• Title/Summary/Keyword: Integrated Nursing Care

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Experience of Visiting Nurse's End-of-life Care: A Qualitative Contents Analysis (방문간호사의 생애말기 간호에 대한 경험: 질적 내용분석)

  • Bang, Misung;Lee, Insook;Yang, Juhyeon;Kim, Sohee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.29 no.2
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    • pp.143-152
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    • 2022
  • Purpose: This study aims to describe and explore the experiences of visiting nurses so as to providing high-quality end-of-life care at home. Methods: Data was collected and recorded through in-depth interviews with 11 visiting nurses and transcribed verbatim. The data were analyzed with qualitative contents analysis. Data were collected from April 8 to July 30, 2021. Results: The results revealed the following four themes and ten sub-themes: The main themes were 'Dignified end-of-life caring practice at home', 'Providing integrated support of end-of-life family caregivers', 'Confronting the limits of visiting nursing at the end of life' and 'Reflection on life and feeling rewarded'. Visiting nurses have performed dignified end-of-life care at home and integrated support for family caregivers. Although the visiting nurse sometimes faced the limits of visiting nursing during end-of-life care, it was surveyed that they rewarded on their lives and felt rewarding through the end-of-life nursing experience. Conclusion: Practical and systematic training is needed to positively change the end-of-life care of visiting nurses. We propose programs, such as expert counseling, to improve coping skills in end-of-life care practice at home. Additionally, we propose various institutional supports which can support the limitations of end-of-life care provision.

The Development and Effects of an Integrated Symptom Management Program for Prevention of Recurrent Cardiac Events after Percutaneous Coronary Intervention (관상동맥 중재술 후 심질환 재발장지를 위한 통합적 증상관리 프로그램의 개발 및 효과검증)

  • Son, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.38 no.2
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    • pp.217-228
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    • 2008
  • Purpose: This study was conducted to develop and to determine the effects of an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention. Methods: Subjects consisted of 58 CAD patients (experimental group: 30, control group: 28). The experimental group participated in an integrated symptom management program for 6 months which was composed of tailored education, stress management, exercise, diet, deep breathing, music therapy, periodical telephone monitoring and a daily log. The control group received the usual care. Results: The experimental group significantly decreased symptom experiences and the level of LDL compared to the control group. The experimental group significantly increased self care activity and quality of life compared to the control group. Although no significant difference was found in cardiac recurrence, the experimental group had fewer recurrences. Conclusion: These results suggest that an integrated symptom management program for prevention of recurrent cardiac events after percutaneous coronary intervention can improve symptom aggravation, recurrent rate, self care activity and quality of life. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented in the overall transition period.

A Study for the Development of Standardized Management Manuel in Sanhujoriwon - Centered on the Management of Women & Newborn - (산후조리원의 표준화 관리 지침을 위한 연구 - 산모와 신생아 관리현황을 중심으로 -)

