• 대한간호학회지
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• 제45권6호
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• pp.919-927
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• 2015

Purpose: Effective transitional care is needed to improve the quality of life in older adult patients with chronic illness and avoid discontinuity of care and adverse events. The aim of this article is to provide an overview of the key features, broader implications, and the utility of Meleis' transition theory intended for the transitional care of older adults with chronic illnesses. We present the role of nurse in the context of transitional care and propose future directions to increase the quality of nursing care. Methods: The online databases Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Science Direct were searched for relevant literature published since 1970 along with textbooks regarding nursing theory. Results: An evaluation of the usefulness of transition theory based on transitional care in older adult patients with chronic illnesses is provided. Healthy transition should be the expected standard of nursing care for older adults across all healthcare settings. Conclusion: Nurses need to contribute to the development of transitional care for vulnerable populations; however, transition theory needs to be enhanced through additional theoretical work and repeated evaluations of the applicability in areas of transitional care.

• 대한간호학회지
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• 제53권5호
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• pp.556-569
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• 2023

Purpose: This phenomenological study tried to understand the essence of the transitional care experience of medicaid case managers and its structural meaning. In addition, it was attempted to establish a system of transitional care and seek support measures for medicaid case managers. Methods: The participants of this study were 7 medicaid case managers who had spent more than 1 year and 6 months in medicaid pilot project. Data were collected with individual in-depth interviews from June to December 2021. The data were analyzed by Giorgi's phenomenological analysis method. Results: The seven constituents derived from the results of this study were 'struggle to establish a living environment', 'dedication to supporting independent living', 'anxiety about safety', 'pressure on care responsibilities', 'distress in building the pilot project', 'pride in role', and 'expectation for improvement'. Conclusion: The study results provide a comprehensive understanding of the transition care reality for medicaid case managers. They also shed light on managers' perceptions and attitudes. These findings can serve as fundamental information for establishing support measures for medicaid case managers and transitional care systems.

• 임상간호연구
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• 제15권3호
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• pp.143-155
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• 2009

Purpose: This study was conducted to develop and evaluate the collaborate transitional care program for improving continuity of care in patients transferred to general wards from ICUs. Methods: 18 years and older who were hospitalized in adult intensive care units at A university affiliated medical center was recruited for the study. The experimental group for patients transferred from an ICU consisted of 33 patients and family caregivers; 34 patients and family caregivers for the control group. This study was utilized a quasi-experimental research design. The collaborative transitional care program was administered in transfer process. Data were collected two times by interviews, medical records, and telephone using questionnaires. Results: There were statistically significant differences between the two groups on relocation stress (p<.001), perceived health status (p<.001), satisfaction of caring (p=.011), physical domain (p=.022) and mental domain (p<.001) of the QOL. There were significant differences between the families of the two groups on burden (p<.001) and satisfaction of caring (p<.001). Conclusion: The collaborative transitional care programs administered in transfer process to general wards from an ICU have positive effects on patients and families' intrinsic and extrinsic factors. This program will be able to be utilized in clinical fields to improve continuity of care for patients and families between ICUs and general wards.

• 대한간호학회지
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• 제40권4호
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• pp.599-609
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• 2010

Purpose: The purpose of this study was to develop and evaluate a transitional care program for patients discharged from military hospitals. The study consists of two phases: developing the program and evaluating its effectiveness. Methods: The conceptual framework used to guide the development of the program was Meleis's transition theory. A quasiexperimental design was employed for this study. Participants were recruited from patients discharged from one military hospital, 72 in the control group and 56 in the experiment group. Data were analyzed using SPSS WIN 12.0 program with chi-square, Fisher's exact test, independent t-test, and mixed model. Results: Participants in the transitional care program reported promoting a positive personal condition, and more healthy patterns of response in the first week after being discharged and a smoother discharge transition. Conclusion: The transitional care program developed for discharge patients from military hospital promoted discharge readiness and promoted smooth discharge transition.

