• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.84-97
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• 2000

The Necessity and Purpose of the Study Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. Methods of Research Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. Data collection Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. Data Analysis For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. Results and discussion 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.602-615
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• 1998

The purpose of this descriptive study was to identify the homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeongnam, 74 nurses responded to an open-ended questionnaire consisting of four need categories : 1) educational & informational need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The findings are summarized as follows : 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational & informational need category(475 items, 36.3%). Physical(414 items, 31.6%), emotional (237 items, 18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational & informational need category, there were seven subcategories of prognosis, diet & exercise, medication & pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin & tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort & safety, others. The largest number of needs were in subcategory of the personal hygiene(82 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse & doctor. The largest number of needs were in subcatgory of the emotional support related to disease(96 items, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 items, 31.5%).

• Research in Community and Public Health Nursing
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• v.20 no.1
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• pp.105-111
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• 2009

Purpose: The purpose of this study was to identify minimum datasets for ulcer assessment and to map the minimum datasets to paper-based nursing records for pressure ulcer care in homecare setting. Methods: To identify minimum datasets for pressure ulcer assessment, the authors reviewed four guidelines for pressure ulcer care. The content validity of the minimum datasets was assessed by three homecare nurse specialists. To map the minimum datasets to nursing records, the authors examined 107 pressure ulcer events derived from 45 pressure ulcer patients who received home nursing from two hospitals in Gyeonggi Province. Results: The minimum datasets for initial assessment were anatomical location, stage, size, tissue, exudate, condition of periwound skin, undermining, odor, and pain. 'Location' was recorded best, accounting for a complete recording rate of 98.1%. 'Exudate' and 'pain' showed the poorest record, accounting for 2.8% and 0%, respectively. The minimum datasets for progress assessment were wound size, tissue, and exudate, each accounted for 31.8%, 2.8%, and 4.7%, respectively. Conclusion: This study concluded that data on pressure ulcer assessment was not sufficient homecare and it can be improved by adopting minimum datasets as identified in this study.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.159-170
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• 2001

Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.

• Journal of Korean Academy of Nursing
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• v.33 no.3
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• pp.395-404
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• 2003

Purpose: To make a contribution to raising the quality of nursing and home healthcare services through reviewing the present state of home healthcare nurse specialist training institutions and education programs and creating concrete measures to establish high-quality education courses. Method: International comparative study of accreditation criteria and curriculum in home healthcare nurse specialist program. Result: The Authorization Standards of home healthcare nurse training institutions consists of 8 items, 23 evaluation criteria and 72 evaluation indexes. Proposal to develop a specialist training program: Curriculum. Modify and complement a present homecare nurse education program. Curriculum I. Designate two forms of certification. The first certification has been granted the authority to serve as a manager and open a home healthcare agency to nurses having masters degrees and clinical experience for five years. The second certification is allowed to perform general home healthcare after having completed a short term training course. Currculum 2. To meet increasing demands, granting a certification to perform home healthcare to registered nurses having clinical experience of more than three years. Conclusion: These results can be utilized in the home healthcare educational program for raising the quality of nurses and home healthcare services.

• Journal of Home Health Care Nursing
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• v.17 no.2
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• pp.135-143
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• 2010

Purpose: The study analyzed continuing educational needs with the aim of developing continuing education program for home healthcare nurse specialists. Methods: A convenience sample of 101 home healthcare nurse specialists affiliated with 89 home health care agencies in Seoul, Busan, Dae-gu, Inchon, Jeonnam, Keongnam was used. Data was collected with a self-report questionnaire from May 10-31, 2010, and analyzed with descriptive statistics using SAS 9.13 program. Results: Of the participants, 88.1% reported that continuing education was necessary and 58.2% reported that the education was needed for peak job performance. The participants also reported that it would be proper if continuing education is given on a Saturday(56.4%) by home healthcare institute(49.5%) or homecare nurses association (38.6%) for 1-3 months(56.4%). The participants scored more than 3.0 in the current performance at six of the seven home healthcare nurse specialist roles, and scored more than 3.5 in the necessity of continuing education for seven roles in 47 jobs. Conclusion: Various programs for continuing education have to be developed and need to focused on the jobs needed for home healthcare nurse specialist and the most frequent disease. For this purpose, every home healthcare organization has to select their unique area and develop their own educational program. Furthemore, home healthcare nurses association has to build an education operating system that incorporates all program aspects.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.41-69
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• 2005

Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.73-84
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• 2003

