• Title/Summary/Keyword: Visiting Nursing Service

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Outcome Assessment of a Demonstration Project on Integration of Home Visiting Health Care and Social Welfare Services (보건소 중심의 방문보건.재가복지 통합시범사업 성과)

  • Ahn Yang-Heui;Jang Sei-Jin;Choi Gyun
    • Journal of Korean Public Health Nursing
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    • v.20 no.1
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    • pp.5-15
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    • 2006
  • 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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Development of Evaluation Indicators for Integrated Home Care (통합가정방문급여 평가지표 개발)

  • Park, Jong Duk;Jung, Dukyoo
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.543-552
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    • 2014
  • Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

The Relations among Health-promoting Behaviors, Self-esteem and Depression in the Vulnerable Elderly of Urban Areas (도시 취약계층 노인의 건강증진행위, 자아존중감과 우울간의 관계)

  • Choi, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.16 no.2
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    • pp.148-156
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    • 2005
  • Purpose: This study was to identify the relations among health-promoting behaviors. self-esteem and depression in the vulnerable elderly in an urban community. Method: The subjects were 185 vulnerable elderly adults aged over 65 in D city, who were selected through convenience sampling. Data were collected by a questionnaire survey. The tools used in this study are the HPLP developed by Walker(1987), the Self-esteem Scale developed by Rosenberg (1965), and the Geriatric Depression Scale developed by Yesavage & Brink(1983). Collected data were analyzed with the SAS program using descriptive statistics. Pearson's correlation coefficient, t-test, ANOVA, Duncan's multiple-range test and stepwise multiple regression. Result: Self-esteem and depression was in a negative correlation with each other (r=-0.21), but no significant correlation was observed between HPB and depression. HPB and self-esteem were in a positive correlation with each other (r=0.38). The most powerful predictor of depression was self-esteem and, next, leisure activity and the type of family living together. The three factors accounted for 41.1% of the variance in depression in the vulnerable elderly. Conclusion: These results suggest that self-esteem, leisure activity, and the type of family living together can be potential risk factors for old age depression. These findings may give useful information for developing visiting nursing service programs focused on depression in the vulnerable elderly.

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Factors Affecting Depression in Elderly Vulnerable People Living Alone (취약계층 독거노인의 우울에 미치는 영향변인)

  • Kim, Hyun-Mi;Choi, Yeon-Hee
    • Research in Community and Public Health Nursing
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    • v.22 no.4
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    • pp.355-364
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    • 2011
  • Purpose: The purpose of this study was to investigate factors that influenced depression of the elderly vulnerable people living alone in the public home visiting health service center. Methods: The participants for this study were 491 Korean elderly men living in G city. Data were collected from February to July, 2011 using structured questionnaires. ${\chi}^2$-test, t-test, Pearson's correlation coefficient and multiple regression with the SPSS/WIN program were used to analyze the data. Results: The levels of ADL and IADL of the elderly living alone were higher, and the levels of social support and life satisfaction were lower than the normal elderly. Depression was positively related to ADL and IADL and negatively to social support and life satisfaction in the elderly living alone. In addition, age, fall experience, ADL, IADL and life satisfaction had influence on the depression. Conclusion: The elderly living alone are in a more serious health status, especially in depression than the normal elderly. It is necessary to develop depression controlling intervention programs in order to promote healthy lifestyles for the elderly vulnerable people living alone.

Factors influencing the community care satisfaction of the urban elderly focusing on the outreach community health service in Seoul (서울시 찾아가는 동주민센터 방문건강관리 사업의 만족도 영향요인)

  • Shon, Changwoo;Seo, Daram;Hwang, Jongnam
    • Journal of Korean Public Health Nursing
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    • v.35 no.2
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    • pp.254-267
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    • 2021
  • Purpose: This study aimed at identifying the factors affecting the service satisfaction of urban elderly, focusing on the outreach community health service in Seoul, and suggesting policy directions for the successful implementation of community care. Method: Individuals aged 65 and 70 who used the outreach community health service from July 2017 to June 2019 were eligible for the survey. A total of 2,028 people were sampled using a proportional allocation method for each autonomous district in the survey which covered 25 districts. A multi-level logistic regression analysis was conducted, taking into account the individual's socioeconomic level, health status, type of service provided, and the healthcare-related environment and service provision period of the autonomous district. Result: The results revealed that the health status of the urban elderly, the type of services provided (health screening, linkage to community health center and clinic/hospital, medical checkup results counseling, frailty evaluation), and personal experience of the service were the major factors associated with the satisfaction with the outreach health services. Conclusion: The development of customized health services based on the close relationship between visiting nurses and the elderly may be considered to promote a sustainable community health care model.

