The needs for the home care of postpartum mothers and their infants are increasing, but the quality control of home care nurses is not developed yet. The objective of this study is to develop assessment - intervention algorithms for the home care of postpartum mothers and their infants. We can use these algorithms when we assess the client's condition, and find appropriate nursing interventions. Also, these algorithms can offer guidelines for home care nurses, so that standardization of home care can be attained. Common problems for postpartum mothers are postpartum hemorrhage, abnormal vaginal discharge(endometritis), episiotomy pain, breast problems, breastfeeding difficulty, edema, urinary dysfunction and defecation difficulties. Also, commom problems for infants are abnormal body temperature, tarchycardia, respiratory problem, neonatal jaundice, cord problem, abnormal stool, breast feeding, and bathing. These algorithms can be used as a basis for the development of computerized infomation system for the home health care.
This study was conducted to develop a home care nursing management system based on the validated and useful data base found through literature review. The contents and structure according to a development procedure for a computer system were as follows. 1. A data base on home care nursing patients was accumulated by putting data respectively in both steps and fields - from selection criteria. basic information. prescription. plan of home visits. to application of nursing process. 2. Accumulated data was classified and designed to search by basic information. drug/injection prescription. examination prescription, treatment prescription. supply. and a record of the nursing process. 3. Various forms of retrieval including graphs were elaborated in terms of diagnosis and intervention aspects.
Purpose: The purpose of this study is to identify factors influencing burnout in primary family caregivers of Home Health Care Patients. Methods: Data were collected from 121 primary family caregivers of home health care patients in three different hospitals in 'D' metropolitan city and the study was conducted from August 10, 2016 to January 17, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's Correlation Coefficient, Stepwise Multiple Linear Regression. Results: Mean scores for the nursing needs of the participants were $3.54{\pm}0.79$, the family functions were $1.24{\pm}0.58$, the burnouts were $2.74{\pm}0.49$. The burnouts were positively correlated with the nursing needs but inversely correlated with the family function. The factor that had the greatest influence on the burnouts of primary family caregivers of Home Health Care was family function (${\beta}=-.245$, p=.001), followed by patients' daily activity (${\beta}=-.213$, p=.014), age (${\beta}=.208$, p=.032), monthly nursing services cost (${\beta}=-.196$, p=.044) and nursing needs (${\beta}=.129$, p=.014). The Explanatory Power of Models was 23%. Conclusion: Individually customized home care nursing intervention programs are required to be provided in accordance with patient's family function and daily activity, monthly home care nursing service cost, nursing needs and general characteristics of primary caregivers of Home Health Care Patients such as their age, the number of family members living together, sex and the name of disease.
Purpose: This study investigated the degree of, and factors influencing the spiritual care among home healthcare nurses. Methods: The subjects were 168 advanced practice nurses working in 94 hospital-based facilities for home health care located in Seoul, Gyeonggi-do, and Incheon Metropolitan City. Data were collected from January 14, 2019, to March 7, 2019, using structured questionnaires on spiritual care and related variables based on the literature. Data were analyzed by t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis (stepwise) using SPSS Version 23.0 program. Results: The results showed that the degree of spiritual care of home health care nurses was 3.44 points out of a possible 5 points. Factors affecting nurses' spiritual care were spiritual well-being(𝛽=.36, p<.001), recognition of spiritual care as the nature of nursing(𝛽=.17, p=.016) and role of nurses(𝛽=.22 p=.002), regular-based education for spiritual care(𝛽=.23, p<.001), patients' discomfort with spiritual discussion(𝛽=-.18, p=.001), and nurses' experience in home health care area(𝛽=.14, p=.010), which explained 57.2% of the observed variation in spiritual care. Conclusion: This study suggests the need to develop regular-based education programs for facilitating spiritual care and strengthening home health care nurses' spiritual well-being and their positive perceptions toward spiritual care.
The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.
The objective of this study is to develope the record forms for the home care nursing. Through the literature review and 4 times of workshop participated with the health practitioner and nursing professors from July 1993 to March 1995, the standands of home nursing care, initial assessment tools, progress notes by diseases and the referral sheet were developed. The Community health practitioner were trained for home nursing care and participated with 5 nursing professors in the workshop to validate the content of the record forms. It is suggested that the more refinement of these record forms fased a defined conceptual framework in the various home nursing area is needed in the future.
Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.
Purpose: This study was conducted to identify health problems and support received from the health and welfare service using MDS-HC(Minimun Data Set for Home Care) in the aged living at home. Method: Eighty-one elderly persons were selected from those listed in community-welfare service centers in Seoul and Kyunggi Province between December 2002 and January 2003. Result: Eleven health problems per elderly person on average were identified, and the frequent care needs were in order: preventive health measure, health promotion, visual function, depression & anxiety, communication disorders, social function, pain, environmental assessment, oral health, cognition and falls. The number of health problems by the level of ADL was ‘ADL 1(Independence)’ 9.87, ‘ADL 2(Partial independence)’ 12.78, ‘ADL 3(Dependence)’ 13.73. Utilization of formal health & welfare services among the elderly was ‘meals on wheels’ 40.7%, ‘home helper’ 38.2%, ‘visiting of social welfare worker’ 21.0%, ‘physical therapy’ 19.6%, ‘day care center’ 12.3%, ‘volunteer's service’ 9.9%, ‘home visiting care’ 3.7%, ‘occupational therapy’ 3.7%, and ‘speech therapy’ 2.5%. Conclusion: The results suggest that using the MDS-HC 2.0 is applicable to help decide criteria for both health and welfare service supplied to the elderly.
