The Effects of Joint Case Conferences with Visiting Nurses on Discharge Planning Ability of Ward Nurses / 日本プライマリ・ケア連合学会誌

Objective: To improve the discharge planning ability of ward nurses, we carried out case conferences for discharged patients involving both ward nurses and visiting nurses, and assessed their effects.Methods: We compared the discharge planning ability of ward nurses with and without experience in home visits before discharge. The study involved 74 nurses from eight wards in three hospitals. We analyzed changes in the discharge planning ability of the 62 nurses without home visit experience after the case conferences.Results: Ward nurses with experience in home visits before discharge had significantly higher discharge planning ability than those without such experience. After a case conference, the discharge planning ability significantly changed for nurses without experience in home visits. Their attitude toward home care changed, and they recognized its importance, associating it with the words "poor-rich", "dirty-clean", and "confined-free". They also scored higher on the Discharge Planning Process Evaluation Measurement (DCP-PEM) for "understands the importance of educating the patient's family", and "devises a plan taking health care needs into account", and on the Discharge Planning Process Scale for hospital ward nurses for "makes contact with a care manager as early as possible".Conclusions: Involving ward nurses in home visits before discharge and case conferences with visiting nurses were effective educational methods to improve their discharge planning ability in the affective and psychomotor domain.

Pain Management of Community-dwelling Older Adults with Dementia Practiced by Visiting Nurses

To clarify nursing practices in pain management of community-dwelling older adults with dementia by visiting nurses, we conducted semi-structured interviews with 10 visiting nurses and analyzed their responses qualitatively and inductively. As a result, 24 subcategories and 8 categories were identified. Visiting nurses were found to conduct pain assessment and assessment based on behavioral changes in usual daily life because of characteristics of health assessment in home care, in which the goal is to comprehensively support clients as living people, in addition to standard pain management of older people with dementia. The results suggest that the viewpoint to integrate information from other professionals and family members and assess daily life comprehensively is important, and some mechanism to facilitate multidisciplinary information sharing is required. When visiting nurses were unsure of whether a patient is in pain, they evaluated the patient’s pain on the basis of behavioral changes in his or her normal daily life after medication or nondrug treatment. A nationwide survey is necessary for further clarification.

The Follow-up Study of Changes in Frailty in Elderly Receiving Home Health Care of the Public Health Center

PURPOSE: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years.METHODS: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used.RESULTS: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p < .001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p < .001).CONCLUSION: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of ‘community care’ and ‘ageing in place’.

The Factors Associated with a Support for Their Understanding of Prognosis by Visiting Nurses of Patients with End-stage Cancer

Purpose: We aimed to clarify the factors associated with the support for their understanding of prognosis by visiting nurses of patients with end-stage cancer likely involves a patient’s wish to die in a desired place. Methods: A cross-sectional nationwide anonymous questionnaire survey was conducted among visiting nurses at 1000 randomly selected home care agencies. Results: Three hundred seventy-four surveys were analyzed. An explanation of the prognosis with regard to daily life was provided to 27.8% of patients. Factors associated with the support given by nurses included notifying patients of a limited prognosis (odds ratio [OR], 3.22; 95% confidence interval [95%CI], 1.81-5.73), recognition of the support by the nurse (OR, 2.12; 95%CI, 1.02-4.43), nurses’ recognition of the patients’ need for a support (OR, 1.54; 95%CI, 1.08-2.21), and having experience in providing home care for at least five patients with end-stage cancer per year (OR, 1.78; 95%CI, 1.04-3.05). Conclusions: The findings suggested that promoting the aforementioned four items is necessary to allow patients their wish to die in a desired place and for visiting nurses to support for their understanding of prognosis.

