• 한국보건간호학회지
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• 제30권3호
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• 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.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2017년도 춘계 종합학술대회 논문집
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• pp.471-472
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• 2017

There are 3,931,822 elderly who receives long-term care at home and 1,704,469 elderly who stay at long-term care facilities in those of 34,610,000 of +65 years old population in Japan; thus, the elderly people who need home care are 2.3 times more than facilities (2016).In the near future, the number of elderly people with a degree of daily life independence and dementia category II or more will increase to 4.7 million (12.8% of the elderly population). Therefore, the use of home-care robots is essential for the disaster evacuation of the overwhelming majority of those elderly who need home care and for of vitals checks to keep family, caregivers, and medical professionals informed to reduce the risk in chronic health conditions in welfare evacuation centers. This also helps to care for the caregivers who are caring for the elderly, and the introduction of home-robots to evacuation centers should receive prompt attention from our care-friendly society.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.725-729
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• 2014

Background: Having been known as a virulent disease in 1970s, cancer is now onsidered a chronic disease and 64% of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care to patients. This descriptive study aims to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. Materials and Methods: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sampling consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken university hospital; caregivers and their patients were informed about the research and their approval was taken as well. Results: It was found that 54.01% of caregivers help patient's nutrition, 50.36% help medicine use, 26.28% help oral hygiene, 26.28% help to meet urinary needs and 51.82% help to change clothes, 69.34% of caregivers help to change bed sheets, 38.69% help the patient to communicate with their environment and 71.53% help to bring the patient to hospital or outside. Conclusions: This study, it was found that caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetency in body temperature and fever control, fatigue, and lack of personal time.

• Journal of Hospice and Palliative Care
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• 제19권1호
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• pp.5-10
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• 2016

Purpose: This study reviewed what the location of death (LOD) means as an outcome and how to use LOD to assess end-of-life (EOL) care. This study also examined the reason why LOD is significant for the quality of EOL care. Methods: A literature review was performed, using LODs and home deaths as outcomes in the field of EOL care, and analyzed the findings associated with key fields in regards to LOD. Results: Palliative care research used LOD, in particular, hospital death (versus home death) as a significant outcome when examining cost savings, quality of life care, and patient and family preferences. Based on substantial evidence from previous research, home hospice or continuous palliative care in non-hospital settings (i.e. homes, nursing homes) have been designed and available for dying patients in developed countries. Conclusion: The LOD delivers practical significance as an outcome for diverse reasons. In-depth examination on LOD in South Korea is needed despite limitations to interpretation of its meaning in the country.

• 지역사회간호학회지
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• 제19권2호
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• pp.157-166
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• 2008

This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.

• KDI Journal of Economic Policy
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• 제31권1호
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• pp.139-167
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• 2009

본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다.

• 가정간호학회지
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• 제25권3호
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• pp.153-163
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• 2018

Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

• 성인간호학회지
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• 제28권5호
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• pp.595-606
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• 2016

Purpose: This study aimed to investigate the influencing factors on self care, respiratory difficulty, sleep impediment, anxiety and depression among patients with neuromuscular disease who are dependent on Home Mechanical Ventilator (HMV). Methods: 157 patients were recruited through hospital based home nursing care departments and HMV rental centers. Data were collected by questionnaires. The analytic methods were n(%)/$M{\pm}SD$, $x^2$/t-test or ANOVA and multiple linear regression. Results: Patients with Amyotrophic lateral sclerosis were more likely to utilize HMV, had shorter periods of morbidity and the most extended daily use of HMV. As for medical equipment, they had ambu-bag (87.2%) and oxygenator (15.4%). Reports of respiratory difficulty and sleep impediment were low. There were no significant difference. In contrast, reported anxiety and depression were high and showed significant difference between non invasive HMV and invasive HMV. Anxiety contributes to respiratory difficulty (t=3.62, p=.002), sleep impediment (t=2.06, p=.042), and depression (t=7.24, p<.001). However, home nursing care exerts a positive influence in reducing anxiety (t=-2.73, p=.008). Conclusion: Anxiety contributes to respiratory difficulty, sleep impediment, and depression. However, those who use home nursing care reported less anxiety. Home nursing care positively impacts patients dependent on HMV as a practical service and available resource.

• 대한간호학회지
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• 제24권3호
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• pp.484-498
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• 1994

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1％ of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.