• 한국노년학
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• 제41권2호
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• pp.271-284
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• 2021

이 연구는 한국형 커뮤니티 케어의 기초가 되는 서울시 찾아가는 동주민센터 방문건강관리 사업을 중심으로, 만성질환 유병상태에 따른 노인 방문건강관리 서비스 만족도 영향요인을 도출하고, 향후 효과적인 커뮤니티 케어 모형 개발을 위한 기초자료로 활용되고자 수행되었다. 이 연구는 찾아가는 동주민센터 3단계('17년 7월 ~ '18년 6월) 및 4단계('18년 7월 ~ '19년 6월)에 참여한 만 65세, 만 70세 노인을 모집단으로 하여, 자치구별 비례할당 방식으로 추출한 2,200명(3단계 24개구 1,100명, 4단계 25개구 1,100명)을 대상으로 가구방문 면접 조사를 실시하였다. 이후 불성실 응답 180건을 제외한 2,020명을 최종 분석대상에 포함하였다. 만성질환 유병상태를 기준으로 하위집단을 나누었고, 방문건강관리 서비스 만족도 영향요인을 도출하기 위하여 로지스틱 회귀분석을 실시하였다. 연구결과, 만성질환이 없는 노인들은 건강교육 및 상담 서비스를, 만성질환을 1개 가지고 있는 단일 만성질환 노인은 지역사회자원 연계서비스를, 만성질환을 2개 이상 가지고 있는 복합 만성질환 노인은 자신의 건강상태평가 및 지역사회자원 연계서비스를 제공받은 경우 서비스 만족도가 통계적으로 유의하게 높아지는 것을 확인하였다. 한편, 만성질환 유병상태와 상관없이 노인이 인식하고 있는 서비스 제공시간은 방문건강관리 서비스 만족도를 높이는 요인이었으며, 설명 이해도는 단일, 복합 만성질환자 모두에게 만족도를 높이는 요인이었다. 지역사회를 중심으로 한 방문건강관리 서비스는 현재 추진되고 있는 커뮤니티 케어의 핵심 요소이므로 향후 커뮤니티 케어의 지속성과 효과성을 증대하기 위하여, 노인의 만성질환 유병상태에 따른 지역사회 중심의 맞춤형 건강관리서비스가 제공되어야 하겠다. 다만, 보다 효과적인 서비스 제공을 위하여, 첫째, 국민건강보험공단이 보유하고 있는 대상자의 건강정보를 지자체로 공유하는 연계시스템 구축과 둘째, 방문건강관리 서비스의 질향상을 위한 방문간호사 역량강화 교육이 병행될 필요가 있다. 이 연구의 결과와 제언이 향후 커뮤니티케어의 성공적 정착을 위한 기초자료로 활용되기를 기대한다.

• 지역사회간호학회지
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• 제13권2호
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• pp.280-291
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• 2002

Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.

• 한국농촌간호학회지
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• 제19권1호
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• pp.55-65
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• 2024

Purpose: This study was intended to gain an in-depth understanding of and explored the experiences and meanings of participating in care services among community-dwelling older adults. Methods: A focus group interview approach was adopted. Twenty older adults were interviewed from November to December 2021 using semi-structured interview questions. The data was analyzed using thematic analysis. Results: Three main themes and seven sub-themes emerged for the elderly people living alone. One main theme was "ambivalence of elderly care services," the second was "desperate need for care services," and the third was "positive changes and expectations experienced with care services." For the elderly people living with their families, two main themes and four sub-themes were identified. One main theme was "care services met within the family system," the second was "needs for care services outside the family system." Conclusion: We aim to provide a basis for strengthening the quality of elderly community care services in the mid- to long-term and establish a system of close linkages between necessary services by understanding the needs of elderly people who live alone or with their families.

• 가정간호학회지
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• 제30권2호
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• pp.141-154
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• 2023

Purpose: This study aimed to explore the social perception of visiting nursing before and after coronavirus disease (COVID-19). Methods: This survey-based study used online big data for comparative analysis by classifying the keywords related to visiting nursing searched on domestic portal sites before and after COVID-19. Results: According to the results of analyzing the Intertopic Distance Map based on Latent Dirichlet Allocation in this study, four topics were extracted, two each before and after COVID-19. The first topic before the COVID-19 period was termed "the expansion of visiting nursing subjects and services visiting nursing," while the second was termed "visiting nursing," which is related to customized welfare. The first topic after the COVID-19 period was termed "the suspension and resumption of visiting nursing services," while the second was "the development of a non-face-to-face home visit healthcare system". Conclusion: The results of this study can be used as useful reference data to contribute to future medical service delivery system reform policies starting at the end of COVID-19 and the revitalization of community care for visiting nursing.