Extraction of Factors for Home-visiting Nurses to Determine Family Caregivers Who Need Support after Bereavement

Purpose: The aim of this study was to extract factors for home-visiting nurses to determine family caregivers who need support after bereavement. Methods: A questionnaire was constructed and administered to 105 family caregivers of terminally ill patients. Using the survey responses, factors were extracted that would allow home-visiting nurses to judge the necessity of bereavement support before and after the deaths of the patients. Of the 105 family caregivers, 30 consented to participate in the survey. Researchers interviewed the 30 family caregivers using the Center for Epidemiologic Studies Depression Scale and the SF-8TM health survey to assess the health-related quality of life. The obtained data were analyzed using the mathematical quantification theory class II. Results: The extracted factors included: the existence of a disease under medical treatment, the existence of dissatisfaction with medical services, the existence of the economic burden of a disease, a married couple consisting of persons aged over 75 years, family members living in the home who tended to leave care to the primary caregiver, no reliable family members or relatives outside the home, and a tendency to refrain from requesting others’ help (the discrimination hit ratio was 76.7%, the correlation ratio was 0.42, and P=0.001). The criterion-related validity of judgments by home-visiting nurses was verified. Conclusion: These seven factors were revealed as important for determining family caregivers who need support after bereavement.

Los orígenes de la enfermería comunitaria en Latinoamérica / The origins of community nursing in Latin America

RESUMEN La trascendencia de la actividad enfermera directamente con la comunidad ha sido invaluable en el desarrollo de la enfermería. Aquellas acciones en apariencia aislada de quienes asistían a la comunidad en sus domicilios constituyen un enorme tejido que ha dado profundo sentido a la actividad enfermera y soporte a diferentes paradigmas de la medicina y la salud pública. De notable relevancia es el profundo vínculo de esta rama de la enfermería con diferentes procesos sociales de acuerdo al contexto histórico y a situaciones particulares de cada país en Latinoamérica. La llamada enfermería comunitaria ha sido fiel reflejo de la crisis de los sistemas sanitarios en diferentes épocas. Además, es un sólido eje que ha aportado en la construcción social y en la formalización de la enfermería como profesión digna y respetable, y cuyo desarrollo se ha gestado en la búsqueda de nuevos caminos en beneficio del arte de los cuidados y de la salud de la comunidad.

ABSTRACT The importance of nursing activity directly with the community has been invaluable in the development of nursing. Those actions apparently isolated from who attended the community in their homes constitute an enormous tissue that has given deep meaning to the nurse activity and support to different paradigms of medicine and public health. Of notable relevance is the deep link of this branch of nursing with different social processes according to the historical context and particular situations of each country in Latin America. The so-called community nursing has been faithful reflection of the crisis of health systems in different times. Besides is a solid axis that has contributed in the social construction and the formalization of nursing as a worthy and respectable profession whose development is based on the search for new ways to benefit the art of nursing and health of the community.

The Problems Recognized by Visiting Nurses When Local Communities Support the Bereaved Families of Users of Home-visit Nursing Stations

Purpose: To elucidate the problems recognized by visiting nurses when local communities support the bereaved families of users of home-visit nursing stations. Methods: A questionnaire survey was mailed to approximately 1,000 home-visit nursing stations throughout Japan. Results: We then analyzed 211 free descriptions and extracted 8 problems, including “Grief care is difficult to continue because it is a voluntary activity,” “It is insufficient in assessing bereaved families and I don’t know the social resources to introduce to bereaved families,” “I am reluctant to be involved with bereaved families,” “Because of the Act on the Protection of Personal Information, it is difficult to support bereaved families,” and “A formal & informal support for bereaved families has not been established.” Conclusion: No system has been established for grief care in Japan and grief care does not generate a profit; therefore, visiting nurses felt limited in their ability to be continuously involved in grief care, although they were concerned about the situations of bereaved families. This study indicated future tasks that home-visit nursing stations that perform grief care for the bereaved families of their users and home-visit nursing stations that request this care be provided by community general support centers should be evaluated in terms of medical remuneration points.

