• Journal of Korean Academy of Nursing
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• v.47 no.5
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• pp.577-588
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• 2017

Purpose: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. Methods: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Results: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. Conclusion: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

• Journal of Home Health Care Nursing
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• v.4
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• pp.86-100
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• 1997

The purpose of the study is to evaluate the community rehabilitation program of the two Public Health Center. Data were collected from the 138 clients who received rehabilitation services from visiting public health nurses. Data were analysed by SAS computer program. The result were as follows. 1. The clients have been average 7years disabled state until public health nurse visit them. 78.3% of them can't advance rehabilitation process because of insufficient family or social support. 2. The clients' burden due to their family's help was average 80.0 and that due to economic distresst was average 76.0. That factors were same that interfere rehabilitation process. 3. The clients needed exercise and modality therapy(78.2), economic support(76.0) and rehablitation advices (64.0). The needs of welfare benefit, medical service and social participation were 68.0, 61.5 and 54.5. 4. The pulblic health nurse visited the clients 2.3 time every month. And they have served emotional support (95.7%, exercise therapy (94.9%), family education(82.6%) and blood pressure management (71.7%), One client have received average 60% of the medical rehabilitation services and 27% of the refer services. 5. The rehabilitation effects of clients' attitude, knowledge and practice were 73.3, 81.0 and 68.7. The physical rehabilitation effect was 70.0. After receving rehabilitation services, the clients' preforrence to pulblic health center was 82.0. 6. The clients hopped that public health nurse visit them earlier (80.0). On the basis of this results, the following suggestions are proposed. 1. The pulblic health center is important institution in community rehabilition program, and every pulblic health center must participate in this program. 2. Various strateges have to be tryed and analysed to improve the visiting nurses' rehabilitation services. 3. For successful community rehabilitation, social welfare rehabilitation program must be developed and correlated with that of the pulblic helth center.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Health Policy and Management
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• v.22 no.4
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• pp.522-537
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• 2012

The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.78-86
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• 2018

Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

• 한국노년학
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• v.29 no.2
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• pp.645-656
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• 2009

The purpose of this study was to address the current status of hospital-based home care(HBHC). We analyzed the data on HBHC from national electronic data information of Health Insurance Review Agency. Beside, we surveyed 75 hospital-based home care agency. In 2006, 20,343 elderly(64.0% from all HBHC user) used 333,889 visits(76.8%from all visits). Medical diagnosis was composed of circulatory disease including cerebrovascular diseases 41.3%, endocrine system disease including Diabetes mellitus 10.4%, neoplasm 9.7%. Some of subjects used HBHC in excess of maximum covered 8 visits a month by National Health Insurance, decubitus 7.0%, the cancer 5.4%, the diabetes 2.5%, the hypertension 1.1%, and the stroke 0.9%. This results will contribute to expand the coverage of hospital-based home care by National Health Insurance. There was distribution difference in medical diagnosis and nursing intervention between HBHC and Public health center-based home care(PBHC) subjects. Therefore, HBHC subjects had more severe medical diagnosis, and were intervened more injections, examinations, than PBHC subjects. These differences must be considered to set up functional role among the three types of home visit care.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Journal of Home Health Care Nursing
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• v.30 no.2
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• pp.141-154
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• 2023

Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

• 한국노년학
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• v.32 no.2
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• pp.593-609
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• 2012

The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.

• Journal of Korean Public Health Nursing
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• v.24 no.1
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• pp.135-150
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• 2010

Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.