• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.624-632
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• 2000

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

• The Journal of the Korea Contents Association
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• v.14 no.6
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• pp.298-306
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• 2014

This study aims to investigate the awareness and needs of patients as consumers and therapists as providers on the introduction of home physical therapy in the long-term care insurance. The survey participants were 96 patients and 132 physical therapists to a questionnaires, we analyzed for frequency of each questionnaire about awareness and necessity. As a result of the test, they considered that physical activity support services provided by nurse and nurses aid ware not specialized enough(pt 60,4%, PT 75,4%) and quality therapy should be available through a home physical therapy(pt 47.9%, PT 59.2%). Also, patients responded that the priorities to improve long-term care insurance were given to lowering expenses(35,4%) and expanding coverage of subjects(32.3%) while the physical therapists responded that professionals should be expanded(73.8%) and diverse rehabilitation services(20.2%) and a rehabilitation team should be introduced. They responded that the reasons of home physical therapy were needed that it was hard for patients to visit medical centers(PT 30.0%) themselves and it would be improvable for them to get physical function in elderly(pt 47.1%) through the service. In conclusion, as most patients as well as physical therapists responded that home visit therapy services should be introduced and their awareness of it was very high, it is suggested that the service should be quickly introduced as soon as possible.

• Journal of Home Health Care Nursing
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• v.9 no.2
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• pp.103-113
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• 2002

Purpose: This study was conducted to explore the relationship among health belief. health locus of control and patients sick-role behavior compliance of diabetic mellitus patients visiting public health center. Method: The subjects of this study were 193 of the diabetic patients who were visiting 4 Public Health Center in B city. The instrument used for measuring health belief was Park's(1985). for health locus of control was Wallston. et al's(1978) and for sick-role behavior compliance was Park's(1984). The data were collected with structured questionnaires; total 58 items contained about health belief. health locus of control and sick-role behavior compliance from 1st to 31st July. 2001. The data was analyzed by the SPSS/PC programs using t-test. Pearson's correlation coefficient. ANOVA and Scheffe-test. Result: The average score of the health belief was $57.99\pm9.45$ health locus of control was $66.83\pm9.48$ and sick-role behavior compliance was $42.81\pm7.00$. Statistically significant factors influencing the health belief among social demographic characteristics were family number(F=3.818. p=0.024), monthly income(F=5.153, p=0.002), time of diagnosis(F=3.937. p=0.002) and difficult to control disease(F=5.803. p=0.000). The significant factors influencing the health locus of control were marital status(F=4.669. p=0.010). Also significant factors influencing the sick-role behavior compliance were monthly incomes(F=5.245, p=0.000). the time of diagnosis(F=4.424. p=0.001) and admission to hospital with diabetes(F=9.031. p=0.000). There was negative mild correlation comparatively between health belief and sickrole behavior compliance(r=-0.142, p<0.05) but no correlation in sensitiveness/severity, barrier, benefit(p<0.05). There was no correlation between internal. external. chance health locus of control and sick-role behavior compliance (P>0.05). Conclusion: There was a negative weak relationship between health locus of control and patient's sick role behavior compliance. Therefore further study to investigate the relating factor of the sick role behavior compliance among above of middle aged diabetes mellitus patients is necessary.

• Child Health Nursing Research
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• v.19 no.3
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• pp.159-167
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• 2013

Purpose: The purpose of this study is to find out preschool children's health status and their mothers' health management in the vulnerable classes. Methods: The assessment tool was developed, taken into consideration existing studies, materials produced by the customized visiting health care system, and review of visiting nurses of health centers and related experts. Data were collected January to February 2010 from 259 mothers by visiting nurses, and analyzed using SAS program for descriptive statistics. Results: Body weight less than 3 percentile was found for 5.0% children and over 97 percentile for 7.7%. Atopy was found in 17.8% children, no hand-washing after toileting and before meal in 30.9% and 36.7% respectively, no breakfast in 15.8%, and irregular meal in 32.0%. Sex education was made by 45.7% mothers, regular dental check by 56.6%, and hearing and eyesight test by 61.1% and 66.8% respectively. Home environment for upbringing is 34.3 in the scale of 41, and accident prevention 17.5 in the scale of 22. Conclusion: It is necessary to make an intervention on children's weight, personal sanitation and meal time in the vulnerable classes. Mothers need to be educated for appropriate health care, and home environments to improve upbringing and accident prevention.

• Proceedings of the KIEE Conference
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• 2007.04a
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• pp.436-438
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• 2007

As the sensors and communication technology get advance, the remote health diagnosis for patients and senior persons at home are possible now without visiting doctors in hospitals. A low-power ubiquitous health check device was developed adapting Real-Time Embedded Linux is developed. This ubiquitous device is consisted of three sensors. The wrist type health checking terminal acquires periodically the health data by using a blood pressure sensor, a pulse sensor and a body temperature sensor. It transmits the health data to the access point located at the home center through the ZigBee wireless communication modem. This health data collector or access point device sends the data again to the main server operated in a hospital or health care organization. The health server control continuously the input data and sends an alarm signal to the assigned. doctor and responsible persons using cellular SMS when any dangerous events occur. This wrist type health check device has an embedded linux OS using Intel PAX255 MPU. The developed U-Health system is applicable for checking patients health in remote at home. And their family or related persons in remote site can check the patients health status at any time. They can be assured by receiving SMS record and alarm of emergency case which is transmitted from the health server.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Korean Journal of Hospice Care
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• v.7 no.1
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• pp.29-45
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• 2007

People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

• Physical Therapy Rehabilitation Science
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• v.11 no.1
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• pp.24-31
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• 2022

Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.160-166
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• 2005

Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.

• Research in Community and Public Health Nursing
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• v.23 no.2
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• pp.165-178
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• 2012

Purpose: The aim of this study was to analyze the tasks of managers who were working in the Customized Visiting Health Services (CVHS) and to prioritize analyzed tasks according to performance frequency, perceived importance, and difficulty. Methods: Job analysis method by Hartley (1999) was used for task analysis and performance frequency, perceived importance, and difficulty were used for prioritize as criteria. A total of 85 managers in the CVHS of public health centers nationwide were recruited through e-mail and mail survey. Using SPSS/WIN 15.0, descriptive statistics, such as frequency distribution, means, median, and standard deviation, were conducted to examine each subject's general characteristics, the frequency, importance, and difficulty of the tasks as well as to prioritize the each task. Results: The job description of the managers revealed 12 duties, 35 tasks, and 104 task elements. Of the 85 managers, 84.8% were classified as nurses, 40.5% were home health care specialists, and 32.9% were social workers. Their coretasks were management of client cases, budget management, and management of work performance and quality assurance. Conclusion: Considering the analyzed managers' tasks and core tasks, we need to examine each manager's role precisely and provide various educational programs for improving overall manager competence.