• Title/Summary/Keyword: out-of-home care

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An Operations Study on a Home Health Nursing Demonstration Program for the Patients Discharged with Chronic Residual Health Care Problems (추후관리가 필요한 만성질환 퇴원환자 가정간호 시범사업 운영 연구)

  • 홍여신;이은옥;이소우;김매자;홍경자;서문자;이영자;박정호;송미순
    • Journal of Korean Academy of Nursing
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    • v.20 no.2
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    • pp.227-248
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    • 1990
  • The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

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The Reciprocal Relationship between Caregiver Relations and Peer Relations of Children in Out-of-home Care: Longitudinal Study Using Autoregressive Cross-lagged Modeling (가정외보호 아동의 양육자 관계와 교우관계의 상호 영향: 자기회귀교차지연모형을 활용한 종단연구)

  • Kim, Dami;Kang, Hyunah
    • Journal of Child Welfare and Development
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    • v.16 no.2
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    • pp.109-135
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    • 2018
  • The purpose of this study was to analyze the longitudinal causal relationship between caregiver relations and peer relations of children in out-of-home care. We analyzed the three years(2011-2013) of longitudinal data from the Panel Study on Korean Children in Out-of-Home Care. The autoregressive cross-lagged model (ARCL) was used to measure the longitudinal causal relationship between caregiver relations and peer relations. As a result, first, caregiver relations and peer relations showed stability over time. In other words, the results of the measurement at three time points showed that the caregiver relations and peer relations at the previous time had a significant effect on the caregiver relations and peer relations at the later time point. Second, the previous caregiver relations had a significant effect on the subsequent peer relations over time. Third, the previous peer relations had a significant effect on the subsequent caregiver relations over time. This study confirmed the interrelationships of caregiver relations and peer relations of children in care by examining the longitudinal data using the longitudinal analysis method.

Survey of Home Healthcare Nursing Services to Establish Quality Assessment Standards (가정간호 서비스 질 평가기준 설정을 위한 조사연구)

  • Kim, Su-Ol;Shin, Hye-Sun;Kim, Gwang-Suk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.2
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    • pp.85-94
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    • 2010
  • Purpose: The study aimedto provide basic data to improve the quality of home healthcare nursing services by evaluating quality of care in representative nationwide sites. Method: The current quality of home care service in 104 nationwide sites was evaluated in terms of structures, processes, and outcomes based on published standards of the Joint Commission on Accreditation of healthcare Organizations. Results: The mean score for three dimensions of quality of home care service was as follows in descending order: structures (77.6), outcomes (60.4), and processes (38.7). Additionally, by specific item compared level of quality of home care servicein each site, the highest score was 97.3 and the lowest score was 42.3 out of 100, with a mean score of 74.7. Conclusions: These findings provide a base for establishing the quality management system and to develop a tool for evaluating the quality of home healthcare nursing. The result should be continuous management and improvement of home healthcare nursing quality.

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The of Perception Types of Related Subjects on the Residential Care Hhome for Disabled People : Application of Q-methodology (장애인거주시설에 대한 관련 집단들의 인식유형 연구: Q 방법론의 적용)

  • Kim, Yong-Deug;Kang, Hee-Seol
    • Korean Journal of Social Welfare
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    • v.60 no.1
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    • pp.29-51
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    • 2008
  • The purpose of this study is to find out perception types of related groups - service providers, welfare public servants and advocates of disabled people - on the residential care home for disabled people. For this purpose, this study adopted Q-methodology which is developed mainly to study on the subjective conceptualization of related people on research theme. This study found out four major types of perception on residential care home for disabled people, which are the types of focusing specialization and professionalization of care home, valuing on user participation on daily decision making, requesting similar style of care home with normal family home. insisting on abolishment of all kinds of residential care home. This research finding can be used to make clear understanding on diverse voices of related groups about residential care home for disabled people. This kind of understanding would contribute to mutual understanding and clear communication to arrive positive consensus related to the matters of residential care services for the disabled people.

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A Direction of Child-care Development through the View of Home Economics (가정학적 접근을 통한 보육의 발전 방향 제시)

  • Yoon, Sook-Hyeon;Lee, Mi-Jeong
    • Journal of the Korean Home Economics Association
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    • v.44 no.5 s.219
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    • pp.89-98
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    • 2006
  • The purpose of this study is to seek for a direction of child-care development through the basic concepts of home economics which have taken charge of much parts of the studies in child-care in the early years. When the problem of child-care is studied in view of the developmental process or the basic concepts of home economics, it is summed up as follows; First, on the basis of human ecological approach, when we study child-care, it needs to emphasize the mutual relationship between the macro-environment in connection with home and child-care. The study of child-care have to find out the relationship between the micro-environment in connection with children and the macro-environment in connection with home. And on the basis of this study, we must endeavor to build up the desirable environment of child-care. Second, on the basis of the concept of Institutional household, we mud be concerned about the developmental stages of young children, and emphasize 'the principle of love and care'. This means that the institution of child-care must be considered as a place which enlarges the merits of home and complements the defects of home through the strengthener of the function of home. Third, on the basis of healthy family, child-care service must support and complement the function of bringing of home in view of 'total healthiness of home'. Child-care service must be offered to be able to be chosen according to the total conditions of family such as the employment of mother, the family life cycle, the life style, the socioeconomic status of family.