• 임상간호연구
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• 제23권3호
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• pp.376-387
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• 2017

Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

• 한국인구학
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• 제18권2호
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• pp.51-69
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• 1995

이 연구는 한국사회에서 사회복지 정책을 어떻게 전개해 나가야 할 것인지에 관한 관심 속에서 선진복지국가인 스웨덴의 사회복지제도가 어떻게 발전해 나갔는지를 인구변천에 초점을 맞추어 살펴보고 있다. 먼저 스웨덴과 한국의 인구발전과정을 인구변천모형에 따라 분석하고, 인구변천 단계에 따라 사회복지가 어떻게 발전해 나왔는지를 주로 사회복지 법규를 통해 규명하고 있다. 다음 각 단계별 법규와 사회보장비 지출을 검토하여 스웨덴의 복지발달과정의 이념을 규명한 후, 한국의 사회복지정책이 어떤 방향을 나가야 할지를 제시하고 있다. 연구결과 스웨덴에 비해 한국의 사회보장비지출은 절대 부족상태이며, 스웨덴이 보편주의적 서비스를 강조하는데 비해 한국은 특수집단에 대한 서비스를 강조하고 있음이 부각되었다. 또 한국은 특수한 역사적, 문화적 요인에 의해 보훈계통의 비용이 지불되고 있다. 이 연구의 정책적 함의는 한국사회도 앞으로 소극적인 복지정책보다는 스웨덴에서 처럼 보편주의, 생산주의 및 가정복지를 바탕으로 한 복지민주주의 정책에 대한 적극적인 자세가 필요함을 제시하고 있다.

• 대한간호학회지
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• 제31권5호
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• pp.932-947
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• 2001

The purpose of this study was 1) analyze the current state of Sanhojoriwon; and 2) to suggest the new model for the community based mother infants health care delivery system: strategies of TMIC are related to Public Health policy, cost-effectiveness, mother infant care provision of medical professionalism, and so on. Method: Forty-seven workers from seventeen Sanhojoriwon participated to analyze several aspects of Sanhojoriwon. Using a questionnaire developed at Korean Sanhojori Research Forum (KSARF), such as the traditional and medical concept of the Sanhojori, postpartum care, Korean traditional postpartum care, job description on women and infant care at Sanhojoriwon, professional management, health care policy and the educational need. Results: Based on the descriptive study results, the TMIC, the community based transitional mother infants care center was suggested as a new model for the cyclic public health care system related on the reproductive health, using an already existing related center, Sanhojoriwon. Also, several strategies were presented on the TMIC.

• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.563-572
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• 2023

Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.

• 지역사회간호학회지
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• 제32권3호
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• pp.382-395
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• 2021

Purpose: The purpose of this qualitative study was to explore the transition experiences of the elderly from long-term care hospitals to their homes. Methods: The participants were eight elderly medicaid beneficiaries, who had been the subjects from the community care project in Korea. The data were collected with one-on-one interviews from April to November in 2020, and analyzed by phenomenological steps. Results: The seven themes derived in this study were 'Space to escape', 'Reliable supporter opened the way to discharge', 'Comfortable life at home', 'Obstacles to independent life', 'Struggling to live alone', 'Fence for community life', and 'Energizing in daily life' Conclusion: The results revealed the positive aspects of Community Care program in Korea. However, it is suggested that active communication between hospitals and community care institutions, and improvement of home environment to live in the community before discharge should be required. And system revision is needed to adjust activity in their home and support health problems of the elderly in the early stage of discharge. The results of this study can be referred to as the foundation of transitional care for the elderly.

• 가정과삶의질연구
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• 제30권6호
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• pp.183-199
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• 2012

Since the Framework Act on Healthy Families came into effect in 2005, family policy has become a primary field of social policy, and 'family' has emerged as an important keyword for solving Korean society's various phenomena and problems. In order to seek practical plans for reforming social policy through family policy, this thesis has analyzed the transitional characteristics of Korean families in relation to where Korean families currently stand and the situation they are facing. This thesis has also reviewed the content of family policy in the master plan of healthy families, the starting point of the actual family policy, and other related policies. It also has analyzed the key content of child care support policy. From these various analyses and discussions, this thesis has emphasized "family care" as the keyword of family policy, family effect analysis as the means of reinforcing family perspective, and family integrity for policy effectiveness.