DOI QR코드

DOI QR Code

Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

노인요양시설 건강지원서비스 현황과 장애요인: 포커스 집단 면접

  • Park, Yeon-Hwan (College of Nursing, The Research Institute of Nursing Science, Seoul National University) ;
  • Bang, Hwal Lan (Department of Nursing, College of Industry, Sangmyung University) ;
  • Kim, Ga Hye (College of Nursing, The Research Institute of Nursing Science, Seoul National University) ;
  • Oh, Seieun (Department of Nursing, College of Health Sciences, Dankook University) ;
  • Jung, Young-Il (Graduate School of Public Health and Institute of Health and Environment, Seoul National University) ;
  • Kim, Hongsoo (Graduate School of Public Health and Institute of Health and Environment, Seoul National University)
  • 박연환 (서울대학교 간호대학.간호과학연구소) ;
  • 방활란 (상명대학교 간호학과) ;
  • 김가혜 (서울대학교 간호대학.간호과학연구소) ;
  • 오세은 (단국대학교 간호학과) ;
  • 정영일 (서울대학교 보건대학원.보건환경연구소) ;
  • 김홍수 (서울대학교 보건대학원.보건환경연구소)
  • Received : 2015.05.11
  • Accepted : 2015.07.14
  • Published : 2015.08.31

Abstract

Purpose: Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents. Methods: A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014. Results: The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'. Conclusion: The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents.

