Purpose: The purpose of this study was to identify factors associated with stress related to home mechanical ventilator (HMV) care in general ward nurses. Methods: The study participants were 110 general ward nurses. Data on participant characteristics, level of knowledge, education needs, coping ability in emergency situations, confidence, and stress were collected from August 1 to 30, 2018 using a structured questionnaire by web-based surveys. Data were analyzed using SPSS/WIN 20.0 for descriptive statistics and independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and multiple regression analysis. Results: Significant factors associated with stress related to HMV care were ward career, intensive care unit (ICU) career, intensive care room (ICR) career, education experience, and satisfaction level of HMV education. Stress had negative correlations with confidence and positive correlations with education needs. The determining factors affecting stress related to HMV care in the general ward were confidence (${\beta}=-.31$, p=.004), ICR career (${\beta}=-.27$, p<.001), education needs (${\beta}=.24$, p=.005), education frequency (${\beta}=-.18$, p=.040), and ICU career (${\beta}=-.18$, p=.025); their explanation power was about 41.8%. Conclusions: It is necessary to develop HMV care training manuals and guidelines and consider ICU or ICR careers for patient safety.
The purpose of study is to develop a home nursing care project model suitable for Korea's heath care system and policy directions for expansion and establishment of home nursing care. Method: The first, status of home nursing care program in medical institution and public health center was evaluated respectively in view of structure, process and performance. And then, issues of the program were analyzed in view of accessibility, safety, and sufficient supply. The second, demand projection of home nursing care according to income level and technical level of service that is needed to the subject was tried. In addition, the level of supply for home nursing care at present was estimated. The third, home nursing care program in advanced countries (Japan and U.S.A.) was examined. Result and Conclusion: Community-based home nursing care program is developed into public-operation model and private-operation model from above the sub-subject result. Functional network for referral system among related institutions is built up to meet various needs, regardless of accessibility to distance and economy. And prior settlements and policy directions for expansion and establishment of home nursing care are suggested.
Purpose: This study was conducted to investigate the educational needs of parents of infants and toddlers with congenital heart disease (CHD) after hospital discharge. Methods: Qualitative content analysis was conducted of in-depth interviews of eight parents, and the results of an online survey of 171 parents were analyzed quantitatively. Results: Only 16.4% of parents reported that they had received education after hospital discharge on how to provide care for a child with CHD at home. The main reason why parents did not receive education on this topic was that they did not have sufficient opportunities or information (75.5%). In addition, 97.1% of parents stated that they needed educational programs that would be available at home after discharge. In terms of specific educational content, parents expressed the highest needs for education on the symptoms of CHD and ways to cope with them, the prognosis of CHD, and the growth and development of infants and toddlers with CHD. Conclusion: The study showed that parents' educational needs were high in many ways. However, the information and educational opportunities offered after discharge were insufficient compared to those needs. Further research is needed to develop post-hospital educational programs that meet their needs.
Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.
Purpose: Long-term care facilities have a responsibility to provide care service that enables residents to maintain their maximal functional capacity and quality of life. Also their needs must be reflected to the service programs. In oder to provide an adequate service, we should assess the elderly's physical, psychological and social health status and the need. In addition to this, the long-term care facilities must be defined clearly by the type of services. This study would contribute to conduct appropriate services in public long-term care policy for the older population in the future. This study would provide informations of long-term care facilities' services and older persons' needs for long-term care. Method: To achieve this objectives, this paper investigates the types, service programs of long-term care institutes and job descriptions of workers. The subjects were consisted of 150 long-term care institutes. 150 institutes of long-term care facilities were drawn from all over the country by a nonrandom, convenience sampling. The data were analyzed by frequency, percentage, $x^2$-test using SPSS program. The instruments of this study were self-reported questionnaires for long-term care institutes. The data were collected from March 1, 2004 to may 31, 2004. Results: Service programs of long-term care institutes were not enough for residents' demands. The job descriptions among nurse, social worker and physical therapist were not clearly defined. The nurse's main role was medication and checking vital sign(49.7%), that of social worker's was observation and supervising (31.2%). The most significant problems were lacking of diverse service programs for residents. Conclusion: Considering these findings and conclusion, the needs of long-term care services should be provided by individual physical and psychological level. And the professional manpower for elderly should be educated in multi disciplines.
Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.
Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.
Purpose: To investigate the actual conditions of health care management in child day care centers and parents needs for a Center-based Child Care Health Program. Methods: Study design was cross-sectional descriptive study. 937 parents from 33 day care centers in Seoul completed a structured questionnaire. Results: 73.0% of the parents experienced sick events with their child at least once or more every 1-3months. These events resulted in 35.2% of the parents having to leave work early or to be absent from their jobs. 30.4% were asked to drive a sick child from the child day care centers to their home. Most parents (76.7%) agreed on the need for a Center-based Child Care Health Program (CCCHP), and expected general health & illness management, and growth & development evaluation from the CCCHP. Conclusion: These results show that there is a great demand for Center-based Child Care Health Program. They suggest that there is an urgent need to develop CCCHPs to promote children's health and to support parents. Also the results of this study can be utilized as a basis for the establishment of a childcare policy in Korea.
Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.
The purpose of this study was to collect the datas about the child care arrangement and the needs of day care programs of teaching mothers with preschool children and to develop the more desirable day care programs for them. The objects were 255 teaching mothers with preschool children. The results were as follows: 1) Teaching mothers who didn't use the day care center tended to put their children in the care of the paternal or maternal grandmothers, Major contributions of those baby-sitters were to protect the children and make everyday life training (44.0%) 2) The first reason for the mothers who used the day care center was that they had no other hands for their children(43.7%) and next reason was that the concerns for their children's socialization(35.4%) 3) Teaching mothers did not want the day care service during the vacation except 20% of them. 4) Teaching mothers absolutely wanted the day care service center especially inside their jobsite(61.0%) than any other type of day care programs and also wanted supporting by the government(66.5%) About the choice criterions of the day care center nutrition health and safety were suggested as the most important factor. They also prefered the experience with other peers and the programs focusing on the emotional development of the children.
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