• Health Policy and Management
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• v.28 no.4
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• pp.392-401
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• 2018

Background: Physical activity (PA) is critical for maintaining the health and well-being of older people in community and also institutional settings. The purpose of this study was to examine the current status of PA and related individual and organizational factors among older nursing home residents with and without dementia. Methods: This is a secondary data analysis study of a nationwide survey of 92 long-term care facilities in Korea, and the study sample includes older residents with dementia (n= 753) and without dementia (n= 480). The level of PA was measured by PA time and whether or not residents had an outdoor activity over the past 3 days. Multi-variate, multi-level analyses were conducted. Results: More than half of the sample in both groups had no or less than 1 hour of PA. About one out of four older people in our sample had no outdoor activity over the past 3 days regardless of whether or not they had dementia. Among the people without dementia, several individual-level factors were associated with PA, including dependency for activities of daily living, social activity participation, and caregivers' belief in the functional improvement of residents. Unlike the non-dementia group, individual- and organizationallevel factors including staffing level and having the relevant equipment for PA were associated with PA among those with dementia. Conclusion: Study findings provide evidence on the lack of PA among older nursing home residents, and the importance of institutional capacity with regard to human resources and physical equipment for promoting PA among people with dementia, in particular. Policies and supports are needed to promote the implementation of healthy aging programs including PA for older nursing home residents. Such programs should be person-centered with consideration to the physical and cognitive status of individual residents.

• Journal of Home Health Care Nursing
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• v.27 no.3
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• pp.306-320
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• 2020

Purpose: This study aimed to explore the subjective perception structures and types of empathy among nurses caring for patients with behavioral and psychological symptoms of dementia (BPSD) using Q-methodology. Methods: Thirty-eight Q-samples (statements) were derived from in-depth interviews with 10 nurses working in long-term care hospitals and nursing homes. The Q-sorting was conducted in rank order (the responses obtained by each of the 30 nurses working at 3 long-term care hospitals and 4 nursing homes) into a normal distribution grid (from -4 to +4). The types of empathy among participants were analyzed using the PC-QUANL program. Results: Five types of empathy accounting for 48.5% of the total variance were categorized as follows: (1) taking the patients' personality into consideration while helping, (2) interacting closely and emotionally, (3) supporting the patient as a companion, (4) performing the duty in a defensive manner, and (5) resolving patients' problems by focusing on their needs. Conclusion: This study shows that there are various types of empathy in nurses caring for patients with BPSD. Therefore, it is necessary to develop strategies and educative programs to enhance empathy competency and deal with burnout based on the type of empathy.

• Health Policy and Management
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• v.32 no.4
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• pp.368-379
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• 2022

Background: This study aimed to establish a strategy to improve the poor working environment and working conditions among long-term healthcare workers in Korea. Methods: A total of 600 questionnaires with which long-term health care workers participated in the targeted base areas of each city and province nationwide were distributed directly and 525 responses were collected and 506 responses were analyzed. Surveys, on-site field visits, and in-depth interviews were also conducted to understand the working environment as well as conditions and establish a strategy for improving the working environment among long-term healthcare workers to understand the demands of working conditions and working conditions. Results: Korean long-term care workers firstly and mostly enumerated their risk factors for ill-health when lifting or moving elderly recipients directly by hand (69.9%), followed by increased physical workload with old beds, tools, and facilities (42.3%) in the workplaces, shortage of manpower (32%), and source of infection (30%). To improve the working environment as well as conditions, Korean long-term care workers considered improving low-wage structures, ergonomic improvements to solve excessive physical loads, and increasing various bonus payments as well as implementing the salary system, positive social awareness, and increasing resting time. Of 506 responses, 92.3% replied that the long-term care insurance system for the elderly should be developed to expand publicization at the national level. Conclusion: This study proposes to improve the low-wage structure of Korean long-term care workers, automation and improvement of facilities, equipment, and tools to eliminate excessive physical loads (beneficiary elderly lifting), and reduction of night labor.

