• Title/Summary/Keyword: Home visiting care

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A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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Effects of Home Visiting Physical Therapy and Environmental Factors Analysis Using International Classification of Functioning, Disability and Health (ICF) (ICF를 이용한 재가 장애인의 방문 물리치료 효과 및 환경 요인 분석)

  • Park, Seung-Kyu;Heo, Jae-Won;Yang, Dae-Jung;Gang, Jeong-Il;Lee, Jun-Hui
    • The Journal of Korean Physical Therapy
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    • v.24 no.4
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    • pp.282-289
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    • 2012
  • Purpose: The purpose of this study is to analyze the home-stay disability's activity, as well as the participation domains and the environment factor domains of international classification of functioning (ICF), in order to examine the effect of the home visiting physical therapy and the disability's activity. Methods: A total of 211 home-stay disabled subjects with brain lesions or crippled disorder, living in 5 cities and districts of Jeollanam-do, underwent 90 minutes of home visiting physical therapy per week during a 6-month period, and using the ICF checklist, evaluated the subject's activity and participation domains and environmental factor domains. Results: The performance qualifier showed a significant statistical change in the movement, self-care, domestic life, interpersonal interactions and relationships, community, society and civic life domains (p<0.05); and the capacity qualifier showed a significant change only in the mobility domains in the before and after of the home visiting physical therapy (p<0.05). The barrier factor in the order of services, systems and policies domains, product and technology domains, and attitude domains it influenced significantly in the performance (p<0.05), and in the facilitator factor in the order of product and technology domains, support and relationships domains, services, systems and policies domains it influenced significantly in the performance of the disabled (p<0.05). Conclusion: The visiting physical therapy can help in the improvement of the activity and participation of the home-stay disabled subjects, and for the accurate evaluation of the home-stay disabled subjects, it is considered that an evaluation including various environmental factors, such as ICF, must be fulfilled.

The Effects of Visiting Nursing Services in Long-term Care Insurance: A Difference-in-Difference Analysis (이중차이분석을 활용한 노인장기요양보험제도의 방문간호서비스 효과)

  • Kim, Jieun;Lee, Insook
    • Research in Community and Public Health Nursing
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    • v.26 no.2
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    • pp.89-99
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    • 2015
  • Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

Effects of Home Nursing Care on Self Care for Early Discharged Mothers Following a Cesarean Section (자가간호향상을 위한 제왕절개산모의 가정간호 효과)

  • Chang, Soon-Bok;Lee, Sun-Kyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.1
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    • pp.38-49
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    • 2001
  • The purpose of this study was to evaluate the self care focused home nursing' care outcomes of parturient women following Cesarean sections, The subjects included 56 parturient women following a cesarean section, and they were randomly assigned to an experimental group or a control group, The experimental group included women who were discharged early from the hospital. 4-5 days after having a cesarean section. Home nursing care for the experimental group consisted of stitch removal. wound care and education for parturient women. Home nursing care was provided for 2-3 days after early discharge. The outcomes of self care focused home nursing care were measured by self-care competency. Data collection was done by a self-reported questionnaire and by a telephone interview 2-3 days after discharge from the hospital(control) or after home care (experimental) from December, 20, 1998 to June, 10, 1999. The questionnaire consisted of 25 items on 9 self-care domains. Data was analyzed by a t-test. and as $x^2$-test. The study results were as follows: 1. The general characteristics of both groups were similar except for the total number of pregnancies, and whether or not they wanted the pregnancy at this time. 2. The self-care competency scores for the experimental group receiving self care focused home nursing care were higher than the scores for the control group(t=2.361. $p{\le}.05$). 3. There was no significant difference in the rate of OPD visiting, readmission, or emergency room use between the two groups. We concluded that self care focused home nursing care is effective in promoting the self-care competency of parturient women following Cesarean sections. It is suggested that further study is needed with a larger sample to be able to generalize these results.

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Health Care Needs and Health Problems of the Subjects in a Health Center (보건소 방문간호 대상자의 건강문제와 방문간호 요구)

  • Kim, Soon-Lae;Lee, Kyeong Yeao
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.103-108
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    • 1999
  • In order to investigate the basic data for the visiting nursing care plan of Health Center in Korea, the questionnaire survey in regard to health care needs and health problems of the subjects with visiting nursing care was carried out on 131 subjects with visiting nursing care. The results were as follows : 1. The subjects consisted of 38.2% in male and 61.8% in female. 77.1% of the subjects had no job. 2. In the health problem, the subjects symptoms were 31.2% of hypertension, 20.6% of arthritis, and 19.1% of diabetes and other chronical illness. Utilization of medical care facilities were 61.8% of private clinics or general hospitals and 29.0% of Health Center. 3. 10 areas of health care needs that subjects wanted were disease management(19.5%), demand for welfare concerns(15.7%), health promotion and disease prevention(14.2%), information for medical institution(12.3%), health management for the aged(10.8%), hospice care(8.0%), prevention of dementia(8.0%), care for mental hygiene(6.7%), management for drinking, smoking and drug abuse(3.3%), home care nursing and rehabilitation nursing(1.2%).

