The purpose of the study is to evaluate the visiting nurses service of a public health center. Data were collectd from the 36 clients who received services from a public health center. In terms of the process evaluation, the tool is composed 4 parts, 27 items such as assessment planning, implementation, and evaluation. It was measured through the health records by 2 peer review. In terms of the outcome evaluation, the level of client satisfaction was measured by self report or interview by 2 supervisor. The result were as follows: 1. 30% of 36 health records showed narsing process was not and out of them, nursing care plann including spectific activities were rarely established or unclear. 2. The lack of systematic data collection' showed and nursing diagnosis was not adressed in health records review. 3. Client satisfaction score was 32, 97, out of maximum score 36. 4. The lack of sufficent objective data, care plan, record of client's health status change, and evaluation was founded therefore quality assurance for visiting nurses service and in-service education are required and the development of standardized record system need.
Purpose: The purpose of this study was to identify the predictors of Quality of Life (QOL) among workers in public health corporations. Methods: Data were composed of 213 office workers in three public enterprise in Seoul. Data were collected from February 11 to March 20, 2007. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression using SPSS Win 12.0 program. Results: The mean QOL of the study participants was 82.60. The QOLs of the workers were significantly different according to perceived health status of workers and working hours per week. The QOL of the workers was negatively related to working hours, job stress, and depression, and positively related to the health status, self-esteem, and health promotion lifestyle (HPLS). Significant predictors of QOL were HPLS ${\beta}=.420$), depression (${\beta}=-.291$), self-esteem (${\beta}=.261$), and hours of work per week (${\beta}=-.114$), which explained 63% in the variance of QOL. Conclusion: These results suggest that strategies to enhance HPLS could improve the level of QOL. Further investigations of the direct relationship between QOL and health promotion program is warranted.
Purpose: This study was to find out the relationships between helplessness and health behavior of patients with rheumatoid arthritis. Method: The subjects were 293 rheumatoid arthritis patients who visit 2 rheumatology outpatient clinics in G city. Data were collected by questionnaires including Arthritis helplessness index(Nicassio, Wallston, Callahan, Herbert, & Pincus, 1985)and health behavior assessment scale(Jo, Oh & Choe, 2000). The data were analyzed with Pearson correlation coefficient, t-test, ANOVA and Duncan's multiple range test. Results: The majority of the subjects were women and the mean age was 50.4years. The mean duration of illness was 8.9years. There were negative correlations between the degree of helplessness and the degree of health behavior. The degree of helplessness was significantly high in those who were older, female, less educated, out of workforce, and those who had no chances to attend any arthritis-related classes. The degree of health behavior was significantly low in those who were older, high school graduate, in higher economic status, married, and those who had chances to attend arthritis-related classes. Conclusion: To reduce the helplessness of rheumatoid arthritis patients, the nursing intervention which is to increase the health behavior should be developed and provided to the rheumatoid arthritis patients.
Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.
This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.
Recent changes in health problems as well as the health delivery system demand expanding nursing roles to improve quality care and at the same time provide cost-effective health services. Nursing leaders of the future will be expected to be excellent care givers who are well prepared as researchers and managers and administrators. The purpose of developing an ND program is to train nursing leaders for the future. The program objective are to demonstrate the role as 1) an advanced practitioner who will provide theory based practice 2) a researcher and manager The target population of the ND program is as follows : 1) Nurses with a BSN degree who are seeking to advance on the career ladder 2) Non-nursing BS, BA graduates who are seeking nursing as a second career 3) Transfer students who are mature and motived to be nursing leaders It is believed that the ND program would meet the diverse needs for potential students, for their role in nursing and the health delivery system and create a meaning and challenging position in the profession of nursing. A task force team was organized to develop the ND program and its activities are as follows; 1) Information on ND programs were collected from 3 universities and reviewed 2)An advanced education needs assessment was completed and it was found that 87.6% of the subjects responded positively about advanced degree work. 3) A tentative curriculum for an ND program was developed. It is a great challenge to develop a new program for nursing however, it is also our task and responsibility to further the development of nursing.
Purpose: This study aimed to identify the educational needs of nurses and nursing students for the development of a simulation module of home visiting care for frail, elderly people. Methods: Focus group interviews were conducted with 15 home visiting nurses working in public health centers and 14 nursing students who experienced home visiting from September 10 to October 10, 2018. Results: Bloom's taxonomy of learning objectives, namely, cognitive, affective, and psychomotor domains was used as a framework for data analysis. The defined educational needs for each domain were as follows: "understanding frail, elderly people" for the cognitive domain; "intervention for mental health" and "building a therapeutic relationship" for the affective domain; and "nursing skills", "health education for healthy lifestyles", "referral to the community resource connection", "protection for visiting nurses" for the psychomotor domain. Conclusion: Based on the findings of this study, a simulation module of home visiting care for frail, elderly people can be developed and used for nursing students and nurses to strengthen the capacity for home visiting care.
Purpose: This study is to determine the predictive validity of the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) for inpatients' fall risk. Methods: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following key words; 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The predictive validity of STRATIFY was as follows; pooled sensitivity .75 (95% CI: 0.72~0.78), pooled specificity .69 (95% CI: 0.69~0.70) respectively. In addition, the pooled sensitivity in the study that targets only the over 65 years of age was .89 (95% CI: 0.85~0.93). Conclusion: The STRATIFY's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, STRATIFY is an appropriate tool to apply to hospitalized patients of the elderly at a potential risk of accidental fall in a hospital.
This study was designed to investigate effects of maternal education using Brazelton Neonatal Behavioral Assessment Scale(the following will be marked as NBAS) on the mother-infant interaction and infant behavior. The subjects of this study consisted of 48 pairs of normal mother and infant, 24 pairs for intervention group and 24 pairs for control group. The subjects were recruited from two general hospitals, and an OBGY clinic located in J city. The data were collected from July 30, 2001 to October 6, 2001. Prior to investigation and data collection, following operational hypotheses were set up in order to compare the investigative data against these operational hypotheses(H). H1: Intervention group will higher mother-infant interaction score than control group. H2: Intervention group infants will higher overall performance in infant behavior test score than control group infants. The results of this study were summarized as follows: 1. The mother-infant interaction score was 59.79 points in intervention group and 53.91 points in control group. The mother-infant interaction score of intervention group showed significant difference than control group. Therefore, hypothesis 1 was supported. 2. The infant behavior score of intervention group was significantly higher than control group, but partially. Therefore, hypothesis 2 was partially supported. 1) The social interaction(orientation) score was 46.58 points in intervention group and 43.50 points in control group. The orientation score of intervention group showed significant difference than control group. 2) The state regulation score was 26.79 points in intervention group and 25.33 points in control group. The state regulation score of intervention group showed significant difference than control group. In conclusion, present work demonstrated that maternal education using NBAS is an effective intervention method for promotion of mother-infant interaction and of infant behavior development. Author believes that many inexperience young mother may find NBAS-based maternal education beneficial for their nursing babies, therefore NBAS-based intervention is recommended to be adopted routinely as an integral part of neonatal nursing strategies.
Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.
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