The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.
Purpose: The purpose of this study is to document the experiences of elderly persons with chronic diseases who are under hospital-based home care services and to find out how they describe the experiences using a narrative inquiry method. Methods: The participants are 7 elderly patients over the age of 70. Data collection and analysis were conducted through Jeong Gwang Soon's six-stages: observing phenomena, selecting participants, talking, talking again, writing, and confirming. Results: The results of data analysis were classified into 4 themes of overall experience related to chronic diseases: response to home health care, overcoming chronic disease, life reconstruction, and 22 categories as common denominators extracted from the elderly persons' lives. Conclusion: This research makes the experiences of the elderly living with chronic diseases more understandable, and it can be utilized as a effective nursing praxis to improve the quality of elderly persons with chronic diseases in hospital-based home care services.
Purpose: This systematic review aimed to investigate the effectiveness of home visiting programs targeting parents who have maltreated their children on the prevention of child maltreatment recurrence. Methods: Major databases were searched (Ovid-Medline, PubMed, Cochrane Library, CINAHL, and RISS). The frequency of maltreatment was measured for the meta-analysis, which was conducted using Review Manager 5.2 software. The effect size was measured using odds ratios (ORs). Results: Six studies were included in the analysis, none of which were conducted in South Korea. The meta-analysis demonstrated that the risk of child maltreatment recurrence significantly decreased after a home visiting program was implemented (OR=0.45, 95% confidence interval [CI]=0.29-0.68). Nurses were the most common intervention providers. Conclusion: Home visiting programs should be provided for families in which maltreatment has already occurred to prevent the recurrence of maltreatment and foster a home environment in which children can live safely. Since the rate of child maltreatment in Korea is increasing, further research is needed to develop and implement home visiting programs in which nurses play a major role in preventing the recurrence of child maltreatment.
Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.
Baek, Hee Chong;Lee, Young Ran;Lee, Jong Eun;Lee, Jin Hwa;Kim, Hyung Seon
Research in Community and Public Health Nursing
/
v.28
no.3
/
pp.324-333
/
2017
Purpose: The purpose of this study was to develop a simulation module for teaching home health care and evaluate the applicability of the program to nursing students' practical training. Methods: The simulation module was developed based on the National League for Nursing Jeffries Simulation Theory. The theme of the developed scenario was teaching nasogastric tube feeding to the caregiver of patient with Parkinson disease. Participants were 61 nursing students who had learned tube feeding, and participated in the questionnaire survey after the simulation training. Results: The evaluation of simulation design showed the highest score on feedback/guided reflection, and was highly evaluated in the order of objectives/information, problem solving and fidelity. The educational practice of the simulation was highly evaluated in the order of active learning, high expectation and diversity of learning. The nursing students showed high satisfaction and self-confidence after the simulation education. Conclusion: We suggest that the developed simulation module can be applied to practical training for home health care. In the future, the change of self-efficacy, clinical judgment and performance ability of the students after the simulation education should be identified. Also, various simulation modules related to the community health nursing competencies should be continuously developed and verified.
Park, Kyung-Min;Kim, Chung-Nam;Park, Myong-Hwa;Kim, Hye-Ryeon;Sin, A-Mi
Journal of Korean Public Health Nursing
/
v.24
no.1
/
pp.71-81
/
2010
Purpose: The aim of this study was to identify the effects of home visiting care program provided by public health center in control of blood sugar for patients with diabetes mellitus who were cared for at home. Method: The subjects were 50 randomly selected diabetics registered at S-Gu Public Health Center. The program comprised in-person education and home visitations; and telephone contact to educate, monitor diet, exercise, blood sugar, and provide consultation. The control group was provided home visitation by only home calls nurses. The program ran from July 7. 2008 to September 12. 2008. Result: After the program, glycated hemoglobin was decreased in the experimental and control groups; the difference in those receiving home care was not statistically significant. Changes on blood cholesterol in experimental group and control groups were not statistically different. Self-efficacy and self-care performance were increased in those receiving home care. Conclusion: While not statistically significant in this small-scale study, home care for diabetes mellitus patients may promote an increased patient responsibility for self-care that is important in their long-term health.
