• 제목/요약/키워드: Home visiting health services

검색결과 146건 처리시간 0.027초

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

  • 전은미
    • 모자간호학회지
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    • 제4권1호
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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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방문간호를 받는 재가노인의 낙상위험 (Fall Risk in the Community-dwelling Elderly who Received Home Care Services: Focused on Residential Environment and Perception of Fall Risk)

  • 이정미;조복희
    • 근관절건강학회지
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    • 제21권1호
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    • pp.36-45
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    • 2014
  • Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals

  • Yoon, Young Mi;Park, Jin Hee;Hwang, Moon Sook
    • 지역사회간호학회지
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    • 제33권4호
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    • pp.357-371
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    • 2022
  • Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

대도시 거주 저소득 독거노인의 자살생각에 영향을 미치는 요인 (Factors Affecting Suicidal Ideation of the Low-income Elderly Living Alone)

  • 백희정;이진화
    • 지역사회간호학회지
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    • 제25권3호
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    • pp.180-186
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    • 2014
  • Purpose: The purpose of this research is to identify factors affecting suicidal ideation of the low-income elderly. Methods: The study subjects were lowest-income(basic living allowance) and lower-income elders who were registered for home visiting services at five District Health Centers in Seoul. Interview data were collected from 280 elders and analyzed. Using SPSS/WIN 21, $x^2$-test and t-test were conducted to analyze the relationship between the subjects' characteristics and their suicidal ideation, and logistic regression was done to identify factors affecting suicidal ideation. Results: Of the subjects, 48.6% had suicidal ideation for the last one year. Self-evaluated psychological status, quality of sleep, depression, and loneliness were affecting factors to the subjects' suicidal ideation. Conclusion: Psychological and social factors are strongly related to the suicidal ideation of the elderly who are living alone in metropolitan areas. Therefore, home visiting services should supply physical, psychological and social cares continuously to the low-income elderly, especially those who live alone in metropolitan areas.

맞춤형 방문건강관리사업 노인대상자의 고혈압군, 당뇨군, 고혈압.당뇨군별 건강상태 및 건강행태 비교 (The Comparison of Health Status and Health Behavior among Hypertension Group, DM Group, and Hypertension DM Group for the Aged Provided with Customized Home Care Service by Visiting Nurses)

  • 형희경;장효순
    • 지역사회간호학회지
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    • 제22권1호
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    • pp.11-21
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    • 2011
  • Purpose: This study aims to compare health status and health behavior among the hypertension group, the DM group, and the hypertension-DM group for aged clients of customized home visiting health care services. Methods: This study was conducted as cross-sectional research. The subjects of this study were 2,235 aged people over 65 living in J City. Data were collected using structured questionnaires and measurements. The collected data were analyzed using the SPSS/WIN 12.0 program, and descriptive statistics, $x^2$ test, t-test and ANOVA were used for the analyses. Results: BP and glucose control showed a significant difference among the groups. BMI and waist circumference were significantly higher in the hypertension-DM group than in the other groups. Stroke, arthritis, and perceived health status were significantly different among the three groups. Depression was high, but not significantly different among the groups. Smoking and drinking were not significantly different among the groups. Physical activity was very low, especially in the hypertension group. Medication was high, especially in the hypertension-DM group. Conclusion: It is necessary to consider care plans for the hypertension-DM group, and educate the group for care management. Also, depression and physical activity programs are needed for the age.

방문건강관리사업 대상 재가노인의 허약정도와 예측요인 (Predictors and Frailty Level in the Frail Elderly Receiving Home Visiting Health Care Services)

  • 박정숙;오윤정
    • 농촌의학ㆍ지역보건
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    • 제41권3호
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    • pp.129-139
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    • 2016
  • 본 연구는 재가 허약노인의 허약정도에 영향을 미치는 예측요인을 파악하기 위해 대상자의 허약정도를 확인하고 일반적인 특성, 건강증진행위, 역량강화, 사회참여, 주관적 건강상태 간의 관계를 분석한 후 다중회귀분석을 실시하였다. 연구결과로는 재가노인의 허약정도 점수는 31점 만점에 10.05점으로 고위험 허약노인군에 포함되었고, 건강증진행위는 4점 만점에 2.56점, 역량강화는 5점 만점에 2.74점, 사회참여는 5점 만점에 2.58점, 주관적 건강상태는 14점 만점에 7.17점으로 중간 정도였다. 재가노인의 허약정도는 연령이 높을수록, 생활만족도가 불만족일수록 심했으며, 허약정도와 건강증진행위, 역량강화, 사회참여, 주관적 건강 상태와는 부적인 상관관계를 나타내었다. 대상자의 허약정도를 설명하는 예측요인으로는 주관적 건강상태, 건강증진행위, 연령으로 나타났고, 이 세 변수가 허약정도의 37.4%를 설명하였으며, 이중 주관적 건강상태가 가장 주요한 예측인자로 나타났다. 따라서 재가노인의 허약을 예방하고 관리하기 위해서는 허약에 영향을 미치는 주요 예측 요인들을 반영한 중재전략을 개발, 적용해야 할 것으로 사료된다. 본 연구의 결과를 토대로 다음과 같은 제언을 하고자 한다. 첫째, 재가노인의 허약정도를 사정할 수 있는 표준화된 도구의 마련이 필요하다. 둘째, 재가노인의 허약정도를 가장 잘 예측할 수 있는 변수로는 주관적 건강상태로 나타났으므로 재가노인의 허약을 예방, 관리하는 프로그램에는 주관적 건강상태를 강화하는 내용을 포함할 것을 제언한다.