A Nationwide Survey on Bereavement Care at Home-visit Nursing Stations

Purpose: To investigate the present situation and to explore future problems in bereavement care. Methods: A questionnaire survey was mailed to approximately 1,000 home-visit nursing stations throughout Japan. Results: A total of 296 (29.8%) valid responses were returned. Of the responding stations, 6.1% answered that they “positively perform” bereavement care, 73.1% “perform [it] when necessary,” and 20.7% “seldom perform” bereavement care. A total of 91.4% of the responding stations provided bereavement care by visiting nurses after a patient’s death. A total of 73.6% of the responding stations always performed care in the form of appreciation for their efforts. A total of 32.4% of the responding stations contacted related organizations to request that the organizations watch bereaved family members who suffered from dementia but lived alone. Reasons for not contacting related organizations included not knowing which organization to contact (17.5% of the responding stations). Conclusion: Approximately 90% of the responding stations provided bereavement care by visiting nurses after the patient’s death, with emotional support as the main activity. Visiting nurses were asked to acquire abilities: 1) to provide bereaved families with information about health and welfare services that could be used in addition to long-term care insurance to rebuild their lives, 2) to ascertain which bereaved families would need continuous support, and 3) to assign these bereaved families to relevant organizations.

Más que curar, prevenir: surgimiento y primera etapa de los Centros de Higiene Infantil en la Ciudad de México, 1922-1932 / Prevention rather than cure: the emergence and first stage of the Centros de Higiene Infantil in Mexico City, 1922-1932

Este trabajo aborda las principales características del surgimiento y primeros diez años de funcionamiento de los Centros de Higiene Infantil, establecimientos dependientes del Departamento de Salubridad Pública desde 1922 en la Ciudad de México y que tuvieron como objetivo atender a las madres, desde el periodo de gestación, y a los niños, desde el nacimiento hasta los dos años de edad. Revisa las acciones que dieron origen a este proyecto y su consolidación. Analiza la estructura de estos Centros, las características de las madres y los niños que atendieron, así como las funciones que realizaron médicos y enfermeras enfatizando la noción de prevención de las enfermedades infantiles, para finalmente mostrar un primer balance acerca de los alcances y limitaciones que tuvieron.

This article deals with the main features of the emergence and first ten years of the Centros de Higiene Infantil, facilities run by the Departamento de Salubridad Pública from 1922 on in Mexico City with the goal of providing care for mothers from pregnancy onwards and children from birth to two years of age. It reviews the actions that gave rise to this project and how it became established. It analyzes the structure of these centers, the characteristics of the mothers and children seen there and the functions performed by doctors and nurses, stressing the notion of preventing childhood illnesses, and ends with a first assessment of the effects and limitations of these centers.

Importance and Performances of Visiting Nurse Services Provided under the Long Term Care Insurance System for the Elderly

PURPOSE: This study was attempted to provide quality improvement and revitalization of visiting nurse services by Importance-Performance Analysis of persons being provided with the services. METHODS: The subjects were 350 people being provided with visiting nurse services from a long term home care institution in the kangwon Province during the period of data collection between Aug. 16 and Sep. 15, 2011. Data analysis was conducted through t-test, ANOVA, and IPA by using the SPSS/WIN 12.0 program. RESULTS: As a result of the Importance-Performance Analysis of visiting nurse services, it turned out that the strength on reliability, assurance, and empathy should be maintained with good work and the aspects of responsiveness appeared to be intensively improved, and the tangibility proved to be subject to improvement. CONCLUSION: For the activation of visiting nurse services, methods for improving the performance in the intensive care area and management strategy establishment which highlights the advantages of strength maintenance area are needed.

Job Stress, Job Satisfaction, and Organizational Commitment of Customized Home Health Care Nurse / 農村醫學 地域保健

OBJECTIVES: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in customized home health care nurses. METHODS: Research participants were 130 nurses who worked in the customized home health care of 20 county in Gyeongnam province. Data collection for this descriptive correlational study was done at August 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, and we analyzed a four step approach in which several regression analyses were conducted and significance of the coefficients is examined at each step. RESULTS: The results from step 1 showed that, the effect of each job stress was significantly related to job satisfaction. In step 2, the direct effect of commitment to organization on job satisfactions were all significant too. Step 3 analysis showed that the total effect of each job stress on commitment to organization symptoms was significant. Step 4 showed the results of controlling for mediating factor (job satisfaction): job demand and insecurity were significantly associated with commitment to organization (p<0.001), the finding supports that others were fully mediated by each job satisfaction, and, the job demand and insecurity were partially mediated by job satisfaction. CONCLUSION: Results of this research indicated that job stress in customized home health care nurses was the principal variable affecting job satisfaction and commitment to organization. Appropriate stress management strategies based on assessment of job demand and job security for these nurses lead to development of improved commitment to organization.