A Study on Model Development for Urban Community Nursing Center (일개 도시 지역사회 간호센터 모형개발을 위한 요구조사)

  • Yun, Soon-Nyoung
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.260-271
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    • 2002
  • Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

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Gender Difference in Factors Related to Depression in Vulnerable Elderly (취약계층 노인의 성별 우울 관련 요인)

  • Kim, Eun-Kyung
    • The Korean Journal of Health Service Management
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    • v.8 no.3
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    • pp.169-179
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    • 2014
  • The aim of this study was to understand the factors related to depression according to gender in vulnerable elderly. We conducted a cross-sectional study with 1,709 elderly beneficiaries of the visiting health care program in Seoul. Depression was measured using the Geriatric Depression Scale Short Form Korea Version(GDSSF-K) questionnaire. Depression score was mild level in vulnerable elderly. There was no gender difference in depression level. Factors related to depression differ by gender. In the elderly men, higher depression showed significant correlation with a lower level of health-related quality of life(HRQOL) and self-rated health(SRH). In addition, higher depression was observed for elderly men living alone than for those living with family. These factors explained depression by 23.1%. In the elderly women, higher depression showed significant correlation with a lower level of HRQOL, SRH and a higher dependence of instrumental activities of daily living. In addition, higher depression was observed for elderly women who has fall experience. These factors explained depression by 22.8%. Gender-specific nursing strategies may be required for prevention of depression in vulnerable elderly.

The severity of clinical symptoms according to cancer diagnosis in fever patients visiting the emergency department: a retrospective analysis (응급실에 내원한 발열 환자에서 암 진단 유무에 따른 임상증상의 중증도에 대한 후향적 조사 연구)

  • Eun Seam Lee;Purum Kang;You Kyoung Shin;Geun Hee Seol
    • Journal of Korean Biological Nursing Science
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    • v.25 no.2
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    • pp.105-112
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    • 2023
  • Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.

A study for the factors on choosing hospitals and patients satisfaction between Geriatric Hospitals and General Hospitals (노인병원과 종합병원의 선택요인 및 환자만족도 분석)

  • Yoon, Seo-Jung;Yu, Seung-Hum;Kim, Young-Hoon;Lee, Ji-Jeon
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.46-75
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    • 2004
  • This research anticipated on acknowledging the inpatients factors in choosing which hospital for the geriatric hospital and general hospital they would prefer to go to the analization of different factors in patients satisfaction, and the relation between satisfactory standards and the patients intentions on recommendation or re-visiting the hospital. The statistical data was based upon the 359 question and answer papers that were done by inpatients that were hospitalized in two geriatric hospitals and two general hospitals, and the methods used for analyzing were frequency, t-test, factor analysis, and hierarchical multiple regression. The results are as follows. 1. The factors on choosing hospitals between geriatric hospital and general hospitals were different. The priority for the geriatrics was kindness, and then considerate nursing, and the reliance of treatment. The patients of general hospitals looked first for reliance of treatment, reputation and history of the hospital, and the kindness of the staff. The kindness of the staff, good nursing, and easy procedures were the primary factors of choosing geriatric hospital. 2. The four primary factors in choosing which hospital patients would go to were the predominance of the facilities, kindness and convenience, the reliance and proximity of medical treatment, and recommendation. The patients in the geriatric hospital first looked for kindness and convenience, second the reliance and proximity of medical treatment, third predominance of facilities, and last recommendation. The general hospitals main priority was the reliance and proximity of medical care, second predominance of facilities, kindness and hospitality, and last recommendation. 3. The satisfaction rate was higher in the geriatric hospital compared to general hospitals, but the satisfactory of factors were very similar. Patients in the geriatric hospital were pleased with the hospital staffs kindness, quick nursing and the improvement of inconvenient matters, and clear diagnosis of the doctors. The general hospital patients were satisfied with the hospital staffs clear explanation and accurate diagnosis 4. The analysis in the satisfactory factors turned out to be the environment of the hospital, kindness of the staff, and convenience. Both the patients of the geriatric hospital and general hospitals were very pleased with the kindness of the hospital staff. Ranking second and third was convenience and service for the geriatric hospital, and environment of the hospital and convenience for the general hospital. 5. According to a rank of multiple recurrent analysis of the patients satisfaction and the intention of re-visiting in addition to intention of solicitation, in the case of a geriatric hospital, when the intention of re-visiting is the dependent variable, the first stage shows that the less insurance the patient has, the higher was the intention of re-visiting. In the second stage, the more satisfied the patient is of the staffs kindness, the higher was the intention of re-visiting. Further more, when the intention of solicitation is the dependent variable, the first stage shows that not all the independent variables were significant, but the second stage shows that the more satisfied the patient is of the staffs kindness and the hospital along with the medical treatment expenses, the higher was the intention of solicitation. 6. In the first stage of a rank of multiple recurrent analysis of the satisfaction of the general hospital and the intention of re-visiting, not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. Moreover, when the intention of solicitation was the dependent variable, the first stage shows not all the variables were significant, but in the second stage, all the satisfaction by factors were significant. That is to say, in the case of a general hospital, the satisfaction of the hospital and the medical treatment expenses were high, and the more satisfied the patient is of the hospitals environment and the staffs kindness, the intention of re-visiting and the intention of solicitation was higher.

