• 재활치료과학
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• 제9권2호
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• pp.87-98
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• 2020

목적 : 본 연구는 재가 뇌졸중 환자를 대상으로 가정방문 작업치료를 제공한 사례를 통해 가정방문 작업치료 서비스의 효과성을 검증하고자 하였다. 연구방법 : 서울시 소재 보건지소에 가정방문 작업치료 서비스를 신청한 뇌졸중 환자 두 명을 대상으로 가정방문 작업치료 프로그램은 대상자의 일상생활동작 기능, 작업수행 기능, 인지기능, 정서 기능을 평가하고 클라이언트 중심 접근(Client-centered approach)을 기반으로 작업치료 목표를 설정하고 중재를 계획하였다. 작업치료 프로그램은 클라이언트의 주요 문제를 바탕으로 여가 활동 탐색 및 참여를 목표로 설정하여 12회기의 프로그램으로 구성하였다. 결과 : 두 사례 모두 COPM 점수에 향상이 있었고, 사례 2에서 MBI와 K-MMSE 점수의 향상이 있었다. 또한 사례 1에서 KGDS 점수의 향상이 있었다. 결론 : 가정방문 작업치료는 뇌졸중 환자의 삶의 질 향상 및 경제적 부담 등을 고려하면서 뇌졸중 환자의 일상생활활동, 인지, 정신적 기능의 변화가 있음을 확인하였다. 가정 및 지역사회 통합에 있어 기관중심재활에서 지역사회중심재활로 지속적이고 연속된 재활 서비스가 활성화가 요구되어지며, 병원에서 퇴원하는 뇌졸중 환자들의 신체적, 인지적, 정신적 및 사회적 접근의 증진을 위한 적극적인 가정방문 작업치료서비스가 필요하다.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.143-153
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• 2002

경상북도 일개면 지역에 거주하는 65세 이상 재가노인 355명을 대상으로 방문보건의료 요구도를 알아봄으로써 향후 보건기관의 효율적이고 효과적인 방문보건의료서비스 제공방안의 기초자료를 제시하고자 하였다. 주관적 건강상태는 64.5%가 허약하다고 하였고, 저ADL과 저IADL이 각각 14.1%, 14.9%였다. 의료인의 도움을 받아야할 건강문제가 있다고 응답한 노인이 73.5%이었는데, 성, 연령, 결혼상태, 의료보장상태, 직업유무, 경제적 상태, 치료여건, 주관적 건강상태, 일상생활수행정도, 수단적 일상생활수행정도에 따라 차이가 있었다(p<0.05). 의료인의 도움을 받아야 할 건강문제가 있다고 느끼는 노인의 주관적인 방문보건의료 요구도는 19.5%였다. 방문보건의료 요구도는 75세 이상인 경우(p<0.05), 직업이 없는 경우(p<0.01) 유의하게 높았고, 가족이 화목하지 않을수록, 주관적 건강상태가 허약한 경우, 저 IADL인 경우 유의하게 높았다(p<0.01). 방문보건의료를 받기를 원하는 경우 이유는 돌봐줄 사람이 없어서가 64.7%로 가장 높았고, 거리가 너무 멀어서(지역적 문제)가 23.5%로 그 다음이었다. 제일원하는 방문보건의료서비스는 투약이 82.3%로 가장 높았다. 방문보건의료를 원하지 않는 경우 이유는 거동이 가능하므로 60.0%, 의사와 직접 만나기를 원하므로 25.7%의 순이었다. 방문보건의료 요구여부를 종속변수로 한 다중 로지스틱 회귀분석 결과, 가족이 화목하지 않을수록, 주관적 건강상태가 허약할수록 방문요구도가 높았다(p<0.05).

• 간호행정학회지
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• 제14권2호
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• pp.182-195
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• 2008

Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.

• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 대한물리치료과학회지
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• 제3권2호
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• pp.997-1009
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• 1996

The purpose of this study was to identify the necessity to provide a much better and more comfortable physiotherapy than institutional physiotherapy to a number of home-keeping handicapped persons and patients with a chronic-degenerative-denile disease. Home visiting physiotherapy can be defined as a behavior which a physiotherapist himself visit home and treat patients who cannot or hardly can visit hospital. To investigate factors which might influence the necessity for introduction of home visiting physiotherapy, this survey was carried out with the out-patients of four general hospital, one Chinese-medicine hospital, one welfare institution for handicapped persons, and also for all the physiotherapists registered in Pusan physiotherapist association using the structured questionare from March 1 to March 30.

• 대한간호학회지
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• 제31권4호
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• pp.619-630
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• 2001

Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

• 한국농촌간호학회지
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• 제15권2호
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• pp.66-73
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• 2020

Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.

• 지역사회간호학회지
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• 제14권2호
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• pp.299-311
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• 2003

Purpose: This is a phenomenological study to describe the experiences of nursing students on home visiting nursing service as a community nursing practice. Method: Individual interviews were conducted on subjective experiences of 17 nursing students. Data were analyzed through Colaizzi's method in which meaningful statements were extracted and these were clustered into 6 themes. Result: The nursing students started practice with anxiety and expectation at the same time. They were frightened at the clients' inferior environment and their level of loneliness. They also felt pity and experienced complicated feelings for the clients. However, the home visiting practice was a chance for them to discard prejudice on the clients. Positive experiences on visiting nursing practice reported by the nursing students included lively interactions between nurses and the clients, and variable provision of primary nursing care. However, facts such as much limited visiting time, non-professional and limited scope of practice were reported as negative experiences. They felt both worthiness of the home visit service and restricted self-capability at the same time through the practice. They also felt sorry for the clients because the home visit services were carried out during limited time period. Regardless of this, the home visit experience provided them an opportunity of self-growth. This self-growth includes increased awareness of issues for elderly, building of self-identity as a nursing student, self-reflection, and realization of the value of family. Conclusion: This study may provide data for better understanding of nursing students experiences of home visiting nursing services. However, more study on the barriers of their community health practice is needed in the future. Moreover, it is needed to establish desirable practice environment through the collaborative relationships between the university and staffs in the public health center.

• 대한지역사회영양학회지
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• 제18권2호
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• pp.142-153
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• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• 성인간호학회지
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• 제26권5호
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• pp.543-552
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• 2014

Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.