• Title/Summary/Keyword: home visiting

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Development of a Home Health Care Model in the Public Health System -Visiting Health Service by Community Health Practitioners (공공보건조직에서의 방문간호사업모형개발 : 보건진료소 방문간호사업)

  • 한경자;박성애;하양숙;윤순녕;송미순
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.472-484
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    • 1995
  • The purpose of this study was to develop a home health care model in the public health system and to test the effectiveness of the model. Seven com-munity health practitioners in Yon- Cheon county. Kyunggi province, carried out home health care service for this research. The subjects of the home health care were a total of 111 community residents with chronic health problems and risk-prone infants and children; 29 persons with hypertension, 18 persons with diabetes, 12 persons with neurologic problems, 12 elderly, and 40 infants and children. During the period of study, from December, 1993 to March, 1995, a demonstrative home health care model was developed in the Yon-Cheon County community health centers with the cooperation of the Yon-Cheon Medical Center and Yon-Cheon Public Health Center for the first six months. A home care practice manual and recording system for home visits were also co-developed by the researchers and community health practitioners. Four workshops and monthly conferences were held for this purpose. Actual home care practice took place for two months, and on-going evaluation and replanning accompanied this process. The result of the evaluation of home care service were as follows. 1) For persons with hypertension, diabetes, neurologic problems, there was significant improvement in knowledge of disease and care, but no significant difference was seen in health behavior or symptoms after home care service. 2) No significant difference was seen in level of self esteem or depression after reminiscence therapy among 12 elderly subjects. 3) There were significant differences in satis-faction toward child rearing and parental sup-port, but no significant difference In education needs for parental role after home care service among parents of infants and children. 4) There was significant improvement in the quality of life among the subjects after the home care service. 5) Subjects responded that they were highly satisfied with the home care service given by the community health practitioners. Although, the actual implementation period was very short, and not all of the evaluation outcomes showed significant improvement, the home health care model of community health practitioners was, in general, positively evaluated. Through this re-search, the possibility of community health practitioners working as active home care personnel in the public health care system is supported. Further research with an expanded area and subjects for a longer period is recommended. Cost effectiveness research is also needed.

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The Relationship among Patients Sick-role Behavior Compliance, Health Belief and Health Locus of Control in Patients with Diabetes Mellitus Visiting Public Health Center (보건소 내소 당뇨병 환자의 건강신념, 건강 통제위성격과 환자역할행위 이행과의 관계)

  • Kong, Kyung-Ja;Tae, Young-Sook;Sahn, Sue-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.9 no.2
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    • pp.103-113
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    • 2002
  • Purpose: This study was conducted to explore the relationship among health belief. health locus of control and patients sick-role behavior compliance of diabetic mellitus patients visiting public health center. Method: The subjects of this study were 193 of the diabetic patients who were visiting 4 Public Health Center in B city. The instrument used for measuring health belief was Park's(1985). for health locus of control was Wallston. et al's(1978) and for sick-role behavior compliance was Park's(1984). The data were collected with structured questionnaires; total 58 items contained about health belief. health locus of control and sick-role behavior compliance from 1st to 31st July. 2001. The data was analyzed by the SPSS/PC programs using t-test. Pearson's correlation coefficient. ANOVA and Scheffe-test. Result: The average score of the health belief was $57.99\pm9.45$ health locus of control was $66.83\pm9.48$ and sick-role behavior compliance was $42.81\pm7.00$. Statistically significant factors influencing the health belief among social demographic characteristics were family number(F=3.818. p=0.024), monthly income(F=5.153, p=0.002), time of diagnosis(F=3.937. p=0.002) and difficult to control disease(F=5.803. p=0.000). The significant factors influencing the health locus of control were marital status(F=4.669. p=0.010). Also significant factors influencing the sick-role behavior compliance were monthly incomes(F=5.245, p=0.000). the time of diagnosis(F=4.424. p=0.001) and admission to hospital with diabetes(F=9.031. p=0.000). There was negative mild correlation comparatively between health belief and sickrole behavior compliance(r=-0.142, p<0.05) but no correlation in sensitiveness/severity, barrier, benefit(p<0.05). There was no correlation between internal. external. chance health locus of control and sick-role behavior compliance (P>0.05). Conclusion: There was a negative weak relationship between health locus of control and patient's sick role behavior compliance. Therefore further study to investigate the relating factor of the sick role behavior compliance among above of middle aged diabetes mellitus patients is necessary.