방문구강건강관리사업에서 정신적 장애인의 구강건강관리시간에 영향을 미치는 요인 (A STUDY ON FACTORS AFFECTING DENTAL TREATMENT TIME OF PATIENTS WITH MENTAL DISABILITY IN VISITING DENTAL SERVICES)

  • 임경철;이재영;진보형;이교린;김소연;백혜란;김영재
    • 대한장애인치과학회지
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    • 제14권2호
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    • pp.78-87
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    • 2018
  • Patients with mental disability who are classified as dental severely disabled, have poor oral health status and many difficulties in taking health services. The purpose of this study was to investigate factors of influencing in visiting oral health care services. After receiving approval from institutional review board in Seoul National University, 39 participants were recruited and the oral health examination and questionnaire were taken. Data were analyzed using one-way ANOVA, independent t-test, hierarchical linear regression for predicting influence of each participants' characteristics on oral examination time and care time. In regression model, the higher the disability grade and the lower the degree of cooperation, the more oral examination time increased. However possibility of communication was not significantly influenced. Also, the higher the disability grade and the lower the degree of cooperation, the more oral care time increased. However possibility of communication was not significantly influenced. These results are expected to provide objective data for introduction and establishment of visiting dental care.

일개 시 보건소의 모자보건 선도보건사업 평가에 대한 연구 (A Study on the Evaluation of Maternal Child Health Services in Public Health Centers)

  • 김용순;박지원;방경숙;정순이;우혜숙;이혜정;장현순
    • 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.

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자료포락분석을 이용한 노인장기요양 방문간호센터 운영의 효율성 평가 (Evaluation of Operational Efficiency among Long-Term Care Visiting Nursing Centers using Data Envelopment Analysis)

  • 임지영;김선희;오은숙;송수영
    • 가정∙방문간호학회지
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    • 제27권1호
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    • pp.16-28
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    • 2020
  • Purpose: The aim of this study was to evaluate the efficiency of long-term care visiting nursing centers in communities using data envelopment analysis (DEA). Methods: Data were collected using a self-reported questionnaire. The average number of staff per 6 months and total space of center were used as input variables. The average number of clients per 6 months and the average profits per 6 months were used as output variables. EMS Window version 3.1 was used to measure the efficiency scores. Descriptive statistics and tobit regression were applied to analyze the general characteristics of the variables and the factors affecting efficiency scores. Results: The average efficiency of 30 long-term care visiting nursing centers in communities was approximately 66.9% on technical efficiency analysis, and 79.1% on scale efficiency analysis. Eight nursing centers on technical efficiency analysis and 12 centers on scale efficiency analysis had 100.0% efficiency. Conclusion: Our findings reveal that long-term care visiting nursing centers in communities have low operational efficiency. Therefore, it is essential to institute policies and regulations to improve the efficiency of visiting nursing centers and to strengthen the business competencies of center officers.

일 지역 취약가구 독거노인의 건강상태에 따른 가정지원과 도움요구 (Home Care Support and Support Requirements According to Health Condition in the Poor Elderly People Living Alone)

  • 박지원;김용순;김기숙
    • 가정∙방문간호학회지
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    • 제16권2호
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    • pp.89-97
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    • 2009
  • Purpose: To identify the health condition, home care support, support requirement of poor and elderly people living alone. Method: Data was collected through self-administered questionnaires and analyzed by descriptive statistics, t-test, ANOVA and correlation. Survey involved 269 conveniently selected who have a social support in H city. Result: Perceived health condition of subjects was bad to moderate (mean score: 2.22). There were significant home care support differences according to gender, religion, education level and dwelling pattern. Support requirement was influences only by the dwelling pattern. Perceived health condition showed a positive correlation with home care support of friends and neighbors, and a negative correlation with support requirement (medical, material, economic emotional support). Conclusion: These findings are expected to make a positive contribution to create an ideal intervention for public visiting nurses and social workers to improve the quality of life in poor and elderly people who live alone.

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