problem was the lack of local health care institutions that can attend on the discharged patients were important issues. Also the low reimbursement and indifferences to the alcohol abuse were considered as important issues.

A Comparative Study on Enhancing the Function of the Health Center in a Urban Area (도시지역 한 보건소 기능 강화 방안에 대한 의견 비교 분석)

  • Lee, Weon-Young;Shin, Young-Jeon;Kwon, Young-Jun;Choi, Bo-Youl;Moon, Ok-Ryun;Jeon, Hye-Jeong
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.857-874
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    • 1998
  • The objective of this study is to collect the opinions on the present condition and the improvement directions of urban health centers from and to make a comparison. Samples were drawn from the various sources of a district in seoul. 53 persons involved in district health's administration(the Members of a District Parliament, the senior officials of a District office, village chief) and 84 health center workers were surveyed with anonymous postal questionaires and 427 district private medical personnels with postal questionaires and 625 users of a health center with direct questionaires, from November 18 to 25, 1996. Additionally, 12,151 households were surveyed with self-reported questionaires including priorities on special district health services of health center, from September 1 to 7, 1996. The major findings were as follows : 1) Although the persons involved in district health administration tend to put lower priority on health service over other community activities, they well acknowledged the importance of health center. But health center workers strongly acknowledged the importance of both health service and heath center. 2) As to the level of human resoureces, equipments and ammenities of Health Center commpared with private medical institute, the persons involved in district health's administration and health center workers responded that health center was higher in following order : 54.9%, 41.6%, 36.5% and 88.0%, 80.7%, 44.1%. 3) Concerning the priorities of health center's improvement, the persons involved in district health's administration replied in the order of reinforcement of proffesional health workers (43.3%), improvement of equipments and ammenities(28.3%), and the health center workers replied in the order of reconstruction of organization(24.1%), public health education and promotion(22.8%), reinforcement of proffesional health workers(21.0%). 4) Both the persons involved in district health's administration and health center workers replied that Ministry Health and Welfare, District office, health center were essential as the most critical organizations in the activation of Health Center's Function. 5) Persons involved in district health's administration and health center workers chose, as the most important health center's Function, medical treatment and prevention of infectious disease, and prevention of acute and chrone disease control and special district health service, respectively. Both Groups replied that fammily planning and parasite control are no longer in need. 6) As the future health service requiring reinforcement, every human resources parties considered health conselling, health line, sex education as the most imortant elements in public health education. Concerning the reinforement of other health services such as medical checkup and visiting nurses, every human resources parties showed more than 80% approval rate, but for oriental medical care service, the private medical personels showed relatively low approval rate(52.9%). Therefore the planning for reinforcement of health center's function requires the reflection of human resources party's opinion and the implication of system which can control and combine the differences in party's opinions.

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A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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A Study on the Situation and Demand with Nutrition Service in Health Promotion Center (건강검진센터에서의 영양서비스 현황 및 요구도 조사)

  • Chang, Ji-Ho
    • Journal of Nutrition and Health
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    • v.40 no.5
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    • pp.475-482
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    • 2007
  • This study was done to analyze nutrition counseling services in health promotion center and to investigate demands of subjects for nutrition services. Data was collected through the survey of 90 subjects. The results were as follows. The results of people receiving nutrition services showed that 58.5% of the counseling group and 46.4% of the non-counseling group answered having experience with nutrition services. And 50% of them received nutrition counseling through individual counseling. Diet therapy with health check-up results also appeared the highest in contents of nutrition counseling. As a source of nutrition information and health knowledge, subjects relied heavily or most on the TV, internet, books, magazines, and newspapers. On the other hand, they relied much less on advice from dietitians, nutritionists, medical doctors and nurses. The experience of receiving nutrition services and thinking about nutrition education related positively. It showed that the counseling group (95.1%) was significantly higher than the non-counseling group (80.5%) in necessity of nutrition assessment. But, necessity of nutrition counseling wasn't significantly different between the two groups. The method of nutrition counseling subjects preferred was individual consultation. The subjects answered to having need of analysis and evaluation of nutrient intake and calorie prescription in nutrition assessment and individual nutritional status results explanation in nutrition counseling. In conclusion all people visiting health promotion centers need nutrition service of some kind.

The Identification of the High-Risk Pregnacy, Usign a Simplified Antepartum Risk-Scoring System (단순화된 산전위험득점체계를 이용한 고위험 임부의 확인)

  • Jo, Jeong-Ho
    • The Korean Nurse
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    • v.30 no.3
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    • pp.49-65
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    • 1991
  • This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situaition. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, $x^2$-test, F-test, Pearsons correation, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants(42.7%) were born to mothers with risk-scores > 7, and 753 infants(57.3%) were born to mothers risk-scores <7. 2. Maternal age" parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies($X^2$=20.88, 42.87, 15.60 P < 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infanl, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. ($X^2$ = 175.96, 87.5, 16.28, 21.78, 9.46, 8. 10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P < 0.01). 4. Abnormal nutrition, anemia, UTI, other medicalcondition(pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 '||'&'||' 5 minute after birth and neonatal body weight. 6. Apgar score at 1 '||'&'||' 5 minute after, birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 '||'&'||' 5 minute after birth, 3 group(0-3, 4-6, above 7), and neonatal body weight, 2 group(below 2.5kg, the other group) (F=104.65, 96.61, 284.92, P<0.01). 8. Apgar score at 1 '||'&'||' 5 minute after birth(below 7), and neonatal body weight(below 2.5kg), were significant relation statistically with risk score.($x^2$=65.99, 60.88, 177.07, P<0.01) were 60.8 %, 60% . 9. Correct classifications of morbid infants(l '||'&'||' 5 minute Apgar score < 7) were 77.8%, 83.8% and that of nonmorbid infants(l '||'&'||' 5 minute Apgar score > 7) were 60.8%, 60%. 10. There were statistically significant difference between dislribution of maternal risk-score among the morbid infants(l '||'&'||' 5 minute Apgar score < 7) and non morbid infants(l '||'&'||' 5 minute Apgar score> 7) ($x^2$=64.8, 58.8, P < 0.001). 11. There were statistically significant difference between distribution of morbid infants(l '||'&'||' 5 minute Apgar score < 7) and fetal death. 12. The predictivity for classifying high.risk cases was 12 % and for classifying low-risk cases was 98.3 % in 5 minute Apgar score. Suggestions for further studies are as follows; 1. Contineous prospective studies, using this newly revised scoring system are strongly recommended in the stetric service. 2. Besides risk facto~s used in this study, assessmenl of risks by factors in another scoring system and paralled studies related to perinatal outcome are strongly recommended.

