• 가정∙방문간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 보건의료산업학회지
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• 제10권3호
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• pp.85-97
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• 2016

Objectives : In this study, the awareness of hospice and the perceptions on the need for visiting palliative care and what constitutes a good death of the citizens of Busan were investigated. The purpose of this study was to develop a hospice system based on the needs of the citizenry of Busan by seeking solutions for current hospice strategies. Methods : One thousand Busan citizens from 20 to 80 years of age were surveyed in this study. Results : Busan citizens defined a good death as spending less than one month of time in the actual process of dying at home between the ages of 80-89 years. They knew about hospice a little and were aware of its necessity. They also knew about the necessity of visiting palliative care and were interested in receiving it when appropriate but did not know much about it. Conclusions : First, there is a large difference between Busan citizens' expectations on what constitutes a good death and what a good death really is. Second, Hospice palliative care should be provided to the community. Third, the older the patient is, the more palliative care visits are necessary. Fourth, 40s and 50s must make preparations for hospice palliative care in their future.

• 지역사회간호학회지
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• 제23권2호
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• pp.117-126
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• 2012

Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

• 성인간호학회지
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• 제13권3호
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• pp.476-485
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• 2001

The purpose of this study was to identify the effect of structured information provided on knowledge and self-care behavior. The subjects of this study were both hospitalized patients and outpatients in K university hospital. The instrument use for this study were the knowledge assessment tool and self-care behavior assessment tool by Eom Soon-Ja(1998) and they were modified for liver cirrhosis patients. The data were analyzed by t-test, Chi-square test, Pearson correlation coefficients using SAS program. The results of this study were as follows. The experimental group which had received structured information provided showed greater increased knowledge of liver cirrhosis(P=.001). The experimental group which had received the structured information provided indicated increased self-care performance rate, especially after information about diet(P=.001), activity and bed rest(P=.001), drug therapy and visiting the hospital(P=.001), prevention of a complication and observation(P=.001). In conclusion, structured information provided showed increased in the degree of knowledge and self-care behavior, so information showing is an effective nursing intervention. It is much needed to employ information showing for chronic patients.

• 한국농촌간호학회지
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• 제1권1호
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• pp.5-10
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• 2006

Purpose: This study was done to identify strategies for the reform of the primary health care delivery system in rural areas. Methods: Official documents on changes in the rural health care environment were reviewed along with previous articles on reform of the health care delivery system in rural areas. Results: The primary health care system in rural areas of South Korea has not been well developed by the government. The government has mainly invested in hardware like facilities and equipment but, not in software like the delivery system or personnel. Nowadays every country is confronted with an aging society, which means an increase in the prevalence of chronic disease. Thus they have again become interested in primary health care delivery system. Further, characteristics of the primary health care system have changed to be more comprehensive and to focus on chronic disease. The primary health care system in rural areas should have basic health care functions and a visiting medical officer(doctor) connected with basic health care. Conclusions: The primary health care delivery system is the best strategy when adjusted to the characteristic of the chronic diseases that are prevalent today. Cooperation of the central government and local government is important if these changes are to be realized.

• 한국보건간호학회지
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• 제14권2호
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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.

• 대한간호학회지
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• 제42권7호
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• pp.1070-1078
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• 2012

Purpose: The purpose of this study was to examine the effects of a face-to-face self-management educational program on knowledge, self-care practice and kidney function in patients with chronic kidney disease (CKD) before kidney replacement therapy. Methods: This study employed a nonequivalent control group, non-synchronized design. Data were collected from 61 patients with CKD visiting an outpatient department of nephrology in a university hospital in Seoul, South Korea. The experimental group (n=31) took the pre-test, then after 3 weeks, face-to-face education and individualized consultation (1st intervention), after a week of self-practice, the 1st post-test, followed by re-enforcement education and consultation (2nd intervention), and 4 weeks later, the 2nd post-test. The control group (n=30) took the pre-test and post-tests at 4 and 8 weeks. Results: Scores for knowledge of CKD and self-care practice over time improved significantly in the experimental group compared to the control group. Kidney function did not improve significantly in the experimental group. Conclusion: Health care providers can identify various and individualized needs, and provide effective education and consultation through face to face self-management for patients with chronic irreversible illnesses. Nurses can coordinate for these program by designing and providing systematic and effective education.

• 디지털융복합연구
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• 제12권8호
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• pp.449-458
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• 2014

본 연구는 방문건강관리사업에서 동일한 문제를 가진 대상자의 자기관리 증진을 위한 자조집단 현황을 파악하기 위한 조사연구이다. 전국 253개 보건소를 대상으로 설문조사하였으며, 2010년 9월 3일부터 9월 20일까지 회수된 109개소의 자료를 SPSS/WIN 18.0프로그램을 이용하여 분석하였다. 연구결과 보건소에서 방문간호사업을 담당하는 간호사는 평균 9.27명, 대상 보건소 중 자조집단 프로그램을 실시한 보건소는 48개(44.0%), 자조집단 중 암 관련 프로그램이 65건(28.8%)으로 가장 많았으며, 실행예산은 500만원 이상은 19.6%로 재정적 지원이 열악한 현실이었다. 반면에 전문인력, 자조집단 관련 정보 및 예산 부족 등의 이유로 자조집단을 운영하지 못하는 보건소들도 자조집단 프로그램의 필요성은 인식하고 있었다. 결론적으로 자조집단 형성과 운영을 위한 매뉴얼 개발 및 효과성 검증을 위한 객관적 척도 개발 연구에 기초자료를 제공할 수 있다고 본다.

• 한국보건간호학회지
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• 제24권1호
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• pp.135-150
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• 2010

Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.

• 지역사회간호학회지
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• 제12권1호
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• pp.214-225
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• 2001

The purpose of this study is to compare the characteristics of the demented elderly and normal elderly over 65 staying at home in Seoul. Here, the demented elderly are defined as the aged who score under 20 on the MMSE-K testing. The subjects were 15.104 elders in home. The method is a cross-sectional study home visiting survey with questionnaires. Data analyses were conducted by using frequency, percentage, t-test and ANOVA procedures. Results are as follows: First, general characteristics such as sex, age, marriage, education, physical health, and family characteristics such as economic level and single living showed a significant variance between demented elderly and normal elderly. Second, the demented elderly showed a significantly high point of AD and IADL. Third, in contrast with normal agents, the dementia showed a high need for assistance from the care giver but followed the same pattern. In conclusion, the above findings suggested that a social support system should be developed for the demented elderly and care givers in the home.