Han, Young Ran;Park, Eun A;Bang, Mi Ran;An, Na Won
Journal of Korean Public Health Nursing
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v.35
no.3
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pp.430-447
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2021
Purpose: The purpose of this study was to analyze the role and tasks of nurses who were working for the elderly in the visiting health services at the public health centers. Methods: Literature reviews, two rounds of meetings with 5 experts and a two-round Delphi technique with 15 experts were performed in this study. Results: The nurses' role and job analysis revealed 5 roles, 16 duties and, 71 tasks. The nurses' roles, including discovery and registration of households/groups in visiting health service in the community, case manager, administrative management, program planning, operation and evaluation, and development of job competency. Sixteen duties included client registration and management, need assessment and plan establishment, education, consultation and support, seasonal health care, prevention and monitoring of infectious diseases, basic nursing care, chronic disease management, linkage and utilization of resources, team cooperation and coordination, home environment management, monitoring and support for intervention outcomes, evaluation, administrative management, program planning, operation and evaluation, development of professional competency and, adoption of fourth industrial revolution technology. Conclusions: Based on the results, the government should provide sufficient nursing personnel to provide universal preventive health services for the elderly and a job training program to perform these roles well.
Purpose: The purpose of this study was to develop effective management indicators for improving efficiencies of visiting nursing centers. Method: This was a methodological research study to develop the key performance indicators based on balanced score cards for long-term care visiting nursing centers. The main methods used in this study were literature review, focus group interview, and content validity index. The data analysis was used frequency, percentage, mean, and standard deviation. Results: The common vision of the long-term care visiting nursing centers was identified as "The healthy visiting nursing center to serve high quality cares." Eight action strategies and 15 key performance indicators to achieve this vision were developed. Conclusion: Based on the results of this study, we suggest that the developed balanced score cards will be used as an effective managerial guideline to improve performances of long-term care visiting nursing centers.
This study aims to develop some guidelines on visiting nursing services for the management of hypertension patients at home in the rural areas of Korea. Firstly, in-depth interviews were given to the eight staff in charge of visiting nursing services in the rural health centers from June 1, 1999 to August 30, 1999. And then, their five patients with hypertension were under participatory observation. At the same time, literature review was conducted. Through those methods, some preliminary items were derived and the initial guidelines were drawn up. They were referred to ten experts, so that their validity was tested with Delphi Technique. Through the verification of their validity, they were complemented into the final ones. The total number of the items in the final guidelines was 22. By areas, they could be categorized as follows; eight items as skilled nursing care, five as general nursing care, three as guidance for diet, two as guidance for exercise, one as hospice care, and one as connection with social welfare services. By methods of activities, 13 items were classified as assessment, two as intervention, two as demonstration, and 17 as explanation. On the basis of the guidelines, nursing services are recommended to be divided and performed; general nursing activities by nurse aids and skilled nursing activities by public health nurses.
Purpose: To analyze the effects of customized home visiting health services on the health and health behaviors of clients with hypertension (n=107) and diabetes mellitus (DM: n=67). Methods: A one group pre and post-test research design was used. The subjects were registered in a customized 8-week, interventional, home visiting health services available in Daegu. Data was collected from November 17, 2008 to January 23, 2009. Analyses involved descriptive statistics, $x^2$ test and paired t-test. Result: Hypertension control rate was improved 25.2% and DM control rate was improved 3.0%. There were significantly beneficial hypertension-related differences in BP, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise, diet, BP monitoring and medication. Significantly beneficial DM-related changes included glucose, health belief, health knowledge and health behaviors including performance of 10 min of moderate exercise and glucose monitoring. But there were no significant hypertension-related differences in health belief (barrier) and health behavior including drinking and exercise length/frequency. Also, no significant DM-related differences were evident in health belief (barrier) and health behaviors including drinking, smoking, exercise length/frequency, diet and medication. Conclusion: Customized home visiting health service can provide effective, but not complete. Whether these benefits are maintained in the longer term is unknown.
Kim, Jin-Hyun;Lee, Tae-Jin;Lee, Jin-Hee;Shin, Sang-Jin;Lee, Eun-Hee
Research in Community and Public Health Nursing
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v.21
no.3
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pp.362-373
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2010
Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.
The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.
