Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.
The Journal of Korean Academic Society of Nursing Education
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제20권2호
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pp.321-331
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2014
Purpose: The purpose of this study was to investigate the effects of case management service for hypertensive elderly patients through the customized visiting home health care program. Method: Non-equivalent control group pretest-posttest design was employed. Data were collected from April 2007 to January 2009. Among a total of fifty subjects, 25 subjects were belonged to the case management group and the others were belonged to the general management group. Results: 1) In experimental group, significant increasing rate of number of people within normal blood pressure by time, but no significant increasing rate of number of people within normal blood neutral fat, total cholesterol, HDL, & LDL. 2) In experimental group, the score of knowledge about disease and healthy life practice were increased on 8 week period but decreased on follow up period. Number of people within normal blood HDL and mean score of healthy life practice were significantly higher than control group on follow up period. Conclusion: Case management service was effective on controlling blood pressure but partly effective on blood lipid, knowledge about disease, and healthy life practice in hypertensive patients. Further study is needed to conduct a periodic re-evaluation of the effect of case management and to verify an optimal interval to provide the case management service.
Propose: This study was to identify the factors affecting the oral health status in vulnerable elders receiving home visiting health care service. Methods: A total of 444 elderly people over the age of 65 at 33 public health centers in Daegu and Gyungbuk areas were included in this survey. The data were collected by personal interview with nurses using oral health knowledge, behavior, and status questionnaires from the $10^{th}$ to $22^{nd}$ of July, 2012. The data were analyzed with t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, and stepwise multiple regression, using SPSS program. Results: Factors affecting the oral health status were chewing satisfaction with denture 14.5% (${\beta}=.391$, p<.001), denture care (wash with water) 3.2% (${\beta}=-.187$, p<.01), and types of health insurance (medical aid type1, 2) 1% (${\beta}=-.111$, p<.05). The factors explained 18.7% of variance in the oral health status of vulnerable elderly subjects. Conclusion: The results of this study indicate that in order to improve the oral health status of vulnerable elders, it is necessary to provide oral health education that includes the proper usage of denture to elders who receive home-visiting care.
Purpose: The purpose of this study was to measure empowerment and to identify factors influencing empowerment. Method: Subjects included 767 clients registered with the customized home visiting health services in Daegu. Data collection was performed from June 3 to July 30, 2011. Descriptive statistics, ${\chi}^2$ test, ANOVA, and stepwise multiple regression were used in this study. Results: The mean score for total empowerment was 3.01(${\pm}0.28$). In subscales of total empowerment, the score for individual empowerment was 2.97(${\pm}0.36$), the score for interpersonal relationship empowerment was 3.09(${\pm}0.34$), and the score for political-social empowerment was 2.96(${\pm}0.48$). Job, education, economic status, living arrangement, and client classification were significant factors related to total empowerment in these clients. Job, education, economic status, types of health insurance, living arrangement, age, and client classification were significant factors related to individual empowerment, interpersonal relationship empowerment and political-social empowerment. 4.4 percent of the variance in total empowerment can be explained by education and living arrangement (Cum $R^2=0.044$, F=13.207, p<.001). Individual empowerment, interpersonal relationship empowerment, and political-social empowerment can be explained by education, job, economic status, and living arrangement. Conclusion: An empowerment intervention that includes general characteristics of clients is essential to improving empowerment of customized home visiting health care services beneficiaries.
Park, Nam-Hee;Jang, Rang;Kim, Jung-Young;Kim, Myoung-Soo
Research in Community and Public Health Nursing
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제23권1호
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pp.71-81
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2012
Purpose: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. Methods: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. Results: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as $8.88{\pm}3.20$ and $7.08{\pm}2.92$, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. Conclusion: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.
Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.
Purpose: This study aims to compare health status and health behavior among the hypertension group, the DM group, and the hypertension-DM group for aged clients of customized home visiting health care services. Methods: This study was conducted as cross-sectional research. The subjects of this study were 2,235 aged people over 65 living in J City. Data were collected using structured questionnaires and measurements. The collected data were analyzed using the SPSS/WIN 12.0 program, and descriptive statistics, $x^2$ test, t-test and ANOVA were used for the analyses. Results: BP and glucose control showed a significant difference among the groups. BMI and waist circumference were significantly higher in the hypertension-DM group than in the other groups. Stroke, arthritis, and perceived health status were significantly different among the three groups. Depression was high, but not significantly different among the groups. Smoking and drinking were not significantly different among the groups. Physical activity was very low, especially in the hypertension group. Medication was high, especially in the hypertension-DM group. Conclusion: It is necessary to consider care plans for the hypertension-DM group, and educate the group for care management. Also, depression and physical activity programs are needed for the age.
Journal of Korean Academic Society of Home Health Care Nursing
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제14권1호
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pp.18-22
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2007
Purpose: The rapid change to an aging society generates an increase in the incidence of chronic diseases. Many chronic patients have been facing their illnesses without enough preparation. In order to solve these problems, we designed and tested a public healthcare service based on ubiquitous technology. Method: Telemedicine has emerged as new medical care system of chronic disease. However, public potential of its technology is difficult to know under current traditional health care system. In this work, we developed a Personal Digital Access (PDA) phone based healthcare system by trained visiting nurses for elderly patients. A field test was performed by SeongBuk Public Health Center in Seoul, Republic of Korea (ROK). Result: Surveys were generated to assess the effects of this system compared to conventional public health system. Findings of trials demonstrate that healthcare coordination enhanced by PDA phone technology is satisfactory to the patients and nurses compared to previous one because prompt responses arouse their recognition of health. Conclusion: Ubiquitous healthcare system applied to public health service proved to be efficient and time-saving to monitor and control the chronic illnesses of large population.
Purpose: This study aims at comparing levels of service satisfaction with and needs for visiting nurse(VN) services among their beneficiaries in order to make a plan for extending VN services. Methods: The number of the subjects of this study is 270 in total. They were selected in random sampling in which 30 VN service recipients were randomly selected from each of 7 regions based on their grades and region types. Results: The highest total score for satisfaction with the VN services was 46.30, which the rural residents gave to their received VN services, then the metropolitan residents gave 44.57, and the small and middle size cities' residents 43.64. On the other hand, the highest total score for needs for VN services was 33.03, which the small and middle size cities' residents gave to their received VN services, then the rural residents gave 31.68, and the metropolitan residents 30.88. Conclusion: As the small and middle size cities' residents showed low satisfaction with and high needs for local VN services, policies need to be made to promote service providers' expertise and accessibility.
The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.
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