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A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care (간호의 질 평가도구 개발에 관한 일 연구)

  • 유지수
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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The Study on the Medical and Nursing Service Needs of the Terminal Cancer Patients and Their Caregivers (말기암 환자와 가족의 의료 및 간호 서비스 요구)

  • 이소우;이은옥;허대석;노국희;김현숙;김선례;김성자;김정희;이경옥
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.958-969
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    • 1998
  • In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Predictive Factors of Health promotion behaviors of Industrial Shift Workers (산업장 교대근무 근로자의 건강증진행위 예측요인)

  • Kim, Young-Mi
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.1
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    • pp.13-30
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    • 2002
  • Industrial shift workers feels suffer mental stresses which are caused by unfamiliar day sleep, noisy environment, sleeping disorder by bright light, unusual contacts with family, difficulty in meeting with friends or having formal social meetings and other social limitations such as the use of transportation. Such stresses influence health of the workers negatively. Thus the health promotion policy for shift workers should be made considering the workers' ways of living and shift work specially. This study attempted to provide basic information for development of the health promotion program for industrial shift workers by examining predictive factors influencing health promotion behaviors of those workers. In designing the study, three power generation plants located in Pusan and south Kyungsang province were randomly selected and therefrom 280 workers at central control, boiler and turbine rooms and environmental chemistry parts whose processes require shift works were sampled as subjects of the study. Data were collected two times from September 17 to October 8, 1999 using questionnaires with helps of safety and health managers of the plants. The questionnaires were distributed through mails or direct visits. Means for the study included the measurement tool of health promotion behavior provided by Park(1995), the tool of self-efficacy measurement by Suh(1995), the tool of internal locus of control measurement by Oh(1987), the measurement tool of perceived health state by Park(1995) and the tool of social support measurement by Paek(1995). The collected data were analyzed using SPSS program. Controlling factors of the subjects were evaluated in terms of frequency and percentage ratio Perceived factors and health promotion behaviors of the subjects were done so in terms of mean and standard deviation, and average mark and standard deviation, respectively. Relations between controlling and perceived factors were analyzed using t-test and ANOVA and those between perceived factors and the performance of health promotion behaviors, using Pearson's Correlation Coefficient. The performance of health promotion behaviors was tested using t-test, ANOVA and post multi-comparison (Scheffe test). Predictive factors of health promotion behavior were examined through the Stepwise Multiple Regression Analysis. Results of the study are summarized as follows. 1. The performance of health promotion behaviors by the subjects was evaluated as having the value of mean, $161.27{\pm}26.73$ points(min.:60, max.:240) and average mark, $2.68{\pm}0.44$ points(min.:1, max.:4). When the performance was analyzed according to related aspects, it showed the highest level in harmonious relation with average mark, $3.15{\pm}.56$ points, followed by hygienic life($3.03{\pm}.55$), self-realization ($2.84{\pm}.55$), emotional support($2.73{\pm}.61$), regular meals($2.71{\pm}.76$), self-control($2.62{\pm}.63$), health diet($2.62{\pm}.56$), rest and sleep($2.60{\pm}.59$), exercise and activity($2.53{\pm}.57$), diet control($2.52{\pm}.56$) and special health management($2.06{\pm}.65$). 2. In relations between perceived factors of the subjects(self-efficacy, internal locus of control, perceived health state) and the performance of health promotion behaviors, the performance was found having significantly pure relations with self-efficacy (r=.524, P=.000), internal locus of control (r=.225, P=.000) and perceived health state(r=.244, P=.000). The higher each evaluated point of the three factors was, the higher the performance was in level. 3. When relations between the controlling factors(demography-based social, health-related, job-related and human relations characteristics) and the performance of health promotion behaviors were analyzed, the performance showed significant differences according to marital status (t=2.09, P= .03), religion(F=3.93, P= .00) and participation in religious activities (F=8.10, P= .00) out of demography-based characteristics, medical examination results (F=7.20, P= .00) and methods of the collection of health knowledge and information(F=3.41, P= .01) and methods of desired health education(F=3.41, P= .01) out of health-related characteristics, detrimental factors perception(F=4.49, P= .01) and job satisfaction(F=8.41, P= .00) out of job-related characteristics and social support(F=14.69, P= .00) out of human relations characteristics. 4. The factor which is a variable predicting best the performance of health promotion behaviors by the subjects was the self-efficacy accounting for 27.4% of the prediction, followed by participation in religious activities, social support, job satisfaction, received health state and internal locus of control in order all of which totally account for 41.0%. In conclusion, the predictive factor which most influence the performance of health promotion behaviors by shift workers was self-efficacy. To promote the sense, therefore, it is necessary to develop the nursing intervention program considering predictive factors as variables identified in this study. Further industrial nurses should play their roles actively to help shift workers increase their capability of self-management of health.

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