• Title/Summary/Keyword: nursing fee

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Development and Application of Critical Pathway for Nasal Bone Fracture Patients (코뼈골절 환자에서 표준진료지침의 개발과 적용)

  • Hwang, Kun;Shin, Jung Yae;Lee, Hye Kyung;Lee, Hwan Jun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.154-163
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    • 2003
  • Purpose: The aim of this study is to develop and apply the critical pathway to the nasal bone fracture patients and to elucidate its effect. Methods: Critical pathway (CP) sheet and questionnaire were developed by a team approach. Critical pathway were applied to 30 nasal bone fracture patients (CP group) from June 2001 to November 2001. Length of hospitalization, cost for hospitalization and bed turnover rate of CP group were compared to those of the 30 patients who had same disease entities and treated by conventional regimen (control group). Results: Length of hospitalization in the CP group (4.20 day) were significantly shorter than that of control group (6.21 day). Mean cost for hospitalization of the CP group (492,106 won) were significantly lower than that of control group (678,376 won). Bed turnover rate in CP group (2.5) were higher than that of control group. The patients satisfaction for the medical personnel, explanation regarding operation procedure, therapeutic operation fee, and length of hospitalization were all affirmative. Conclusion: Critical pathway that we developed for nasal bone fracture definitely improved the quality of treatment and lowered cost of medical service. Furthermore, other critical pathways should be developed for another facial trauma patients.

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Effects of Social Support for Elderly Residents' Primary Caregivers in Long-Term Care Facilities on Caregivers' Positive Feelings and Burden (요양시설 입소 노인 주보호자에 대한 사회적 지지가 부양긍정감과 부양부담에 미치는 영향)

  • Kim, Ji Hyang;Han, Suk Jung
    • Journal of Home Health Care Nursing
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    • v.26 no.2
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    • pp.199-209
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    • 2019
  • Purpose: This study was conducted to determine factors affecting the positive feelings and care burden of elderly residents' primary caregivers in long-term care facilities. Methods: The survey was conducted between November and December 2018. A structured questionnaire was used to collect data, and 148 individuals voluntarily participated. The collected data were examined through descriptive statistical analysis using SPSS WIN ver.24.0, t-test, one-way Anova $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression. Results: Factors that significantly affected caregivers' positive feelings included caregivers' education level(${\beta}=-.32$, p<.001), social support(${\beta}=.31$, p<.001), care burden(${\beta}=-.29$, p=.001), and total support fee(not more than 1.5million won)(${\beta}=-.18$, p=.012). The explanation power was as high as 40.0%(Adj $R^2=.40$). Factors that significantly affected caregivers' burden included social support(${\beta}=-.25$, p=.002), positive feelings(${\beta}=-.25$, p=.002), elderly individual's religion(${\beta}=-.17$, p=.007), and elderly individual's marriage status(${\beta}=.17$, p=.021). The explanation power was as high as 45.0%(Adj $R^2=.45$). Conclusion: Our results suggest that it is necessary to increase social support for elderly residents' primary caregivers in long-term care facilities. This can be helpful to decrease burden and enhance positive feelings in caregivers. We should also collect caregivers' information as well to provide appropriate assistance.

A Case Study on the Hospital Information Systems Usability (병원정보시스템 사용성에 대한 실증연구)

  • Park, Chan-Seok;Lee, Hyen-Uoo;Koh, Seok-Ha
    • Information Systems Review
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    • v.10 no.3
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    • pp.289-311
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    • 2008
  • This study is a development of quality scale and a measurement of quality levels for the Hospital Information System(HIS) used in the hospital industry. This study is to provide decision-making guidelines for hospital managers, system analysts, and software designers, and to provide feedback for the users' information needs. The target people of the study were medical doctors, nurses, pharmacists, and clerical staff. The service contexts of usability were diagnosis/treatment, nursing, medicine preparation, and treatment fee receipt/claim. The quality factors were the efficiency, effectiveness, and satisfaction of IS09241-11. This study shows that the current domestic HISs are mostly based on patient diagnosis/treatment and treatment fee accounting, and that other quality scales are necessary according to different job categories, specializations, positions, and service domains. Especially, the low quality of HIS was found in the abnormal service processing, information sharing by outside institutions, and standardization. It may be added that the HIS should be improved and developed in these respects.

The role and implications of dental hygienists in oral rehabilitation in Japan (일본 구강 재활 분야에서의 치과위생사의 역할 및 시사점)

  • Joo-Hyun Kang;Sung-Mi Choi
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.6
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    • pp.477-483
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    • 2022
  • Objectives: The purpose of this study was to provide basic data that would inform the direction of oral rehabilitation and how to expand of the role of dental hygienists in Japan. Methods: A systematic literature review was conducted on the role of dental hygienists in the field of oral rehabilitation in Japan. Results: Japan has been making academic and practical developments in the field of oral rehabilitation for over 30 years, and has been gradually implementing a fee support policy since the 1990s. In addition, Japan has been operating a dental hygienist system specializing in oral rehabilitation since 2006. The related work was being carried out with the dental hygienist's expertise in the field of rehabilitation medical treatment secured. Dental hygienists work full-time at long-term care facilities for the elderly in addition to conducting oral care activities under the local comprehensive care system, in the areas of convalescence and acute rehabilitation, as well as in the field of visiting rehabilitation. It can be seen that, in the field of nursing care, they are specialized in oral care tasks for the elderly. Conclusions: In the future, a policy and related fee system should be gradually prepared to expand the role of dental hygienists in the field of oral rehabilitation that can contribute to improving oral health linked to systemic diseases.

