• Title/Summary/Keyword: Home health nursing

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The Effect of Mother-fetus Interaction Promotion Program of Talking and Tactual Stimulation on Mother-fetus Interaction and Mother-infant play Interaction (태담과 촉각 자극의 모-태아 상호작용 증진 프로그램이 모아 상호작용에 미치는 효과)

  • Kim, Jung-Soon
    • Korean Parent-Child Health Journal
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    • v.5 no.2
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    • pp.253-276
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    • 2002
  • Mother and infant relationship has a great influence on child's developments. Expecially, mother and infant relationship is affected by mother and infant interactions during one year after birth and an omen of mother-infant interaction after birth is mother-fetus interaction. This study was conducted to develop mother-fetus interaction promotion program of talking and tactual stimulation aimed at enhancing sensitivity of primiparas and to evaluate the effect of the nursing intervention program on mother-fetus interaction and mother-infant play interaction. Non-eguivalent control group posttest design was used, and Blumer's symbolic interaction theory and Barnard's mother-infant interaction model was used a conceptual framework of this study. Fifty primiparas and infant(26 mother-infant dyads for intervention group and 24 dyads for control group) were recruited from three general hospital and an OBGY clinic located in Kwang Nung city. Data was collected from January 30th to December 20th in 2001. For the intervention group, programed education which focused on mother-fetus interaction in the 1st trimester. Telephone counselling was provided with interval of two weeks. For two groups, home visiting for data collection of mother- fetus interaction was conducted at 36 to 38 weeks of gestational age. And mother-infant play interactions were assessed at 4 to 6 weeks after birth using videotapes. Play situations were videotaped and two trained observers analyzed the tapes. The data were analyzed using chi-square test and Fisher's Exact Test to test the equivalence of two groups, and the effect of intervention progrom was determined with t-test and Wilcoxon Rank Sum test. The results were as follows: 1. The significant difference was found in mother-fetus interaction between two groups(t=2.085, P=0.0425). It indicated that intervention progrom was effective in improving mother-fetus interaction. 2. The significant difference was found in mother-infant play interaction between two groups(W=347.5, P=0.0001). In subscale analysis, three subscales showed significant differences between the groups: interactional behavior of mother(t=5.921, P=0.0001), interactional behavior of infant(t=5.736, P= 0.0000), and synchronic interactional behavior of mother and infant(t=7.940, P= 0.0000). In conclusion, this study has shown that the applied nursing intervention aimed at enhancing sensitivity of primiparas promoted mother-fetus interaction and mother-infant play interaction. Therefore, this study suggests that this nursing interventions to increase maternal sensitivity to the fetus's movement should be broadly applied to primiparas, which can be beneficial for formation of mother - infant relationship, and for promotion the social, affective, and cognitive developments of their children.

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Umbilical cord care differences in the time of cord separation and the skin condition of periumbilical area (신생아 제대관리방법에 따른 제대탈락 시기와 제대주위 피부상태 비교)

  • Park Young Ae;Kim Dong Yeon;Choi Mun Jin;Park Ho Ran
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.158-166
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    • 2000
  • The purpose of this study was to confirm the efficient umbilical cord care of healthy newborns in nursery. In order to determine the efficient care, the time of umbilical cord separation and the skin condition of periumbilical area were evaluated. The data were collected in sample of 529 normal, healthy newborns of C hospital in Seoul, from September 1st, 1999 to January 16th, 2000. The babies were randomly selected and allocated into four groups-alcohol swab/tub bath, alcohol swab/partial bath, natural dry/tub bath, natural dry/partial bath- by the methods of care. The mothers of babies were also surveyed by questionnaire about general characteristics. The data were analyzed by SAS program. The results of this study were as follows : 1. The average gestation period of newborns was 39+3 weeks. The average birth weight was 3.27Kg. In gender of babies, boys were 51.7% and girls were 48.3%. The 65% of newborns were born normal vaginal delivery, 35% were C-section. The feeding methods were 55.3% of the babies fed by mixed type, 22.9% by breast, and 21.8% by bottle. There was no significance among four groups by general characteristics. 2. The average time of umbilical cord separation was 8.27 days(SD=2.3). The time was no difference significantly among four groups(F=1.68, P=0.17). 3. The prevalence of the umbilical care complication did not show differences among four groups( 2=3.93, P=0.27). In conclusion, Nurses have preferred the traditional alcohol swab/partial bath method in care of newborns. But there was no difference among the ways to take care of umbilicus according to this study. The way to naturally is more efficient due to reduce the time and expense in umbilical care for normal babies of nursery. This also matched the change in approach to healthy population from intervention to nonintervention way. This could be suggested in education for normal and healthy babies care at home and nursery as a useful way. Endly, the further study about bacterial colony nda infection rate at umbilicus by ways of care is needed.

