A Study on the Status of Application of Health Insurance Fees for Nursing Activities of Nurses in Rehabilitation Unit / 재활간호학회지

Purpose@#The purpose of this study was to analyze the nursing activities of registered nurses working in rehabilitation units, and to investigate the application of the health insurance fee for each nursing practice. @*Methods@#Using the Delphi survey method, nursing activities were analyzed as job-task-task elements. Then, the status of the application of health insurance fees was investigated for the task elements according to National Health Insurance Benefit. @*Results@#15 jobs, 61 tasks, and 290 task elements were derived as nursing activities in rehabilitation units.According to the opinion by the expert panel, Among the 290 task elements, 166 (57.2%) out of 290 take elements should be accepted as insurance fees (fee agreement CVR≥0.56). However, the health insurance was applied to only 40 items (24.1%) for nursing management fees, 25 items for nursing care (15.1%), and 26 items for other rehabilitation related medical fees (15.7%). 82 items (49.4%) were not covered by insurance, and most educational interventions were not covered. @*Conclusion@#To provide high-quality nursing services in rehabilitation units, it is essential to apply an appropriate level of health insurance coverage. Further research to expand the application of medical fees related to rehabilitation and institutional arrangements to obtain recognition of the fees for nursing services are necessary.

Performance, Delegation, Job Importance and Education Needs for Tasks of Rehabilitation Nurses / 재활간호학회지

PURPOSE: The aim of this study was to identify performance, delegation, job importance and education needs for duties and tasks perceived by rehabilitation nurses. METHODS: Performance, delegation, job importance and education needs in regard to 11 duties and 57 tasks were surveyed 191 nurses who worked at the rehabilitation unit. RESULTS: Performance, job importance and education needs were high in most duties and tasks. Performance was significantly correlated with job importance. Job importance and education needs was also significantly correlated. Direct care was the highest duty in performance, job importance, and education needs. Psycho-social care, coordination, and self-development were high in job importance but low in performance. Psycho-social care, managing mobility disorder, and dysphagia care were most delegated duties. The most delegated person were employed caregiver/careworker, followed by nurse aid, and family members. CONCLUSION: The educational strategies and opportunities were needed for the rehabilitation nurses and delegated persons.

Experience of Discharge from Rehabilitation Facility / 재활간호학회지

PURPOSE: The purpose of this study was to explore and describe the essence of hospital life concerning discharge from rehabilitation facility as defined by clients with complete quadriplegia. METHOD: This was a qualitative research using Giorgi's descriptive phenomenology. Four participants with complete quadriplegia were participated. RESULTS: The lived experience of discharge from rehabilitation facility among clients with complete quadriplegia was structured by 10 components and was defined as a life event which those patients felt fears and worries to leave the therapeutic environment and to return to their community with various changes due to their disability. During their hospital stay, the patients with quadriplegia were concerning to prepare proper living conditions and their health conditions so that they could keep their life independent and worthy. They also cherished a hope for cure for their cervical injury even at the moment of discharge. CONCLUSION: This study suggests developing a discharge program which relieves the clients' emotional burden for discharge from inpatient rehabilitation facility and helps them to take an active role in preparing for returning to their daily life.

Sexual Adjustment Process of Individuals with Spinal cord Injury / 재활간호학회지

The purpose of this study is to identify and describe a process of sexual adjustment of individuals with spinal cord injury: and to describe and explore positive and negative influences on the adjustment process. This qualitative study was conducted with 10 Korean individuals with spinal cord injury who had been physically disabled for more than one year. Data were collected and analysed at a same time using grounded theory method. Major categories of this study showed a process how the individuals with spinal cord injury adjust to their individual life as sexual beings. The process included Changes of life caused by physical disability> Emotional distress> Stability of life> Recognition of self as a sexual being> Re-establishing own sense of values for sexual life> Behavioral efforts for restoration of sexual life> and individual responses to the behavioral efforts including Frustration> Resignation> Satisfaction> Dissatisfaction> and Limited satisfaction>. Initially physical aspects of sexuality seemed to be affected by spinal cord injuries. The changed physical aspects then influenced other aspects of their sexual life. Life satisfaction of each individual as a sexual being revealed as very subjective. It could be defined according to how the individual approved their sexual life no matter what and how much behavioral effort the person had done. In this study 3 types of sexual adjustment aspects were explored: 'Active adjustment' 'Passive adjustment' 'Maladjustment'. There were negative and positive factors influencing the adjustment process of individuals with spinal cord injury. Those factors might come from themselves. from families. or from social situations. Findings of this study suggested that sexual life of individuals with spinal cord injury should not be understood as a physical or behavioral matter. It was a combination of physical. psychological and social aspects of life. Therefore. appropriate rehabilitation programs for the sexual adjustment of individuals with spinal cord injury need to concern heterogeneous life values of them and obtain individualized services for each individual at a different stage of the sexual adjustment process.