• 제목/요약/키워드: home care nursing interventions

검색결과 105건 처리시간 0.028초

재가 치매노인 배우자의 돌봄 체험에 관한 해석학적 현상학 연구 (Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home)

  • 장혜영;이명선
    • 대한간호학회지
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    • 제47권3호
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    • pp.367-379
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    • 2017
  • Purpose: This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia. Methods: The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants' actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others. Results: Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as "the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship." Conclusion: The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

퇴원 후 미숙아의 수유 유형과 영향요인 (Factors Associated with the Method of Feeding Preterm Infants after Hospital Discharge)

  • 한수연;채선미
    • Child Health Nursing Research
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    • 제24권2호
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    • pp.128-137
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    • 2018
  • Purpose: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. Methods: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. Results: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. Conclusion: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.

Hospital-Acquired Pressure Injury: Clinical Characteristics and Outcomes in Critical Care

  • Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Hixon, Brenda
    • International Journal of Advanced Culture Technology
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    • 제7권2호
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    • pp.28-33
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    • 2019
  • Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

국내외 ICT기반 노인 건강관리 서비스 동향분석 (Analysis of Health Care Service Trends for The Older Adults Based on ICT)

  • 이성현;홍성정;김경미
    • 한국융합학회논문지
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    • 제12권5호
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    • pp.373-383
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    • 2021
  • 우리 사회는 빠른 속도로 고령화가 진행되고 있다. 이러한 초고령화 사회에서는 의료비 증가도 늘어나고 있으며 이 상황은 사회보장제도의 지속가능성을 저하시키는 국가적인 문제로 인식되고 있다. 이를 해결하기 위해 노인 건강관리를 위한 다양한 서비스가 추진되어왔지만 대부분 취약계층, 만성질환 발병 후 건강관리에 집중해 왔으며 예방차원의 건강관리는 부족하였고 대부분 시범사업으로 그치고 있는 것이 현실이다. 이에 본 논문에서는 국내외 노인대상 건강관리 서비스의 현황을 분석하고 이를 근거로 한계점과 개선점을 분석하여 IoT 기반의 토탈실버케어센터 구축을 제안하였다. IoT 기반의 토탈실버케어센터는 다양한 센서, 의료기기, 스마트밴드 등을 통해 노인들의 건강상태를 편리하게 모니터링 할 수 있으며, 이를 바탕으로 긴급히 방문해야 하는 사용자를 구분하여 간호제공자의 시간절약 및 업무의 효율화를 통해 간호서비스의 질을 향상시킬 수 있다. 또한 사용자의 건강상태 변화가 있는 경우 건강간호 중재를 적시에 제공할 수 있을 뿐만 아니라 실시간 영상시스템을 통해 정신적인 어려움을 극복하는데 도움을 줄 수 있다.

기본간호학 연구동향 - 기본간호학회지 논문분석을 기반으로 - (The Research Trends in Fundamental Nursing - Based on the Analysis of Journal of Korean Academy of Fundamental Nursing -)

  • 정인숙;강규숙;김경희;김금순;김원옥;변영순;송경애;손영희;양선희;조현숙
    • 기본간호학회지
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    • 제8권2호
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    • pp.132-146
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    • 2001
  • Purpose: This study was to analyze the trends and content of all the research (171 research papers) published in the Journal of Fundamentals of Nursing from 1994, when it began to 2000 using an objective tool developed by the researches, and to identify the direction for the future research in Fundamentals of Nursing. Method: Research published in the Journal of Fundamentals of Nursing from 1994 were reviewed. Result: Most of research (94.2%) was non-degree based and funded research was very limited. The average number of researchers per research study was 2.2 and collaborative research has been gradually increasing. The total number of key words was 331 and the average was 2.6 per research. The major key words were not different from other nursing departments and included home care nursing (10 times), health promotion (8 times), self-care (7 times). self-efficacy (7 times), and homo-dialysis (6 times). Eighty seven percent of the research was quantitative research. and there were very few qualitative studies. Considering theory level, it was found that 40% were factor related research For study design, non-experimental studies were most frequent (66%), and the rate, especially of surveys, has remarkably decreased. Selection of subjects by convenience sampling, was most frequent and there were very few studies that provided the rationale for the calculation of sample size. The major subjects of study were patients (44.8%) with various diagnoses. The subjects usually gave oral consent to take part in that study. Giving information (46.9%) and exercise (26.5%) were common nursing interventions, and physiological indices (16.5%). vital signs (10.3%), physical functioning (8.2%), level of knowledge/skill (7.2%) and level of activity (6.2%) were frequently measured as outcome. Variables questionnaires were the major approach used to collect data, and 57.8% of the research provided the Cronbach alpha to guarantee internal consistency of study instruments. Data were analyzed with computerized statistical packages using, ANOVA (42.0%), T test(39.5%), and chi-square test. For the last seven years, nursing research in Fundamentals of Nursing has gradually improved in both quantify and quality. Conclusion: It was difficult to find any uniqueness or difference compared to other departments of nursing. In fact, because the history of the Journal of Fundamentals of Nursing is rather short, we can expect that there will be further improvement in qualify and content in the future.

