• Research in Community and Public Health Nursing
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• v.19 no.4
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• pp.660-672
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• 2008

Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.209-217
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• 2004

Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

• Journal of Home Health Care Nursing
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• v.12 no.1
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• pp.70-91
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• 2005

Purpose: Long-term care facilities have a responsibility to provide care service that enables residents to maintain their maximal functional capacity and quality of life. Also their needs must be reflected to the service programs. In oder to provide an adequate service, we should assess the elderly's physical, psychological and social health status and the need. In addition to this, the long-term care facilities must be defined clearly by the type of services. This study would contribute to conduct appropriate services in public long-term care policy for the older population in the future. This study would provide informations of long-term care facilities' services and older persons' needs for long-term care. Method: To achieve this objectives, this paper investigates the types, service programs of long-term care institutes and job descriptions of workers. The subjects were consisted of 150 long-term care institutes. 150 institutes of long-term care facilities were drawn from all over the country by a nonrandom, convenience sampling. The data were analyzed by frequency, percentage, $x^2$-test using SPSS program. The instruments of this study were self-reported questionnaires for long-term care institutes. The data were collected from March 1, 2004 to may 31, 2004. Results: Service programs of long-term care institutes were not enough for residents' demands. The job descriptions among nurse, social worker and physical therapist were not clearly defined. The nurse's main role was medication and checking vital sign(49.7%), that of social worker's was observation and supervising (31.2%). The most significant problems were lacking of diverse service programs for residents. Conclusion: Considering these findings and conclusion, the needs of long-term care services should be provided by individual physical and psychological level. And the professional manpower for elderly should be educated in multi disciplines.

• Journal of Korean Academy of Rural Health Nursing
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• v.3 no.1
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• pp.34-43
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• 2008

Purpose: The purpose of this study was to suggest new direction for domiciliary care for elders provided by public institutions in rural areas. Method: The participants in the study were elders using one of 11 public health care institutions, of which 8 operated day care services exclusively, and 3 operated both day care and short-term respite care services. A survey was conducted using a structured questionnaire that included items on general characteristics of the service users, conditions of the services, personnel, financial status, facilities, and perception of the tasks of the staff. Result: The service content of the day care centers included Western and Chinese medical service, physical services, activities of ADL, nursing care services, meal services and transportation services. Domiciliary care centers provided a wide variety of health and social welfare service for elders. Personnel consisted of 3 to 8 staff for day care centers and 7 to 10 for domiciliary care centers. Both types of centers rely on financial support from local government for operation. The perception of the staff was the need for operation of these centers by public health facilities such as public health centers and sub-centers. Conclusion: The result suggest a need to activate the function of public institutions to provide domiciliary care for elders. For this new change, the role as a social support system must be developed.

• Architectural research
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• v.9 no.1
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• pp.9-18
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• 2007

The objective of this research study was twofold; 1) to explore and identify health supportive design factors in Swedish elderly care homes and 2) to understand their usefulness and suggest implication in Korean elderly care settings. A descriptive and explorative method was applied using a combination of field studies and semi-structured interviews. Three study trips were carried out during Sept. $14^{th}$ and Oct. $12^{th}$ 2005; two facilities situated in Stockholm suburbs and one in the south of Sweden. According to this research, the valuable factors to support health and well-being for the elderly are as follows; 1) Community integration: These elderly care homes are generally places close to a residential area center or a city center. Services are often shared between residents and community members at large, consequently there is a flow of "visitors" of all ages connecting with the facility on a daily basis. 2) Homelike environment: A noteworthy aspect of Swedish elderly care homes is keeping the facility appearance as homelike as possible. The associations with home may be explored through the appearance and configuration of both the exterior and interior of the building. These homes seemed to be designed with a conscious aim to create a homelike setting. 3) Small scale approach: Clustering of resident rooms is one method through which the small scale approach can be achieved in larger facilities. With unit clusters, the facility can foster opportunities for social interactions among resident. 4) Accessibility to garden and nature: The courtyard is a well developed concept in planning elderly care homes in Sweden. They are generally safe and easily accessible to the residents. Studying Swedish models may provide practical knowledge of how the physical setting may improve resident's health in Korean elderly care homes.

