• Journal of Korean Academy of Nursing
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• v.24 no.3
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• pp.484-498
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• 1994

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1％ of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.

• 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 Korean Academy of Nursing
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• v.8 no.1
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• pp.131-138
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• 1978

The change of society has brought about various health problems which have become to demand comprehensive health services not only for individuals but also for families and communities as the unit. To meet the societal needs W Hospital in a rural Korea established a Department of Community Health Nursing Services and provided nursing services to patients under a early discharge program. This study is to evaluate the community health nursing services carried out the department in general, and has following specific objectives : 1. To learn attitude of the consumers and the "referees" toward early discharge program. 2. To find out attitude toward home care and cure services. 3. To find out the consumers and the "Referees" attitude toward the 15 selected home cue and cure activities by public health nurse. 4. To investigate possibility of charging fee for the 15 selected home care and cure activities by public health nurse. Three different study population were chosen: namely the consumer, the "referee" I and II. Excluding families moved out and not able to be contacted, the total families (77) referred to the department during the study period of September 1974 - December 1975 are defined as the consumer. Thirty seven nurses among 81 nurses who have been working in W Hospital since the inception of the Community Health Nursing Service Program were randomly selected. Thirty two nurses were defined as the "referee"I, because 5 questionnaires were not able to be collected. Twenty four doctors out of 37 who have been working since the Community Health Nursing Service Program started, and who were able to contact were called as the "referee" II. Data collection method employed for the consumers was direct interviewing with preposed interview schedules, and for the "referees"questionnaire method was utilized. x$^2$test and 100-percentage were employed in analyzing the data. The study findings are follows: 1. Attitude toward early discharge: Above 85% of the consumers and the "referees" approved the early discharge: Above 85% of the consumers and the "referees" approved the early discharge program. 2. Attitude toward the home care and cure services: Above 75% of the consumers and the "referees" showed positive attitude toward the home care and cure services by public health nurses. 3. Attitude toward 15 selected home care and curative activities by public health nurses: On the average more than 50% of the consumers and the "referees" expressed an affirmative attitude to perform 15 selected home care and cure services by public health nurses. 4. Attitude toward charging fee for 15 selected home care and curative activities by public health nurses: Above 85% of the consumers thought that they would pay for the services. Only 12.8% of the consumers and 5% of the "referees" what to have the services for nothing. Based upon the findings of this study; That is, the home care and cure services to be given by public health nurse were positively responded by the consumers and the pro-fissionable, one can conclude that the services provided by the Department of Community Health Nursing Service of W Hospital have been well accepted, and that early discharge program of hospital is believed to be a means to lessen the expenses of patients from hospitalization and to promote recovery from illness. It is recommended that hospital centered cure services should be reconsidered and scrutinized to meet community health needs. NOTE : "referees" are nurses and doctors who refer the early discharged Patient to the Department of Community Health Nursing Service.

• 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.

• Research in Community and Public Health Nursing
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• v.33 no.4
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• Korean Journal of Adult Nursing
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• v.28 no.5
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• pp.595-606
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• 2016

Purpose: This study aimed to investigate the influencing factors on self care, respiratory difficulty, sleep impediment, anxiety and depression among patients with neuromuscular disease who are dependent on Home Mechanical Ventilator (HMV). Methods: 157 patients were recruited through hospital based home nursing care departments and HMV rental centers. Data were collected by questionnaires. The analytic methods were n(%)/$M{\pm}SD$, $x^2$/t-test or ANOVA and multiple linear regression. Results: Patients with Amyotrophic lateral sclerosis were more likely to utilize HMV, had shorter periods of morbidity and the most extended daily use of HMV. As for medical equipment, they had ambu-bag (87.2%) and oxygenator (15.4%). Reports of respiratory difficulty and sleep impediment were low. There were no significant difference. In contrast, reported anxiety and depression were high and showed significant difference between non invasive HMV and invasive HMV. Anxiety contributes to respiratory difficulty (t=3.62, p=.002), sleep impediment (t=2.06, p=.042), and depression (t=7.24, p<.001). However, home nursing care exerts a positive influence in reducing anxiety (t=-2.73, p=.008). Conclusion: Anxiety contributes to respiratory difficulty, sleep impediment, and depression. However, those who use home nursing care reported less anxiety. Home nursing care positively impacts patients dependent on HMV as a practical service and available resource.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.28-38
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• 2019

Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Journal of Hospice and Palliative Care
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• v.2 no.1
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• pp.36-45
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• 1999

Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.