• 제목/요약/키워드: Home health care need

검색결과 349건 처리시간 0.027초

가정전문간호사의 자아존중감, 영적안녕이 영적간호수행에 미치는 영향 (Influence of Home Health Care Nurses' Self-esteem and Spiritual Well-being on their Spiritual Care)

  • 김채원;박미현
    • 가정∙방문간호학회지
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    • 제28권3호
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    • pp.233-242
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    • 2021
  • Purpose: This study investigated the degree of, and factors influencing the spiritual care among home healthcare nurses. Methods: The subjects were 168 advanced practice nurses working in 94 hospital-based facilities for home health care located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from January 14, 2019, to March 7, 2019, using structured questionnaires on spiritual care and related variables based on the literature. Data were analyzed by t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis (stepwise) using SPSS Version 23.0 program. Results: The results showed that the degree of spiritual care of home health care nurses was 3.44 points out of a possible 5 points. Factors affecting nurses' spiritual care were spiritual well-being(𝛽=.36, p<.001), recognition of spiritual care as the nature of nursing(𝛽=.17, p=.016) and role of nurses(𝛽=.22 p=.002), regular-based education for spiritual care(𝛽=.23, p<.001), patients' discomfort with spiritual discussion(𝛽=-.18, p=.001), and nurses' experience in home health care area(𝛽=.14, p=.010), which explained 57.2% of the observed variation in spiritual care. Conclusion: This study suggests the need to develop regular-based education programs for facilitating spiritual care and strengthening home health care nurses' spiritual well-being and their positive perceptions toward spiritual care.

노인장기요양 재가서비스 이용자의 시설 입소 영향 요인 (Factors Related to Nursing Home Institutionalization of Elderly using Home Care Services)

  • 한은정;황라일;이정석
    • 한국보건간호학회지
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    • 제30권3호
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    • pp.512-525
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    • 2016
  • Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교 (A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients.)

  • 김용순;임영신;전춘영;이정자;박지원
    • 대한간호
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    • 제29권2호
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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노인대상 의료기관 가정간호사업의 운영실태 (An Analysis of the Elderly Care and Management in Hospital-Based Home Care Agencies)

  • 송종례;강임옥;김윤옥;조혜숙;황문숙
    • 지역사회간호학회지
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    • 제19권4호
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    • pp.660-672
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    • 2008
  • Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

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NIC에 근거한 척수손상환자의 가정간호 중재 프로토콜 개발 (Development of Home Care Nursing Intervention Protocols for Spinal Cord Injury Patients Based on NIC)

  • 문성미;김선희
    • 가정∙방문간호학회지
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    • 제8권1호
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    • pp.25-37
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    • 2001
  • Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

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한국과 독일 방문요양의 등급별 급여 비교 연구 (A Comparative Study on the Care Services According to Care Levels in the Korean and German Home Care System)

  • 박종덕
    • 가정∙방문간호학회지
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    • 제23권2호
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    • pp.243-252
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    • 2016
  • Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

The Follow-up Study of Changes in Frailty in Elderly Receiving Home Health Care of the Public Health Center

  • Lee, Dong Ok;Chin, Young Ran
    • 지역사회간호학회지
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    • 제30권4호
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    • pp.528-538
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    • 2019
  • Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.

일개 병원에 내원하는 관절염 환자의 가정간호 요구 (Needs of Home Care Services for the Arthritic Patients of One Hospital)

  • 이은옥;유경희
    • 근관절건강학회지
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    • 제1권1호
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    • pp.88-96
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    • 1994
  • Treatment for the arthritic is mostly on the out-patient basis. The present rheumatologists practicing in Korea do not cover the total number of the patients. Also patients with arthritis need medical treatment for long period of time. Therefore, the number of patients waiting for the treatment is huge in number. This vicious cycle need to be broken in some way. Purpose of this study is to identify the need for home care of the arthritic patients. Nineteen hundred and sixty two subjects were interviewed in one hospital for one month. The following findings were observed : 1. The rates for demanding home care were from 60% to 100% depending on the areas. 2. Reasons for no need of home care were mainly credibility and short distance from the hospital. 3. Time spent for one way transportation was more than 3.3 hours except from Seoul and Kyungki area. The longer they spend time for transportation, the more they want home care services. 4. The number of patients who asked other persons to travel for prescription was 446(22.73%) and average number was 3.26 per year in those 446 cases. 5. Average expenses for transportation and other cost for each time of hospital visit were 21,073won ranged from 8,373 won to 132,571 won. The more spend money for visiting the hospital, the more they want home care services. In order to reduce the physical and economical burden of the arthritic patients living in remote areas, hospital-based home care services are justified on the bases of patients' demand and legislative support.