• 대한간호학회지
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• 제47권5호
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• pp.577-588
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• 2017

Purpose: This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. Methods: We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Results: Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. Conclusion: As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

• 한국직업건강간호학회지
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• 제12권1호
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• pp.80-88
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• 2003

Rehabilitation has emerged in recent years as major topic for the handicaped in industrial accident compensation insurance(IACI). Specially social support helps the handicaped adjust themselves psychosocially to handicap. This study was conducted to examine different contents and perceived social support, and provide guidlines for specific and proper rehabilitation for the handicaped of IACI. This study is a descriptive study which were collected through two phases using structured questionnaire. In the first stage, surveys were performed via telephone interviews. In the second stage, surveys were performed via home-visit subjects in the first stage included the handicaped of IACI. Finally data were collected from 338 subjects and analyzes by SPSS/PC+10. The instruments of this study were the perceived social support scale which developed by Lee(1996). These scales in the form of 5-point Likert type, consists of 20 items, including 3 subscales of emotional support, informational support, instrumental support. The mean score of social support was 57.2, emotional support 21.0, informational support 21.2 and instrumental support 15.2. The mean of depression for psychosocial factors is 37.5. Threre were significant differences in total perceived social support; age, job status, handicaped degree in IACI, post-traumatic complication and use of instrument. Emotional support was significant differences; age, number of dependent family, job status, handicaped degree in IACI, use of instrument and depression. Informational support was significant differences; job status, posttraumatic complication, use of instrument and depression. Instrumental support was significant differences; sex, job status, handicaped degree in IACI, use of instrument, and depression. The current system of the Labor Welfare institute is not appropriate for solving health problems of the handicaped in IACI. Therefore, it is necessary to develop the plan which can provide the handicaped in IACI high-quality rehabilitation services, so that they must use those services in the community without being dependent on hospitals. This study proposes home visit nursing services as the way to provide various health services within community for the handicaped in IACI.

• 보건행정학회지
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• 제14권1호
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• pp.1-23
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• 2004

This study was carried out to investigate the activities and job satisfaction of public health doctors in charge of community health programmes. Subjects were 138 public health doctors charged with community health project, registered in the roll of public health doctors, made out by Central Supporting Team for the District Health Work in 2002. Data was obtained from Ninety-six public health doctors. The response rate was 70%. The survey was conducted from March to April in 2003 bye-mail. The items of the questionnaire consisted of general characteristics of participants, understanding of their activities, support system, job satisfaction, and suggestions to improve the system. Collected data was analyzed using PC-SPSS 10.1. Descriptive analysis, t-test, and ANOVA test were used. The results are as follows: Most of the respondents showed a low participation rate in community health services, but they agreed to the importance of their activities and the necessity to modify and improve the system. 70% of the respondents were dissatisfied with their jobs. The participation in health planning and programmes of health center, and the degree of acceptance of their opinion from health center workers were significantly related to their job satisfaction. The participation rate of the public health doctors having specialty, in community health services is higher than that of the others. In terms of the supports for system operation, the reflection of one's intention in job arrangement process, education and public relation of this system, and the administrative and financial supports made significant differences in the job satisfaction and the accomplishment of their duty. The respondents hoped that the administrative and financial supports for public health doctors in charge of community health programmes should be reinforced to motivate them. They also wanted that they could keep from being overloaded with clinical services. They favored to conduct home visit, community diagnosis, health planning, and health promotion programs as their appropriate activities. From these results, we suggest some strategies to motivate and empower the public health doctors in charge of community health programmes.

• 한국농촌간호학회지
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• 제19권1호
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• pp.35-43
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• 2024

Purpose: This study aimed to explore the influence of knowledge, problem-solving processes, and self-efficacy on the clinical competency of nursing students in the home health nursing management of diabetes mellitus (DM). Methods: The subjects of this study were 136 nursing students. Data were collected from April 18 to April 29, 2022, and analyzed using the SPSS 23.0 program. Results: The total mean scores of nursing students' knowledge, problem-solving process, self-efficacy, and clinical competency in DM home health nursing management were 71.24, 3.92, 7.47, and 4.09, respectively. Clinical competency was significantly and positively correlated with the problem-solving process (r=.60, p<.001) and self-efficacy (r=.48, p<.001) but not with knowledge (r=.09, p=.311). The problem-solving process was also positively correlated with self-efficacy (r=.41, p<.001). Regression analysis revealed a 41.4% variance in the nursing student's clinical competency with problem-solving process (β=.47, p<.001) and self-efficacy (β=.28, p<.001). Conclusion: The results of this study provide valuable evidence for the development of educational interventions aimed at enhancing the clinical competency of nursing students in relation to home-visit healthcare services for DM management.