Job Stress, Organizational Commitment, Way of Coping and Turnover Intention among Korean Visiting Nurses / 한국직업건강간호학회지

PURPOSE: The purpose of the study was to identify factors related to turnover intention among Korean visiting nurses. METHODS: The data from 192 of 208 nurses working in southern part of Korea were collected for analysis during in-service education in May 19~20, 2011. Descriptive statistics, chi-square tests, ANOVA, and logistic regression analysis were performed using SPSS 19.0 program. RESULTS: Among the general characteristic factors, young, married, university graduation, lower satisfaction with income and longer work experience as a nurse were associated with higher odds of turnover intention. Organizational commitment was associated with low turnover intention. Way of coping was not statistically significantly associated with turnover intension. CONCLUSION: Stress from the organizational system was found to be the most important variable that explains the turnover intention in this study. Use of sensible communication methods and introduction of effective conflict resolution system is suggested to reduce turnover intention. Further research is recommended to identify the job demands and organizational systems of visiting nurses.

The Correlation between Nursing Professional Values and Job Satisfaction Depending on the Types of Visiting Nurses' Personality / 산업간호학회지

PURPOSE: The purpose of this study is to identify nursing professional values and job satisfaction depending on the types of personality in visiting nurses. METHODS: Two hundred twenty six visiting nurses participated in this study. Data collection was conducted in 26 Public Health Centers in Korea. The Korean version of the Enneagram nursing professional values and job satisfaction was used to measure the nursing professional values and job satisfaction. RESULTS: The most common personality is type 9, a center of the Instinctive Center where energy tends to stress outwards. There was a significant difference in nursing professional values depending on the type of personality. The type 1, 2 and type 9 had a significant difference by depending on the type of personality. There was but no difference in job satisfaction. There was a negative correlation between nursing professional values and job satisfaction by depending on the type of personality. The nurses with the type 9 and type 1 of personality showed a significant differences with the negative correlation between professional values and job satisfaction. CONCLUSION: The findings of this study showed the necessity of a self-understanding program to improve the working efficiency by increasing the professional values and job satisfaction of visiting nurses.

Effect of preoperative visiting by special visiting nurses before operation on relieving mental tension of patients / 中国实用护理杂志

Objective To discuss the influence of preoperative visiting by special visiting nurses before operation on relieving mental tension of patients. Methods 80 patients were randomly divided into the experimental group and the control group with 40 patients in each group.All patients were prepared in the same way except that patients in the experimental group were visited by the operation room nurses before the operation.The differences in heart rate and blood pressure were compared between the two groups as the criteria for judging mental tension of the patients. Results Blood pressure and heart rate of patients in the experimental group did not fluctuate as much as the patients in the control group. Conclusions Visiting patients before the operation can stabilize patients' emotion and reduce their stress reaction and mental tension so as to help them get through the perioperative period more smoothly.

The Correlation between Nursing Professional Values and Job Satisfaction Depending on the Types of Visiting Nurses' Personality / 한국직업건강간호학회지

PURPOSE: The purpose of this study is to identify nursing professional values and job satisfaction depending on the types of personality in visiting nurses. METHODS: Two hundred twenty six visiting nurses participated in this study. Data collection was conducted in 26 Public Health Centers in Korea. The Korean version of the Enneagram nursing professional values and job satisfaction was used to measure the nursing professional values and job satisfaction. RESULTS: The most common personality is type 9, a center of the Instinctive Center where energy tends to stress outwards. There was a significant difference in nursing professional values depending on the type of personality. The type 1, 2 and type 9 had a significant difference by depending on the type of personality. There was but no difference in job satisfaction. There was a negative correlation between nursing professional values and job satisfaction by depending on the type of personality. The nurses with the type 9 and type 1 of personality showed a significant differences with the negative correlation between professional values and job satisfaction. CONCLUSION: The findings of this study showed the necessity of a self-understanding program to improve the working efficiency by increasing the professional values and job satisfaction of visiting nurses.

