Introduction.
In order to provide health services, it is essential to know the health needs of the community being served.
In July of 1974, a study of the health and nursing needs of people living in the Yonsei University community health project area on Kang Hwa Island was conducted in order to obtain basic data for planning Community Health Nursing Services.
The objectives of the study were as follws.
1) To determine specific demographic, social and economic aspects of the area which influence community health nursing services.
2) To determine the major health problems and nursing needs of the community.
3) To determine the health resources needed to solve the health problem determined.
4) To obtain basic data which can be used for future planning and evaluation.
5) To assist the government in formulating a realistic health policy for rural areas.
The study sample was 404 households in Nega Myun and Sun Won Myun of Kang Hwa Island. Kang Hwa Island has a total population of 100,000. There are approximately 20,000 households. Nega Myun and Sun Won Myun, in the study area, have 43 natural villages. These were divided into 3 different levels according to an estimate of their economic living standard. The levels were designated as upper, middle and lower. 3 natural villages of each myun were selected, each representing one level of 3 economic living stadard.
The breakdown of the number of house holds from each myun according to economic living standard is as follows.
Method of study
1) An interview, using a questionnaire based on the study of Extra-Hospital nursing needs(Johns Hopkins University), of the housewife in each household was done in the home.
2) The interviewers were 4th year students of College of Nursing Yonsei University. There was a 3 day training period of interviewers regarding survey methods and the use of the interview manual.
3) Pretest of the questionnaire was conducted in two natural villages not included in the study.
The questionnaire was designed to investigate 17 different categories of the nursing needs. There were as follows.
1) Housing and Sanitation
2) Accident prevention
3) Acute and long-term illness 4) Rehabilitation
5) Pre hospital
6) Post hospital
7) Diagnostic and medical
8) Preventive" health practices 9) Dental
10) Immunization
11) Maternal
12) Infant and preschool
13) School age
14) Home management
15) Family Planning
16) Recreation
17) Food habits
For each category of need the severity of the nursing problem and the ability of the family to cope with the problem were estimated.
A five point scale for estimating the severity of need was used. No need, slight need, moderate need, serious need, critical need. The five point scale for coping ability was as follows; unable to cope, slight, moderate, good, excellent. The interview manual provided criteria for estimating the need and the ability to cope.
Interpretation of Results
Findings were as follows.
Among the 404 households, 31 households had serious and -critical nursing needs; 234 households had moderate nursing needs; one
third of total households had slight nursing needs.
In estimating family´s capacity to cope with overall health problems, one third of total households had slight ability to cope and 13 households were unable to, manage their problems.
The category in which households had the most serious and critical nursing needs was housing and sanitation. Twenty seven point seven (27.7%) percent of the households had serious or critical needs in this area..
Sixteen point three percent of total households had serious and critical nursing needs in the area of preventive health practice. Estimating the level of ability to cope with preventive health practice, 16. 3 % of households had no ability to cope and 44.5% of household had slight ability to cope.
The data indicated that one half of households have a lack of knowledge of preventive health practice and a low capacity to cope with preventive health practices. This would appear to be a first priority health problem in the community.
A second priority of health problem was; shown to be in the area of dental health. 376 households had dental health problems.
Forty point eight percent of households´ had slight ability to cope with dental health problems.
The number of ´households that have nursing needs in the area of immunization, is 335 households. Among these households, 12.6% of the total 404 households have serious and critical nursing needs.
134 households (or 33.2%) have no ability and slight ability to cope with health problems in the area of immunization.
164 households had diagnostic and medical" nursing needs. 12.4% of :the total households: had serious and critical nursing needs in the area.
In estimating of level of family´s capacity to cope with diagnostic and medical needs, one fifth of total households had no ability or slight ability to cope.
100 households of the total households had problems in the area of acute and long term illness. 10.6% of all households had serious and critical nursing needs in this category. 13.3% of total households had no ability or slight ability to cope with acute and long term illness.
238 households had problems in Family Planning.
In estimating of level of nursing needs of -154 households (excluding 84 having ability
to cope with family planning), 12.3% had serious and critical nursing needs in this .area. Sixteen point one percent of all households had no ability or slight ability to cope with family planning problems.
The households which had maternal nursing needs were 138 households.
In estimating the ability to meet maternal nursing needs, 17.3% of total households had no ability or slight ability to cope.
Only 66 households had infant nursing needs.
37.8% of total households had problems in preschool age category. Two fifth of all households had no or slight ability to meet problems in infant and preschool age category. Two hundred twenty two households had problems in school age category.
Twenty one point two percent of total households had no ability or slight ability to cope with problems in this area.
The following recommendation are presented according to the results of the study.
1) Reliability tests are needed to ensure the accuracy of the interviewing method.
2) Community health services should be directed towards the areas of preventive health services, Housing and Sanitation Dental. Immunization and family planning, since these were the areas with the greatest needs and the least ability to cope.
3) The interview schedule and manual for determining the nursing needs of families would appear to be a useful guide for community health nurses in their regular visiting.
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