The purpose of this study was to describe the perceived burden of the terminally III patients's caregiver and to analyze relationship between the perceived burden and the various demographics, illness characteristics, family relationships, and economic factor of the family & patients. The sample of 132 caregivers who care for the terminally III patients Kyung-Gi province, Seoul, Korea. The period of this study was from August to September, 2002. The perceived burden of the family caregiver was measured by the burden scale(20 items, 4 point scale) developed by Montgomery et al. (1985). The Data was analyzed using SAS-program by t-test and ANOVA. The results were as follows; 1. The mean of the family caregiver's burden score was 3.02. The score showed that caregivers perceive severe the level of burden. The hight items of the family caregiver's burden were' I feel it is painful to watch patient's diseases'(3.77). 'I feel afraid for what the future holds for my patients'(3.66), 'I feel it reduced to amount of privacy time'(3.64). 2. The caregiver's burden was significantly related to patient's gender(F=3.17, p= 0.0020), patient's job(F=2.49, p=0.0476), caregiver's age(F=4.29, p=0.0030), and caregiver's job(F=2.49, p=0.0476). 3. The caregiver's burden according to illness characteristics showed no significant difference. 4. The caregiver's burden was significantly associated with patient's family relationship (F=4.05, p=0.0041), patient's care mean period in a day(F=47.18,
Purpose: This study investigates the social network, self-care agency, and quality of life of high-risk beneficiaries in case management of Medicaid and the correlations between these variables. It also identifies influencing factors on their quality of life. Methods: The subjects included 187 individuals chosen from the high-risk beneficiaries in case management of Medicaid in D Metropolitan City. Data was collected through direct interviews based on a structured questionnaire on home visits. Results: The perceived health status was the most influential factor in their quality of life, followed by self-care agency, mutual support network, and natural support network in order. These factors explained 40.6% of their quality of life. Conclusion: These findings raise a need to develop a nursing intervention program to increase the self-care agency of the high-risk beneficiaries in case management of Medicaid.
The aim of this study was to identify the performance and requirements of the visiting nursing care using Omaha system in public health center. The highest performance were 'personal hygiene', 'pain', 'medication regimen', 'nutrition', 'physical activity', 'sanitation', 'sleep and rest patterns', 'oral hygiene', 'mental health' in order. The lowest performance were 'sexuality', 'postpartum', 'income', 'family planning', 'pregnancy', 'spirituality', 'abuse', 'reproductive function', 'neglect' in order. Problems such as 'postpartum', 'pregnancy' and 'family planning' need to strengthen the role of visiting nurses according to the region. this result will be the basis for visitung nursing care.
Purpose: The purpose of this study was to investigate the knowledge and prevention attitudes of female North Korean refugees regarding cervical cancer and human papillomavirus(HPV) infection. Methods: A descriptive study was conducted. Data were collected from November 2015 to March 2016 and 130 female North Korean refugees participated. Data were analyzed using SPSS 21.0. Results: Score on knowledge and prevention attitudes regarding cervical cancer and HPV were 2.53 out of 8 points, 1.67 out of 17 points, and 28.90 out of 36 points. There were significant differences between entry duration, the number of children, previous cervical cancer tests, Precognition about HPV, preferred education method, and knowledge of cervical cancer. There were significant differences between previous cervical cancer tests, Precognition about HPV and knowledge of HPV. The correlation between knowledge and prevention attitudes regarding cervical cancer and HPV was significant positive. Conclusion: Female North Korean refugees' knowledge level of cervical cancer and HPV is very low. However, their attitudes towards prevention was higher. These results imply a need for education, aimed at guiding North Korean female refugees, so as to enhance their knowledge regarding cervical cancer and HPV, and to promote their sexual health.
The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.
Purpose: Expecting a new system of nursing security for elderly in operation in 2007, a substantial expansion of nursing facilities for elderly and quality management of those facilities are imperative now. Therefore. specific quality management measures or schemes which could be used for the operation of small-scale nursing homes are in urgent need. The purpose of this study was to develop a Quality Management Index(QMI) to guide Nursing Home management. Method: This study developed a QMI for small-scale nursing homes, which focused on quality management in structural dimensions such as environment, staffs, local community network, atmosphere, and quality management in process dimensions such as nursing, communication, resident satisfaction. The QMI developed in this study is based on extensive review of literature and the actual experiences of nursing home operation. It consists of 7 dimensions, 39 components and 148 indexes, which have been verified by three times validity tests of experts group. Then the QMI was used to evaluate the quality management levels of nursing homes in Korea. Result: In sum, after analyzing all nursing homes in Korea operated by nurses, this study found that there were significant differences of quality management level among facilities in several dimensions such as environment, staffs, local community connections, communication. In dimensions such as nursing, atmosphere, resident satisfaction, however, little differences of quality management level among facilities were reported. It is considered that this result has to do with several factors like the size of facilities, operation expenses, operation forms, the disposition of professional human resources, and philosophy and management policy of the owners. As far as generalization is concerned, however, it needs to be noted here that the sample size for this study is not statistically big enough to generalize the results. Conclusion: Having Developed a QMI for small-scale nursing home with 7 dimensions, 39 components and 148 indexes, this study is expected to be used in developing more elaborated quality evaluation tools for nursing homes, and also function as a practical guide of quality management for those who are opening and managing nursing homes. I hope this quality index could lead to further development of a standardized quality management index, and eventually contribute to quality improvement of nursing homes.
This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.
Park, Eun A;Jung, Aeri;Kim, Dasom;Hyun, Hye Sun;Shin, Sangsoo
Journal of Korean Academy of Rural Health Nursing
/
v.19
no.1
/
pp.55-65
/
2024
Purpose: This study was intended to gain an in-depth understanding of and explored the experiences and meanings of participating in care services among community-dwelling older adults. Methods: A focus group interview approach was adopted. Twenty older adults were interviewed from November to December 2021 using semi-structured interview questions. The data was analyzed using thematic analysis. Results: Three main themes and seven sub-themes emerged for the elderly people living alone. One main theme was "ambivalence of elderly care services," the second was "desperate need for care services," and the third was "positive changes and expectations experienced with care services." For the elderly people living with their families, two main themes and four sub-themes were identified. One main theme was "care services met within the family system," the second was "needs for care services outside the family system." Conclusion: We aim to provide a basis for strengthening the quality of elderly community care services in the mid- to long-term and establish a system of close linkages between necessary services by understanding the needs of elderly people who live alone or with their families.
In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.
Purpose: This study was conducted to investigate the correlation between health status, health-promoting behavior, self-esteem and suicidal ideation among the elderly. Method: Subjects consisted of 115 elderly persons. Data were collected from January to March 2013, and were analyzed using descriptive statistics, a t-test, ANOVA, Pearson's correlation analysis. Results: The mean scores for health status ($2.41{\pm}.68$), health-promoting behavior ($2.38{\pm}.43$), and self-esteem ($2.87{\pm}.69$) among the elderly fell in the average range, whereas scores for suicidal ideation ($.48{\pm}.36$) among the elderly fell in the below average range. Health status differed significantly according to age, educational level and economic status. Health-promoting behavior did not differ significantly based on these general characteristics. Self-esteem differed significantly according to age, job, and number of people living in the household. Suicidal ideation differed significantly based on age, educational level, and economic status. Significant correlations were found between health status, health-promoting behavior, self-esteem, and suicidal ideation. Conclusion: These findings indicate that perceived health status, health-promoting behavior, and self-esteem may be factors that need to be considered in order to decrease the prevalence of suicidal ideation among the elderly. These results can be used to develop a suicide prevention program for the elderly.
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