• Korean Journal of Health Education and Promotion
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• v.25 no.3
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• pp.1-19
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• 2008

Purpose: The research was performed to distinguish the group of users of the health promotion programs in health care center, to identify the characteristics of this group, and to investigate the factors that have influence on the use of the health programs. The specific research purposes are: First, to compare the group which uses the health promotion program of health care center and that which does not. Second, to analyze the factors that have influence on the use of the health promotion program. Method: This study was done from November 15th 2006 and March 30th 2007. The study subjects were Seoul and Provinces. Seoul was divided into 4 areas of eastern western, northern, and southern area. Provinces were Gimchon, Gumi and Sosan. From each area, one health care center was chosen from the ones that wanted to participate. Total number of observations was 994. The survey questionnaire consisted of individual, interpersonal, organizational, community, policy factors based on socio-ecological model. The analysis method was logistic regression. Results: Odds ratios of individual factors is sex(1.39), age(1.05), marriage status(1.71) severity(1.20). Odds ratios of interpersonal factors is use and support of family(1.96), use and support of resource persons like friends and neighbor(4.58). Odds ratios of organizational factors is the comfortness of space(0.74), the satisfaction of health care center facility(1.40), kindness of employ(1.97). Odds ratios of community factors is health care center program recognition(1.70). Odds ratios of policy factors is advertisement(4.69) and expense(1.42). Conclusion: Socio-ecological model of health promotion in health care center is obtained based on five factors and health planners should consider these determinants of health promotion program in health care center and develop intervention methods.

• Korean Journal of Health Education and Promotion
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• v.32 no.3
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• pp.85-96
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• 2015

Objectives: This study aims to identify the influencing factors of using postnatal care among illiteracy women who live in the Democratic Republic of Congo. Methods: Household survey was done from February 1 to 8, 2013 in the Kwango district of Democratic Republic of Congo, and 400 childbearing women who has under 5 years old children and pregnant women was randomly selected and answered through the interview with a questionnaire. For analysis the data, ${\chi}^2$ test and logistic regression analysis were used. Results: Woman who can read, write and mathematical calculation was 195 (47.4%) of total 411 answers and 161 (39.2%) used postnatal care for their latest pregnancy. Age at first marriage (${\chi}^2=18.481$, p<.001), religions (${\chi}^2=11.165$, p=.011), languages (${\chi}^2=35.586$, p<.001), the experience of children death (${\chi}^2=16.507$, p<.001), antenatal care over 4 times (${\chi}^2=15.315$, p<.001), postnatal care (${\chi}^2=15.558$, p<.001) is significantly different from literacy level. Among illiterate women group, who are protestant (OR=.330), using Lingala (OR=.128), took elementary education (OR=.223) and farmer (OR=.040), used less postnatal care. Conclusions: For increasing usage of postnatal care among illiterate women, new approach method should be considered such as a visual communication method and a community health workers' training program for giving an outreach service to pregnant women care.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.242-252
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• 2017

Purpose: Given the emergence of a new profession called a palliative care aide, this study aims to develop the scope of its practice using the Delphi consensus method. Methods: This study was participated by a panel of experts comprising 36 members who were involved in either hospice palliative care practice or making relevant policies. Through a four-step Delphi study, the feasibility of the duty, task and task element was examined. Among the results, items that scored over 4.0 out of 5.0 were selected. Results: The analysis of the Delphi study suggested four job duties, 15 tasks and 46 task elements to be included in the practice scope for palliative care aides. Conclusion: This study defined the scope of practice for palliative care aides, which is expected to prevent any conflict or confusion regarding their job and to promote the quality of their service.

• Health Policy and Management
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• v.24 no.3
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• pp.228-241
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• 2014

Background: The purpose of this study is to evaluate the effect of health insurance coverage expansion for cancer patients on equity in health care utilization and catastrophic expenditure. Methods: To analyze the causal relationship between the policy to expand benefit coverage and the change in health care utilization and out-of-pocket payments of cancer patients, this study employed a difference-in-differences (DID) method. In the DID model, the change in health care utilization, such as health care expenditure, visit days and length of stay, of cancer patients was compared with that of liver disease patients, using Korea Health Panel Data in 2009 and 2010. Results: The policy of reducing cost sharing from 10% to 5% for cancer patients did not have significant effects on equity in health care utilization. The results of this study were different from those of the previous study that showed that the reduction of cost sharing from 20% to 10% significantly improved the equity in health care utilization of cancer patients. In addition, the result of catastrophic expenditures analysis showed the policy did not change the probability of catastrophic expenditures. Conclusion: The results of this study imply that payment for non-covered services account for high out-of-pocket payments, and the reduction in cost sharing for covered services alone may have a limited effect on total financial burden on patients.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.2
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• pp.182-195
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• 2008

Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.