|
가정간호사업 대상자 중에서 가장 많은 비율을 차지하고 있는 뇌졸중과 뇌ㆍ척수손상 입원환자를 대상으로 가정간호사업 대상자를 선정하는 기준을 개발하고, 이들의 건강문제를 중심으로 가정간호사업에서 제공되어야 하는 간호 써비스 내용을 밝힌 것이다.
첫째, 가정간호사업 대상자 선정기준을 개발하기 위한 방법론적 연구로서 6단계의 절차를 거쳐 선정 기준 작성과 검증의 단계 및 종합병원에 실제 적용을 하였다.
둘째, 가정간호 사업을 실시할 때 제공되어야 하는 써비스 내용을 밝히기 위한 분석적 연구방법을 사용하였다. 문헌에 나타난 사업의 내용을 조사하고 가정간호 산업 대상자로 분류된 환자들의 건강문제와 이 문제를 해결하기 위한 간호내용 등을 분석하였으며 또한 이 환자들이 실제 입원 기간동안에 제공받은 간호내용 등을 조사하여 이를 종합하여 가정간호 써비스 내용을 제시하였다.
This study was done to clarify the types of health care that should be offered. It focus on developing client selection criteria based on the needs of inpatients with cerebral vascular diseases, head injuries and spinal cord injuries.
Two research methods were adopted. One was a methodological approach for developing client selection criteria and the other was analytical approach to clarify the types of services to be offered. -
From the research findings, the following summarized conclusions have been drawn.
1. The problem and item criteria used to select patients requiring home health care, namely, a prototype evaluation tool, consisted of 12 items in four areas ; phsiological status, functional status, psychological status and environmental status. After assessing each item at three levels, the categorization was done according to the classification criteria.
The item internal consistency of the completed tool was .8358, .8390, the inter-rater reliability was in the range of 84 percent98 percent and the classification consistency was 92 percent.
As external criteria, the relationship of the prototype tool to the Health Status Scale, the Barthel Index of Functional Status Assessing Devices and the number of health problems of the patient was examined and all were found to be statistically significant, verifying the validity of the tool.
2. Using the tool to classify the inpatients according to the established client selection criteria, 84.2 percent were classified as patients requiring home health care, 8.8 per-cent were assessed as suitable for outpatient care and 7.0 percent were assessed as patients needing to be hospitalized.
3. Clients assessed as requiring home health care had 72 different kinds of health problems, which could be classified into four categories ; 54 types of physiological status problems, 8, psychological, 6, functional and 4, environmental status problems.
For each problem, the percentage of patients who suffered from the disorders ranged from 2.1 percent66 percent. More than half of the subjects had problems related to urination, paralysis, contracture or locomotion. For the physiological category, many of the health problems were due to disorders of muscles and bone, whereas skin and breathing disorders were relatively low. The mean number of health problems in this category as 11.1.
4. Reviewing the literature, it was found that home health care consisted of 10 activity areas, namely, sanitation, nutrition, breathing, skin, body temperature maintenance, medication, assessment and observation, education and counselling. The service areas and activities presentedein the literature were similar, not only to the activities necessary to treat the physical status of patients in home health care but also, to the nursing care activies the patients received during hospitalization. Considering the types of service presented in the literature and the nursing care actually offered in the hospital and physiological problems of the patients, it was found the the types of home health care that need to be offered covered 50 different kinds of activities in 10 areas.
2. Using the tool to classify the inpatients according to the established client selection criteria, 84.2 percent were classified as patients requiring home health care, 8.8 per-cent were assessed as suitable for outpatient care and 7.0 percent were assessed as patients needing to be hospitalized.
3. Clients assessed as requiring home health care had 72 different kinds of health problems, which could be classified into four categories ; 54 types of physiological status problems, 8, psychological, 6, functional and 4, environmental status problems.
For each problem, the percentage of patients who suffered from the disorders ranged from 2.1 percent66 percent. More than half of the subjects had problems related to urination, paralysis, contracture or locomotion. For the physiological category, many of the health problems were due to disorders of muscles and bone, whereas skin and breathing disorders were relatively low. The mean number of health problems in this category as 11.1.
4. Reviewing the literature, it was found that home health care consisted of 10 activity areas, namely, sanitation, nutrition, breathing, skin, body temperature maintenance, medication, assessment and observation, education and counselling. The service areas and activities presentedein the literature were similar, not only to the activities necessary to treat the physical status of patients in home health care but also, to the nursing care activies the patients received during hospitalization. Considering the types of service presented in the literature and the nursing care actually offered in the hospital and physiological problems of the patients, it was found the the types of home health care that need to be offered covered 50 different kinds of activities in 10 areas.
|