This study was done to examine the home care service provided by home care nurses and the level of client satisfaction. Data were collected from 110 clients who received the home care service at the P-hospital in Pusan from 23th April, 2001 to 30th November, 2002. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale. Data was analyzed by using SPSS/WIN 10.5 program, the results of this study are summarized as follows; 1) 77.3% among 110 clients were over sixty years old. By the disease pattern. subjects were distributed into cancer(52.7%), cerebro-vascular disease(22.7%) and the others. 36.4% of clients were received home visits from 10 to 20 times by home care nurse. 2) The total number of home care services was 20,828. And most of the clients received the health education and training. 3) The mean score of satisfaction on provided home care services was $3.36\pm0.45$, out of 4. among 16 items. 'The home care nurses were kind enough' was highest ($3.59\pm0.49$), the total level of satisfaction of home care services was very high. with total mean score $53.84\pm7.16$. As mentioned above. the satisfaction level of home care services was very high. so we can except that the prospect of home care services is very challengeable. Therefore. we should try to expand the service recipients with promotional education to the home care clients under the cooperation with medical staff and make more efforts to develop the management system about clients' information. to improve the quality of the service, to assure close ties with the public health centers for the continuous home care service linking.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.81-93
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• 2001

The purpose of this study was to develop a continuing nursing care program for cancer patients and the caregivers staying at their home and to test its effects on patients' symptom distress, caregiver burden, and satisfaction of life. The continuing nursing care program was based on the homecare needs of cancer patients, and was provided by three clinical nurses who took care of the patients while they were hospitalized. The program consisted of discharge education about selfcare using education materials(book and handout) and provisions of direct care. These were counselling and education during which visiting patients' home one week after discharge and telephone counseling two weeks after discharge. Counseling by telephone was always available during the research period. A quasi-experimental research design was used to test the effects of the program. Subjects for this study were 53 cancer patients discharged from the hospital and caregivers. These subjects were assigned to an experimental group (n=23) receiving continuous nursing care, or to a control group (n=30) not receiving continuous nursing care. Data from control group was collected first to protect from contamination. Data collection was done from October of 1998 to February of 2000. The collected data was analysed using mean, t-test, and chi-square test computed by SPSS software. The summary of results was as follows: 1) The symptom distress was a little decreased at posttest, but there were no significant differences between the experimental and the control group in symptom distress. 2) The score of caregiver burden was significantly decreased in experimental group at posttest, but no differences in control group. 3) There were no significant differences between the experimental and control group in the satisfaction of life. 4) The score of satisfaction of continuing nursing care program in experimental group at posttest was 2.321 of 3. In conclusion, even though this study did not obtain evidence of effectiveness of continuing nursing care program on patients, such as. It is still expected to be effective by a more improved program. Therefore we want to give some suggestions for further studies. 1) It is needed to make a communication channel with the patient's doctor to response promptly and appropriately to patient's conditions. 2) The research is necessary on patients in terminal stage or early stage of cancer diagnosis who have many nursing needs. 3) It is needed to readjust the roles and job assignment of clinical nurse to implement effectively as a program provider.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.109-120
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• 2001

This study has been done in order to help the people understand the cancer patients and provide the basic materials for the care of cancer patients by deeply understanding the living experience of the practice of alternative therapy for cancer patients. Data were collected with several in depth interviews and observations. Collected datas were analyzed by using phenomenological method of study by Giorgi (1970). The trial experience of alternative therapy for cancer patients has been classified into the one of having concerns, following, being infatuated, and coming out by pushing, and the experience of having concerns appeared as the meaning of the limit of modern medicine, despair, loneliness. hope, emotional support. dissolution of the feeling of uneasiness. the feeling of burden of the medical expense, self-treating, the subject of treatment. and indifference while the experience of following appeared as the meaning of blind following, temptation, going outside to look for something, wandering. following unconditionally, advise of the professionals, mistaken belief. self-abandonment, powerlessness. disconnection of dialogue with the medical staff. elevation of immunity, strengthening the physical power, absence of the source of examined information, clinging, self-responsibility. the experience of being infatuated appeared as the meaning of thorough trial. affirmative experience. devotion. diverse efforts, faithful trial. affirmative self-suggestion. change of the style of life. the feeling of burden of expense, being envious, bitter feeling toward the family, considering family, family discords, and difficulty of enforcement. The experience of coming out by pushing appeared as the meaning of waiting. self-reflection. maintaining the distance. cutting attachment, throwing the greed away, coming out by pushing. being thoughtful. accepting disease. individual difference of physical quality, and ambivalence. But they return to the experience of being concerned all over again in case of recurrence or metastasis of the disease even though they come out of such stage, and they always have ambivalence even in the condition with no recurrence and metastasis. In conclusion, the trial of alternative therapy for cancer patients could be explained as the adaptive behavior to the disease which is difficult to be cured. the cancer. The cancer patients are exposed to the side effects and harm without the examined information resources. Therefore the nurse should well aware of the alternative therapy and be able to do the appropriative management through the open communication with the patients who are under the trial of alternative therapy.