• Title/Summary/Keyword: home visiting

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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Development of Dementia Care Model in a Community (지역사회 치매관리 모형 개발 : 광명시의 경우)

  • 배상수;김동현;우영국;오진주;민경복;이수현;이미라;이상숙;표옥정
    • Health Policy and Management
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    • v.9 no.1
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    • pp.30-71
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    • 1999
  • There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

A Study on the Characteristics of the Demented Elderly staying at home (서울시 일개 구 재가 치매노인 특성 연구 -일반노인과의 비교를 중심으로-)

  • Oh, Jin-Ju;Kim, Hee-Girl;Kwon, Young-Suk
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.214-225
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    • 2001
  • The purpose of this study is to compare the characteristics of the demented elderly and normal elderly over 65 staying at home in Seoul. Here, the demented elderly are defined as the aged who score under 20 on the MMSE-K testing. The subjects were 15.104 elders in home. The method is a cross-sectional study home visiting survey with questionnaires. Data analyses were conducted by using frequency, percentage, t-test and ANOVA procedures. Results are as follows: First, general characteristics such as sex, age, marriage, education, physical health, and family characteristics such as economic level and single living showed a significant variance between demented elderly and normal elderly. Second, the demented elderly showed a significantly high point of AD and IADL. Third, in contrast with normal agents, the dementia showed a high need for assistance from the care giver but followed the same pattern. In conclusion, the above findings suggested that a social support system should be developed for the demented elderly and care givers in the home.

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A Time Study of Nursing Activities by Home Care Nurses for Non-Cancer Terminal Patients (가정전문간호사의 비암성 말기환자 간호행위 시간 분석)

  • Lee, Hanul;Lee, Jong-Eun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.2
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    • pp.180-188
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    • 2019
  • Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.

Oral health care intervention protocol for older adults at home in dental hygienists: a narrative literature review (치과위생사의 재가방문 구강건강관리 중재 활동을 위한 프로토콜 고찰 )

  • Jong-Hwa Jang
    • Journal of Korean society of Dental Hygiene
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    • v.23 no.5
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    • pp.333-341
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    • 2023
  • Objectives: This study aims to propose a standard protocol for oral health care intervention activities by dental hygienists. Methods: A narrative literature review of home visit oral health care intervention activities reported in Cheonan, South Korea was conducted to enable the proposal of a standard home visit protocol for dental hygienists in the context of community care. Results: Oral health management intervention activities contributed to improving the quality of life, as well as the oral health, of older adults living at home. This was a result of applying a protocol consisting of oral observation, oral massage, expert oral hygiene management, oral muscle function training, and final stages. Conclusions: The visiting oral health intervention protocol was effective in resolving oral health problems of older adults. In the future, customized programs and reimbursement systems should be developed to promote oral health care for older adults that can be provided at home.

Effects of Home Nursing Care on Self Care for Early Discharged Mothers Following a Cesarean Section (자가간호향상을 위한 제왕절개산모의 가정간호 효과)

  • Chang, Soon-Bok;Lee, Sun-Kyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.1
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    • pp.38-49
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    • 2001
  • The purpose of this study was to evaluate the self care focused home nursing' care outcomes of parturient women following Cesarean sections, The subjects included 56 parturient women following a cesarean section, and they were randomly assigned to an experimental group or a control group, The experimental group included women who were discharged early from the hospital. 4-5 days after having a cesarean section. Home nursing care for the experimental group consisted of stitch removal. wound care and education for parturient women. Home nursing care was provided for 2-3 days after early discharge. The outcomes of self care focused home nursing care were measured by self-care competency. Data collection was done by a self-reported questionnaire and by a telephone interview 2-3 days after discharge from the hospital(control) or after home care (experimental) from December, 20, 1998 to June, 10, 1999. The questionnaire consisted of 25 items on 9 self-care domains. Data was analyzed by a t-test. and as $x^2$-test. The study results were as follows: 1. The general characteristics of both groups were similar except for the total number of pregnancies, and whether or not they wanted the pregnancy at this time. 2. The self-care competency scores for the experimental group receiving self care focused home nursing care were higher than the scores for the control group(t=2.361. $p{\le}.05$). 3. There was no significant difference in the rate of OPD visiting, readmission, or emergency room use between the two groups. We concluded that self care focused home nursing care is effective in promoting the self-care competency of parturient women following Cesarean sections. It is suggested that further study is needed with a larger sample to be able to generalize these results.

