DOI QR코드

DOI QR Code

A Survey of Hospital-Based Home Healthcare Utilization in Patients using Home Mechanical Ventilator

가정용 인공호흡기 적용 환자의 가정간호서비스 이용실태

  • Lee, Mi Kyoung (Department of Clinical Nursing Science, Sungkyunkwan University School of Medicine) ;
  • Song, Chong Rye (Department of Home Health care Nursing, Aju University Hospital) ;
  • Oh, Eun Kyung (Department of Home Health care Nursing, Seoul National University Hospital) ;
  • Yoon, Young Mi (Department of Home Health care Nursing, Seoul Veteran's Hospital)
  • 이미경 (성균관대학교 임상간호대학원) ;
  • 송종례 (아주대학교병원, 가정간호팀) ;
  • 오은경 (서울대학교병원, 가정간호사업팀) ;
  • 윤영미 (서울중앙보훈병원, 가정간호팀)
  • Received : 2017.07.21
  • Accepted : 2017.08.20
  • Published : 2017.08.31

Abstract

Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.

Keywords

References

  1. American Association for Respitatory Care. (2007). AARC clinical practice guideline: long-term invasive mechanical ventilation in the home-2007 Revision & Update. Respiratory Care, 52(1), 1056-1062.
  2. American Thoracic Society (2005). Statement on home care for patients with respiratory disorders. American Journal of Respiratory Critical Care Medicine, 171(12), 1443-1464. https://doi.org/10.1164/rccm.2504001
  3. Boroughs, D., & Dougherty, J. A.(2012). Decreasing accidental mortality of ventilator-dependent children at home. Home Healthcare Nurses, 30(2), 103-111.
  4. Cho, S. H., Go, M. G., Jung, J. H., Lee, H. O., Nam, J. M., Oui, M. S., & Yi, Y. H. (2012). A survey on nurses' and physicians' knowledge and educational needs on home ventilator. Journal of Korean Critical Care Nursing, 5(1), 56-66.
  5. Downes, J. J., Boroughs, D. S., Dougherty, J., & Parru, M. (2007). A statewide program for home care of children with chronic respiratory failure. Caring, 26(9), 16-18.
  6. Hwang, M. S., & Chang, S. J.(2013). Self-care education experience, self-care performance, and home care service needs of patients with rare and incurable disease who use a home ventilator. Journal of Korean Academic Society of Home Health Care Nursing, 20(1), 5-15.
  7. Hwang, M. S., Lee, M. K., & Song, J. R. (2014). The factors affecting Burdens and Quality of life of the family caregivers of patients with rare and incurable diseases using home ventilators. Korean Journal of Adult Nursing, 26(2), 191-202. https://doi.org/10.7475/kjan.2014.26.2.191
  8. Jardine, E., & Wallis, C. (1998). Core guidelines for the discharge home of the child on long term assisted ventilation in the United Kingdom. Thorax, 53(9), 762-767. https://doi.org/10.1136/thx.53.9.762
  9. Kang, S. W. (2011). Operation of a central control system for pulmonary rehabilitation in patients with rare and incurable diseases. Report of Korea Centers for Disease Control and Prevention.
  10. Kang, S. W. (2013). Operation of a central control system for pulmonary rehabilitation in patients with rare and incurable diseases. Report of Korea Centers for Disease Control and Prevention.
  11. Kim, D. H., Kang, S. W., Kim, W., Lee, S. C., Yoo, T. W., & Moon, J. H. (2007). Follow up survey of non-invasive intermittent positive pressure ventilatory support in patients with neuromuscular diseases. Journal of Korean Academy Rehabilitation Medicine, 31(4), 427-433.
  12. Kim, D. H., Kang, S. W., Choi, W. A., Moon, J. H., Baek, J. H., Choi, S. H., Park, J. H., Shin, Y. B., & Seo, J. H.(2010). A research on the management of ventilatory insufficiency in patients with neuromuscular diseases. Journal of Korean Academy Rehabilitation Medicine, 34(3), 347-354.
  13. Kim, J. Y., Min, Y. S., Kim, M. S., Kim, J. S., Kim, H. L., & Shin, H. I. (2010). A survey of respiratory care in amyotrophic lateral sclerosis patients using non-invasive ventilatory support. Journal of Korean Academy Rehabilitation Medicine, 24(1), 49-53.
  14. Lee, S. J. (2004). Cost analysis of home care with activity-based costing(ABC). Journal of Korean Academy of Nursing, 34(6), 1117-1128. https://doi.org/10.4040/jkan.2004.34.6.1117
  15. Marchese, S, Coco, D. L., & Coco, A. L. (2008). Outcome and attitudes toward home tracheostomy ventilation of consecutive patients: a 10-year experience. Respiratory Medicine, 102(3), 430-436. https://doi.org/10.1016/j.rmed.2007.10.006
  16. Min, Y. S., Kim, J. Y., Kim, M. S., Kim, J. S., Kim, H. L., & Shin, H. I. (2010). Quality of life and care burden of caregivers of ventilator-dependent amyotrophic lateral sclerosis patients. Journal of Korean Academy Rehabilitation Medicine, 34(4), 442-450.
  17. Park, K. H., Kim, H. Y., Nam, Y. H., Kim, J. H., Joo, I, S., Sung, J. J, Lee, K. W., & Kim, S. H. (2006). Preliminary study on clinical characteristics and caregivers' burden of Korean patients with amyotrophic lateral sclerosis; survey based on database of Korea ALS association. Journal of Korean Neurology Association, 24(3), 252-259.
  18. Ryu, H. S. (2006). Current status of costs and utilizations of hospital based home health nursing care in Korea. Journal of Korean Academy of Nursing, 36(7), 1193-1203. https://doi.org/10.4040/jkan.2006.36.7.1193
  19. Ryu, H. S., Park, C. S., Kim, I. A., Kwon, Y. D., & Kang, S. W. (2008). Use of home nursing therapy and need of home care equipments. Journal of Korean Academy of Community Health Nursing, 19(2), 157-166.
  20. Shin, H. I. (2011). 2008 Survey of ventilatory support in patients with rare and incurable disease. Report of Korea Centers for Disease Control and Prevention.
  21. Simmons, F. M., Ferro, J., & Thomas-Nelson, S. (2010). Discharging the ventilator-dependent patient to home-part 1. Professional Case Management, 15(5), 296-298. https://doi.org/10.1097/NCM.0b013e3181f5a9b9
  22. Song, C. R., Lee, M. K., Hwang, M. S., & Yoon, Y. M. (2014). The current state of hospital based home care services in Korea: analysis of data on insurance clames for home care from 2007 tod 2012. Journal of Korean Academic Society of Home Health Care Nursing, 21(2), 127-138.
  23. Stuban, S. L. (2010). Home mechanical ventilation. American Journal of Nursing, 110(5), 63-67. https://doi.org/10.1097/01.NAJ.0000372080.63145.13
  24. Swedberg, L., Michelsen, H., Chiriac, E. H., & Hylander, I. (2014). On-the-job training makes the difference: healthcare assistants' perceived competence and responsibility in the care of patients with home mechanical ventilation. Scandinavian Journal of Caring Science, 29(2), 369-378. https://doi.org/10.1111/scs.12173
  25. US Census Bureau State and country QuickFacts 2010. http://quick-facts.census.gov/qfd/index.html. Accessed June 30, 2017.