• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.773-785
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• 1998

This study aims at providing more qualitative care in family nursing practice. It is designed to analyze the degree of quality of life(QL) among families of the patients. The subjects consisted of 79 families of hospital hospice patients and 74 families of home-based hospice patients. The ages of the subjects were 17-74 years, at five university hospitals in Seoul, Inchon, and Kyung Gi Province, and one clinic in Chunchon. The data were collected from September, 1996 to August, 1997. The instrument used for the study was the Quality of Life Scale (QLS), which was composed of six factors, developed by Ro, You Ja. The analysis was done using t-test, ANOVA Scheff test, and Stepwise multiple regression. The results were as follows : 1. There were no statistically significant differences between the families of hospital hospice patients and the families of home-based hospice patients ; however, the mean score of the families of hospital hospice patients was higher than that of the families of home-based hospice patients. The scores on QLS ranged from 75 to 224 with a mean score of 140.58 in the families of hospital hospice patients. In the families of home-based hospice patients, the scores ranged from 79 to 214, showing a mean score of 135.25. Among six factors of QLS, family relationships showed the highest score in both groups, but economic life showed the lowest score in the families of hospital hospice patients, and emotional state showed the lowest score in those of home-based hospital patients. Self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of home-based hospice patients (t=2.69, P= 0.008 ; 1=2.04, p=0.043). 2. In the families of hospital hospice patients, QL had significant relationship with family member's age(F=2.52, p =0.029), marital status (F=3.57, P=0.018), economic state(F=6.07, P=0.004), and education level(F=3.77, P=0.014). In the families of home-based hospice patients, QL had significant relationship with marital status (F=2.53, P=0.049), education level(F=4.35, P=0.007), occupation(F=3.93, P=0.002), and patient's age(F=2.73, P=0.020) 3. Economic status accounted for 17% of QL, and diagnosis accounted for an additional 7% of QL in the families of hospital hospice patients by means of stepwise multiple regression analysis. In the families of home-based hospice patients, relationships with patient accounted for 12% of QL. The findings showed that self-esteem and relationship with the neighborhood were significantly higher in the families of hospital hospice patients than the families of homed-based hospice patients and family relationships showed the highest value in QL. These findings should be considered in nursing practice.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.303-314
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• 1997

This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients and tie degree of nerses' educational performances perceived by mothers who look after mainly nephrotic syndrome patients. The study subjects were composed of 74 mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pen from June in 1996 to Januaryin 1997. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. The data analysis was done by SAS. t-test, and ANOVA were done to determine the effect of general characteristics of subjects on their educational needs. Pearson correlation was done to measure relations between general characterictics of subjects and their educational needs and Stepwise Multiple Regression was done to test a variable affecting educational needs. The results were as follows. 1. Mean score of educational needs of subjects was 137.06(Maximum 176). The score of the educational needs of home care was the highes, but the question numbers(of that category) are smaller than others. So, the educational need of the diagnosis art treatment was regarded as the highest in contents. 2. The mean score of nurses' educational performances was very low, 74.91(Maximum 176). Nurse's educational performances score in the diagnosis and treatment of the disease ranked as the highest Burt that score in the care during hoapitalization was the highest in contents as the educational needs was. 3. The number of children excepting the patient (r²=.215289. p=.006) and the age of patient(r²=.23770, p=.001) were emerged as important variables affecting the degree of mother's educational need.

• Child Health Nursing Research
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• v.3 no.1
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• pp.30-41
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• 1997

This is descripitive study conducted to identify educational needs of mothers of nephrotic syndrome patients. The study subjects were composed of 74 mothers of nephrotic syndrome patients whose children were hospitalized in 2 Pediatric wards of University Hospital in Seoul and 1 in Pusan from June to september in 1996. A questionaire for this study was item Kikert type 5 point scale, developed on the basis of previous literature and researcher's clinical experience and the reliability of the used instruments was α=.97. t-test, and ANOVA were used to determine the effect of general characteristics of subjects on their educational needs. Pearson correlation was done to measure relations between general characterictics of subjects and their educational needs and Stepwise Multiple Regression was done to test a variable affecting educational needs. The results were as follows. 1. Mean score of the educational needs of the subjects was 137.06(Maximum 176) . The educational needs of home care was the highest score, but the question numbers are smaller than other categories. So, the educational need of the diagnosis and treatment was regarded as the highest in contents. 2. The number of subject's children, except for patient revealed significant negative correlation to educational need. 3. The number of subject's children, except for patient(R²=.215289 P=.0006)and the age of patient (R²=.23770 P=.0001) were emerged as important variables affecting the degree of mothers' educational need. Suggestion are as follows on the basis of these results. 1. It is proposed that nurses use these results of the study activly for the educational program for Nephrotic Syndrome patients and their mothers. 2. It is identified that the educational needs of the mothers of nephrotic syndrom is high. So, it is suggested to identify and analysis the degree of the nurse's educational performance perceived by mother. 3. It is suggested to make a comparative study of the degree of nurse's understanding of the importance on educational items with the instruments of this study.

• The Korean Journal of Rehabilitation Nursing
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• v.4 no.1
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• pp.73-83
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• 2001

The aims of this study were to identify the mothers educational needs when they have children who have had open heart surgery in congenital heart disease, to identify the children's characteristics with this problem, and also to provide the basic information on the development of the educational program for the mothers. The subjects of the study were 101 mothers of children and their children hospitalized with congenital heart disease in pediatric wards of G. University Hospital in Inchon and S. Hospital in Puch on from June to November 2000. The study used a Likert-type questionnaire with 39 questions which was based on a previous questionnaire developed by Lee Mi-ryun(1989) for adult open heart surgery patients. The reliability of the questionnaire was Cronbach' ${\alpha}$=.9375. The data were collected directly from mothers of the patients in wards. The t-test, ANOVA was adopted for the data analysis. The key results of the study are as follows : 1) The average age of the children was 32.90 months. The majority of the children are male and weighted 3.0-3.5Kg at birth. Most of the children had VSD(29.7%), and 10.9% of children had a family history of heart disease. 2) An average score of 4.62 out of a maximum of 5.00 was recorded for the educational needs of the children's mother. The highest score of 4.69 was for home care after discharge followed by a score of 4.67 for diagnosis and prognosis on congenital heart disease. And pre-post operation care scored 4.51. The mean scores of single-question items of educational need were, in order, 4.81 for immunization after operation, 4.80 for recovery process, and 4.77 for prognosis of the disease. The score of 4.18 for measurement of intake and output was the lowest. 3) The analysis on the children's mothers educational needs by social-demographic characteristics such as sex, age of patient and mother, economical status, educational status, number of child, hospitalization times, and hospitalization cause showed no significant difference statistically, but there was a significant difference between mothers with jobs and with out jobs.

• The Journal of Korean Academic Society of Nursing Education
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• v.3
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• pp.78-98
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• 1997

Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

• Journal of Hospice and Palliative Care
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• v.22 no.1
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• pp.8-18
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• 2019

Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.514-526
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• 2000

The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

• The Korean Nurse
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• v.36 no.5
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• pp.45-62
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• 1998

The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.