• Korean Journal of Culture and Social Issue
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• v.12 no.5_spc
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• pp.133-147
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• 2006

Korean society is rapidly becoming an ageing society. The Korean may have to live longer than did their parents. Increasing life expectancy and changing social structure, Korean people are getting interested in quality of life, and well-being is becoming a matter of concern. And, the Korean is fully aware of the importance of health for well-being or good life. This concern about health may bring about specific behaviors related to health. Although health care expenditures of Korea are currently smaller than those of other developed countries, it is continuously increasing. Large portion of increased amount of health care expenditures is to spend for disease prevention and expansion of long-term care facilities. Constructs of well-being of the Korean, not living in western culture, may be different from those of people living in western society. Health is not top-ranked to importance for quality of life in previous studies. It does not mean health isn't determinant factor for good life or well-being. Health is an essential element for well-being. It has been proved in several researches which examined poor quality of life caused by certain diseases and management of health-related quality of life. Some theories relate to health-seeking behaviors suggested the health belief or the attitude toward health, intention to do health behavior, perceived behavioral control, and self efficacy as important factors which could predict health-related behaviors. With getting older, people decline in physical and physiological functions and become vulnerable to chronic diseases. Quality of life depends on how to adjust to these changes in senescence. Social supports, especially supports from offspring, are very important to quality of life in senescence, because supports from offspring have influence on pride of the older, they may be afraid of disclose the conflict with their offspring. Avoiding self-disclosure exclude other source of social supports and harm individual's health, therefore psychological intervention is needed to. Increasing life expectancy of the Korean, Korean government has to provide numerous long-term care facilities as well as psychosocial supports. The Korean, so far, does not recognize that psychologist could render great service to promoting individual or community health and improving individual's quality of life. It is highly expected that psychologists take actively interested and involve in health related to quality of life.

• The Journal of Korean society of community based occupational therapy
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• v.2 no.1
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• pp.75-84
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• 2012

Objective : This study aims to identify the effect of an occupational therapeutic intervention program including horticultural therapy on cognition and daily living performance of the elderly with dementia. Methods : For the purpose, the study measured the changes before and after the therapy, targeting sixteen women with dementia who were living in nursery facilities. We used MMSE-K to analyse the cognition, and evaluated daily living performance using K-MBI(p<.05). Results : The results of the study were presented as follows: 1. To identify changes of MMSE-K before and after the therapy between the control and test groups. As a result, it was discovered that MMSE-K of the control group was $16.25{\pm}1.38$ before the therapy and $16.00{\pm}.92$ after the therapy, which indicated no significant differences, but MMSE-K of the test group was $16.00{\pm}1.51$ before the therapy and $17.87{\pm}1.35$ after the therapy, which was statistically significant (p<.05). 2. To identify changes in daily living performance(K-MBI) between the two groups before and after the therapy, and it was discovered that scores of the control group were $74.00{\pm}1.30$ before the therapy and $74.25{\pm}1.16$ after the therapy, which showed no significant difference, but those of the test group were $73.75{\pm}1.28$ before the therapy and $76.37{\pm}1.30$ after the therapy, which was statistically significant(p<.05). Conclusion : Based on the results above, it was demonstrated that the an occupational therapeutic intervention program including horticultural therapy had a positive effect on cognition and daily living performance of elderly women with dementia and it is suggested that the results can be used as basic data for clinical intervention of the elderly with dementia.

• The Journal of the Korean dental association
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• v.53 no.10
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• pp.688-695
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• 2015

Purpose: The institutionalized elderly have placed the most vulnerable state, and the report about the oral health status of the institutionalized elderly was scarce. The aims of the current study were to investigate the oral health status of institutionalized elderly. Materials and methods: The survey of the oral health status was carried out on 487 institutionalized elderly from 4 longterm care facilities of Seoul metropolitan city, Gyunggi province, and Gangwon province in Korea. Results: The prevalence of dental caries, root caries, and dental calculus of the institutionalized elderly was 19.2%, 15.3%, and 23.7%, respectively. The percentage of edentulism among the institutionalized elderly was 26.2%. Those who had poor oral hygiene and tongue coating were 43.9% and 90.5%, respectively. The percentages wearing complete and removable partial denture on maxilla were 12.8% and 3.3%, respectively. The percentages wearing complete and removable partial denture on mandible were 7.8% and 5.6%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on maxilla were 29.7% and 27.2%, respectively. The percentages of institutionalized elderly needing complete and removable partial denture on mandible were 24.5% and 30.9%, respectively. Conclusion: The oral health stuatus of institutionalized elderly was poor. For the oral health promotion of elderly in longterm care facilities, it is essential to educate nurses and caregivers about the importance of the oral health and oral hygiene method.