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A study on current situation of self-help group program in community-based home visiting health service (보건소 방문건강관리사업의 자조집단 운영 현황)

  • Park, Jeong Sook;Kwon, Sang-Min
    • Journal of Digital Convergence
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    • v.12 no.8
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    • pp.449-458
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    • 2014
  • The purpose of this study was to examine and analysis self-help group program performed in community-based home visiting health service. The data was collected public servants from the Home Visiting Health Care Service of 253 public health centers all over the country and was analyzed by SPSS/Win 17.0 program. 43.1% of self-help program was performed and 56.9% was not from year 2007 to 2010. As the years passed, the number of self-help group program was getting increased. The action for activating self-help programs was voluntary participation of clients, enthusiasm of management practitioner, and encouragement about self-help group. Self-help group programs based on public health center are insufficient. Self-help programs should be activated for clients of home visiting health care service. A systematic operating model of self-help group is also needed to develop and apply in consideration of these findings.

A Study for Evaluating the Performance of a Community-based Home Care Services Model (일개 지역사회 중심 가정간호시범사업소의 성과평가 연구)

  • Kim, Se-Young;Park, Sung-Ae
    • Research in Community and Public Health Nursing
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    • v.19 no.4
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    • pp.673-683
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    • 2008
  • Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.

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Effects of Low Intensity Exercise Program with Telephone Coaching on Physical Fitness (전화코칭을 동반한 저강도 운동 프로그램이 방문건강관리 노인의 체력에 미치는 효과)

  • Kim, Sang-Hee;Lee, Ji-Hyun;Koh, Kwang-Wook;Ha, Hyun-Bo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.15 no.4
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    • pp.457-466
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    • 2008
  • Purpose: The purpose of this study was to determine the effects of low intensity exercise program with telephone coaching on the physical fitness of elderly people who are receiving home visiting nursing care. Method: This study was conducted using a non-equivalent control group pretest-posttest design. The participants were 61 elders. Elders (34) in the experimental group performed low intensity exercise and of these 16 received telephone coaching. The low intensity exercise program consisted of stretching, muscle strengthening with an elastic band, massage, and ball exercise, five days a week, for sixteen weeks. Data were collected from July 2007 to December 2007. $x^2$-test, ANCOVA with SPSS WIN 11.0 program were used to analyse the data. Results: There were statistical differences in the right grasping power in the right hand (p=0.021), Raising behind of right arm (p=0.006), Raising behind of left arm (p=0.007). Conclusion: These results indicate, that a low intensity exercise program with telephone coaching can help improve physical fitness in elders receiving served home visiting nursing care.

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A Study on Educational Needs in Married Immigrant Women Perceived by Their Home Visiting Educator (방문교육지도사가 인지하는 여성 결혼이민자의 교육요구)

  • Kim, Mi-Jong;Kim, Tae-Im;Kwon, Yun-Jung
    • Korean Parent-Child Health Journal
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    • v.13 no.1
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    • pp.44-53
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    • 2010
  • Purpose: This study was conducted to identify the educational needs of married immigrant women perceived by their home visiting educator. Methods: Data were collected using in-depth interviews and structured questionnaires during July 1st to 28th, 2009. 5 HVEs participated in focus group interview, and 27 HVEs in the questionnaire survey. Data were analyzed by content analysis and descriptive statistics using SPSS/WIN program. Results: Educational needs of Married Immigrant Women were conjugal and family relationship, child rearing and child health care, health management, sex education, and self-identification. There is no proper teaching materials about child rearing for HVEs. The educational needs of HVEs were physical and cognitive characteristics of child development, developmental screening skill and play according to the each developmental stages of the multi-cultural families. Conclusion: Family relationship, child rearing and child health care, must be stressed in educational program for Married Immigrant Women. To maximize the effectiveness of support for multi-cultural families, it must be developed a systematic educational program and teaching materials according to family developmental stages.

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Estimation of Home-visiting Care Costs for Low-income Elderly with Chronic Disease in a Metropolitan City Using the Severity Classification and ABC(active-based costing) (대도시 저소득층 만성질환 노인을 위한 가정.방문간호 원가산정 - 환자 중증도 및 활동기준원가계산법(ABC) 적용 -)

  • Kang, Sung-Ye
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.2
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    • pp.118-130
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    • 2008
  • Purpose: The purpose of this study was to estimate of home-visiting nursing costs for low-income elderly with chronic disease in a metropolitan city using the severity classification and ABC(active-based costing). Methods: First, the HHC activity pool was established. The performance time of each nursing activity were estimated. Second, nursing resources(labor costs, operating costs, and traffic expenses) were analyzed and nursing cost per minute was calculated. And then the cost of each activity was estimated. Third, 202 visiting cases were classified into three group by their severity. And then nursing cost per visit according to their severity was estimated. Results: 59 nursing activities were included in HHC activity pool. The average working time of 59 nursing activity was 6.7minutes and nursing cost per minute was 489 won. According severity, nursing cost per visit were in class I, 54,296 (won), class II 83,124(won), and class III 93,455(won).

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