• Title/Summary/Keyword: Out-of-Home Care

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Development of a Home Health Care Model in the Public Health System -Visiting Health Service by Community Health Practitioners (공공보건조직에서의 방문간호사업모형개발 : 보건진료소 방문간호사업)

  • 한경자;박성애;하양숙;윤순녕;송미순
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.472-484
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    • 1995
  • The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

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Effect of Case Management Intervention Program for Registered Clients with Home Health Care of Hypertension (고혈압 대상자의 방문간호 중재프로그램의 효과)

  • Oh, Suk-Hee;Kim, Yong-Soon;Park, Jee-Won;Yoo, Moon-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.1
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    • pp.28-35
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    • 2010
  • Purpose: The study compared the hypertension care efficacy of a case management intervention program for registered clients. Methods: The nonequivalent control group pretest-posttest design involved 53 registered hypertensive patients of a customized visiting health care service in S-city(n=28 experimental group, n=25 control group). Data collection and case management intervention were carried out from April to July, 2009. The experimental group had six home visits and two phone calls, and the control group had two home visits during the 8-week period. Outcome variables for test hypotheses were changes in physiologic index (blood pressure and total cholesterol) and degree of self-management performance and confidence. Results: Repeated measure ANOVA and t-test of means revealed significant differences before and after program for systolic and diastolic blood pressure and self-management performance and confidence, but no significant difference concerning total cholesterol. Conclusion: A case management program can have positive effects on blood pressure control and self management. However, research is needed to create a more effective case management for vulnerable patient populations.

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The Factors Influencing Service Outcomes of Group Homes and Residential Care Centers : Focusing on Blinder-Oaxaca Decomposition (그룹홈과 아동양육시설의 운영성과에 영향을 미치는 요인 : Blinder-Oaxaca 분해를 중심으로)

  • Chung, Ick Joong;Woo, Seok Jin;Kang, Hyun Ah;Chun, Jong Serl;Lee, Jung Ae
    • Korean Journal of Child Studies
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    • v.33 no.4
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    • pp.107-127
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    • 2012
  • This study investigates the factors influencing service outcomes of group homes and residential care centers, as well as the factors causing any differences between the two service outcomes. 119 and 137 5-6th graders were selected from group homes and residential care centers respectively, using the cluster sampling method. Multiple regression and Blinder-Oaxaca decomposition were used in this study. The results revealed that 'stigma', 'school adjustment', and 'social support' were significant factors influencing service outcomes among children in group homes, while 'stigma', 'primary caregivers' attitude', and 'peer relations' were identified as significant factors among children in residential care centers. The study also found that the mean service outcome score for group homes was higher than that of residential care centers. The 74 percent of this difference in the mean scores was due to the difference in children' characteristics of the two out-of-home care service types. The remaining 26 percent of this difference was due to unobserved characteristics. Finally, the implications of this study in child welfare practices were also discussed.

Effects of a Maternal Care Program on Self-Efficacy and Postpartum Depression in Mothers with Preterm Babies (미숙아 출산 산모 돌봄 가정간호가 산모의 자기효능감과 산후 우울에 미치는 효과)

  • Cho, Young-Yi;Park, Young-Hea;Jang, Jung-suk;Lee, Jong-Eun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.22 no.2
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    • pp.187-195
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    • 2015
  • Purpose: This study aimed to evaluate the effects of Maternal Care Program(MCP)-carried out by trained home care nurses on self-efficacy and postpartum depression in mothers with preterm babies. Methods: This study was a quasi-experimental study comparing the effects of an MCP on self-efficacy and postpartum depression before Participants were 34 mothers who were referred to the home care nursing center of the C University Hospital in Seoul from April 8 2014 to January 12 2015. Results: The average self-efficacy score was 97.24 points before and 123.26 points after receiving the program, showing a significant increase of 26.03 points (p<.001). Postpartum depression scores were 8.65 points before the program and 5.56 points after, showing a significant decrease of 3.09 points (p<.001). Conclusions: The normal development of preterm babies was confirmed-through regular physical examinations in the MCP. Professional services were provided by-education and consultation on problems related to child-rearing and health to deal with psychological and social problems as well as physical care to mothers by trained home care nurses.