Keywords

References

  1. Sunoo D. Quality evaluation of long-term care facilitation in Korea: results and implications. Seoul: Korea Institute for Health and Social Affairs. 2014;1-8.
  2. Lee TW, Cho E, Ko YK, Whang Y, Kim BN, Lim ES, et al. Development of the quality indicators in long term care service. Journal of Korean Academy of Nursing Administration. 2012;18(1):106-17. https://doi.org/10.11111/jkana.2012.18.1.106
  3. Lee Y, Kim S. A study on the systematization of service quality management system of long-term care (LTC). Korea Institute for Health and Social Affairs. 2012;32(4):66-93.
  4. Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy and Planning. 2009;24(1):63-71. http://dx.doi.org/10.1093/heapol/czn037
  5. Saltman RB, Dubois HF, Chawla M. The impact of aging on long-term care in Europe and some potential policy responses. International Journal of Health Services. 2006;36(4):719-46. https://doi.org/10.2190/AUL1-4LAM-4VNB-3YH0
  6. OECD. Long-term care for older people [Internet]. 2005. Paris: OECD Publishing; 2005 [cited 2015 August 16]. Available from: http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/long-term-care-for-older-people_9789264015852-en#page1
  7. Yoo H-J. Characteristics of senile diseases: geriatric syndromes. Korean Journal of Medicine. 2009;77(4s):S1073-6.
  8. Lee K, Im M. A study on the level of demand for nursing service for the old people resident in the nursing home. Nursing Science. 2002;14(2):45-56.
  9. Boorsma M, Langedijk E, Frijters DH, Nijpels G, Elfring T, van Hout HP. Implementation of geriatric assessment and decision support in residential care homes: facilitating and impeding factors during initial and maintenance phase. BMC Health Services Research. 2013;13(8):1-9. http://dx.doi.org/10.1186/1472-6963-13-8
  10. Kim Y, Lee J, Kim H, Hwang J. A comparison of nursing problems identified through RAI-FC and by nurses caring for nursing home residents. Journal of Korean Gerontological Nursing. 2011;13(1):58-68.
  11. Lee TW, Chung J. Structural factors influencing the quality management activities in nursing homes. Journal of Korean Academy of Nursing Administration. 2010;16(2):162-71. https://doi.org/10.11111/jkana.2010.16.2.162
  12. Morgan DL. Focus groups as qualitative research: Sage; 1997.
  13. Krueger RA. Focus groups: a practical guide for applied research: Sage; 2009.
  14. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101. http://dx.doi.org/10.1191/1478088706qp063oa
  15. Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-88. http://dx.doi.org/10.1177/1049732305276687
  16. Weman K, Kihlgren M, Fagerberg I. Older people living in nursing homes or other community care facilities: registered nurses' views of their working situation and co-operation with family members. Journal of Clinical Nursing. 2004;13(5):617-26. http://dx.doi.org/10.1111/j.1365-2702.2004.00906.x.
  17. Kwon YJ. The 2 years experience and vision of long-term care system: seeking direction for performance oriented development of long term care insurance. The symposium of second anniversary of long term care insurance. Seoul: Ministry of Health and Welfare; 2010.
  18. Murphy K. Nurses' perceptions of quality and the factors that affect quality care for older people living in long-term care settings in Ireland. Journal of Clinical Nursing. 2007;16(5): 873-84. http://dx.doi.org/10.1111/j.1365-2702.2006.01633.x
  19. Rapp MP. Opportunities for advance practice nurses in the nursing facility. Journal of the American Medical Directors Association. 2003;4(6):337-43. http://dx.doi.org/10.1097/01.jam.0000095253.60570.43
  20. June KJ, Lee JY, Yoon JL. Effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health services for older people. Journal of Korean Academy of Nursing. 2009;39(3):366-75. http://dx.doi.org/10.4040/jkan.2009.39.3.366
  21. Sunoo D, Kim CW, Im HY, Kim SO, Seo DM, Yang YA, et al. Public long-term care insurance for the elderly in Korea: status and challenges. Seoul: Elderly Information Center. 2012.
  22. Boorsma M, Frijters DH, Knol DL, Ribbe ME, Nijpels G, van Hout HP. Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial. Canadian Medical Association Journal. 2011;183(11):E724-32. http://dx.doi.org/10.1503/cmaj.101498
  23. Harrington C, Zimmerman D, Karon SL, Robinson J, Beutel P. Nursing home staffing and its relationship to deficiencies. Journals of Gerontology: Social Sciences. 2000;55(5):S278-87. https://doi.org/10.1093/geronb/55.5.S278
  24. Kim H, Jung YI, Sung M, Lee JY, Yoon JY, Yoon JL. Reliability of the interRAI long term care facilities (LTCF) and interRAI home care (HC). Geriatrics & Gerontology International. 2015;15:220-8. http://dx.doi.org/10.1111/ggi.12330
  25. Boumans NP, Berkhout AJ, Vijgen SM, Nijhuis FJ, Vasse RM. The effects of integrated care on quality of work in nursing homes: a quasi-experiment. International Journal of Nursing Studies. 2008;45(8):1122-36. http://dx.doi.org/10.1016/j.ijnurstu.2007.09.001
  26. Ryden MB, Snyder M, Gross CR, Savik K, Pearson V, Krichbaum K, et al. Value-added outcomes: the use of advanced practice nurses in long-term care facilities. The Gerontologist. 2000;40(6):654-62. https://doi.org/10.1093/geront/40.6.654
  27. Park HU. Nurses' knowledge and attitude toward the elderly in medical welfare facilities for old people. [master's thesis]. Gwangju: Chonnam National University; 2007.
  28. Dellefield ME. Implementation of the resident assessment instrument/minimum data set in the nursing home as organization: implications for quality improvement in RN clinical assessment. Geriatric Nursing. 2007;28(6):377-86. http://dx.doi.org/10.1016/j.gerinurse.2007.03.002

Cited by

  1. Nurses' Views on Infection Control in Long-Term Care Facilities in South Korea: A Focus Group Study vol.30, pp.6, 2015, https://doi.org/10.7475/kjan.2018.30.6.634
  2. 인간중심돌봄에 대한 요양병원 간호사의 인식: 포커스 그룹 연구 vol.19, pp.11, 2015, https://doi.org/10.5762/kais.2018.19.11.441
  3. 장기요양시설 규모별 간호서비스 요구 및 제공현황 비교 vol.26, pp.1, 2015, https://doi.org/10.14370/jewnr.2020.26.1.28
  4. Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes vol.61, pp.3, 2021, https://doi.org/10.1093/geront/gnaa090