Purpose: The purpose of this study was to evaluate the effects of a school-based intervention program for middle school adolescent girls with depression. Methods: The study was a pretest-posttest repeated-measure design with a nonequivalent control group. Fifty eight students with depressive symptoms were recruited from two middle schools in Seoul, Korea. The data were collected from the intervention (n=30) and the comparison group (n=28). The research instrument was Reynolds Adolescent Depression Scale. Results: The intervention group greatly improved from baseline to 10 weeks and then saw a slight positive change between 10 and 13 weeks. Conclusion: The results of this research show that depression intervention programs are effective for young female adolescents. Thus the investigation has important school-based treatment implications, and should be integrated into school curriculums by school health nurses for early intervention of depressive symptoms in middle school adolescent girls.
Purpose: The purpose of this study was to evaluate hospital service utilization by the types of hospitals in Type I Medicaid claims frequently cited by elderly beneficiaries. Methods: Three frequently claimed inpatient diseases were selected: cerebral infarction, hypertension and diabetes mellitus. Relevant data were collected for the year 2008 from the computer database of the National Health Insurance Corporation. The data was analyzed using SPSS by descriptive statistics, ANOVA and coefficient of variation. Results: The coefficient of variance of hospitalization per episode was higher than daily hospital expenditure among hospitals for all three diseases. The coefficient of variance of hospitalization per episode was highest for cerebral infarction. The coefficient of variation of hospital expenditure per hospital day was highest for hypertension. Conclusions: Evaluating of the volume and pattern of hospital service utilization and the appropriateness for hospital admission for Type-I Medicaid elderly beneficiaries is important for Medicaid-based case management.
The Journal of Korean Academic Society of Nursing Education
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v.14
no.2
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pp.294-304
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2008
Purpose: Cancer patients experience a range of physical and psychological sequelae. Consistent nursing support should be provided along the cancer treatment path. This study aimed to i)examine the effects of a telephone counseling program after discharge on perceived health, psychological well-being, and satisfaction with nursing services, and ii)describe symptom distress and their coping methods. Method: The study was a quasi-experimental design with a non-equivalent pre-post test. The sample included 20 women with gynecologic cancer in the experimental group and the same in the control group from a university hospital in Seoul. The telephone intervention was given once from 5 to 7 days after the chemotherapy. The General Well-Being Schedule and Symptom Distress Scale were used. Result: An effect from telephone counseling was found only in the vitality subscale of psychological well-being. Other subscores, perceived health, or satisfaction with nursing services did not differ between the two groups. Pain, skin change, decreased appetite, and constipation were the major symptoms and a relatively few coping strategies were utilized. Conclusion: Protocol of telephone counseling led by a nurse needs to be further developed in regard to best timing, amount, and target effects for follow-up care of gynecologic cancer patients.
Purpose: This study was designed to develop Nursing Service Quality Indicators(NSQIs) in nursing homes that would lead to an appropriate evaluation and improvement of nursing service quality. Methods: The preliminary NSQIs were developed through literature reviews and analysis of existing quality indicators. A content validity testing was done twice by using a panel of experts who were from academia and the clinical areas. The final NSQIs were confirmed and applied in three nursing homes to test feasibility. Results: The preliminary NSQIs had 4 domains and 31 indicators. Two content validity testings were performed. The indicators scoring over.80 CVI for each testing were selected and modified by experts' opinions. The final NSQIs consisted of 7 domains and 33 indicators. They were applied in three nursing homes and it was revealed that all the indicators were applicable. Conclusion: In this study, it is shown that this new 'Nursing Service Quality Indicators in Nursing Homes' is suitable for a holistic evaluation of nursing service quality of elderly patients in nursing homes. This NSQIs will be able to provide a basis for establishing nursing care standards and improving the nursing care quality in nursing homes.
Purpose: Nursing homes are a type of residential care that provide diverse services such as planned activities, convalescent care, skilled nursing and memory care. Nursing homes are good facilities for old people with dementia to improve their quality of life. On the other hand, the subjectivity toward nursing homes can vary to greater or lesser degrees. The purpose of this study was to identify the subjective attitudes and viewpoints toward nursing homes in undergraduate nursing students. Methods: The Q methodology, which is a research method to study the people's subjectivity, was used. The 40 Q-statements selected from each of 43 participants were classified into the shape of a normal distribution. The data collected were analyzed using the QUANL program. Results: Three types of subjectivity toward nursing homes emerged: 'Type I, in terms of usage of nursing homes-hesitative perspectives;', 'Type II, in terms of running of nursing homes-progressive perspectives;', and 'Type III, in terms of admission to nursing homes-constructive perspectives'. Conclusion: The findings of this study suggest that nursing intervention programs should be developed for the three types. The study results will lead to further research.
The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.
Park, Eun-Sook;Lee, Sook-Ja;Park, Young-Ju;Ryu, Ho-Sihn
Journal of Korean Academic Society of Home Health Care Nursing
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v.7
no.1
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pp.58-72
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2000
This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting 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 the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical 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 test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.
Kim Chung Nam;Kwan Young Sook;Koh Hyo Jung;Kim Myung Ae;Park Chung Ja;Shin Yeong Hee;Lee Byung Sook;Lee Kyung Hee;Seo Hanng Suk
Journal of Korean Public Health Nursing
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v.14
no.2
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pp.246-259
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2000
The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebralcardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.
Purpose: This study was done to investigate the effects of breast-feeding education and support services on rate of breast-feeding three and six months after birth, and the effect on infant's growth (weight, height, body mass index [BMI]). The experimental group which had both education and support services was compared with the control group which had only breast-feeding education. Methods: This study was a quasi-experimental study with a time-series design. The participants were 39 mothers who were hospitalized for childbirth. Twenty mother were assigned to the experimental group and 19 mothers, to the control group. The breast feeding education was done during hospitalization, and support services were provided once a week after discharge for a month (a total 4 times) by a maternity ward nurse. Data regarding breast-feeding rate at one month after childbirth was collected by phone call; the breast-feeding rates at three and six months after childbirth were collected in a visit to the families. The child's weight and height were also measured during the visit. Results: The experimental group had a statistically significant higher rate for frequency of breast-feeding at one, three and six months after childbirth than the control group. However, there was no meaningful difference between the two groups for infant growth. Conclusion: The results of this study suggest that breast-feeding education is helpful for a start, but support services are also necessary to sustain breast-feeding.
This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.
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