Factors associated with Health-related Quality of Life among Family Caregivers of Elders Receiving Home Care Services

PURPOSE: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. METHODS: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. RESULTS: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was 6.33+/-6.49 and the mean health-related quality of life score was 0.69+/-0.39. It was found that the factors affecting the health-related quality of life of family caregivers included depression (beta=-.406, p<.001), home-visit nursing use (beta=.296, p<.001), and daycare use (beta=.178, p=.015), which accounted for 36.6% of their health-related quality of life. CONCLUSION: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

A Survey on the Use of Visiting Nurses in Child Day Care Centers

PURPOSE: The purpose of this study was to contribute children's health care and health promotion by surveying the use of visiting nurses in child day care centers. METHODS: This study is a descriptive study, and the study period covers July to September, 2010. The research subjects were 27 public health center managers, 166 visiting nurses and 137 child care teachers. RESULTS: Teachers' need of visiting health care services and visiting nurses' work performance of were statistically significantly different. The teachers' need of visiting health care was higher in all areas (health examination, health life practice, infectious disease control, safety accidents and disaster management, emergency measures and linkage, nutrition, parent education) but the visiting nurses had a low level of work performance. CONCLUSION: Child care teachers are not health professionals for child health care, and therefore they are in need of professional help. Thus, for the current public health centers in need of customized visit health care, new visiting nurses in charge of professional child health care need to be developed. Also, new models need to be developed for visiting nurses and child care teachers through the connection of community child health care.

Customized Home Visiting Nurses' Experiences in Telephone Visiting

PURPOSE: The purpose of this study was to explore and understand customized home visiting nurses' experiences in telephone visiting. METHODS: Qualitative data were collected from several discussions of 4 focus groups consisting of 20 customized home visiting nurses. All interviews were recorded and transcribed according to thematic content analysis processes. RESULTS: The five main themes on customized home visiting nurses' experiences of telephone visiting were 'greeting', 'counseling', 'using strategies', 'maintaining attitude for enhancing relations' and 'enduring difficulties'. The category of 'counseling' was composed of confirming, educating, supporting, adjusting, and indicating. And, the category of 'using strategies' included complimenting, scolding, persuading, compensating, and ignoring. CONCLUSION: Developing a standardized manual on telephone visiting is needed to guide an effective counseling. In order for a customized home visiting nurse to be a good telephone counselor, training of motivational interviewing is recommended.

A Study on Link of Health and Welfare Service and Barrier's Factors of Visiting Nurses and Social Welfare workers / 간호학회지

PURPOSE: The purpose of this study was to explore the link between health and welfare service and barrier's factors by reviewing the connection between the public health center's visiting nurse and social welfare center's social workers METHOD: A survey by mail or a face-to-face interview of 151 visiting nurses in 25 public health centers and 48 social welfare workers in general social welfare centers in Seoul, was preformed from Feb. 12, 2001 to Mar. 15, 2001. The data were analyzed with frequency, percentage, mean value, paired t-test and independent t-test using SPSS/WIN 7.5 program. RESULT: 1. 'The necessity and degree of cooperation with social welfare workers of visiting nurse' scored average 4.49 and 3.19, and 'The necessity and degree of cooperation with visiting nurse and social welfare workers' scored average 4.81 and 3.15 on the five-point scale ; there was a significant difference between the two variable in visiting nurse and social welfare workers. 2. In barrier's factors which health and welfare service offer to, visiting nurses showed statistically significant higher score than social welfare staff ; 'job factor', 'resource factor', 'clients factor', 'individual ability factor' CONCLUSION: In order to provide link system that hold clients in common in public health center and social welfare center, it is recommended a case management team should be constructed and educate visiting nurses for case manager.