• 제목/요약/키워드: home health management

검색결과 999건 처리시간 0.024초

제주지역내 재가암환자관리를 받은 환자와 보호자에게 제공되는 프로그램 만족도와 요구 (Satisfaction and Needs of Cancer Patients and Caregivers under Home-based Cancer Patients Management in Jeju)

  • 김현주;허정식
    • 한국산학기술학회논문지
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    • 제19권8호
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    • pp.276-282
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    • 2018
  • 본 논문은 일개 지역암센터에서 제공되는 재가암환자관리프로그램의 만족도와 요구에 대한 조사를 통해 프로그램의 질 향상을 높이기 위해 시행하였다. 재가암환자관리에 등록된 된 환자와 보호자를 대상으로 2015년 3월부터 2015년 10월까지 자체적으로 개발된 설문지를 통해 면대면으로 조사를 시행하였다. 환자 59명과 보호자 41명, 총 101명을 대상으로 설문조사가 이루어졌다. 암종에서는 유방암이 주된 암이었으며 재가암환자의 방문회수에 대하여 51명(86%)의 환자와 36명(85%)의 환자 보호자가 만족하였다. 서비스 신청경로는 환자의 경우 암센터홍보지가 22명(37.29%), 보호자의 경우에는 주변사람의 권유가 11명(26.19%)으로 가장 많았다. 환자에게 직접 제공되는 처치를 제외하고 가장 선호하는 것은 심리상담이었으며, 나들이와 암종별 교육의 만족도도 높게 나타났다. 프로그램의 만족도는 5점 척도에서 $4.14{\pm}1.21$로 비교적 높게 나왔으며 환자가 보호자보다 높았으나 통계적으로 의미는 없었다($4.29{\pm}1.11$, $3.93{\pm}1.31$, p=0.141). 자아존중감은 보호자가 환자보다 높았으나 통계적으로 유의하지 않았다. 향후 재가암환자와 보호자들의 삶의 질을 높일 수 있도록 심리상담과 환자의 경제적인 상황을 고려한 맞춤형 프로그램개발이 필요할 것이다.

허혈성 뇌졸중 환자의 재원적절성 평가 (Appropriateness Evaluation of Hospitalization for the Cerebral Ischemia Patients)

  • 염효영;김순례
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.80-92
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    • 1999
  • The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

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서울지역 가정간호사의 업무수행능력 실태조사 (A Study on the Nursing Performance of the Home Care Nurses in Seoul)

  • 서문자;박호란;강현숙;김소선;신경림;김금순;김혜숙
    • 가정간호학회지
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    • 제6권
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    • pp.46-58
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    • 1999
  • The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

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보건소 맞춤형 방문건강관리사업 관절염 사례관리 효과 (The Effects of a Case Management Program of Customized Home Visiting Health Service for Clients with Arthritis)

  • 양순옥;권명순;최용준;이승희
    • 지역사회간호학회지
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    • 제22권2호
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    • pp.151-161
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    • 2011
  • Purpose: The purpose of this study was to analyze the effects of a case management program on range of motion, pain, depression and self efficacy in community-dwelling older women with knee arthritis. Methods: The research design was one-group pre and post-test design with 40 participants with knee arthritis who agreed to participate in the 12-week case management program. Data were collected four times, before and after 4, 8 and 12 weeks. Results: Repeated measures ANOVA revealed significant differences between before and after the service in range of motion, pain, depression and self efficacy. Significant improvements from the baseline to 4 weeks after the service were observed in the measurements of range of motion, pain, depression and self efficacy. There were no significant differences in range of motion, pain and depression between 4 and 12 weeks after the services. Conclusion: This study represents the first effort showing that a case management program can have positive outcomes on range of motion, pain, depression and self efficacy for older women with knee arthritis. More research using a control group pre-post test design considering time lapse is needed in order to examine more accurately the effects of case management programs for knee arthritis.

한국노인의 건강상태에 대한 조사연구 (Health Status of Elderly Persons in Korea)

  • 최영희;김문실;변영순;원종순
    • 대한간호학회지
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    • 제20권3호
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    • pp.307-323
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    • 1990
  • This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychologyical and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practioners working in Kungsang-Buk-Do, Kyngsang- Nam - Bo, Jonla Buk -Do, and Kyung Ki- Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climination functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows : 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliavility indicated by a cronbach=0.97793. 2. Average score of the subjects physical health status was 4, 054 in a 5 point likert scale, mentalemotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status ; physical health status was the highest. 3. Educational background, perceived health status, the amount of pocket money were related to physical and mental-emotional health status and family structure was related mental-emotional physical and social health status. Occupation was related to physical and mental-emotional status. Area of residence was related to metal-emotional and social status. Source of living in the expeneses was related to physical and mental-emotional health status marital status to mental-emotional and social health status, and the number living in the home physical health status and religion to social health status. The following conciusions were derived from the above results ; 1. The health status of Korean elderly was relatively sound but social health status was the most vulnerable. The Social activity for Korean elderly is needed to improve social health. 2. Educational background, perceived health status and the amount of pocket money must be considered in the health assessment criteria of the elderly, Family structure, marial status, occupation, residence variables and sources of living expense must also be considered as significant. 3. A health education program based on the educational background of the elderly, and provision of an occupational socioeconomic welfare policy will be useful in order to increase social health status of Korean elderly.