Home health care is moving into a set of new realities. An era of competition and cost containment has arrived. Before nurses are able to contain costs or describe the relationship between nursing activities, cost must be accurately measured based on the nurse's workload. Nurses in home health care usually desire to measure expenses for one of three reasons : reimbursement, management, or research. The purpose of the study was to investigate the work input by Registered Nurse in each of the home health care activities by relative value units and identify the factors affecting the nurses' total work input in health care services. To measure the work input by nurses, work was defined by four dimensions: time, physical effort, mental effort, and stress. This study used a descriptive-correlational design. Data collection consisted of two phases. In phase I, data on home health activities performed by nurses were collected. In phase II, data on nurses' time, physical effort, mental effort, and stress in each of home health care activities discovered phase I were collected. In this method, the respondent was asked to rate a service in relation to a reference service using a ratio scale. The sample included 39 home health care nurses. The results of the study indicated that home health care activities performed by the nurses were in 10 categories and 69 items. Measuring the relative work inputs in each of home health care activities, and foley catheterization was selected as the reference to service. In terms of time and physical effort dimensions, full bath service was rated as the most strenuous among 69 activities by the respondents, and intramuscular injection was rated as least. It was found that emergency treatment required the highest mental effort and the highest stress, while blood sugar tests required the lowest mental effort. Approximately 91.3% of the variance in total work input was accounted for by the linear combination of time, physical effort, mental effort judgement, and stress. Examining the regression coefficients of those variables, physical effort, time, and stress were found as the predictors which were significantly associated with the total work of nurses in home health care. Professional nursing's next step in the conundrum of economic volatility is to develop a tool to reflect the interaction of functional deficiency and direct professional nursing care. And this will be a more accurate predictor of nursing resource use and ultimately a great forcaeter cost.
Purpose: This study aimed to investigate the self-care education experience, self-care performance, and home care service needs of patients with rare and incurable diseases who use a home ventilator. Methods: From2 ventilator rental companies and 5 hospitals, records of 162 subjects were collected to obtain data regarding self-care education experience (23 items) and home care service needs (25 items). Results: Of the subjects, 65.4% were male and 55.6% had a myotrophic lateral sclerosis. The items with the highest and lowest levels of self-care education experience were "using the ventilator"(94.0%) and "community-available resource information"(27.0%), respectively. Meanwhile, self-care was performed well in terms of "personal hygiene"(59.6%) but not performed well in "community-available resource information"(23.7%). "Health status assessment" had the highest need(88.2%) of home care services. Generally, the need of home care services was higher for the patients using invasive ventilators than that for those using non-invasive ventilators. Conclusion: Home care nurses need to not only provide physical care for the patients but also strengthen their roles of enhancing patient access to and utilization of various community resources to provide systematic and individualized training and care.
Purpose: This study defines a vulnerable group in a community that has become the main target of a national health project also, it is descriptive research to suggest an evidence-based direction to meet their deficit health-related needs, Method: This research examined 833 families and 1,835 family members of the financially vulnerable class that was registered in a home visiting program of a public health center. Among them, 892 persons who had health problems, and their family members were examined in detail to find out their characteristics of vulnerability and health needs by assessment during a nurses home visit. Frequency distribution, stepwise-regression and factor analysis were used to analyze the data. Result: The vulnerable group that was defined with social indexes set as standards, involved substantial characteristics of vulnerability. The characteristics of demand showed tendencies of being clustered in 5 factors needs of intensive nursing care, chronic nursing care problems and helplessness, maintenance of family functioning with a disability, deficient problem solving ability, and simple financial fragility. Conclusion: Categorization of needs is an evidence-based estimator of workload in nurse home visiting services, and can be used as a basic resource for direction to meet the deficit needs of a vulnerable group.
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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