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노인의 가족지지와 삶의 질 (A Study on Perceived Family Support and the Quality of Life in the Elderly)

  • 신동순;홍춘실
    • 가정∙방문간호학회지
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    • 제4권
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    • pp.76-85
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    • 1997
  • In modern society, the human average life span has been prolonged due to medical benefits and changes in society, which results in the rapid and world -wide increase in the population of elderly. Consequently, the field of nursing science, as well as the field of many other discipline, has shown increasing interests in issues on the elderly. In addition, to improve the quality of life for elderiy people a great deal of effort has been made. The purpose of our study is to analyze the correlation between family support and quality of life in order to develop basic data for nursing interventions to maintain life satisfaction of the elderly. The sample consists of 108 subjects residing at home whose ages are over 65 years old. The data has been collected, from November 11, 1996 to November 23, 1996, through interviewing the elderly using a questionnarie. For the family supoort we used two: 1) the 5 - point Likert scale questionnarie developed by Gallo and Warren (Family support I) and 2) the 5-point Likert scale developed by H. S. Kang(Family support II), and for the quality of life we used the 3 - point likert scale questionnarie developed by Choi, Young Hee. For data analysis we used percentages, means, Pearson Correlation Coefficient and ANOVA. The results of our study are as follows: 1. For perceived family support I & II, the minimum score is 12 & 19, the maximum score is 32 & 46, the mean score is 24.49 & 34.90, respectively. 2. For Quality of life, the minimum score is 13, the maximum score is 39, the mean score is 28.61. 3. there is a very strong correlation between the perceived family support of the subjects and Quality of life (for I r=0.35047, p<.001 and for II r= 0.60558, p<.001). 4. The relationship between the general characteristics of the elderly and our two variables. family support and Quality of life, is as follows: 1) According to age(for II F=5.32, p<.01), the amount of monthly pocket money(for II F= 3.52, p<.05), inmate(for I F=2.93, p<.05, for II F=2.84, p<.05), economics(for I F=8.99, p<.01. for II F=7.51. p<.01), supporter(for I F=4.01. p<.01. for II F=3.43, p<.01), there is a statistically significant difference in family support. 2) According to the amount of monthly pocket money(F=6.69, p<.01), inmate(F=2.24, p<.05), economics(F=15.38, p<.01), there is a statistically significant difference in Quality of life. In conclusion, it can be said that the family support is an important variable to the Quality of the elderly life.

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모유수유 전화 상담 내용의 분석 (Analysis of the Content of Telephone Counseling with Breastfeeding mothers)

  • 김혜숙
    • 대한간호학회지
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    • 제25권1호
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    • pp.17-29
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    • 1995
  • This study was done to analysis data on breastfeeding mothers. This stud was conducted using data from telephone counseling in one metropolitan area. The subjects who had received consultation about breastfeeding were 100 breastfeeding mothers. The period of consultation was from Mar. 9, 1994 to August 23, 1994. Consultants were referred from UNICEF, hospitals, TV, newspapers or magazines. Analysis of the problem patterns resulted in 11 classifications. These were physio -anatomical factors(11 cases) , psychological factors(15 cases), breastfeeding methods(21 cases), breastfeeding intervals and frequency(19 cases) , disease in the breastfeeding mothers(13 cases), disease in the babies (12 cases), lack of support (4 cases), food and drugs while breastfeeding(5 cases), weaning(11 cases), others(27 cases). The highest frequency was for breastfeeding methods (21 cases). When the contents of the counselling were analyzed for the 100 cases, 36 problem patterns were identified. Patterns with over 10 responses were diarrhea, insufficient milk supply, sore and cracked nipples, weaning, inverted nipples and jaundice. The age of infants when mothers were telephoned was as below : 1 week(28 cases), 2 weeks(12 cases), 3-4 weeks(18 cases), 5-8 weeks(7 cases), 9 weeks-3 menths(4 cases), 4 menths-6 months(12 cases), over 6 months(2 cases), and the number of pregnant women was 12. The nursing diagnosis were classified according to problem patterns and each diagnosis was assigned an appropriate Problem Pattern The total number of nursing diagnoses was 22. When clients are referred for counselling nurses need guidelines about problems, possible causes and nursing. In this study, the example of guidelines for sore nipples is suggested. The recommendations based on the telephone counseling results are as follows : Prenatal education about the advantages of breastfeeding and breast care, and home visits after delivery for counseling related to breastfeeding. During the hospital stay, nursing intervention such as education on breastfeeding methods using slides, audio-visual tapes, pamphlets are needed as well as an initial trial of breastfeeding. Further research is indicated on the perceived lack of breast milk and on the effectiveness of nursing interventions to pro-mote breastfeeding.

