Quality of Life of Older Adult with Home Health Services: Applied PRECEDE Model / 재활간호학회지

PURPOSE: The purpose of this study was to determine factors that affect poor quality of life (QOL) of older adults who received home health service. METHOD: The sample 492 older adults participated in the study. The QOL was measured using the scale of QOL of Ware and other data were collected through face-to-face interviews from September to August, 2009. RESULTS: The level of QOL was moderate (Mean 24.4, SD 7.4). The QOL was poorer in older adults (p<.05) and in those living alone (p<.01) compared to older adults and those living with couple or family respectively. The QOL was positively correlated with a sense of mastery (r=.213, p<.05), connection of health (r=.160, p<.05) and a cognitive function (r=.119, p<.01), and negatively correlated with Activities of Daily Living (r=-.266, p<.01) and Instrumental Activities of Daily Living (r=-.339, p<.01). Sense of mastery, connection of health & welfare, and IADL were significant predictors of QOL. CONCLUSION: Finding suggest that home health service program should incorporate strategies for increasing sense of mastery and capability of performing IADL, and strengthening connection of health service that may improve QOL of older home health service recipients.

Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People

PURPOSE: To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people. METHODS: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP). RESULTS: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410). CONCLUSION: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

An Analysis of Interrupting Factors in Collaboration between Medical Professionals in Home Health Service / 간호학회지

The propose of this study is to give a theoretical basis for better home health service by looking at the subjective structure the collaboration between the home health nurse and doctor and at how collaboration can be improved. There are at least three types of recognition that can help the collaboration. The first type is to put more weight on the relationship between doctors and home health care nurses. This means that doctors and home health care nurses should make an effort to improve, their collaboration. The second type is to put more weight on the reward for doctors' participation. Reward will help collaboration. The third type is to put more weight on organization support. Organization support will bring about trust between doctors and home health care nurses The following conclusion were reached: 1) Trust should exist between doctors and home health care nurses. 2)Doctors should maintain an equal relationship with home health care nurses and accept them as professionals. 3) Appropriate reward should be given to doctors for their participation. 4)Home health care nurses should reinforce their skills through education, training, and professionalization. 5) Home health care nurses should cooperate with doctors by building a system that centers on patients. 6) Collaboration between doctors and home health care nurses is important because it is useful to recognize patients and their families in a broader light. 7) Doctors and home health care nurses need to be more concerned about patients. 8)More active support of hospital administrators and systems is needed to enhance collaboration between doctors and home health care nurses. 9) The present legal system for collaboration between doctors and home health care nurses can be a factor. The nine nursing strategies above will help doctors and home health care nurses build more positive relations and get closer to their patient, more effective home healthcare will get closer to people who want quality medical service.