• Journal of the Korean Society of Food Culture
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• v.34 no.4
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• pp.389-400
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• 2019

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

• Journal of the Korea Convergence Society
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• v.11 no.12
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• pp.329-341
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• 2020

As COVID-19 pandemic sweeps across the world, more than 45 million confirmed cases and over 1,000,000 deaths have occurred till now, and this situation is expected to continue for some time. In particular, more than half of the infections in European countries such as Italy and Spain occurred in nursing homes, and it is reported that over 4,000 people died in nursing homes for older adults in the United States. Therefore, the issues that need to be addressed after the COVID-19 crisis include finding a fundamental solution to group care and shifting to family-centered care. More specifically, it is expected that there will be ever more lively discussion on establishing and expanding hyper-technology based community care, that is, family-centered care integrated with ICT and other Industry 4.0 technologies. This poses a challenge of how to combine social security and social welfare with Industry 4.0 in concrete ways that go beyond the abstract suggestions made in the past. A case in point is the proposal involving smart welfare cities. Given this background, the present paper examined the concept, scope, and content of non-face-to-face care in the context of previous literature on the function and scope of the social security platform, and the concept and expandability of the smart welfare city. Implementing a smart city to realize the kind of social security and welfare that our society seeks to provide has significant bearing on the implementation of community care or aging in place. One limitation of this paper, however, is that it does not address concrete measures for implementing non-face-to-face care from the policy and legal/institutional perspectives, and further studies are needed to explore such measures in the future. It is expected that the findings of this paper will provide the future course and vision not only for the smart welfare city but also for the social security and welfare system in administrative, practical, and legislative aspects, and ultimately contribute to improving the quality of human life.

• The Journal of Industrial Distribution & Business
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• v.9 no.10
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• pp.39-50
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• 2018

Purpose - This study is to propose discriminative management strategies to long-term care facilities based on the empirical analysis after reviewing the effects of social support, perceived by long-term care facility employees, to service orientation. Research design, data, and Methodology - The research model designed social support, job stress, organizational commitment, and service orientation. The survey collected data from 453 customers in a long-term care facility in jeju. The SPSS 18.0 package was used for analysis. Results - First, social support for long-term care facility employees has a negative(-) effect to job stress. Test results, social support factors except appraisal support had a negative impact on job stress. Second, social support has a positive(+) effect to organizational commitment. Test results, informational support, tangible support and appraisal support had significant effects on organizational commitment. However, emotional support had a positive impact on affective commitment and normative commitment. Third, social support has a positive(+) effect to service orientation. Test results had a positive impact. Fourth, job stress has a negative(-) effect to organizational commitment. In the test results, employee's continuance commitment and normative commitment had significant negative effects in job stress. However, affective commitment had no significant impact. Fifth, job stress has a negative(-) effect to service orientation. Test results showed a negative impact. Conclusions - The study implies the following. First, that there should be a change in the social perception of long-term care facilities. 'Long-Term Care Insurance for The Elderly' was enacted to emphasize this responsibility for the elderly problems as a new system. Enactment of this Act was expected to improve the quality of life of the people by stabilizing the elderly life and reducing the burden of families. Therefore, long-term care facility system should be as efficient as possible for making plans for systematic and organizational support. Second, the efforts of facility managers to minimize job stress of employees is necessary. Accordingly, performing spontaneous work is required for a comfortable working environment and management. Third, the systematic education and training to employees for service oriented behavior of the facility will be required in the long term.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.