• 보건행정학회지
• /
• 제9권1호
• /
• pp.30-71
• /
• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 한국보건간호학회지
• /
• 제34권1호
• /
• pp.5-21
• /
• 2020

Purpose: This study compared visiting nursing services of Denmark, Sweden, Japan, and the United States to provide baseline data for the development of models for community care nursing services in South Korea. Methods: A review of the literature was performed that include journal articles, government reports, institutional reports, and national/international statistics. Site visits were performed to explore the visiting nursing services of Denmark. Results: Government centered visiting nursing services were provided in Denmark and Sweden mostly by public organizations, while private services prevailed in the United States and Japan. Nursing services included case management or care coordination services, while nurse practitioners or nurse specialists provided visiting nursing services in all of the four countries and the services were provided 24 hour a day. Conclusions: Based on the review of visiting nursing services in foreign countries, the development of models is needed to provide integrated visiting nursing services in Korea that encompass home care nursing, visiting nursing, and visiting health care services.

• 지역사회간호학회지
• /
• 제29권4호
• /
• pp.530-538
• /
• 2018

Purpose: This study tried to identify changes in family burden after the introduction of the long-term care insurance and to examine the factors influencing subjective and objective caring burden and depression of family caregivers of elders receiving home-based long-term care. Methods: Data were collected from 203 family caregivers of elders from August 1 to 31, 2015 using questionnaires. They were analyzed in descriptive statistics, t test, ANOVA test, and multiple regression analysis. Results: The mean score of depression was 7.24, which suggested mild depression level. The subjective family burden was 2.71 and the objective burden 3.04. The factors affecting depression included subjective burden (t=5.08, p<.001), objective burden (t=2.80, p=.006), time of elderly care per day (t=-3.61, p< .001), caregiving duration (t=3.33, p=.001), age (t=3.13, p=.002), family relationship (t=2.48, p=.014), and economic status (t=1.99, p=.047). Conclusion: The family burden was most important influencing factor on caregiver's depression. Therefore, services and supports to alleviate caregivers' burden in the home-based care should be added to long-term care.

• 지역사회간호학회지
• /
• 제16권4호
• /
• pp.437-445
• /
• 2005

The purpose of this study was to understand the meaning of experiences in home visiting nursing service among the elderly in community provided by nursing students. Method: This is a phenomenological study to investigate the experience of community-based patients. Data were collected through in-depth interviews from the 4th of March to the 15th of December 2003. Individual interviews were conducted with 8 patients on subjective experiences. Data were analyzed through Colaizzi's method, in which meaningful statements were extracted. Result: Four categories were identified from nine theme clusters. The four categories were 'thankfulness', 'dependence', 'sorrowfulness' and 'the sense of being'. Conclusion: These results show the importance of visiting nursing service for the elderly in community

• 지역사회간호학회지
• /
• 제32권1호
• /
• pp.51-63
• /
• 2021

Purpose: This study aimed to develop an integrated health promotion program for cancer survivors residing in the community based on the shared care model, and evaluate its effectiveness. Methods: A quasi-experimental trial was conducted. The participants consisted of 35 cancer survivors with completed intensive cancer therapy at the cancer hospital. The intervention group (n=20) and the control group (n=15) were recruited from among a district home cancer patient registrations. The intervention group participated in an integrated health promotion program based on the MAPP (Mobilizing for Action through Planning and Partnership) development process. The program consisted of physical, psycho-social and body image units. The participants were assessed before the program, and immediately after the program. Data were collected between July 1 and September 2, 2018 using FACT-G quality of life (QOL), distress thermometer (DT), and resilience. The data were analyzed by performing a χ2 test, Fisher's exact test, Mann-Whitney test, and ranked ANCOVA using SPSS. Results: The intervention group reported a higher QOL overall and significantly higher social/family well-being than the control group. Distress was significantly lower in intervention group than in the control group. Resilience had no significant difference between the two groups. Conclusion: These findings indicate that the integrated health promotion program base on the shared care model and MAPP development process could be effective intervention for improving social/family well-being and the QOL, and reducing distress of cancer survivors at home. Community health center nurses need to provide intervention to support self-care competency for cancer survivors' comprehensive care with physical, psycho-social, and body image to help them adjust their life to a moderate risk group in the community.

• 대한간호학회지
• /
• 제36권6호
• /
• pp.1042-1054
• /
• 2006

Purpose: Previous evaluation studies of the visiting nursing program explained an average change of the participants' health status, without considering socio-ecological characteristics and their impacts. However, these factors must affect individual health problems and lifestyles. For effective and appropriate community based programs, the Geographical Information System(GIS) can be utilized. GIS is a computer-based tool for mapping and analyzing things that happen on earth, and integrates statistical analysis with unique visualization. The purpose of this study was to evaluate visiting nursing care and to advocate the usefulness of planning and evaluating visiting nursing programs using Exploratory Spatial Data Analysis(ESDA) with GIS technology. Methods: One hundred eighty-four elderly participants with cerebrovascular risk factors who lived in 13 areas of one community received visiting nursing care. The data analyzed characteristics of pre-post change and autocorrelation by ESDA using GIS technology. Results: Visiting nursing care showed an improvement in the participants' lifestyle habits, and family management ability and stress level, while the improvements were different depending on the regions. The change of family management ability and stress level correlated with neighborhoods (Morgan's I=0.1841, 0.1675). Conclusions: Community health providers need to consider the individual participant's health status as well as socio-ecological factors. Analysis using GIS technology will contribute to the effective monitoring, evaluation and design of a visiting nursing program.

• 지역사회간호학회지
• /
• 제19권3호
• /
• pp.480-494
• /
• 2008

Purpose: The study was to got basic data on the well-being of middle-aged people concerning their preparation for their upcoming old age and their quality of life. Methods: The subjects were 440 people aged between 40 and 59 living in Seoul and Gyeonggi-do. Results; First, Physical Preparation for old age was affected by religion, children, health, monthly income, and economical status, and these factors were shown statistically significant. Emotional preparation and spiritual Preparation were also related to the above-mentioned factors. Secondly, in the subjects' mental picture, a nursing home was a place for the aged without anyone who is going to take care of them and without abilities to care of themselves. Preference for nursing home was based on two factors. i.e., nursing and treatment care. and the cost was about one million won per month. Also they wanted that the government should pay a certain amount for private users. Conclusion: Therefore, people should lead a life of good health-related habits along with economical preparation for their old age.

• 가정∙방문간호학회지
• /
• 제12권1권
• /
• pp.41-69
• /
• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• 지역사회간호학회지
• /
• 제21권3호
• /
• pp.362-373
• /
• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• 한국간호교육학회지
• /
• 제27권1호
• /
• pp.68-79
• /
• 2021

Purpose: This study aimed to identify the educational needs of nurses and nursing students for the development of a simulation module of home visiting care for frail, elderly people. Methods: Focus group interviews were conducted with 15 home visiting nurses working in public health centers and 14 nursing students who experienced home visiting from September 10 to October 10, 2018. Results: Bloom's taxonomy of learning objectives, namely, cognitive, affective, and psychomotor domains was used as a framework for data analysis. The defined educational needs for each domain were as follows: "understanding frail, elderly people" for the cognitive domain; "intervention for mental health" and "building a therapeutic relationship" for the affective domain; and "nursing skills", "health education for healthy lifestyles", "referral to the community resource connection", "protection for visiting nurses" for the psychomotor domain. Conclusion: Based on the findings of this study, a simulation module of home visiting care for frail, elderly people can be developed and used for nursing students and nurses to strengthen the capacity for home visiting care.