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A Study on Practical Approaches of Home Care Services - Based on Home Care Services in Japan- (가정간호사업의 실천적 방법론에 관한 고찰 -일본의 사례를 중심으로-)

  • 조유향
    • Korean Journal of Health Education and Promotion
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    • v.7 no.2
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    • pp.78-88
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    • 1990
  • The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

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Attitude and Management Contents of Health Workers Engaged in Visiting Health Service (보건기관(保健機關)의 방문보건사업(訪問保健事業) 담당인력(擔當人力)들의 사업(事業)에 대한 태도(態度) 견해(見解)와 환자관리(患者管理) 양상(樣相))

  • Park, Mi-Young;Park, Jae-Yong
    • Journal of agricultural medicine and community health
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    • v.23 no.1
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    • pp.91-108
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    • 1998
  • This study was conducted to use the feedback of health personnel to improve the Visiting Health Service. The data was collected from 471 Home Health Workers serving 24 local health organizations in the Kyung-Pook province. 62.5% of the respondents were men under thirty-nine years of age. 92.8% of the respondents are married. 47.1% had degrees from junior colleges. It was ascertained 52.7% of the workers visited their patients six to twelve times within a six month period. And one to three patients were visited per day by one worker. Workers of older age, higher job position, and more experience were more positive in their feedback about the program. In addition, local health center employees, including nurses, were more positive about the program. Younger workers with a higher level of education, less experience, and lower job position had more insight into the problems of the program. Deeper insight into these problems led to a more negative conception of the program. Older workers with higher ranking jobs were found to be most competent. in their jobs. Workers at the main health center were assessed higher than the workers at the health sub-center or the primary health post. In addison nurses at all centers were found to be slightly more competent than the nurses' aide. The primary health post established the highest degree of patient satisfaction. It was discovered that the more positive the workers felt about the program, the higher their patient satisfaction feedback. There was a positive correlation between management assessment and patient satisfaction. This means that better program management was found to produce higher patient satisfaction. Workers feel being more educated about patient management would lead to better service. However, they take no action to produce these results. Where the problems of the system are most commented upon, the need for further education is greatest. Through multiple regression analyses it is apparent that the assessment of patient management is the greatest variable affecting patient satisfaction of patients is dependent on the management by the visiting health worker. Therefore, the development of the visiting health program is highly dependant on the feedback of those workers with a negative conception of the program. So the development of programs, motivation, education and training must be established. These works would lead to active participation by visiting health workers in the improvement of the Visiting health program.

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A study on Hospital based Home Health Care Service and the Level of Client Satisfaction (일 대학 병원의 가정간호시범사업 서비스 내용 및 만족도에 대한 조사연구)

  • Kim Chung Nam;Kwan Young Sook;Koh Hyo Jung;Kim Myung Ae;Park Chung Ja;Shin Yeong Hee;Lee Byung Sook;Lee Kyung Hee;Seo Hanng Suk
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.246-259
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    • 2000
  • The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

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Survey on the Status and Needs of Korean Food Consumption for the Development of Home Meal Replacement for Chinese and Japanese (중국인, 일본인 대상 가정식사 대용식 개발을 위한 한식섭취 현황 및 요구도 조사)

  • Han, Gyusang;Choi, Jiyu;Kwon, Sooyoun
    • Journal of the East Asian Society of Dietary Life
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    • v.27 no.4
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    • pp.420-430
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    • 2017
  • This study investigated the status of Korean food consumption and the need for home meal replacement of Korean food for Chinese and Japanese in order to export Korean food to China and Japan. In total, 78.2% of Chinese and 33.0% of Japanese showed significant differences in their experiences of visiting Korea. The most common place to consume Korean food was a Korean restaurant for Chinese (55.8%), whereas Japanese (44.9%) consumed Korean food at Korean restaurants in Japan. In the purchasing experience of Korean home meal replacement, 59.2% of Chinese and 40.5% of Japanese responded that they had 'purchase experience', and the reason for purchasing was 'delicious' (32.5%) for Chinese and 'convenience' (34.8 %) for Japanese. The place to purchase Korean home meal replacement was large marts in both countries. Most Chinese (92.2%) and Japanese (62.1%) respondents said they were willing to buy Korean home meal replacement. Both Chinese (54.8 %) and Japanese (48.0%) said that 'taste' was the most important factor to consider when developing Korean home meal replacement. The favorite tastes were 'spicy' (35.3%) for Chinese and 'savory' (38.8%) for Japanese. For the taste of Korean home meal replacement, Chinese answered that the product should be developed by maintaining 'Korean traditional taste as it is' (57.7%), whereas Japanese responded 'change according to the taste of Japanese' (65.2%). For the preferred packaging form of home meal replacement, Chinese preferred 'vacuum' package while the Japanese preferred 'frozen'. The results of this study can be used as basic data for domestic food companies to establish marketing strategies to enter the Chinese and Japanese home meal replacement markets.