Purpose: This study aimed at describing the characteristics and nursing needs of vulnerable families in a City. Methods: A total of 427 vulnerable families enrolled in the Visiting Health Care Center in K-gu of S city were investigated in this study. Data were collected using questionnaires for one year from Jan to Dec, 2003, and analysed using mean, standard deviation and $x^2$. Results: Most of the vulnerable families investigated here showed many deficits, especially incomplete family structure (62.8%), financial problem (84.0%), lack of support (55.8%) were prevalent. The score of level of economic status in Family Capability for Self management ($1.95{\pm}0.65$) was lowest, and the score of perception of family problem and health of family members ($2.62{\pm}0.78$) was highest. The four family groups divided according to the total score of family management capability showed significant differences in family interaction, support, and coping domain. The total score of family management capability increased as family functioning-related problems decreased in the vulnerable families. Conclusion: In order to find vulnerable families, and improve their family function, it is required to develop the systematic assesment tools, community supportive systems and nursing interventions for family strength.
Purpose: The study aim was to provide basic data needed for formulating systematic visiting nursing strategies by comprehending the characteristics and self-care ability of the object families of public health centers in Korea. Method: The research examined 252 families and 339 family members of the vulnerable class that were registered in a visiting nursing program of an urban public health center. The data of 220 families were analyzed using descriptive analysis, t-test, and ANOVA, after excluding any incomplete data. Result: 1. The most frequent characteristics of families were solitary families (52.8%) and financially vulnerable families (87.3%). The most frequent way of family detection was request of the community office. 2. The most frequent type of family problems were vulnerable families (93.2%), followed by patient families (91.0%). 3. The mean score was 11.67 for family self-care ability. 4. The variables of the number of family members, disease type of the patient family members, and the type of vulnerable family showed a significant difference of family self-care ability. Conclusion: This study suggests that vulnerable families demand specific nursing interventions focused on their own problems and that visiting nurses need to obtain and use supportive resources.
Purpose: The objective of this study was to identify the relationships between family function and successful aging of vulnerable elderly using the circumplex model. Methods: The participants were the elderly (N=401) who were over 65 years old living in H city under the National Livelihood Security Act. Family Adaptability and Cohesion Evaluation Scale III and Successful Aging Instrument were used. Results: The family function perceived by the study subjects was average $43.20{\pm}16.62$ out of maximum 100 points. According to the analysis on family types suggested by circumplex model, there were 183 people for balance family (45.6%) and 218 people (54.4%) for extreme family. The total points on successful aging were $1.67{\pm}0.37$ out of 3 points. When the difference in points on the Successful Aging instrument were analyzed according to the scores on the Family Adaptability and Cohesion Scale those points of the balanced family were statistically significant (t=2.087, p=.038). Conclusion: In case of the balanced family type, the level of perceiving successful aging was relatively higher. For the improvement of family function, it is advised that the successful aging perception among vulnerable elderly can be uplifted through a program that enables effective communication with other family members.
Purpose: To explore the barriers and solutions of immunization programs for children among vulnerable classes in the position of service providers in Community health centers. Method: Data were collected through focus group interviews with 3 groups (17 providers), and were analyzed according to the analytic method of Morgan (1998) and Krueger (1998). Results: The following five categories were identified: difficulties in obtaining a list of children among vulnerable classes, difficulties in first contact with them, difficulties in up-to-date immunization, various difficulties according to the types of vulnerable family and suggestions of solution. These results indicated that there are many difficulties in providing expanded immunization service for children among vulnerable classes in terms of manpower, cooperation of departments in public health centers and linkages between health and welfare. Finally, the characteristics of the types of vulnerable family need to be elucidated. Conclusion: To increase immunization rates among children of vulnerable classes, policies need to be prepared at the public health organization itself and the linkages between health and welfare and need for hiring additional personnel.
Purpose: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs, Method: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. Result: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. Conclusion: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.
Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.