A Trend of Research in Community Health Nursing (지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로-)

  • Lee, In-Sook;Kim, Yu-Na;Choi, Key-Won;Chin, Young-Ran
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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Analysis of New Patient's Willingness to Pay Additional Costs for Securing Satisfactory Consultation Time (외래 초진환자의 만족진료시간과 관련 추가 비용 지불 의사)

  • Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Yoon, Soojin;Park, Yang Sook;Kim, Sun Ae;Park, Eun-Cheol;Kang, Jung-Gu
    • Health Policy and Management
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    • v.27 no.1
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    • pp.39-46
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    • 2017
  • Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

A Study on Elderly People's Needs in Daycare Centers in the Next Generation (낮보호 시설에 대한 차세대 노인들의 인식에 관한 연구)

  • Chung, Yeoun-Kang;Yeoum, Soon-Gyo;Kwon, Hye-Jin;Kim, Kyung-Hee;Kim, In-Kook
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.324-335
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    • 1998
  • This study describes the extent of recognition of problems to the aged in a future society, the recognition and necessity of day care facilities, and the service contents and patterns preferred as a method of mediation for nursing the aged and increasing their quality of life. It also tries to certify the relations between those subjects. The result of the study is as follows: 1. Concerning problems of the aged of social significance the aged of the next generation consider the difficulties in nursing the aged to be the most important at 63.6%. 2. Concerning the nursing of parents, 49.4% of those answered 'children should take care of their parents and live together', while 46.7% answered that 'it is enough for children to provide an economic support, not necessarily living together. 3. Concerning information of day care facilities, 66.9% answered that they have no information. 4. Concerning the use of day care facilities, 54.6% answered that 'they would under certain circumstances', and 21.0% that 'they had better use them in the future'. 5. Concerning the feelings of the aged using day care facilities, 46.6% say 'they do not look poor', and 33.4% said that 'they look a little poor'. 6. Concerning the reasons for using day care facilities, 56.1% answered' because children do not proride care', and 48.5% answered 'because their economic ability is not sufficient'. 7. Concerning the programs potentially needed, food supply, medical services and physical therapy were ranked in that order. 8. Concerning social facilities necessary for the aged, centers that specialize in dementia, free day care facilities, home care services, and fee - based day care centers were ranked in that order. 9. Concerning institutions providing day care, welfare centers for the aged, those centers auxiliary to hospitals, asylums, and individuals were ranked in that order. 10. Concerning the responsibity running day care facilities, social workers, doctors/nursing assistants, nurses, and entrusted visitors were ranked in that order. Based on the results of this study, the study proposes that the study of applied cases of therapy in day care facilities for the aged continue.

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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Current Status and the Future Prospect of Rehabilitation Nursing in Korea (한국 재활간호 현황과 전망)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Hae-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.240-247
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    • 2001
  • The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

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A Study on Stroke Patients' ADL, Depression, Self-Efficacy and Quality of Life (재가 뇌졸중 환자의 일상활동 수행능력, 우울, 자기효능감 및 삶의 질과의 관계)

  • Cho, Bok-Hee;Ko, Mi-Hye;Kim, Soon-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.1
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    • pp.51-60
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    • 2003
  • This study was a descriptive research in search of a nursing intervention scheme to improve stroke patients' quality of life by understanding the relationship of stroke patients' ADL, depression, self-efficacy and quality of life with various variables and identifying factors that affect their quality of life. Each subject was interviewed one to one based on a structured questionnaire. With regard to research tools, Modified Barthel Index (MBI: Fortinsky et al., 1981), which was translated by Choi, Hye-sook (1996), was used in measuring ADL, Randloff's (1977) tool, which was translated by Choi, Soon-hee, was used in measuring depression, and the tool developed by Sherer et al. (1982), which is to measures self-efficacy under general conditions not limited to specific conditions, and modified by O, Bok-ja (1994) was used in measuring self-efficacy. The quality of life was measured using the scale of satisfaction of life developed by Diener et al. (1985). The results of this study were as follows: 1. The means of ADL of the subjects was $79.5{\pm}31.9$, depression $26.8{\pm}10.4$, self-efficacy $47.1{\pm}25.7$, and the quality of life $12.3{\pm}4.9$. 2. The subjects' quality of life showed a statistically significant difference according to gender (t=7.9, p= .006), satisfaction with income (F=5.8, p= .004), the burden of medical fee (F=3.7, p= .028) and the period of disease (F=2.8, p= .042). 3. With regard to relationship among ADL, depression, self-efficacy and the quality of life, ADL was in a relatively low positive correlation (r= .293, p= .003) with and the quality of life, depression in a high negative correlation (r=- .634, p= .000) with the quality of life, and self-efficacy in a positive correlation with the quality of life (r= .388, p= .000). 4. Factors that made a significant influence on the quality of life were depression (B=- .309, p= .001) and satisfaction with income (B=-2.611, p= .001). Based on these results, this study made following suggestions: 1. It is necessary to run rehabilitation programs to improve stroke patients' ADL, depression and self-efficacy. 2. It is necessary to perform research of monitoring stroke patients' quality of life in various areas using measuring tools.

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