The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.
Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.
Kim, Jeong-Eun;Park, Sung-Ae;Yoon, Soon-Nyoung;Lee, In-Sook;Park, Hyeon-Ae;Kim, Jin-Hyun;Lee, Kyung-Soon
Perspectives in Nursing Science
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v.8
no.1
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pp.32-41
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2011
Purpose: This study sought to determine the possibility of developing the data-sharing infrastructure of an integrated information system to improve the quality of home and visit-based healthcare services. Methods: The articles of study here were the forms used by a visiting healthcare agency, a home healthcare system of a home healthcare agency, and those used in long-term care insurance for elderly. We visited a visit-based healthcare agency and a home healthcare agency to survey their forms and interviewed relevant practitioners, and we searched for forms associated with long-term care insurance for the elderly on the Internet. We then organized the terms in each form and mapped them among the form after analyzing the concepts as a whole to inquiry into the possibility of integration. Results: The mapping procedure divided the terms into those related to personal information, problems and interventions. Mapping between the standard system (Omaha system) and the type of form was also done. Conclusion: In this study, we found that programs were configured differently depending on the objectives of the service. It is necessary to develop the program with an integrated information system by comparing the three services in terms of their distinct advantages, after which such a service should be utilized. The results of this study can serve as a database for the creation of a new integrated system.
Purpose: This study aimed to investigate the effects of a program for increasing self-care with activities of daily living among the elderly living at home. Methods: The study adopted a non-equivalent control group pretest-posttest design. The number of participants were 30 in the experimental group and 30 in the control group. Participants were persons aged 65 years and above in Busan. The experimental group was provided with for 16 different types of self-care behaviors by family nurses who made weekly home visits to these participants. Each visit lasted for more than 30 minutes, and the visits were conducted for 12 weeks. The research instrument used in this study was a scale developed by Shimanouchi et al. (2003) which assessed self-care behavior, activities of daily living, and depression. Results: The experimental group showed an increase in self-care behavior compared to the control group. Time and group variables were also found to have an interaction effect on the daily living activity level. The experimental group showed an increase in the activities of daily living compared to the control group. Depression scores dropped from 9.4 to 5.8 in the experimental group and from 8.6 to 7.0 in the control group. Conclusion: We found that the self-care behavior program improved the levels of independence and activities of daily living among the elderly living at home.
Purpose: This quasi-experimental study was performed to evaluate the effectiveness of an early nursing intervention program to support mothers of children aged 0-3 yr living in poverty. Methods: In this study, mothers who received financial support from the government were recruited from one city and assigned to an intervention group (24) and comparison group (18). They completed a baseline questionnaire about depression, child rearing burden, agreement on physical punishment, and child temperament. Also, Denver II screening of the children was performed by the researcher. Mothers in the intervention group received a home visit intervention every two weeks for three months. At 3-months post-baseline, questionnaire and Denver II screening were reused to compare these two groups. Results: Mother's depression, child rearing burden, agreement on physical punishment, and child temperament were not significantly different between the two groups. However, the percentage of depression declined only in the intervention group. Mothers in the intervention group showed higher Home Observation for Measurement of the Environment (HOME) scores than mothers in the comparison group. Conclusion: The findings of the study show that this nursing intervention is an effective parenting program. The early nursing program for mothers with infant and toddlers in poverty is effective in promoting HOME, the child rearing home environment.
Purpose: The purpose of this study was to explore the experiences of nursing students' practice on community visiting nursing. Methods: For this study, in-depth interviews were conducted with a total of 12 nursing students, and data were collected through individual in depth interviews from September to December 2018. The data were analyzed using the phenomenological analysis method suggested by Colaizzi. Results: The experience of visiting nursing practice consisted of four themes. Four themes are 'Understanding visiting nursing work: Tight time and problems to overcome', 'Understanding visiting nursing object: People waiting for a visiting nurse', 'Visiting nursing practice experience: Sometimes to get reprimanded but rewarding practice', and 'Expectations for visiting nursing business: Hopes for development'. Conclusion: Findings from this study presented vivid experiences of nursing students who on community home visit nursing. Community visiting nursing practice became an opportunity for students to understand visiting nursing and target people and to think about the necessity of visiting nursing and future development direction. It is necessary to develop an institutional and policy basis with regard to the increasing number and role expansion of community visit nurses.
Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.
Kim, Han-Nah;Kim, Gi-Yon;Noh, Hie-Jin;Kim, Nam-Hee
Journal of Korean society of Dental Hygiene
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v.18
no.4
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pp.455-462
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2018
Objectives: This study was carried out to identify plans to activate home visit oral care services by dental hygienists in Long-term care insurance. Methods: In-depth interviews were carried out with 21 Long-term Home Care Center Managers as target. A total of 21 (27%) Home Care Centers were selected through convenience sampling among 78 Home Care Centers that are located in Won-ju city. The Managers were presented with questions and answered in 20-30 minutes in accordance with the interview instructions. The interview results were analyzed through content analysis, and their experiences and perceptions were classified into two themes and categorized again into four components. Results: The Home Care Center Managers suggested that dental hygienists should activate home-visit oral hygiene services. It is necessary to improve the management process and awareness of the elderly. Conclusions: To activate oral hygiene services, it is necessary to improve the service guideline and enhance the efficiency of the service process. This should be acceptable both to the elderly who need the services and the dental hygienists who provide them.
Purpose: This study aimed to identify the workload of home healthcare nurses and their job satisfaction. Methods: The research was conducted on 87 home healthcare nurses in nationwide medical institutions. Results: Number of visits was correlated with direct nursing hours. The monthly average number of visits was 108.84 ; the average number of patients was 45.66; the average daily working hours were $8.95{\pm}0.95$, of which $5.43{\pm}1.06 $ were indirect nursing hours, and $3.57{\pm}1.05$ were direct nursing hours. The average nursing time by severity condition was 22.25 minutes for group 1 patients, 28.04 minutes for group 2, 34.97 minutes for group 3, and 42.88 minutes for group 4. Of possible scores out of 5 for the job satisfaction of home healthcare nurses, their satisfaction was low for their welfare ($2.68{\pm}1.12$), workload ($2.90{\pm}0.88$), and enough time to work ($2.98{\pm}0.90$). Conclusion: The severity of patient's conditions influenced the workload of home healthcare nurses. Although workload did not correlate significantly with job satisfaction, it is necessary to devise a measure for manpower so that home healthcare nurses can secure sufficient nursing hours when they visit clients.
Kim, Jung Hee;Mun, Kyung Sook;Shin, Bok Soon;Jang, Eun A
Journal of Home Health Care Nursing
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v.22
no.2
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pp.216-227
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2015
Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.
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