Purpose: This study was to identify the relations among health-promoting behaviors. self-esteem and depression in the vulnerable elderly in an urban community. Method: The subjects were 185 vulnerable elderly adults aged over 65 in D city, who were selected through convenience sampling. Data were collected by a questionnaire survey. The tools used in this study are the HPLP developed by Walker(1987), the Self-esteem Scale developed by Rosenberg (1965), and the Geriatric Depression Scale developed by Yesavage & Brink(1983). Collected data were analyzed with the SAS program using descriptive statistics. Pearson's correlation coefficient, t-test, ANOVA, Duncan's multiple-range test and stepwise multiple regression. Result: Self-esteem and depression was in a negative correlation with each other (r=-0.21), but no significant correlation was observed between HPB and depression. HPB and self-esteem were in a positive correlation with each other (r=0.38). The most powerful predictor of depression was self-esteem and, next, leisure activity and the type of family living together. The three factors accounted for 41.1% of the variance in depression in the vulnerable elderly. Conclusion: These results suggest that self-esteem, leisure activity, and the type of family living together can be potential risk factors for old age depression. These findings may give useful information for developing visiting nursing service programs focused on depression in the vulnerable elderly.
Purpose. The purpose of this study was to determine the subjects' health status according to the needs of visiting health and the function of the family in home care nursing. Sample and Method. The data collection period was from 07/01/04 to 10/31/04 and the subjects were 488 of those above 60 years of age staying at home or living alone who registered at a visiting health service of public health center at an urban area in Korea. This survey was carried out by visiting health nurses and participation was agreed on by the elderly people. Results. The extent of the subjects' total health status to the general characteristics had differences according to the age, sex, monthly income, perceived health status, known functional disorder, and yes-or-no for disease. At all health status domains, visiting health need care in the group I was very lower than one in II, III, or IV groups. Also the severe dysfunctional family was lower than lightly dysfunctional family and normal functional family in all health status domains. Conclusion. Nurses must provide their characteristics considered nursing intervention for the elderly who have high visiting health needs and severe dysfunctional family with vulnerable health care.
The problems and needs of families in Hong Kong are becoming more complex. Traditional family structures and functions are rapidly eroding. Moreover, family problems are further exacerbated by a growing number of socio-economic issues including rising divorce rates and extra-marital affairs. continuous family reunion migration from Mainland China, emotional and financial cost of caring for the older people and the changing economy which has pushed more families into hardship. In effect, more and more families are becoming vulnerable to risk. Traditional family services in Hong Kong are varied in mode, operation and provision, often overlapping in service boundaries with other family-oriented programs. In many instances, family service centers are stretched far beyond their capacity. As a consequence, they become too reactive, remedial and casework dominated. The University of Hong Kong Consultant Team recommended that family service programs have to protect vulnerable families and strengthen family capacities to promote maximum independence. The direction of family services is summarized as: strengthening families; child-centered, family-focused and community-based. New integrative family service centers aim at attaining the principles of promoting accessibility to users with minimum physical, psychological and administrative barriers; early identification of needs and intervention before the further deterioration of problems; integration of services cutting across program boundaries, and partnership between service providers to achieve efficient and effective use of scarce resources. Under the new model, multi-skilled teams can respond more proactively to a wide range of social needs, rather than addressing needs in isolation. To demonstrate the effectiveness of the new model, the consultant team has been commissioned by the government to evaluate the performance of these two-year pilot projects. More importantly, a coherent and family-friendly social policy should be formulated to strengthen family capacity against family-related problems.
Purpose: This is a qualitative descriptive study with the purpose of identifyng the health problems and related factors of socially vulnerable school-age children in Seoul, South Korea. Methods: Two focus group interviews and two individual interviews were conducted with eleven participants. They were two class teachers, three school nurses and two daycare teachers working at elementary schools and three social workers and a welfare worker working at community childcare centers. Data were analyzed using qualitative content analysis. Results: The identified psychosocial problems were 'distracting and excessive behavior', 'depression and helplessness,' 'aggression and violent behaviors', and 'internet overdependence'. The revealed physical health problems were 'poor hygiene', 'obesity', and 'gastrointestinal problems'. In addition, the fact that physical and psychosocial problems are closely inter-linked was reaffirmed through practical examples. Meanwhile, socioeconomic, family environmental, social experiential and individual factors were found to affect children's health. Relationships within a family or a peer group and healthy lifestyle were considered critical issues to deal with in order to improve the childrens' health status. Conclusion: It was proved that socially vulnerable school-age children have various physical and mental health problems due to multiple factors. Therefore, it is required to design nursing approaches that help them achieve optimal health status.
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