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The Need for Rehabilitation Day Care Program Service of Stroke Survivors (재가 뇌졸중환자의 주간재활간호 프로그램 서비스 요구조사)

  • Jeong, Seong-Hee;Suh, Moon-Ja
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.29-44
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    • 1999
  • This study was carried out to obtain basic data required to plan and develop Rehabilitation Day Care Program for the stroke Survivors at home in Korea. The subjects comprised of 118 stroke survivors who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3, 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of dally living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN program. The results obtained are as follows ; 1. The mean score of the general need of rehabilitation day care program of stroke survivors was 2.78(range 1-4). The highest need among the service categories of the rehabilitation day care program was self-care and restorative activities category, and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows ; 1) In the health services referral category, the need for speech therapy was highest, followed by the need for physical therapy and occupational therapy. 2) In the psychosocial activities category, the need for self-help group was highest. 3) In the self-care and restorative activities category, the need for bathing was highest, followed by bowel training, and ambulation training. 4) The need for the recreation category was 2.62. 2. Among the need for the effect related to the utilization of day care program, the need for survivors' physical and psychological well-being was highest and was followed by the need for caregiver's physical and psychological wellbeing. Pearson's correlation analysis revealed following results ; 1. The need for rehabilitation day care program service displayed a correlation with the level of education, ADL, and the level of depression, and a reverse correlation with age. 2. The need for the effect related to the utilization of rehabilitation day program displayed a correlation with the level of education, ADL, and the level of depression. The stepwise multiple linear regression analysis revealed following results : 1. For the need for rehabilitation day care program service, 28.4% of the variance was initially explained by one variable, level of depression. The level of depression plus two variables, survivors' age and ADL, explained 34.2% of the variance in the need for rehabilitation day care program service. 2. For the need for the effect related to the utilization of rehabilitation day care program, 12.4% of the variance was initially explained by one variable, level of depression. The level of depression plus one variable, level of education, explained 20.4% of the variance in the need for the effect related to the utilization of rehabilitation day care program. In conclusion, above characteristics should be considered when we are planning to develop stroke survivors' rehabilitation day care program.

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Yoga Self-help Management Program for the Patients with Fibromyalgia syndrome Effect on Health status and Depression (요가자조관리 프로그램이 섬유근통증후군환자의 건강상태와 우울에 미치는 영향)

  • Lim, Kyoung-Suk
    • Journal of Digital Convergence
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    • v.16 no.3
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    • pp.457-468
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    • 2018
  • The purpose of this study was to investigate the effect of yoga self-help management program on the health status and depression of patients with fibromyalgia syndrome. The subjects who participated in the study were patients diagnosed with fibromyalgia syndrome at a university hospital in G city. The total number of participants was 43, 21 in the experimental group and 22 in the control group. For the experimental group, a total of 16 yoga self-help management programs were held twice a week for eight weeks at the yoga center, and yoga DVDs, photographs, and educational booklets developed for the home were provided. The control group was subjected to pre - test and post - test without intervention. Data were analyzed using SPSS/WIN 18.0 program. As a result of the study, it was found that the experimental group had significantly improved health status(Tender point, FIQ) and the depression was lower than the control group, which was effective in the intervention strategy of the fibromyalgia syndrome patients.

Life Stress, Social support, and Depression of Arthritis Patients Living in a Rural Town (일 농촌 지역 거주 관절염 환자의 생활스트레스, 사회적 지지, 우울)

  • Suh, Moon-Ja;Kim, Keum-Soon;Noh, Kuk-Hee;Jung, Sung-Hee;Kim, Eun-Man;Kim, In-Ja
    • Journal of muscle and joint health
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    • v.9 no.1
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    • pp.68-81
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    • 2002
  • Arthritis patients living in a rural town are thought to have more problems in terms of life stress, social support, and depression than those living in an urban city. But there were few studies which investigated the status of arthritis patients living in a rural town. This study investigated how much life stress they got, which life events were perceived as stress, what kind of social support were most perceived, and how much they were depressed. Fifty six arthritis patients were surveyed using structured questionnaire. Life stress, social support, and depression were assessed using the following scales: Life changes scale, Duke's short scale to measure social support, and CES-D(Center for Epidemiologic Study- Depression), respectively. They were found to perceive life stress in home-work, health and work, in order. And they were found to perceive relatively good social support. But they sot most of social support from their family members especially their spouses and children. Lastly, it was found that they were moderately depressed. Based upon these results, it is suggested that integrative rehabilitation programs which provide professional support and reduce depression are necessary for arthritis patients living in rural towns.