A Study on the Home Care Nurses' Perception of the Complementary & Alternative Therapy (가정전문간호사의 대체요법에 대한 인식)

  • Jang, Kyoung-Ja;Kim, Hyun-Li
    • 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.

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A Study on the Care Worker's Working Condition and Wage with Public Data of the NHIC (공공데이터를 활용한 요양보호사 근로실태 및 임금 분석)

  • Kyoung, Seung-Ku;Jang, So-Hyun;Lee, Yong-Gab
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.339-350
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    • 2017
  • In December 2014, the study analyzed the wage level of Long-term Care Facilities reported by the National Health Insurance Organization Database. From 2008 to 2014, 1,231.357 people in Korea were acquired qualification for care worker. This study tries to the wage of 1,221,085 care workers. We found out that 91.3% of all are women, and 41% out of care worker qualification were between 50-59 years old. And only 14.8% were employed as care workers. About 73.2% of the nursing care workers had less than 3 years of service at the current job, and their wages were 129.2 million won per month for Nursing Home and 6,421 won per hour for the home care center. In order to investigate care workers, it needs to distinguish between Nursing Home and home care center, and it was also confirmed that wage increases was not reached. In addition, we can question the effect of improvement allowance for better working condition, and suggest fundamental problems for care workers' wage and status.

The Effect of Individual Education for Hypertensives at Home on Knowledge of Hypertension, Attitude about Chronic Disease, Self-care Management And Blood Pressue. (개별접촉 교육이 고혈압 환자의 지식$\cdot$태도와 자기건강관리 이행 및 혈압 변화에 미치는 영향)

  • Kim Myung Soon;Yang Young Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.2
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    • pp.52-68
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    • 1995
  • This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

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Personalized Healthcare System for Chronic Disease Care in Cloud Environment

  • Jeong, Sangjin;Kim, Yong-Woon;Youn, Chan-Hyun
    • ETRI Journal
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    • v.36 no.5
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    • pp.730-740
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    • 2014
  • 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.

Study of home Nursing Core Needs and Implementation of Self Care of Chronically Ill Patients (만성질환자의 자가 간호수행과 가정간호 요구에 관한 연구)

  • U, Seon-Hye;O, Hyeon-Suk
    • The Korean Nurse
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    • v.33 no.1
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    • pp.80-91
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    • 1994
  • This study was done to gather the basic information needed to identify how the home nursing care needs and implementation of self care is being carried out for chronically ill patients. The subjects of the study were 294 from chronically ill patients in a general hospital, a university hospital and seven primary health care center and the data was collected by a nurses, public health nurse practioners using questionairs from July 30 to September 30, 1993. The data were analyzed using percentage, mean, and T-test, ANOVA. Our objectives were to understand basic nursing information general characteristics, implementation of self care, home nursing care needs, implementation of self care depend on general characteristics. The results of the study were as follows 1) General characteristics of subjects. The majority of subjects are female (54.8%) 66.7% of residence are fishing and agrarian villages. 20.1% of disease are neurologic system (backache, neuralgia, HIVD, C.V.A). 2) Evnironmental offord reveals high point in implementation of self care.($2.76{\pm}1.37$) 3) B.P check reveals high peroentage in home nursing care needs.(84.7%) 4) Implementation of self care depend on general characteristics reveals significantly different by $sex^{*}$, educational $level^{**}$, monthly $income^{**}$, number of $family^*$,{\;}$disease^*$, and reason of $untreatment^{**}(^*<0.05,{\;}^{**}<0.01)$. In conclusion the study requires efforts of nurse practitioners, and the support of useful resouress by government.

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A Study on the Nursing Performance of the Home Care Nurses in Seoul (서울지역 가정간호사의 업무수행능력 실태조사)

  • Suh, Moon-Ja;Park, Ho-Ran;Kang, Hyun-Sook;Kim, So-Sun;Shin, Kyung-Lim;Kim, Keun-Soon;Kim, Hae-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.46-58
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    • 1999
  • The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

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