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가정간호대상자와 입원간호대상자의 간호만족도 및 간호사이미지 비교 (A Study of Nursing Care Satisfaction and the Image of Nurses As Compared Between Home Health Care and Hospitalized Clients)

  • 용진선;한성숙;유인자;홍현자
    • 가정∙방문간호학회지
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    • 제9권1호
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    • pp.14-26
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    • 2002
  • The purpose of the study was to compare both the nursing care satisfaction and the image of nurses as experienced by home health care clients and hospitalized clients. For the descriptive survey study. data were collected from 69 home heath care clients and 342 in-patients in a university hospital. The tools used for the study were modified by Quality Patient Care Scale(Wandelt & Ager. 1974) and Image of Nurses (송인자, 1993). The data were analyzed using Pearson Correlation. Scheffe test. factor analysis. t-test. and ANOVA. The major findings were as follows: Regarding nursing care satisfaction, the mean score of total nursing care satisfaction in home health care clients was 3.28 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the general. the professional. the physical. and the communication domain. The level of nursing care satisfaction was not significantly different according to demographic variables except for age: the age group of 41-60 showed the highest score (p<0.05). The mean score of total nursing care satisfaction in hospitalized clients was 2.95 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the physical and the communication. the professional. and the general domain. The level of nursing care satisfaction was not significantly different according to demographic variables except age: the higher the age the higher the score (p<0.05). The levels of nursing care satisfaction in all five domains were significantly higher in home health care clients than in hospitalized clients(p=0.0005). Regarding image of nurses, the mean score of total image of nurses in home health care clients was 3.32 out of 4.0. Among four domains, the domain with the highest score was the sincerity domain, followed by the kindness. the spirit. and the knowledge and skill domain. The level of image of nurses was not significantly different according to demographic variables. The mean score of total image of nurses in hospitalized clients was 3.05 out of 4.0. Among four domains. the domain with the highest score was the sincerity domain, followed by the kindness, the knowledge and skill, and the spirit domain. The level of image of nurses was not significantly different according to demographic variables. The levels of image of nurses in all four domains were significantly higher in home health care clients than in hospitalized clients (p=0.001). Both the levels of nursing care satisfaction and image of nurses, part of an evaluation for quality of nursing care were significantly higher in home health care clients than in hospitalized clients. In light of the findings, we could consider that home health care nurses provided client-centered comprehensive nursing care. However, nurses need to have methods that more promote the social recognition of the image of nurses and nursing care services as well as professional knowledge and skills.

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농어촌지역의 가정간호 요구자와 비요구자의 특성 비교 (A Comparison of Characteristics between Home Health Care Needers and Non-needers in Rural Areas)

  • 이동숙;조유향
    • 지역사회간호학회지
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    • 제16권2호
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    • pp.115-126
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    • 2005
  • Purpose: The aims of this study were to describe general characteristics and needs of home health care, and to find the differences between home health care needers and non-needers. Method: In this study, 642 subjects participated who lived in Muan, Jollanam-do. Data were collected in August 2001 using a self-reported questionnaire. The questionnaire was a revised and simplified form of the Organization of Community Health System Program at the Seoul National University. Collected data were analyzed through Kruskal-Wallis test. t-test. and Chi-squire for cross-sectional analysis. Result: The average age of the subjects was 52.6 years and 33.3% of them aged over 65 years. Twenty six percent of them had chronic degenerative diseases. The percentages of hypertension patients and D.M. patients were 6.4% and 2.5%, respectively. The number of family members was 2.95 on the average, 2.19 in cases of families with the elderly and 3.33 in cases of families without the elderly. The rate of disability of the elderly was 10.5%. Marital status (p=.000), the number of family members (p=.000), education (p=.000), job (p=.000) and health insurance (p=.027) were significantly different between home care needers and non-needers. Home care needers had less living expenses (p=.001), more frequent hospital admissions (p=.004), higher chronic disease rate (p=.000) and more frequent visits to public health center (p=.027) than non-needers. Home care needers who wanted free service were twice as many as non-needers. Conclusion: Home care need was very high in rural areas and the needers had worse characteristics (low educational level. low income, no job and no family). Therefore, it is necessary to develop cheaper and more accessible services for home care needers in rural areas.

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