• Title/Summary/Keyword: Problem related to the care-giving for patients.

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A Study on the Family Problem of the Hospitalized Patients (입원환자가족의 가정문제에 관한 연구)

  • Hwang Youngbin
    • Journal of Korean Public Health Nursing
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    • v.4 no.2
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    • pp.79-99
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    • 1990
  • This study was conducted to identify the family problems of the in-patients and to analize factors Influencing to the family problems. The subjects for this study were 277 family members those who were giving care for the adult patients during hospitalized in general wards at Seoul National University Hospital in Seoul. Data were collected through interviews with the questionnaire from September second to September twentieth in 1989. The instrument used for this study was the family problems scale which was developed by the researcher. Analysis of data was done by frequency, percent, mean, t-test, ANOVA, Pearson-Correlation Coefficients, and Stepwise Multiple Regression Analysis. The results of this study are summarized as follows: 1. General characteristics of the care-giver in family. The average age of care-givers was 37.9 years, and the $26.4\%$ of monthly Income of family was 310,000-500,000 won group. The $93.5\%$ of family had taken the responsibility of caring for the patients instead of hiring the care-givers, and the $12.3\%$of the care-givers complained weakning of health status during care giving for the patients. The spouse took the largest part of responsibility of the care-giving services to the patient among the family members. 2. General characteristics of the patients. The average age of patient was 47 years, and the $80.9\%$ of patient was married status. The $39\%$ of patient was father in the position of family, and the $41.5\%$ had the responsibility to support their family before hospitalization. The average hospitalization period of patient was 24.3 day and the $50.9\%$ had admission experience. 3. The factors of family problems which were faced by the family were classified into six problems. The factors of family problems were ranked as follows; the first rank problem was related to care-giving for the patients. the second problem was resulted from the patients diseases, the theirds problem was related with adaptation to the hospital enviroments, the fourth problem was related to the arisen conflicts with medical team. the fifth problem was related to the change of family function. and the sixth problem was the financial problem. 4. The relationship between the family problems and the general charateristics of the care-givers showed that the nuclear type family was higher the family problems, that the admission period of patients became longer, and that the family who had the worse condition of health status of the care givers during care giving for the patients. From the above results, it was confirmed that the family care giving for patients was faced with some problems resulted from patient's illness, relation to the medical team, adaptation to the hospital enviroment, financial problem. change of family function, and care-giving for patients.

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Analyzing the Problem of the Caregiver Education System through a Research of the Caregiving Service Activity (요양보호 서비스 활동 조사를 통한 요양보호사 교육과정의 문제점 분석)

  • Suh, Tae-Soo;Kim, Kyong-Tae;Jun, Kyoung-Hee
    • The Journal of Korean Physical Therapy
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    • v.20 no.4
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    • pp.61-69
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    • 2008
  • Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

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The evaluation of active daily living after patients had stroke - focus on active daily living habit & physical therapy - (뇌졸중 환자의 퇴원 후 일상생활에 대한 고찰 - 일상생활 습관 및 물리치료 중심으로 -)

  • Kim, Hye-Seun;Lee, Chang-Hyun
    • Journal of Korean Physical Therapy Science
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    • v.10 no.1
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    • pp.30-37
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    • 2003
  • Purpose : The purpose of this study is giving the healthy promotion and it's related data base for out-patients who had stroke via evaluating the general characters of their active daily living and physical therapy Method : This study researched 81 patients who had received physical therapy service in 6 general hospitals located Pusan city responded to the self-assessment questionnaires from July 2002 to August 2002. Conclusion : In this study, patients were composed of 61.7% of male, 65.4% of 50's-60's in the age, 56.8% of cerebral infarction, and 60.5% of right hemiplegia. 74.1% of patients received physical therapy after 6 months from an attack, only 62.9% used orthosis & gait aids, and 59.2% received medical care 2 or 3 times per week. 40.7% of patients had over 9 hours sleeping time and 22% had reduced $1{\sim}2hours$ before hospitalization. 90% did not have drinking and smoking. 91.4% had 3 times eating per day, and 67.7% did not have good nutrition. The reasons of that were their eating habit, 542% of eating-giver, 3.7% of economic problem. 46.9% of patients used healthy food. In active daily living, patients can't do drinking by cup, voiding & defication by themselves, however patients can't do wearing/take off, etiquette for dressing, bathing, stepping by themselves. 40.7% of patients don't wear orthosis, 55.6% of patients don't use W/C. Part of physical therapy that patients concerned importantly exercise for prevention of joint distortion, management of affected side, and 80% of patients was also concerned other's part, significantly. 71.8% of patients & care-givers want to receive physical therapy at home, and 74% of patients do physical therapy by themselves at home along teached hospitalization.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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