  • Jung, Eun-Sil;Yoo, Eun-Kwang
    • Women's Health Nursing
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    • v.8 no.2
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    • pp.301-313
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    • 2002
  • The purpose of this study was to develop the frame for standardized manual for Sanhujoriwon by finding out the status of the management of women & newborn in Sanhujoriwon, like postpartum care center. The subjects were 95 staffs of 22 Sanhujoriwon agreed on oral consent, in Seoul and Bundang, Korea. Data were collected from Sep. 15 to Oct. 24, 2001. The instrument used for this study was a structured questionnaire consisted of 16 items of general characteristics & educational characteristics about postpartum care, 31 items of degree of management of women's postpartum care (Cronbach's $\alpha$.93 ), 24 items of degree of management of newborn's care(Cronbach's $\alpha$.94 ), 10 items of methods of management of women's postpartum care, 8 items of methods management of newborn's care. The data were analyzed by the SPSS/PC+ program using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient. The results of the study were as follows ; 1. The mean of the degree of management for postpartum women was 4.1. The mean score for the degree of management of general postpartum care for women was 4.00 & traditional postpartum care(Sanhujori) was 4.20. The degree of management of traditional postpartum care was higher than general postpartum care for women. 2. The degree of management for newborn : The mean score for the degree of management of newborn was 4.37. 3.There was a strong positive correlation between general postpartum care and traditional postpartum care($r=.744^{**}$), and postpartum mother care and newborn care($r=.798^{**}$). 4.The basic frame for the management of the women and newborn in Sanhujoriwon. 1) For women: Integrated postpartal care Physical management : Vital sign & BP check, contraction of uterus, form and amount of lochia, management of personal hygiene, management of breast & breast-feeding, management of postpartum exercise, prevention of infection, symptom & sign of high risk and prevention & management of high risk condition; Emotional-psychological management: assessment and management of mother-baby attachment, emotional state; Educational management : education of vaccination schedule, urinary incontinence, rearing infant, breast-feeding ; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. 2) For newborn Physical management : check of vital sign, management of umbilical cord, jaundice, prevention of infection, management of diaper rash; Emotional-psychological management : assessment of sleep, crying, activity, response of mother-baby attachment; and Environmental management : temperature, humidity, disinfection, cleaning, light, infection control integrated with 6 principles of Sanhujori. In conclusion Sanhujoriwon must be health care center for the postpartum women and newborn. Therefore, the establishment of various laws and regulations in such a way to meet the realistic needs of Sanhujoriwon as a health care center for women and infants future health should be done. The standardized management manual based on the results is absolutely required above all.

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Managerial Effectiveness of Integrated Delivery System in Japan (의료서비스 복합화의 경영효과 분석 : 일본의 사례)

  • Jeong, Seung-Won;Inoue, Yusuke;Seo, Young-Joon;Kim, Yun-Hee
    • Korea Journal of Hospital Management
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    • v.14 no.2
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    • pp.60-74
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    • 2009
  • This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.

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The Preliminary Study for the evaluation of the Rehabilitation Nursing Program integrated with Day Care Program of Stroke Survivors (뇌졸중환자의 낮 병동 재활간호프로그램의 적용평가를 위한 예비연구)

  • Suh, Moon-Ja;Kang, Hyun-Sook;Lee, Myung-Hwa
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.1
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    • pp.98-107
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    • 2000
  • A Preliminary study for the evaluation of the Rehabilitation Nursing Program(RNP) implemented to the 25 stroke survivors at the Day Care Program Center of National Rehabilitation Hospital in Seoul was done at 1999. The purposes of this study was to assess the psychological effects as outcome-variables such as depression, powerlessness and self efficacy of the stroke survivors who were discharged from acute care hospitals. The Rehabilitation Nursing Program (RNP) integrated with the Day Care Program for rehabilitation was implemented and the psychological outcome variables were measured by 3 psychologic instruments of Zung Depression Scale, Millers's powerlessness and the Bandura's self efficacy scale. These instruments were translated into Korean and the contents validity and the reliability were tested. The subjects were 17 males and 8 females and 52% were aged over 51 years old and 24% were from 31 to 50 years old. Most of them (72%) had been educated more than high school level. The contents of RNP were 8 sessions composing of self-introduction, individualized assessment, health contract and feedback, management of depression, shaving experiences, effective communication, self efficacy teaching, health information, and daily care activities. This study found that the level of depression and the powerlessness were within average level and had not been changed the level of self efficacy after RNP were somewhat higher than before, but it was not changed significantly. According to the results, the psychological state of the subjects were not changed significantly. Only the level of self efficacy was a little improved after having the RNP. Based on theses results, the RNP should be focussed on the psychological nursing care and the psychological outcome variables were retested strictly with the enough sample size.