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Development of Wholistic Hospice Nursing Intervention Program for In-patient of Hospice Palliative Care Unit (병동형 호스피스 대상자를 위한 전인적 호스피스 간호중재 프로그램의 개발)

  • Kang, Eun-Sil;Choi, Sung-Eun;Kang, Sung-Nyun
    • Korean Journal of Hospice Care
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    • v.7 no.1
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    • pp.29-45
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    • 2007
  • People in the end of life and their families suffer in their physical disease and other aspects as a whole person. They need hospice care to palliate their total suffering in physical, emotional, social and also spiritual aspect through professional hospice team. To care their whole personal needs, hospice team must be a multi-discipline team which consists of medical doctors, nurses, social workers, pastors and volunteers. Recently those who die in hospice palliative care unit have trend to increase more than in home year by year. So it is necessary to develop the nursing intervention program to be performed by multi-discipline team approach for in-patient of hospice palliative care unit. The purposes of this study were to develop of wholistic hospice nursing intervention program for inpatient of hospice palliative care unit. The subjects of study were collected from 30 patients those who were over 18 years old and admitted in hospice palliative care unit of S hospital in P city with agreement in hospice palliative care in their terminal disease. The period of data collection was from December 15, 2003 to March 15, 2004. The result were as follows : 1. The result of Wholistic Hospice Nursing Program's development was as follow : A Wholistic Hospice Nursing Program was developed by me in this study is one of the service program for hospice palliative care unit. It was named as ‘Rainbow Program’ to be approached easily by hospice patients. The purposes of it are to improve the quality of life of the terminal patients with their dignity, to help them live in abundant and meaningful in their lives, to care them in peaceful in dying process with understanding them in whole personal, and also to palliate the grief and suffering of the bereaved. It was provided by hospice professionals(nurses, medical doctors, social worker, pastors, art therapists) and volunteers those who were educated in hospice for multi-diciplinary team approach to collaborate with each role play I 20-30 minuters of each through visiting their rooms individually and a place of hospice palliative care unit of S hospital in P city. The subjects of it were the terminal patients those who admitted hospice palliative care unit and their familes. with agreement in hospice palliative care in their terminal disease. The characteristics of it were multi-disciplinary team approach, whole personal care, individual care and total care according to their needs in their condition. The contents of it were pain control, symptom control, counseling patient, counseling family, hair cutting, hair shampooing, bed bath, recreation, taking a walk, event of culture(screen, recital, festival of praises, exhibition and so on), pastoral counseling, ritual service in bed, praying, service in bed, sing a worship praise, listening to the music, sharing remembrance of life, individual visiting music service(sing and praying), meditation Bible, art therapies(dance and drawing), social worker's counselling, confessing and sharing love and thanksgiving. The experimental group subjects participated in Wholistic Hospice Nursing Program which takes 120 minutes per session, total 10 sessions(total 1,200 minutes) altogether. In conclusion, this Wholistic Hospice Nursing Intervention can be used actively for whole personal well-being of the patients in hospice palliative in hospice palliative care unit and also applied in hospice practice as an useful model of multi-disciplinary team approach by hospice professionals.

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