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Determining Factors of Intention to Actual Use of Charged Long-term Care Services for the Aged (유료노인장기요양보호서비스 이용의사 결정요인)

  • Yoo, Jin-Yeong;Chun, Jin-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.1
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    • pp.16-24
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    • 2005
  • Objectives : To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. Methods : Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. Results : About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socioeconomic level. Desired charges were about 10,000 won for the bath service, 20,000 won for the rests services per day, and about 500,000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as $63{\sim}71%$. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. Conclusions : Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.

The Correlation between Cognition, Depression and Leisure Activity of Elderly People (65세 이상 노인의 인지기능, 우울 및 여가활동 간의 관련성)

  • Lee, Jin-Wook;Lim, Gang-Hyun;Kim, Ha-Rin;Bang, You-Kyung;Lee, Ji-Young;Cho, Mi-Lim;Kim, Deok-Ju;Yang, Yeong-Ae
    • The Korean Journal of Health Service Management
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    • v.8 no.1
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    • pp.65-73
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    • 2014
  • The purpose of this study is to analyze the correlation between cognition, depression and leisure activity in elderly people above 65 years of age, and to improve their health and quality of life by providing baseline data for occupational therapy intervention. This investigation was performed on 118 elderly people above 65 years of age who lived in local community and two senior welfare centers. In order to collect the data, we used MMSE-K, KDS, Questionnaire for leisure activity. The depression of elderly people was negatively correlated with their cognition(p<.01) and leisure activity(p<.001), whereas cognition was positively correlated with their leisure activity(p<.01). In conclusion, the correlation between cognition, depression and leisure activity of elderly people appeared statistically significant. Therefore, leisure activity program should be designed through additional research and effectively provided in nursing home and community senior welfare center to prevent depression increase and cognitive decline.

A Study on the Postpartum depression in Postpartum Women. (산욕기 산모의 산후우울정도와 영향요인)

  • Yang, Young-Ok;Choi, So-Young;Ryu, En-Joung;Kim, Young-Hae
    • Korean Parent-Child Health Journal
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    • v.6 no.2
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    • pp.159-168
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    • 2003
  • The purpose of this study was to provide the basic data for developing a program for effective prevention for postpartum depression (PPD) by investigate the level of PPD in postpartum women. The subjects were 104 women. The data were collected from march, 2003 to June, using a 36 item questionnaire and analyzed by SPSS program for t-test, ANOVA, multiple regression. The results were as follow 1. The score of Postpartum depression was 44.1. The level of PPD according to General Characteristics was significantly difference according to home care need. 2. The level of PPD according to obstetrical characteristics was significantly differences according to postpartum complication(p<.05). depression in pregnancy(p<.01), baby's health state(p<.01). 3. The variables to predict postpartum depression in postpartum women are depression related to depression during pregnancy, complication after delivery, and a baby's condition. As the result of multiple regression analysis, variables bringing about postpartum discomfort were depression during pregnancy, complication after delivery, and a baby's condition, and this model showed the explanatory power at 28.8%. In conclusion, it is necessary to care mothers belonging to a risk group more concentrically by taking the factors causing postpartum depression into account, and to keep on studying repeatedly in order to raise the number of objects and to find related variables because this study has more or less limited objects not enough to generalize a bit. It is also necessary to study to make a program of arbitration in nursing of postpartum depression actually.

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Critical Pathway for Spinal Stenosis Patients (척추관 협착증 환자 진료 프로세스 개발)

  • Lee, Hwan Mo;Kim, Ho Jung;Kim, Keung Nyun;Ahn, Poong Gi;Chun, Jahae;Shin, Hyun-Ju;Kim, Yang Soo;Shin, Hye Sun;Kim, In Sook;Chung, Hye Kyung;Kim, Young Ah;Chae, Hyung Ki;Park, In Young
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.83-86
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    • 2009
  • 연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

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The U.S. Experience of the DRG Payment System and Suggestions to Korea (DRG 지불제도에 대한 미국의 경험과 우리 나라에의 시사점)

  • Park, Eun-Cheol;Lee, Sun-Hee;Lee, Sang-Gyu
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.105-120
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    • 2002
  • In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

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