• Journal of Home Health Care Nursing
• /
• v.26 no.3
• /
• pp.253-264
• /
• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• Korean Journal of Occupational Health Nursing
• /
• v.17 no.1
• /
• pp.5-13
• /
• 2008

Purpose: The purpose of this study is to identify Activities of Daily Living(ADL) of industrial accident disabled with a caregiver and to evaluate the degree of satisfaction with services according to kinds of caregiver, professional or non-professional. Method: Data was collected from 178 patients in three workers' accident medical corporations of H, A and D cities from July to August, 2006. Five inspectors interviewed with the disabled by visiting the hospital. Collected data was analyzed for the frequency, percentages, t-test, etc. Results: The average score of ADL which ranged from 1 to 7 was 3.6. The 51.5 percent of caregivers for industrial accident disabled were non-professional and the 48.5 percent of caregivers were professional. 50.9 percent of the reason for the family caregivers was because of economical one. The caregiver satisfaction degree was 3.7 out of 4. The satisfaction degree with the professional caregivers was significantly higher than that with non-professional family caregivers for their excellent knowledge and techniques. Conclusion: A nursing expenses for the industrial accident disabled was intended to provide appropriate nursing services for the patient and so, it should not be a kind of income. So, the system for caring services should be investigated and the qualification of caregivers should be classified according to the health condition of the patient or ADL.

• Journal of Korean Public Health Nursing
• /
• v.25 no.2
• /
• pp.289-301
• /
• 2011

Purpose: This study was conducted to investigate the level of health behaviors, perceived health status, emotional and cognitive conditions and depression of the elderly residence in homeless shelters, and to identify related factors on their depression. Method: This was a descriptive study using a questionnaire. Geriatric Depression Scale (GDS-15) was used for examining depression, and other questionnaire were adopted and modified from the customized visiting health care service. Result: The 41 subjects displayed mild depression ($5.34{\pm}3.33$). The majority were non-smokers (73.2%) and non-drinkers (85%), and 81.1% of the subjects did light activities with 74.4 % performing regular exercise more than once per week. Perceived health status was above average in 70.7%, and feeling stress (70.7%), suicidal thoughts (12.2%) and abnomal KDSQ-C (29.3%) were shown in emotional and cognitive conditions. Depression had a significant relationship with regular exercise (t=3.61, p=.001), perceived health status (t=3.47, p=.041) and suicidal thoughts (t=2.85, p=.007). Conclusion: It is necessary to increase shelters for the elderly homeless and construct the system for examining not only their physical health but also their psychological problems, and to ensure long- term care recognizing their unique characteristics and needs, and their increasing number.

• Journal of Korean Public Health Nursing
• /
• v.20 no.1
• /
• pp.5-15
• /
• 2006

Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

• Journal of Home Health Care Nursing
• /
• v.7 no.1
• /
• pp.26-38
• /
• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• Research in Community and Public Health Nursing
• /
• v.7 no.1
• /
• pp.154-169
• /
• 1996

Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.

• Korean Journal of Occupational Health Nursing
• /
• v.16 no.1
• /
• pp.67-77
• /
• 2007

Purpose: To provide concretely for support system to occupational health management grasped the present condition about the private support organizations for the migrant workers. Method: The subjects were 30 organizations to support migrant workers with the healthy and medical problem. The organizations were investigated by the internet search, and the visiting and telephone interview. Then a expert advisory conference and researchers' regular meeting were held. Result: The support organizations for the migrant workers played multiple activities, but the medical treatment and education regarding the occupational safety & health were scarcely accomplished. The government constructs a network between the organizations. A health problem of a worker should be requested to the medical centers which cooperated with the private support organizations, it makes business expand to the existing organizations which take charge of the health business of a small-scale workplace rather than it constitutes new organizations. The organizations which can manage which build the online network which can grasp all the information concerning the migrant worker from whom the government became a principal axis. Conclusion: Support system on the occupational safety and health for migrant workers that it will be help to the occupational disease prevention and occupational safety and health management, is needed.

• Journal of Hospice and Palliative Care
• /
• v.3 no.2
• /
• pp.136-143
• /
• 2000

Purpose : The purpose of this study was to identify the characteristics of hospice volunteers and care-takers and analyze activities of volunteers. Methods : First, to identify the characteristics of hospice volunteers and care-takers, 87 records that registered in for the hospice volunteer education program in Wonju C.C.C from 1997 to 2000 were analyzed. Second, to analyze activities of volunteers, 30 volunteers were participated in this study. The data were collected through a self reporting questionnaire developed by research team. Results : 1) Hospice volunteers were mostly female(93.1%) with an average age of 45 years. 32.4% of persons who completed the hospice volunteer education program has been participated hospice care continuously. 2) The care-takers average age was 50 years and mostly with cancer. The majority(13.6%) of cancers was lung cancer. 3) The mean frequency for visiting was 10 and the mean duration for offering hospice care was 49.4 days. 4) The highest score of activity was spiritual area(mean=1.97) and next activity was emotional area(mean=1.49). Conclusion : The findings in this study have an important basic data to develope program for hospice volunteers in W city.

• The Korean Journal of Health Service Management
• /
• v.8 no.3
• /
• pp.169-179
• /
• 2014

The aim of this study was to understand the factors related to depression according to gender in vulnerable elderly. We conducted a cross-sectional study with 1,709 elderly beneficiaries of the visiting health care program in Seoul. Depression was measured using the Geriatric Depression Scale Short Form Korea Version(GDSSF-K) questionnaire. Depression score was mild level in vulnerable elderly. There was no gender difference in depression level. Factors related to depression differ by gender. In the elderly men, higher depression showed significant correlation with a lower level of health-related quality of life(HRQOL) and self-rated health(SRH). In addition, higher depression was observed for elderly men living alone than for those living with family. These factors explained depression by 23.1%. In the elderly women, higher depression showed significant correlation with a lower level of HRQOL, SRH and a higher dependence of instrumental activities of daily living. In addition, higher depression was observed for elderly women who has fall experience. These factors explained depression by 22.8%. Gender-specific nursing strategies may be required for prevention of depression in vulnerable elderly.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.5 no.1
• /
• pp.39-57
• /
• 1999

Essential hypertension is a typical chronic disease requiring adequate and continuous management. And many studies supported that self-care was the essential factor to promote the wellbeing. The purpose of this study is to identify and understand the behavior patterns of self-care in hypertensives. As a research method, 35 Q-statements were collected through Individual interviews and review of the related literatures. 21 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. There were 6 different self-care types classified as follows 1) Type 1 was the self-oriented control type, monitoring the blood pressure and taking the low salt diet. But they didn't take the anti -hypertensive drug and visit the health agency regularly. 2) Type 2 was the stress-control type. Their main activities were meditation to relieve the stress and communication with family. 3) Type 3 was called daily-life control type. This type tried to make their mind comfort and think positively. They also preferred walking and exercise regularly. 4) Type 4 was the medical-oriented control type, taking the anti-hypertensive drug, visiting the medical personnel and following the medical regimens. 5) Type 5 was the medication-oriented type. They only took the anti -hypertensive drug regularly and didn't any other self-care like as monitoring the blood pressure, taking the low salt diet and exercise. 6) Type 6 was called non-medication control type. This type had no medication, but tried to visit the health agency and health personnel. From the above results, it can be concluded that the self-care types were very various and self-care education have to provide individually according to the characteristics of self-care type. Another repeated study can be recommended to improve the nursing intervention the self-care behavior in chronic patient like as diabetics or rheumatoid arthritis.