The purpose of the study was to compare both the nursing care satisfaction and the image of nurses as experienced by home health care clients and hospitalized clients. For the descriptive survey study. data were collected from 69 home heath care clients and 342 in-patients in a university hospital. The tools used for the study were modified by Quality Patient Care Scale(Wandelt & Ager. 1974) and Image of Nurses (송인자, 1993). The data were analyzed using Pearson Correlation. Scheffe test. factor analysis. t-test. and ANOVA. The major findings were as follows: Regarding nursing care satisfaction, the mean score of total nursing care satisfaction in home health care clients was 3.28 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the general. the professional. the physical. and the communication domain. The level of nursing care satisfaction was not significantly different according to demographic variables except for age: the age group of 41-60 showed the highest score (p<0.05). The mean score of total nursing care satisfaction in hospitalized clients was 2.95 out of 4.0. Among five domains, the domain with the highest score was the psychosocial domain, followed by the physical and the communication. the professional. and the general domain. The level of nursing care satisfaction was not significantly different according to demographic variables except age: the higher the age the higher the score (p<0.05). The levels of nursing care satisfaction in all five domains were significantly higher in home health care clients than in hospitalized clients(p=0.0005). Regarding image of nurses, the mean score of total image of nurses in home health care clients was 3.32 out of 4.0. Among four domains, the domain with the highest score was the sincerity domain, followed by the kindness. the spirit. and the knowledge and skill domain. The level of image of nurses was not significantly different according to demographic variables. The mean score of total image of nurses in hospitalized clients was 3.05 out of 4.0. Among four domains. the domain with the highest score was the sincerity domain, followed by the kindness, the knowledge and skill, and the spirit domain. The level of image of nurses was not significantly different according to demographic variables. The levels of image of nurses in all four domains were significantly higher in home health care clients than in hospitalized clients (p=0.001). Both the levels of nursing care satisfaction and image of nurses, part of an evaluation for quality of nursing care were significantly higher in home health care clients than in hospitalized clients. In light of the findings, we could consider that home health care nurses provided client-centered comprehensive nursing care. However, nurses need to have methods that more promote the social recognition of the image of nurses and nursing care services as well as professional knowledge and skills.
This study was done to define nursing diagnose and to test the validity of the characteristics for patients with cerebrovascular accidents being seen at home by home health care nurses. This study was a descriptive study. The sample consisted of 10 experts(professors and home health care nurses) who had had a variety of experience using nursing diagnoses in clinical practice, and 336 nurse progress notes for 18 patients with cerebrovascular accidents. First, 32 nursing diagnoses were defined by the analysis of 336 nurse progress notes, and ten nursing diagnoses were selected according to a criteria of frequency and four nursing diagnoses from home health care clinical practice. Second, content validity was examined by an expert group which considered the sign / symtoms of the fourteen nursing diagnoses. The instrument used for this was a checklist for sign / symtoms based on the nurse progress notes and literature : Carpenito(1993), Kim Cho Ja et al (1994), Lee Sun Ok et al.(1994), Kim Mae Ja et al. (1992), Seoul University Hospital (1993) , Kim Mi Ja et al. (1991). The data were collected from March 1995 to April 1995. Data were analyzed using Content Validity Incidence where if 80% or more of the expert group agreed, characteristics were defined as a major sign/symtoms, if between 50% and 79% of the expert group agreed with the characteristic it was defined as a minor sign / symtoms. The results of this study are summarized as follows : 1. Thirty-two nursing diagnoses related to patients with cerebrovascular accidents were defined. There was a high frequency for the following : 'Potential for disuse syndrome (61%)', 'Impaired physical mobility(50%)', 'Impaired skin integrity (44.4%)', Potential for aspiration(33.3%)', 'Potential for infection: respiration(33.3%)', 'Self-care deficit : bathing /hygine(27.8%)', 'Ineffective family coping(22.2%)', 'Potential for trauma(22.2%)', 'Alteration in nutrition: less than body requirements(22.2%)'. The following diagnoses were also used in home health care clinical practice : 'Anxiety in family (50%)', 'Caregiver fatigue(27.8%)', 'Ineffective treatment behavior (22.2%)', 'Ineffective Levin tube management and Levin tube feeding(22.2%)'. Fourteen nursing diagnoses were selected. 2. Ten of the nursing diagnoses for patients with cerebrovascular accident were listed as nursing diagnoses by NANDA but four nursing diagnoses were new nursing diagnoses used in home health care clinical practice. 3. Characteristics of the ten Nursing Diagnoses from NANDA were developed from the sign /symtoms in the literature and in the nurse progress notes. These characteristics was verified as major or minor sign / symtoms by the expert group. 4. Characteristics of the four nursing diagnoses used in home health care were not defined by the literature but only by the nurse progress notes and verified as major or minor signs /symtoms by the expert group. On the basis of the findings of this study, the following recommendations are made : 1. Continual study is necessary to identify other signs /symtoms not verified in this study. 2. It is necessary to use verified signs /symtoms in home health care clinical practice. 3. It is necessary to define related factors which define each diagnoses in this study. 4. It is necessary to develop of standardized nursing are plans which include defined signs and symtoms. 5. It is necessary to study the outcomes of the standardized nursing care plans.
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