Purpose: The purposes of this study were to examine the relationships among activities of daily living, self-efficiency, nursing home care quality and nursing home adaptation, and to identify the influencing factors of nursing home adaptation in nursing home residents. Methods: The study employed a descriptive correlational design. The data were collected from 148 older adults without dementia by interview from six nursing homes in three cities from February 1, 2008 to February 28, 2008. Results: Levels of nursing home adaptation in older adult residents were different by type of decision maker of nursing home admission, reason of nursing home admission, type of payment and length of nursing home stay. The nursing home adaptation was significantly correlated with self-efficiency and nursing home care quality. The strongest predictor of nursing home adaptation was type of decision maker of nursing home admission followed by the self-efficiency. Conclusion: The study suggested that during the decision making period of nursing home admission, older adults should have enough time and careful considerations of their families to decide by themselves in positive ways. Nursing home staff should be able to identify reasons of nursing home admission and demands or expectations of older adults and their families.
Journal of Korean Academy of Nursing Administration
/
v.5
no.3
/
pp.415-424
/
1999
The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.
The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.
Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.
Since patients with strokes occupy a high priority among patients for home nursing, the development of guidelines for such nursing is required and the needs of these patients should be reflected in the guidelines. Therefore, this study was done to identify the content and levels of home nursing for patients with strokes and to utilize the data in developing the most effective home nursing guidelines for these patients. The level of A, D. L. and the ability to control upper extremities were measured, and through a questionnaire. the needs for home nursing and related variables were also evaluated. The subjects for the study were 121 patients, 58 inpatients and 63 home care patients who had had a Stroke. Data collection was done from September 1996 to January 1997. The collected data were analyzed utilizing SPSS /PC, and the results are as follows : 1. Home nursing need of inpatients The priority order of home nursing needs for inpatients was : "Training in emergency treatments and how to cope with a stroke"(2.28+1.06), next, "Explanation of diets as limited or recommended", and last, "Nursing care for sleeping Problems". 2. Home nursing need home of patients The priority order of home nursing needs for home patients was : "Care for the paralyzed side" (2, 89+.34), next, "Maintenance of right posture and how to change position" (2.87+.34), and last, "Counseling on sex". 3. Comparison of the levels of home nursing needs between in patients and home patients The results of analyses of home nursing needs according to causes were grouped into seven categories : and t-tests of the seven categories showed significant differences between the two groups in all categories, that is, the level of home nursing needs were significantly higher for home patients than for inpatients in all categories of home nursing. 4. Level of home nursing needs by characteristics The variables that have affected the level of home nursing needs for these patients were sex, profession, level of education, accompanying diseases, paralyzed position. A.D.L. levels and ability levels in coordinating upper extremities. There variables, displayed a reverse correlation with the level of home nursing needs, and the degree of correlation was high. In conclusion, the above results, show there were differences in the priority order of home nursing needs between inpatients and home patients : but the content of home nursing needs wanted by these patients was similar. Meanwhile, the levels of demand for home nursing was exceptionally higher on the part of home patients than inpatients. Although it is realized that nursing guidelines for home nursing needs in all items need to be developed, there is also a necessity to guidelines in accordance with priority orders, and with consideration of the factors that affect the level of home nursing needs. of the factors that affect the level of home nursing needs.
Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.
The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.
This study was conducted to identify the current situation of home care nursing research and to propose future research in the area of home care nursing in Korea. The design was a retrospective descriptive study based on 171 studies. The studies were collected from nursing academic magazines, the national library web site and dissertations on home care. The data were classified according to the independent and dependent variables which were represented in the research title. The final category classification was defined by considering the research objectives and content as found in the 171 studies. Eight categories were created to describe the results of home care nursing research in Korea. They included: home care needs. home care services. home care costs. development of home care programs and equipment. management of home care services. effectiveness of home care services, development of an educational curriculum for home care, and recognition of home care services. Based on our research we have identified other future research areas that need to be developed such as community needs assessment, standards and guidelines for home care nursing, quality assurance and quality improvement for controlling home care quality, home care informatics. and a system of home care cost and ethics.
This study is investigate the eating behavior between the elderly living at home and the elderly at nursing home in Inchon City. This survey was carried out by questionaires. The result are summarized as the followings: 1. Both the elderly living at home and the elderly at nursing home are not smoking and drinking. They are in good health. 2. The elderly living at home and the elderly at nursing home have diseases like neuralgia, hypertension, diabetes etc. 3. Both the elderly living at home and the elderly at nursing home have methods of health care of a regular eating and a good sleeping. The elderly at nursing home have a regular medical examination but the elderly living at home do not. 4. Health giving drugs are depression of blood pressure, a medicine for the stomach and bowels, an anodyne. And health giving sports are walking and jogging. 5. The elderly living at home and the elderly at nursing home are significant relationship on knowledge of nutrition. 6. The elderly living at home and the elderly at nursing home prefer to taste sweet, boiling, korean foods. 7. elderly living at home have meats once a week and the elderly at nursing home have twice a week. Both the elderly living at home and the elderly at nursing home have fish, fruits, vegetables twice a week. The elderly at nursing home have milks twice a week. 8. The frequency of snack intake is higher the elderly at nursing home than the elderly living at home. 9. The elderly living at home and the elderly at nursing home are satisfied their dietary life.
Chunchoen Community Home Nursing Program (CCHNP) sponsored by Chuncheon City and Gangwondo Nurses Association was the first trial of community based home health nursing in Korea. The services have started since 1996. The purpose of the study was the evaluation CCHNP to establish standard of community based nursing program in Korea. The methods of evaluation were quantitative and Qualitative approaches. Evaluation for organization and management were conducted by the American Community Health Accreditation Program Standards With the result. several recommendations were suggested : It is necessary to expand the program to all the Gangwondo cities. And the liaison system is necessary between medical care facilities and community nursing home agency to establish the continuity of health care delivery system in home nursing program. Also it is necessary to set up the supporting system between community home nursing care agency and hospital home nursing department. Finally, the National Health Insurance should cover the cost of community home nursing care.
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