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Community Care and Visiting Nursing Services in Denmark, Sweden, the United States, and Japan (국외 커뮤니티 케어의 방문간호서비스 사례 분석)

  • Han, Young Ran;Yang, Sook Ja;Ham, Ok Kyung;Lee, Guna;Kim, Seo Hyeon;Ha, Jae Young
    • Journal of Korean Public Health Nursing
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    • v.34 no.1
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    • pp.5-21
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    • 2020
  • Purpose: This study compared visiting nursing services of Denmark, Sweden, Japan, and the United States to provide baseline data for the development of models for community care nursing services in South Korea. Methods: A review of the literature was performed that include journal articles, government reports, institutional reports, and national/international statistics. Site visits were performed to explore the visiting nursing services of Denmark. Results: Government centered visiting nursing services were provided in Denmark and Sweden mostly by public organizations, while private services prevailed in the United States and Japan. Nursing services included case management or care coordination services, while nurse practitioners or nurse specialists provided visiting nursing services in all of the four countries and the services were provided 24 hour a day. Conclusions: Based on the review of visiting nursing services in foreign countries, the development of models is needed to provide integrated visiting nursing services in Korea that encompass home care nursing, visiting nursing, and visiting health care services.

Development and Evaluation of Integrated Management Program for Hemodialysis Patients (혈액투석 환자를 위한 통합적 관리 프로그램의 개발 및 효과)

  • Kim, Bora;Yoo, Hana
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.31 no.1
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    • pp.66-76
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    • 2024
  • Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.

Helping Health Care Providers Recognize and Respond to Sensitive Issues

  • Choi, Hee-Seung;Mayahara, Masako;Rasamimari, Amnuayporn;Norr, Kathleen F.
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.121-128
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    • 2011
  • Sensitive issues are both common and problematic for health care providers because sensitive issues may interfere with the future provider-client relationship and effective care. Most current training for providers focuses on a particular issue, but this is inadequate because many issues may be sensitive, and which issues will be sensitive is unpredictable. We argue that issues become sensitive when they activate one or more of three common triggers, fear, stigma, and taboo. A cycle of negative internal and interpersonal responses to the sensitive issue often leads to unresolved health issues for clients and stress and feelings of inadequacy for providers. We recommend integrated pre-service and in-service skill building to help individual health care providers respond appropriately to a wide variety of sensitive issues. We also identify specific policies and procedures to strengthen organizational support for caregivers so that providers can address these sensitive issues effectively with their clients.

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Suffering and Spiritual Care (고통(suffering)과 영적 간호)

  • Kim, Myung-Ja;Yang, Nam-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.16 no.1
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    • pp.40-48
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    • 2009
  • Although the general concept of suffering care includes palliative care for the terminally ill that is designed to alleviate pain, it is much more holistic and encompasses emotional, spiritual and other life dimensions. Human suffering is multi-dimensional including spiritual and religious aspects, which diverge from the concept of pain understood in the context of materialistic medical approach. In this caring perspective, the body, mind and spirit are integrated so that objectivity and subjectivity can merge. The extended awareness with inner source or energy, and positive thinking about the personally-relevant God can be meaningful the dying person, family members and the caring team. Despite the importance of an inclusive understanding of human suffering, actual nursing practice still does not fully embrace the full understanding of human suffering. A more fundamental meaning of human suffering from the nursing perspective may fruitfully adopt a more inclusive view of human suffering.

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A Study on the Effects of Comprehensive Nursing Care Service Quality to Health Care Service Performance -Focusing on the Mediating Effects of Relational Commitment- (간호·간병 통합서비스 품질이 의료서비스 성과에 미치는 영향 -관계몰입의 매개효과를 중심으로-)

  • Kim, No-Sa;Choe, ho-Gyu
    • Industry Promotion Research
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    • v.3 no.2
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    • pp.21-31
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    • 2018
  • This study conducted a hypothesis test to examine the effect of integrated service quality of nursing and care on medical service performance. The results of this study are as follows. First, the perceived performance, loyalty, perceived performance, perceived loyalty, and perceived loyalty of medical service achievement, perceived performance of medical service performance, responsiveness, confident, empathy, The results show that adoption has a positive impact on loyalty. In other words, the integrated service quality proved to be very important for the medical service capacity. In order to do this, institutional efforts should be given priority to increase the number of nursing staff. In order to nurture excellent nursing team members, in addition to professional nursing ability, emphasis should also be placed on personality education for positive relationships through patient empathy. In this study, we can find the implication of the study that we measured the effect of integrated service quality on medical service performance.