• 생물정신의학
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• 제25권3호
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• pp.72-78
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• 2018

Objectives The high suicide rate has risen as a main concern in South Korea. Given the complexity of the mechanism resulting in complete suicide, studies targeting various populations are needed for broader understanding of its risk factors. This study aims to analyze the factors affecting the suicidal tendency in the population of the elderly living alone in Seoul depending on basic elderly-care services. Methods A total number of 415 people participated in the study. Home-visit interviews were administered by trained interviewers. Suicidal tendency was measured by the Korean version of mini international neuropsychiatric interview (K-MINI). Health-related quality of life was measured by a brief version of the World Health Organization Quality-of-life Scale (WHOQOL-BREF). Alcohol problem was assessed by the Korean version of the alcohol use disorders identification test (AUDIT-K). Among total subjects of 415 interviewees, the actual responses of 408 people were used for the final analysis. Results The result showed that the suicide risk was high in persons isolated from social support [odds ratio (OR) = 4.49], having depression (OR = 14.85), and having low quality of life (OR = 4.39). Conclusions We found that social support, depression and health-related quality of life are associated with suicidal tendency in the elderly living alone on basic services. Our evidence will contribute to suicide prevention policy for the elderly living alone on care services.

• 한국노년학
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• 제30권4호
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• pp.1345-1357
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• 2010

본 연구에서는 장기요양보호 서비스 중 방문목욕을 이용하는 여성노인을 대상으로 방문목욕을 받으면서 경험하게 되는 신체적, 심리적 변화는 무엇인가에 대해 심층적으로 분석코자 하였다. 이를 위해 장기요양보호서 비스를 이용중인 8명의 여성노인을 대상으로 심층면접하고 서비스 이용과정 중 경험하게 되는 신체적, 심리적 경험을 질적자료로 활용하여 자료를 분석한 탐색적 연구이다. 연구결과를 살펴보면 다음과 같다. 첫째, 여성노인의 신체적 측면에서는 방문목욕서비스를 받는 동안 변화된 여성노인의 신체적 요인을 살펴보면 서비스 이용 후 몸이 건강해지고 편해졌으며 신체적으로도 나아지고 있다고 믿고 있었다. 둘째, 심리적 측면에서는 자신의 신체적 장애로 인해 방문목욕을 받는 것에 대해 자신의 몸을 보이는 것을 추잡하고 부끄럽게 여기다가 방문목욕을 편하게 여기게 되었다. 또한 요양보호사와의 상호작용을 통해 목욕서비스 이외에 정서적측면에서 지지를 받음으로 자신에 대한 존재가치를 긍정적으로 바라보는 모습이 나타났다. 그 결과 장애로 인해 부끄럽고 불편하며 추잡스럽게 자신을 여기던 부정적 태도에서 장애를 지닌 자신의 신체적 상태를 수용하고 받아들임으로 방문목욕서비스를 편하게 받아들이게 되는 변화의 과정이 나타나 장애수용이 현실적응에 큰 영향을 미치게 되는 계기임을 알 수 있었다. 이상의 결과를 근거하여 다음과 같이 제언하였다. 첫째, 장기요양보호에서 노인에 대한 체계적인 관리 및 정서적 안정을 높이기 위해서 자신의 장애를 수용하여 현실에 적응할 수 있도록 사회복지사의 개입과정이 도입되어야 할 것이다. 둘째, 노인에게 있어 긍정적 정서에 많은 영향을 미치는 대상이 요양보호사임을 고려할 때 단지 요양보호사로써의 역할을 벗어나 노인의 강점과 긍정성을 발견하고 강화시키는 멘토의 역할을 감당할 수 있도록 요양보호사에 대한 체계적인 교육시스템의 마련이 제안되어야 할 것이다. 셋째, 지역사회를 중심으로 장기요양기관, 방문요양기관, 복지관 등과 건강보험관리공단이 통합네트워크를 구성하여 권역별로 장기요양보호를 이용하는 가정 및 긴급·위기가정에 대해 지원하는 통합사례관리체계가 마련되어야 할 것이다.