• Journal of Home Health Care Nursing
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• v.8 no.1
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• pp.5-24
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• 2001

The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

• Research in Community and Public Health Nursing
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• v.15 no.4
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• Journal of East-West Nursing Research
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• v.26 no.1
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• pp.28-38
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• 2020

Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.

• Journal of Sensor Science and Technology
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• v.15 no.5
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• pp.362-370
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• 2006

The wireless sensor network (WSN) based ECG and body temperature measuring system for ubiquitous health-care were designed and developed. The system was composed of a wireless sensor network node, base station and server computer for the continuous monitoring of ECG signals and body temperatures of patients at home or hospital. ECG signal and body temperature data, important vital signals which are commonly used in clinical and trauma care, were displayed on a graphical user interface (GUI). The data transfer from sensor nodes on patients' body to server computer was accomplished through a base-station connected to a server computer using Zigbee compatible IEEE802.15.4 standard wireless communication. Real-time as well as historical, ECG data of elderly persons or patients, can also be retrieved and played back to assist the diagnosis. The ubiquitous health care system presented in this study can effectively reduce social medical expenses, which will be increased greatly in the coming aging society.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.31-42
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• 2002

Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.

• Journal of Home Health Care Nursing
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• v.10 no.1
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• pp.15-24
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• 2003

This study provides some basic information on the improvement of diabetics' self-care activities through examining the patients' knowledge on diabetes, self-care activities, and how much they feel those activities are effective and through studying the correlation among the three factors. One hundred and fifty four patients were subjected to this study, who were treated or hospitalized in a hospital in Pusan. Researches were conducted from October 21 to November 9, 2002, and information were gathered by questionnaire and direct conversation with the patients. The data was processed through SPSS WIN 10.0 program. The Date were analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient and Spearman rank correlation coefficient. The results of this study was the followings; 1) The subjects' knowledge on diabetes ranged from 6 to 23 points with a mean of 17.01 points. 2) The subjects' self-care activities ranged from 21 to 103 points with a mean of 67.72 points. That of the patients with regular treatments appeared to have the highest points (3.51) and the lowest points appeared in the measurement of sugar level in blood (2.60) 3) The subjects' feelings of effectiveness ranged from 21 to 103 points with a mean of 70.01 points. Drug therapy had the highest point (3.94) and diet showed the lowest (3.37) 4) In the general characteristics of the subjects, the more education a subject had, the more knowledge on diabetes he or she appeared to have (F=3.36, p=0.012). The self-care activities were significantly high among non-alcoholic subjects (F=4.301. p=.016). The subjects' feelings of effectiveness were higher in female patients than in male patients(t=2.132 , p=.035), and those in the ages between 51 and 60 felt more effectiveness (F=4.198. p=.003). In addition, married subjects felt more effectiveness than the unmarried (t=2.856, p=0.005), and the more education a patient had. the more effectivess he or she felt (F=2.879, p=.025). 5) In the subjects' pathological characteristic, the subjects who experienced diabetes education showed more knowledge on diabetes, more self-care activity, and more effectiveness than those without the education (t=3.193, p=.002; t=2.299, p=.023; t=2.128, p=.035). 6) As the results of the analyses of correlations among knowledge on diabetes, self-care activity, and effectiveness, the more knowledge on diabetes a patient had, the more self-care activity and the more effectiveness he or she showed (p=0.283. p=0.002; p=0.182, p=0.036). Self-care activity became higher as the feeling of effectiveness appeared higher (r=.550, p=.000). Based on the results above, several suggestions were made; 1) This study was conducted in one hospital, so it is difficult to generalize the results. It is necessary to gather more information from more patients through repeated researches. 2) The study on the other factors which can affect a patient's self-care activity is required. 3) The development of a program which improves a patient's self-care activity, knowledge on diabetes. and effectiveness is needed.

• Korean Circulation Journal
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• v.52 no.10
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• pp.785-794
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• 2022

Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

• Women's Health Nursing
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• v.21 no.4
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• pp.308-320
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• 2015

Purpose: The aim of this study was to determine the predictive factors for maternal role development for mothers of premature infants. Methods: A descriptive correlational study was conducted. A total sample of 121 mothers of premature infants following discharge from the neonatal intensive care unit were recruited using two strategies; an internet-based survey and an in-person data collection in a tertiary university hospital in Korea. A self-report questionnaire was used to collect data regarding personal, birth variables, marital intimacy, maternal attachment, maternal identity and maternal role development. Results: A hierarchical multiple regression analysis indicated that parity, maternal attachment, marital intimacy and maternal identity were predictors for maternal role development for mothers of premature infants, accounting for 70% of the variance. Among these variables, maternal attachment is the most powerful predictor for maternal role development. Conclusion: Nursing interventions during hospitalization to post-discharge education that includes parents of premature babies with positive interaction between couples strengthening marital intimacy and promotes maternal attachment that leads to integrate maternal identity should be considered by priority. Community-based family services such as home visits should be focused on maximizing the predictive factors for maternal role development in transition to motherhood that can contribute to maternal health as well as optimal growth and development of premature infants.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.10-19
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• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

• Child Health Nursing Research
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• v.10 no.1
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• pp.5-13
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• 2004

Purpose: The aim of this study was to analyze the correlation of gestational age and birth weight with weight gain of very low birth weight infants(VLBWI) during their hospital stay. Method: This is a 5 year retrospective study of which data were collected through review of medical records. Subjects were 124 VLBW infants with a birth weight more than 1000g and less than 1500g who received neonatal intensive care at the university hospital between January 1, 1997 to December 31, 2001. Result: After calculating the z scores of birth weights and discharge weights, z scores of discharge weight and birth weight were compared with the median weight of a fetus of comparable gestational age based on an intrauterine growth reference. There was a significant difference between z scores of birth weight and discharge weight(t=11.60, df=122, p=0.000). Regardless of intensive care during the prolonged hospital stay, VLBW infants showed slow growth rate compared with the median weight of a fetus of comparable gestational age. Conclusion: VLBW infants developed a poor velocity of weight gain during the prolonged hospital stay after birth. The development worsened during the period of physiological weight loss and regain, and they did not reach to comparable growth rate of normal fetus even at the time of discharge. This poor growth velocity of VLBW infants influence negatively for their future growth. Therefore nureses who work at the neonatal intensive care unit must develop an effective nursing intervention protocol to promote the velocity of weight gain and to conduct the parental educational sessions to emphasize the importance of weight gain for VLBW infants at home.