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일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구 (A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area)

  • 장인순
    • 가정∙방문간호학회지
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    • 제2권
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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Impact of Home Education on Levels of Perceived Social Support for Caregivers of Cancer Patients

  • Demirbag, Birsel Canan
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권6호
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    • pp.2453-2458
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    • 2012
  • Background: The healthcare needs of cancer patients are complex and persons involved in their caregiving process are faced with many issues that need to be addressed. The entire family and particularly the person taking on responsibility for patient care develop expectations from healthcare professionals, especially nurses. Objective: The study was conducted to evaluate the impact of a home education program provided to caregivers of cancer patients on the level of their perceived social support and problems in caregiving. Interventions/Methods: The caregivers of thirty seven cancer patients of 2,400 registered people in a family center were given an educational program in this descriptive and cross-sectional study twice a week for a month during the period of March 2011 - April 2011. Results: Of all caregivers, 56.8% were between the ages 36-40, 94.5% were female, 91.9% had received no education on caregiving, 81.0% stated that they mostly felt physically and mentally inadequate in their caregiving. Perceived Social Support from the family indicated a significant difference at $8.05{\pm}4.38$ before and $11.7{\pm}4.97$ after the education. A comparison of the mean scores of caregivers on emotional issues before and after the education revealed the following: spiritual distress scores were $2.54{\pm}0.69$ before and $2.44{\pm}0.43$ after the education; hopelessness scores, $2.24{\pm}0.59$ before and $2.23{\pm}0.38$ after the education; ineffective individual coping was $3.89{\pm}1.42$ before and $2.45{\pm}0.59$ after the education; competing needs in decision-making were $3.54{\pm}0.69$ before and $2.10{\pm}1.24$ after the education; depressive feeling were $3.01{\pm}1.53$ before and $2.02{\pm}0.99$ after the education (p<0.05). Conclusions: Positive effects of home education on levels of perceived social support and caregiving problems of caregivers of cancer patients were observed. Home educational programs for caregivers of cancer patients are important for both better understanding of the requirements of their patients and themselves.

취약계층 남성노인의 연령별 건강관련 삶의 질과 영향요인 (Factors Affecting the Health-related Quality of Life According to Age in Vulnerable Aged Men)

  • 전은영;최연희
    • 대한간호학회지
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    • 제40권3호
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    • pp.400-410
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    • 2010
  • Purpose: The purpose of this study was to investigate the factors that influenced the health-related quality of life of young-old (65-74 yr) men, old-old (75-84 yr) men, and oldest-old (85 yr or above) men in vulnerable aged received home care from public health center. Methods: The participants for this study were 318 aged Korean men living in D city. The data was collected from August to October, 2009 using structured questionnaires. Chi-square, One way ANOVA, Duncan test, Pearson's Correlation Coefficient and multiple regression with the SPSS WIN 14.0 program were used to analyze the data. Results: There were statistically significant differences among young-old, old-old, and oldest-old men regarding the health-related quality of life, health promoting behavior, IADL (Instrumental Activities of Daily Living), rehabilitation, depression, and social support. The model including variables related to physical, psychological, and social aspects of life, explained variance of the health-related quality of life of aged men differently, such as 39.6% of young-old, 35.4% of old-old, and 47.0% of oldest-old. Finally, IADL and social support were predictors in explaining the level of health-related quality of life among vulnerable old men regardless of age. Conclusion: Based on the findings of the study, nursing interventions should be developed to improve health-related quality of life of vulnerable aged men according to age differences.