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소비 생활용품의 노출계수 조사 방법의 고찰 (Review of Exposure Assessment to Obtain Exposure Factors of Consumer Products)

  • 박지영;이기영;신호상;양원호
    • 한국환경보건학회지
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    • 제39권6호
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    • pp.532-540
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    • 2013
  • Background: Exposure factors for consumer products have been developed since the 1980s. Such exposure factors are important in risk assessment. Since the exposure/use patterns of consumer products in a country may reflect its respective cultural, meteorological, and socio-economic circumstances, unique Korean exposure factors for consumer products are needed. Such exposure factors are required for newly-enacted chemical regulations in Korea. For this review, published papers and survey reports on exposure factors of consumer products were examined for their assessment methodologies. Results: Investigation into exposure factors for consumer products used a variety of methods: home visit, online, telephone, and mail surveys using questionnaires; face to face interviews; modeling using a constructed database; and direct measurement. To collect more accurate exposure information or to check the reliability of the sampling method, some studies were repeated using the same questionnaire, in-home observation, direct measurement of usage, and videotaping. In Korea, nationwide exposure surveys were conducted five times over five years to obtain Korean exposure factors. However, with the exception of the $5^{th}$-year study, the surveys were online questionnaires and only the $5^{th}$-year study validated the accuracy of exposure information by re-visits and direct measurement. Conclusion: Accurate exposure factors are an essential part of risk assessment to assure safe use of consumer products. For better and safer management of consumer products, accurate exposure factors in Korea should be assessed for various exposure pathways.

체계적 문헌고찰과 메타상관분석을 이용한 간호사 재직의도 영향요인 고찰 (Influencing Factors on Nurse's Intention to Stay: Systematic Review and Meta Correlation Analysis)

  • 임지영;신정애;김슬기;이은미;김선희
    • 가정간호학회지
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    • 제26권3호
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    • pp.265-277
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    • 2019
  • Purpose: This study was performed to explore research trends in the intention to stay of hospital nurses and provide basic data to establish nursing management strategies to increase the intention to stay. Methods: Articles published between 2009 and 2018 were searched. The search terminologies were "intention to stay," "nurse", and "hospital". In the first search, 381 articles were extracted from academic databases. Thirty articles were used in the systematic review, and 29 articles were used in the correlation meta-analysis. Results: Thirty-two variables were explored in relation to the intention to stay. In the correlation analysis, job satisfaction and work environment showed statistically significant positive correlations in many studies. In the correlation meta-analysis, 7 variables including organizational commitment showed statistically significant effect sizes. Conclusion: We suggest that structural equation model analysis to identify causal relations among influencing variables of the intention to stay of hospital nurses may be conducted. This study can be used as a guideline to develop intention-to-stay enhancement programs for hospital nurses.

응급실 간호사의 언어폭력경험과 공감피로 및 직무열의의 관계 (The Relationship between Experience of Verbal Abuse, Compassion Fatigue, and Work Engagement in Emergency Nurses)

  • 김희준;이영진;유문숙
    • 가정간호학회지
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    • 제26권3호
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    • pp.300-308
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    • 2019
  • Purpose: This study is a descriptive research study to identify the relationship between the experience of verbal abuse, compassion fatigue, and work engagement among nurses in the emergency unit. Methods: Study subjects were 107 nurses working in a university hospital in Gyeonggi-Do. The instruments used were a verbal abuse checklist, a subscale of the Professional Quality of Life Scale used to measure compassion fatigue, and the Utrecht Work Engagement Scale. The data were analyzed using the IBM SPSS version 22.0 program for independent t-test, one-way ANOVA, and Pearson's correlation coefficients. Results: Emergency nurses experienced more verbal abuse and compassion fatigue than nurses in other departments, and the level of work engagement was low. There was a positive correlation between experience of verbal abuse and compassion fatigue and a negative correlation between both of these variables and work engagement. Particularly, verbal abuse appeared in the order of nurses, patients & caregivers, and doctors. This means there were serious problems with communication with nurses. Conclusion: In order to reduce verbal abuse, it is necessary to establish a communication culture of mutual respect between nurses, medical staff, patients & caregivers. Moreover, a compassion fatigue management program is needed to reduce emotional fatigue.

간호대학생의 스트레스 수준, 근원 및 대처방식 (Nursing Students' Stress Level, Source and Coping)

  • 주민선;이영란;김선희
    • 가정간호학회지
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    • 제19권2호
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    • pp.195-203
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    • 2012
  • Purpose: This study is conducted to investigate the stress level, stress source and stress coping of nursing students in college. Methods: This study was a cross sectional survey and the data was collected from 341 nursing students by means of self-reported questionnaires from April 2 to May 31, 2012. Collected data were analyzed on SPSS win 18.0. Results: The nursing students experienced moderate levels of stress. The source of stress for students came from 'one's own self'. The most common stress coping used by students was 'make a wish'. There were significant differences in the source of stress and the stress coping according to the nursing students' year of school and other general characteristics, such as motivation of entrance and satisfaction in school life. Conclusion: These results suggest that it is important to develop stress management program and strategies based on nursing students' individual characteristics and sources of stress.

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일 종합병원 외래간호단위의 효율성 평가 -자료포락분석법(Data Envelopment Analysis)의 적용 (Evaluation of Efficiency of Outpatient Clinic in a General Hospital using Data Envelopment Analysis (DEA))

  • 임혜빈;임지영
    • 가정간호학회지
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    • 제19권1호
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    • pp.11-18
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    • 2012
  • Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

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