Objectives: The nurse visiting health service named Customized Visiting Health Care Program(CVHCP) requires the service innovations incorporating community support into a local service network. The purpose of this study was to assess the community network in CVHCP and inform improvement in this network. Methods: We used Social Network Analysis(SNA) in one CVHCP at H city. Network links were generated by self-administered questionnaires by the 14 community resource centers who quantified their links to all other 25 agents on the list. Links were analyzed by a dichotomous scale for any experience of collaboration and a scored scale of 0 to 3 for level of collaboration using UCINET v6. Results: A list of 14 agents was generated, and local network was dominated by the Public Health Center and a local welfare center named Unlimited Care Center(UCC). According to centrality score, UCC was the most prominent agent, and Public Health Center was the most influential agent, being a link in the pathway flow between other agents for 9.5% of contribution. CVHCP scored lower rank of prominent with 30.8% of other agents reported referring to it. Conclusions: Social network analysis provides a useful network description for informing and evaluation service network improvement in maximizing its service for the CVHCP.
In Korea, visiting nursing services in pubic health centers have been in place since 1991. The purpose of this study is to compare the job characteristics, job motivation and job performance between visiting nurses and other public health nurses. 196 subjects were sent mailed questionnaires from Aug. to Sep., 1997. The response rate was 65.3%. Data were analyzed by a SPSSWIN program with a t-test, $X^2-test$, ANCOVA. The results were as follows : 1. The level of job ability in visiting nurses was higher than that of other public health nurses, but it was an insignificant difference(t=1.5975, p=.2078). Among job characteristics, skill variety was significantly higher in other public health nurses(t=8.2121, p=.0046); autonomy and feedback were significantly higher in visiting nurses(t=8.1877, p=.0047/t=7.7026, p=.0085). 2. There was no significant difference in the level of job motivation(t=.6485, p=.4216) and in job performance between the two groups (t=2.7393, p=.0995). In job performance, general nursing and organizational jobs were significantly higher in other public health nurses (t=4.8486, p=.1288/t=9.4237, p=.0024). 3. It was reconfirmed that there was, a significant difference in the level of skill variety, autonomy and feedback in analyzing age and career as covariates. 4. Significant positive relationship was found in job characteristics and job motivation(r=.5488, p=.0000). No significant relationship was found in job characteristics and job performance(r=.0486, p=.498). Through these results, it was supported that there were differences in some of the job characteristics and job performance between visiting nurses and other public health nurses. Therefore, it is requested to redesign job standards, training programs and management styles focusing on the job characteristics of visiting nurses.
In recent years, the recipients of the services of the health centers in Korea have been shifted from individual sick persons to families as a unit. As a result, the home visiting care records which are all filled out manually, will be increased. Since there is virtually no increase in the number of community health nurses, the CHNs are required to work more efficiently. One of the ways to make the CHNs' work more efficient is to reduce recording time by using a computer. However, a computer system that can manage the families as a unit has not yet been developed. In response to this need, we developed a database system that can be utilized in home visiting care service. The family assessment data is collected. diagnosed. and evaluated according to the family diagnosis classification. The system for family diagnosis consists of seven areas. Those areas are family structure. maintenance of the family system, interaction and interchange. support. coping and adaptation, health management. and housing environment. The areas of the family diagnosis consists of 99 items in all. We expect the following from this system. First. the CHNs will be able to identify family problems more easily. Second. the community's health level can be confirmed by the statistics the system produces. Thirdly, the CHNs' nursing services will be cost effective via reduced recording time. Finally, the family problems of the sick individuals which have been neglected under the health system oriented on individual persons can be effectively managed.
The purpose of this study was to analyses the main factors of research papers for related with home physical therapy. This study was retrospective descriptive study, the period of data collection was from 1991 to 2011. The data was collected by the journal related in physical therapy, the dissertation of academic degree, National Assembly Library and the web-site for academic information. In the web-site, searched with the keyword 'home physical therapy' and 'after school voucher'. The results were as follows; 1. In the home physical therapy, visiting physical therapy, school physical therapy, there were different based on laws; home physical therapy was based on medical law, visiting physical therapy was based on law for community health and law for long term health insurance, school physical therapy was based on special education law. 2. The summary of research title/thema from 1991 to 2011 was as follows; for the home and visiting physical therapy 'the needs and necessity of home and visiting physical therapy' was 18 papers, 'the contents of service of home and visiting physical therapy' was 18 papers, 'program and skill development' was 16 papers, 'system developing and induction strategy of home and visiting physical therapy 'was 15 papers, 'costs of nome and visiting physical therapy' was 2 papers, 'perception and information of home and visiting physical therapy' was 9 papers, 'Recoding system and administration management' was 9 papers, 'the others 'was 14 papers, for the school physical therapy 'after school voucher system' was 9 papers, the others was 4 papers. The total papers was 114 papers. 3. Finally suggested 'Model of Educational Program for HomeVisiting and School Physical Therapy'.
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