Relationship between Critical Thinking Disposition and Clinical Decision-Making Abilities in Home Health Advanced Practice Nurses (가정전문간호사의 비판적 사고성향과 임상의사결정능력과의 관계)

  • Choi, Seong Mee;Lee, Mi Kyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.21 no.2
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    • pp.147-155
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    • 2014
  • Purpose: Clinical decision-making carried out by nurses is a complex process that influences the quality of care provided and various patient outcomes. This study examined the relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Method: The study had a non-experimental correlational design. Data were collected from 100 home health advanced practice nurses in 20 hospitals. Results: The mean critical thinking disposition score was $3.69{\pm}.39$ out of 5 and the mean score for clinical decision-making abilities was $3.48{\pm}.22$ out of 5. In this correlation analysis, a significant positive correlation (r=.58, p<.001) was found between critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses. Conclusion: In order to improve the clinical decision-making ability of home health advanced practice nurses, we need to improve their critical thinking disposition. In order to make this change, appropriate training program are needed to increase the critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses.

Effect of Home Care Service on the Quality of Life in Patients with Gynecological Cancer

  • Aktas, Demet;Terzioglu, Fusun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4089-4094
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    • 2015
  • The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits ($1^{st}$, $12^{th}$ weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols ($1^{st}$, $12^{th}$ weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: $6.01{\pm}0.64$), while the control group had comparatively lower quality (average mean: $4.35{\pm}0.79$) within the 12 week post-discharge period (p<0.05). This study found home care services to be efficient in improving the quality of life in patients with gynecological cancer.

A study on Changes in ADL Functioning of Residents in Taejon City (가정간호환자의 일상생활작동수행능력 변화에 대한 연구)

  • Choi, Myoung-Han
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.4
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    • pp.53-64
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    • 1997
  • This study was done to investigate the ADL differences between before and after home care. For this survey, the Barthel index, an ADU(activities of daily living) assessment, and general history questions were asked. Functional performance, i.e. ADL, was studied in a population a total of 56 men and women aged 65 and older from the city of Taejon. Among the independent subjects, women, 73 years of age and older, married status, 1-2 times taking home care per month, the case answering 'Quite' about satisfactory of home care, elderly dwelling with others and who have helper and spouse, elderly having a snack regularly, are statistically significant. Also ADL differences were found in grooming, getting in and out chair, getting on and off toilet, walking 500 meters on the level. Further studies should evaluate the activities of daily living to predict important disability-related outcomes.

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A Survey on the Demand for Home Care of the Mother's of the Hospitalized Children (입원 환아 어머니의 가정간호 요구도 조사)

  • Dim Young Hae;Kwon Bong Sook;Park Soon Og;Bae Young Soon;Lee Young Eun;Lee Ji Won;Lee Hwa Ja;Chung Gyung Ae
    • Child Health Nursing Research
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    • v.3 no.1
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    • pp.99-107
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    • 1997
  • The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are(1) the problems encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purposes above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS : PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as 'pain control, OPD visits, diet-control problems' among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, 'OPD visits and knowledge deficit' would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under 50. 0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was 'very necessary' and 'somewhat necessary'. 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as

    . 'Assessment, Lab, basic nursing technology, relay ' transfer, training ' education and curative nursing' showed comparatively high scores. However, the items belonging to pediatric Home Care Services such as 'umbilical cord care, breast-feeding, infant care, and post-partum care & loan of breast-pump' showed relatively low scores.

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  • A Curriculum Strategy for Advanced Practice Nursing; Home Health Care and Hospice (간호대학원의 교육운영전략 : 가정전문간호사와 호스피스전문간호사 중심으로)

    • Lee, Won-Hee;Kim, Cho-Ja;Kang, Kyu-Sook;Oh, Eui-Geum;Kim, Soyaja;Kim, Eun-Jeong
      • Journal of Korean Academic Society of Home Health Care Nursing
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      • v.11 no.1
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      • pp.57-70
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      • 2004
    • Purpose: This study was to develop a cost-effective and efficient curriculum for advanced practice nurse (APN) programs in home health care and hospice. Method: The process was to: (1) compare and analyze the present curriculum in home health care and hospice programs, (2) identify the needs of 7 expert nurses in home health care and hospice, and (3) develop a common curriculum structure and contents between home health care and hospice specialty courses. Result: Out of the 10 credits constituting the home health care and hospice specialty courses respectively, 6 credits were identified the common courses, Common content areas included introduction to hospice, communication skills, pain control. symptom control. teaching methods, and agency management. Conclusion: These results can be utilized in the development of APN programs for home health care and hospice in terms of qualified and cost-effective aspects of education.

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