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Health Status of Vulnerable Preschool Children and Their Mothers' Health Management (취약계층 학령전기 아동의 건강상태와 어머니의 아동 건강관리실태)

  • Kang, Young-Sil;Kwon, In-Soo
    • Child Health Nursing Research
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    • v.19 no.3
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    • pp.159-167
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    • 2013
  • Purpose: The purpose of this study is to find out preschool children's health status and their mothers' health management in the vulnerable classes. Methods: The assessment tool was developed, taken into consideration existing studies, materials produced by the customized visiting health care system, and review of visiting nurses of health centers and related experts. Data were collected January to February 2010 from 259 mothers by visiting nurses, and analyzed using SAS program for descriptive statistics. Results: Body weight less than 3 percentile was found for 5.0% children and over 97 percentile for 7.7%. Atopy was found in 17.8% children, no hand-washing after toileting and before meal in 30.9% and 36.7% respectively, no breakfast in 15.8%, and irregular meal in 32.0%. Sex education was made by 45.7% mothers, regular dental check by 56.6%, and hearing and eyesight test by 61.1% and 66.8% respectively. Home environment for upbringing is 34.3 in the scale of 41, and accident prevention 17.5 in the scale of 22. Conclusion: It is necessary to make an intervention on children's weight, personal sanitation and meal time in the vulnerable classes. Mothers need to be educated for appropriate health care, and home environments to improve upbringing and accident prevention.

A Location Model and Algorithm for Visiting Health-care Districting for the Rural Elderly (농촌지역 노년인구를 위한 방문 의료서비스 구역 설정 모델 및 알고리즘)

  • Kim, Kam-Young;Shin, Jung-Yeop;Lee, Gun-Hak;Cho, Dae-Heon
    • Journal of the Korean Geographical Society
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    • v.44 no.6
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    • pp.813-832
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    • 2009
  • As accessibility to health-care service in less populated rural areas is geographically limited and demand for public health-care by the aging is increasing, a new approach for health-care service such as a home care service is becoming more popular. For a home care service, health-care personnels directly visit to location of health-care clients. Such changes in provision of health services require developing innovative and scientific approaches for efficient allocation of health resources and managing services by public health-care organizations. The purpose of this study is to formulate a location model for visiting health-care districting for the rural elderly and to develop an Automated Zoning Procedure (AZP) to solve this model. Mobility, workload balance and contiguity criteria are considered in the model. Three different objective functions are evaluated; 1) minimizing the sum of network distance between the unit areas in a district, 2) maximizing spatial interaction between the unit areas in a district, and 3) minimizing tour distance that visits each unit area exactly once in a district. The AZP for solving the model is developed and applied to a rural area. The application results demonstrate that the AZP can generate different districting systems for each objective functions.

The Effect of Home stayed Stroke Patients' gait, Valance, Activities of Daily Living, Depression in the Aerobic Walking Exercise Program. (유산소 걷기운동 프로그램이 재가 뇌졸중 환자의 보행, 균형, 일상활동 수행능력, 우울에 미치는 효과)

  • Roh, Kook-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.5 no.2
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    • pp.193-204
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    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.

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A Study on Effectiveness of the Home Care Services for the Low Income Inhabitants (일부 지역사회 저소득층 주민을 대상으로 한 가정간호사업의 효과에 관한 연구)

  • Lee Kunja;Kim Myongsoon;Yang Younghee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.70-107
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    • 1992
  • This study was intended to assess the need of home nursing care and analyze the effect of home nursing care, and find out the problems during the performance of home nursing care for the chronic patients among the low-income people in urban area. Data collection by interview was carried out from Nov. 1991 to Jul. 1992. The main results were as follows; 1) Total subjects for the need assessment of home nursing care were 123 households wi th 488 persons in a urban poor area. Over half of households $(57.7\%)$ was teenage family. The overall living conditions were poor and the average monthly income was 580 thousands won. $74.8\%$ of subjects was covered by medical care insurance and only $4.7\%$ was covered by public assistance. The morbidity rate was $8.2\%$ among 488 subjects and $27.5\%$ of them was not treated at all, $30\%$ was treated in utilizing pharmacies or local clinics. 2) The subjects of home nursing care were 46 with Hypertension or DM who agreeded the participation of study among registered patients at a public health center in Incheon. Home visiting was performed at intervals per one month for one year. Most of them were the elder(mean age=61 years) and long term patients(7.8 years continued). Home nursing care was effective. That is, blood pressure(including systolic and diastolic pressure) was significantly reduced (t(n=22)=2.31, P=.031, t(n=24)=4.16, P=.000 respectively) and knowledge of disease(t(N=46)=-7.63, P=.000), attitude of disease (t(N =46) = -4.92, P=.000), and self-care(t(N =46) = -4.89, P= .000) were significantly improved through home nursing care. But there was no difference in blood sugar for diabetics between the beginning and the end of visits. At the beginning of visit for home nursing care, sex$(\beta=-0414,\;t=-3.012)$ and nursing need({3=.310, t=2.164) were influencing self-care, and duration of disease$(\beta=.297,\;t=2.106)$ and nursing need $(\beta=.385, t=20417)$ were influencing blood pressure, blood sugar level. Namely, the subjects who were male and had higher nursing need showed better self-care and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. At the end of visit for home nursing care after one year, the blood pressure and blood sugar level was influenced by age $(\beta.320,\;t= 2.242)$, duration of disease ($(\beta.352,\;t= 2.395)$ and nursing need $(\beta=.350,\;t=2.623)$ and self-care had no influencing factor. The higher age and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. 3) The problems that were found out during the performance of home nursing care were the absent of useful protocols for services and the clear evaluation base, and the difficulty of teaching elders who were the major part of our subjects.

