• Journal of Korean Academic Society of Home Health Care Nursing
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• v.19 no.2
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• pp.139-149
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• 2012

Purpose: The purpose of this study is to provide the basic data required for quality improvement of home health care nursing and development of nursing services for cancer patients by examining the frequency of practices, level of service needs and satisfaction for nursing services. Methods: The subjects were 231 patients who agreed in participating on this study and were receiving home health care nursing services by the home health care advanced practice nurse from two national hospitals and four subsidiary general hospitals, located in Seoul from September 30, 2008 to February 28, 2009. Data were analyzed by frequency, percentage, t-test and ANOVA, using SPSS WIN 12.0 program. Results: The most frequent practices were 'checking vital sign' and 'explaining what patient want to know.' Total service need had an average of 3.03 point and emotional domain showed the highest average of 3.44 point. Total satisfaction had an average of 4.23 point and satisfaction along diseases had the highest average of 3.65 point in case of non-metastasis cancer. Conclusion: The subjects were highly satisfied with home health care nursing services which gave positive effect to them. It will be helpful to give cancer patients physical and spiritual care complementally when home health care nurses provide nursing services.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.13 no.1
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• pp.5-15
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• 2006

Purpose : This study was done to examine the home care service provided by home care nurses and the level of client satisfaction in community. Method : Data were collected from 120 clients who received the home care service at the community home care service center in Pusan from 2th May. 2003 to 31th May 2003. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale by Kim. Data were analyzed by using SPSS/WIN 10.5 program. Result: 1) 67.5% among 120 clients was over sixty years old and 30.6% of clients received home visits 20 times by home care nurse. 2) The total number of home care services was 15,783. And most of the clients received therapeutic nursing care. 3) The mean score of satisfaction on provided home care services was 3.31, among 16 items, "The home care nurses kept up the secret of patients and family" was the highest($3.67{\pm}0.48$). the total level of satisfaction of home care services was very high, with mean score $3.31{\pm}0.32$. Conclusion : The satisfaction level of home care services was very high. so we can expect that the prospect of home care services is very challengeable. Therefore we should try to expand the service recipients with promotional education to assure close ties with the public health centers for the continuous home care service linking and make more efforts to improve the quality of the service.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.122-136
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• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.73-84
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• 2003

This study was done to examine the home care service provided by home care nurses and the level of client satisfaction. Data were collected from 110 clients who received the home care service at the P-hospital in Pusan from 23th April, 2001 to 30th November, 2002. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale. Data was analyzed by using SPSS/WIN 10.5 program, the results of this study are summarized as follows; 1) 77.3% among 110 clients were over sixty years old. By the disease pattern. subjects were distributed into cancer(52.7%), cerebro-vascular disease(22.7%) and the others. 36.4% of clients were received home visits from 10 to 20 times by home care nurse. 2) The total number of home care services was 20,828. And most of the clients received the health education and training. 3) The mean score of satisfaction on provided home care services was $3.36\pm0.45$, out of 4. among 16 items. 'The home care nurses were kind enough' was highest ($3.59\pm0.49$), the total level of satisfaction of home care services was very high. with total mean score $53.84\pm7.16$. As mentioned above. the satisfaction level of home care services was very high. so we can except that the prospect of home care services is very challengeable. Therefore. we should try to expand the service recipients with promotional education to the home care clients under the cooperation with medical staff and make more efforts to develop the management system about clients' information. to improve the quality of the service, to assure close ties with the public health centers for the continuous home care service linking.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.19 no.2
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• pp.173-182
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• 2012

The purpose of this study is to identify the appropriateness and validity of the HIV/AIDS nurse counselor's job, and to propose the job description. Mixed method was used: nominal group interview was used as a qualitative research and a survey was used as a quantitative research. Three of the nominal group members evaluated the appropriateness of the duties and tasks. To identify the validity of the evaluated duties and tasks, importance, difficulty and frequency were surveyed by 14 nurses who were working at the hospital as a HIV/AIDS nurse counselors. For the HIV/AIDS nurse counselor, 7 duties and 35 tasks - infection control of the HIV/AIDS, counseling, client advocacy, development of the educational material, referral to the resources, referral services at the hospital, and self-improvement - were identified. Proposed job description will be used as a reference for the role position and the training curriculum of the HIV/AIDS nurse counselors who are working at the hospital.

• Research in Community and Public Health Nursing
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• v.22 no.4
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• pp.438-450
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• 2011

Purpose: This study was to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit perspective. Methods: Target participants were enrolled in 2007~2008 for home visiting care and provided with a home visiting nursing service for more than 18 months in J Ward of S City. Of 391 participants, 244 who satisfied the inclusion criteria were used in the final analysis. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: After providing the home care nursing service, the blood pressure control rate increased from 50.8% to 75.4%. Of the subjects, 39.8% maintained their blood pressure level within the target range. As a whole, the net benefit of home visiting care per person ranged from 434,964.86 to 447,112.43 won and the benefit/cost ratio ranged from 2.82 to 2.84. Conclusion: Home visiting care for vulnerable populations with hypertension was effective in both maintaining blood pressure and reducing blood pressure to the target range. Therefore these results are especially useful for establishing the value of home visiting services for policy makers as well as for prioritizing vulnerable populations.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1543-1555
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• 2000

Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.

• The Korean Nurse
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• v.32 no.1
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• pp.61-76
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• 1993

This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.209-217
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• 2004

Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.673-683
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• 2008

Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.