• Title/Summary/Keyword: Home visit health services

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Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services (재가간호서비스 제공자의 업무 수행 현황과 장애요인)

  • Oh, Eui Geum;Lee, Hyun Joo;Kim, Yukyung;Sung, Ji Hyun;Park, Young-Su;Yoo, Jae Yong;Woo, Soohee
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.742-751
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    • 2015
  • Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

Effect of Home-Visit Occupational Therapy on Community Dwelling Stroke Survivors: A Case Study (지역사회 거주 뇌졸중 환자의 가정방문 작업치료 효과: 사례 연구)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.87-98
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    • 2020
  • Objective : The purpose of this study was to verify the effectiveness of home-visit occupational therapy in stroke patients. Methods : Two patients with stroke who applied for home-based occupational therapy services at a health center in Seoul were enrolled. The home-visit occupational therapy program evaluates the subject's daily living, task performance, cognitive, and emotional functions, sets occupational therapy goals and plans interventions based on a client-centered approach. Occupational therapy programs consisted of 12 sessions based on the client's major problems. Results : COPM scores improved in both cases, there was an improvement in COPM scores, and in Case 2 there were improvements in MBI and K-MMSE scores. There was also an improvement in KGDS scores in Case 1. Conclusion : Home-visit occupational therapy was found to be effective in improving daily activities, cognition, and mental function of stroke patients. During home and community integration, continuous and continuous rehabilitation services need to be activated from institutional rehabilitation to community-based rehabilitation. Active home-visit occupational therapy is needed to promote physical, cognitive, mental and social access in stroke patients discharged from hospitals.

Improvement of Activities of Daily Living through Visiting Nursing Care under Long-Term Care Insurance: A Case Report using the OMAHA System (방문간호를 통한 일상생활동작 수행능력 개선에 대한 사례보고: 오마하시스템을 활용하여)

  • Song, Yeon Yi;Park, Eun Jin
    • Journal of Korean Academy of Rural Health Nursing
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    • v.15 no.2
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    • pp.66-73
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    • 2020
  • Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.

A Consideration on the Instituting Home Health Care in Korea (우리나라 가정간호제도화 방안에 관한 고찰)

  • Yun, Soon-Nyoung;Hwang, Na-Mi;Hyun, Hye-Jin;Choi, Joung-Myoung;Kwon, Mi-Kyung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.2
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    • pp.5-18
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    • 1995
  • While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

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The Barriers and Solution of Providing Long-term Care Services at Home for the Beneficiaries with Mild Dementia: A Focus Group Interview (치매특별등급 대상자 재가요양관리의 장애요인과 해결방안 - 포커스 그룹 인터뷰 활용 -)

  • Song, Mi Sook;Lim, Kyung Sook
    • Journal of Korean Public Health Nursing
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    • v.30 no.2
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    • pp.259-273
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    • 2016
  • Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.

Working with Vulnerable Families: A Nurse Home Visiting Perspective (취약계층의 방문간호 서비스 요구 특성)

  • Lee Insook
    • Journal of Korean Academy of Nursing
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    • v.34 no.6
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    • pp.1025-1034
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    • 2004
  • 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.

The Effect of Case Management for Clients with Hypertension.DM Registered in Customized Home Visiting Health Care Services (일 지역 맞춤형 방문건강관리사업의 고혈압.당뇨병 사례관리 효과분석)

  • Park, Jeong-Sook;Oh, Yun-Jung
    • Journal of Korean Public Health Nursing
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    • v.24 no.1
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    • pp.135-150
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    • 2010
  • Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.

Levels of Health-related Quality of Life (EQ-5D) and Its Related Factors among Vulnerable Elders Receiving Home Visiting Health Care Services in Some Rural Areas (일부 농촌지역 맞춤형 방문건강관리 대상 취약계층 노인들의 건강 관련 삶의 질 (EQ-5D) 수준 및 관련요인)

  • Kim, Jong Im
    • Research in Community and Public Health Nursing
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    • v.24 no.1
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    • pp.99-109
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    • 2013
  • Purpose: The purpose of this study is to identify levels of quality of health-related life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Methods: The subjects of this study were vulnerable elders aged 65 or higher receiving visiting health care benefits by a public health center in a county. Results: Levels of health-related EQ-5D were high when the subjects were males, their ADL and IADL were high. The EQ-5D of the vulnerable elders and social supports had a positive correlation, while their IADL and depression had a negative correlation with the EQ-5D. We can see that the EQ-5D related factors are variables that have significance influence on gender, subjective health status, BMI, IADL, depression levels, and social support. Conclusion: To improve the EQ-5D of the vulnerable elderly, it needs maintenance of independent IADL levels, social supporting systems using small meeting of the elderly in community. It is necessary to maintain independent IADL levels, enhance social supporting systems including small group gatherings for elders living alone by means of places like community halls, and develop specific intervention programs for the prevention and management of depressive elders.

Evaluation of Shortening the Stay Time of Patients in an Emergency Medical Center (EMC) (응급실 환자의 응급의료센터 체류시간 단축프로그램 개발 및 효과)

  • Kim, Eun-Joo;Lim, Ji-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.1
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    • pp.21-27
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    • 2010
  • Purpose: The study evaluated a program to shorten EMC stay time. Methods: The subjects were EMC patients, and comprised a control group of 8,477 and an experimental group of 8,378. Data were collected from June 2006 to August 2007, and analyzed concerning stay time for doctor visit, decision making, and discharge. The data were analyzed by $X^2$-test and ANCOVA using SPSS14.0. Result: The stay time of doctor visit, decision making and discharge of the experimental group was significantly less compared to the control group. Using second and third grade triage criteria, the stay time of experimental group was statistically reduced from the control. Conclusion: The implemented shortening program was effective in reducing EMC stay time and increasing EMC effectiveness.

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A Study on the Characteristics and Satisfaction of the Recipients of Home Care (재가복지대상자의 특성과 서비스 만족도)

  • Han, Hye-Kyung
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.429-448
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    • 1999
  • The objectives of this research are (1) to identify characteristics and needs of the recipients of home care, and type of services (2) to examine the factors that predicts the degrees of recipients' satisfaction. This study uses the data based on the responses of 490 recipients selected randomly from 22 home care centers. The results show that recipients have higher frequencies in age of 60+, disabled status, difficulty with ADL, IADL items, no family, and lowest class. And the type of services offered by home care centers have highest frequencies in home maker services. Recipients' attitude toward home care services is "helpful," but they are not satisfied with the frequency of visit. The study found that disabled status, difficulty with ADL, IADL, health services, and home maker services are negatively related with degrees of recipients' satisfaction. Based on the findings, the study would conclude that home care policy should be recipients' need-based, developing systematic: need assessment tool. Expanded home health caring must be required for the disabled elderly.

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