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A Survey on Communication Status between Parents and their Adult Children (부모와 분거자녀간의 상호연락실태)

  • 박광모;강복수;이성관
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.93-106
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    • 1984
  • Today, elderly people has desperately felt isolation and desolation due to the loss of activity at home and society by the change of social structure and the tendancy of nuclear family. The mutual-relationship between parants and their children is important to solve the problem of eldery people's isolation and desolation. The present study was conducted to investigate the status of mutual-communication by visiting, telephone and letter on 678 parents over 55 years of age and 1,316 their adult children from September 1st to 30th, 1982. It was investigated with questionaire by students. The frequency of communication from children to parents was highest in 25.4% by telephone and 21.6% by visiting, 4 times a month. Correspondence of letter showed only 18.1% in a year. The frequency of communication from parents to children was highest 16.1% by telephone and 15.6% by visiting, 4 times a month. Correspondence of letter showed only 11.3% in a year. Urban parents showed higher frequency than rural parents by visiting and telephone, but lower by letter. The older age group of children showed higher frequency than the younger by visiting and telephone but 3rd decade was highest by letter. The younger age group of parents showed higher frequency than older age group. Mother was showed higher frequency than father by visiting and telephone, but father by letter. Higher education level group showed higher frequency than lower education level group. Merchants and factory workers showed the highest frequency by visiting and telephone, but officials by letter. Upper class group in socio-economic status showed higher frequency than lower class group generally, but lower class group dy letter from parents to children. The group within samedistrict between parents and children showed the highest frequency by visiting and telephone, but the group within long distance by letter.

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Effects of Elastic Band Resistance Exercise on Physical Fitness, Activities of Daily Living, Falls Efficacy, and Quality of Life Among Older Women Receiving Home Nursing (탄력밴드저항운동이 장기요양 방문간호 이용 여성노인의 체력, 일상생활수행능력, 낙상효능감 및 삶의 질에 미치는 효과)

  • Cho, Jeongok;Ahn, Okhee
    • Journal of muscle and joint health
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    • v.27 no.2
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    • pp.71-80
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    • 2020
  • Purpose: This thesis study aimed to examine the effects of elastic-band resistance exercise on physical fitness, activities of daily living (ADLs), falls efficacy, and quality of life among older women receiving home nursing care under long-term care insurance. Methods: We used an equivalent control group pre-test/post-test design. We assigned older women at the nursing care center J to the experimental group (n=21), and older adult women at the nursing care center H to the control group (n=21). The experimental group engaged in an elastic band resistance exercise twice per week from February 18 to April 12, 2019. Results: There were significant differences in the Short Physical Performance Battery score (t=4.15 p<.001), left grip strength (t=0.57, p<.569), right grip strength (t=1.38 p<.177), flexibility test scores (t=2.34, p<.024), ADLs (t=6.86, p<.001), falls efficacy (t=5.16, p<.001), and quality of life (t=3.87, p<.001). Grip strength was increased slightly in the experimental group, but the increase was not significant. Conclusion: Elastic band resistance exercise is an effective nursing intervention to enhance physical fitness, flexibility, ADLs, falls efficacy, and quality of life among older women receiving home nursing care under long term care insurance.

Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital (일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석)

  • Park, Sung Hye;Jang, Yeon Soo;Kim, Su Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

Nutritional Status according to the Frailty Status of the Elderly at Home in Seo-gu, Gwangju, Korea (광주광역시 서구 재가노인의 노쇠정도에 따른 영양상태)

  • Kim, Ye Eun;Heo, Young-Ran
    • Korean Journal of Community Nutrition
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    • v.26 no.5
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    • pp.382-395
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    • 2021
  • Objectives: This study examined the nutritional status according to frailty status in the elderly at home. Methods: The participants were a total of 76 elderly at home living in Seo-gu, Gwangju, Korea. The nutritional status and frailty status were analyzed using the Nutrition Quotient for Elderly (NQ-E) and the Korean version of the Fatigue, Resistance, Ambulation, Illnesses and Loss of weight Scale (K-FRAIL), respectively. Results: The distribution of frailty status was robust (17.1%), pre-frailty (38.2%) and frailty (44.7%), and its distribution was significantly different in genders, age groups and the number of medications. The mean NQ-E score was 47.0 for total subjects, indicating a low grade. The scores of balance, diversity and dietary behavior factors were within the low grade, while the score of the moderation factor was within the medium-high grade. According to the frailty status, pre-frailty and frailty showed significantly higher scores for sugar-added beverages intake in the moderation constructs than robust. Robust showed significantly higher scores for the exercise hours and perception level for one's health than pre-frailty and frailty. Conclusions: These results suggest that nutrition status is associated with frailty status. Regular nutrition education and visiting nutrition service should be established to improve the balance and diversity of food intake and improve the dietary behavior of the elderly at home.