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정신보건간호사의 방문간호 내용 조사연구
Analysis of Psychiatric Home Care Implemented by Psychiatric-Mental Health Nurse Practitioners
조선희 ( Jo Seon Hui ) , 하양숙 ( Ha Yang Sug )
UCI I410-ECN-0102-2009-510-003331756

In this research, a list of Psychiatric Home Care Items, framework of the present analysis, through participant observation, analysis of nursing record, and literature review was developed. This developed list was used by 56 psychiatric-mental health nurse practitioners working at the community mental health center and 18 working at public health centers. The result of the implementation of the list was surveyed and analyzed for the purpose of this research. A summarized conclusion of this research is as follows: ASSESSMENT consisted of assessments of: mental health status; home environment; safety issues; MSE; GAF; needs for support and resources; physical assessment; social and economic status and family of the patient. INTERVENT10N included: individual psychotherapy or counseling; family psychotherapy or counseling; relaxation therapy; social-interpersonal skill training; cognitive therapy; crisis-emergency intervention; behavior modification; medication administration; medication monitoring; drug side effects monitoring; medication instruction; family education regarding illness and coping skills; individual education regarding illness and coping skills; intervention in physical problems; monitoring of follow-up schedule; management of daily life status; coordination with other mental health services; referral to community resources; provision of information; financial support.EVALUAT10N covered: evaluation of each nursing intervention; adjustment of frequency in visit after evaluation. For ASSESSMENT, the measurement of psychiatric home care work and the degree of implementation of the list resulted in the highest average point of 3.56 out of 4.00 with the assessment of psychiatric status and the lowest of 2.51 with GAF. For DIAGNOSIS and PLANNING, the measurement results were relatively low; for instance, "nursing diagnoses" scored 2.26. For INTERVENT10N, the items related to medication management scored highly, among which the highest was 3.67 with "medication monitoring" and the lowest 1.92 with "financial support". For EVALUAT10N, the "evaluation of each nursing intervention" scored 2.60. The comparison of the psychiatric home care work and the degree of implementation of the list of the two institutions (community mental health center and public health center) showed that the former scored higher significantly in items such as: MSE; behavior modification; medication monitoring; management of daily life status; provision of information (p<.05); assessment of psychiatric status; GAF; individual psychotherapy or counseling; drug side effect monitoring; evaluation of each nursing intervention (p<.01); adjustment of frequency in visit after evaluation (p<.001). In conclusion, this research shows that the overall qualitative improvement of psychiatric home care requires not only the individual psychiatric-mental health nurse practitioner`s efforts, but also standardized work guidelines and evaluation tools, proper budget and qualified personnel, continuing education of the practitioners, and a better quality of the psychiatric home care through a quality control system, all this contributing to developing the nation`s mental health services and improving the quality of life of the people with mental illness. The constraints of this research were the relative lack of data from the public health center, thus limiting the generalization based on these results as well as the possible over-presumption resulting from the self-reports, which leaves needs for more further research on the activities of the public health center practitioners.

[자료제공 : 네이버학술정보]
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