• 대한영양사협회학술지
• /
• 제22권1호
• /
• pp.53-69
• /
• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• International journal of advanced smart convergence
• /
• 제10권4호
• /
• pp.141-148
• /
• 2021

This study was tried to explore the mediating effect of workplace learning and self-efficacy on the relationship between technostress and job satisfaction in convalescent hospital nurses. Data were collected from 149 nurses working at one of 10 convalescent hospitals located in Korea's D region and between July 20 and August 12, 2019 and analyzed using SPSS 24.0. The mediating effects of workplace learning and self-efficacy in the relationship between technostress and job satisfaction were investigated by conducting hierarchical regression analysis and testing for significance based on bootstrapping p values. We found that workplace learning had a complete mediating effect, and self-efficacy a partial mediating effect, in the relationship between technostress and job satisfaction in convalescent hospital nurses. Exploring diverse factors and environmental features affecting job satisfaction in convalescent hospital nurses is highly relevant to clinicians, especially given the gradually increasing number of convalescent hospitals, changes during the era of technology fusion, and the strategic demands arising from an aging society.

• 대한영양사협회학술지
• /
• 제20권3호
• /
• pp.199-211
• /
• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• 보건행정학회지
• /
• 제31권4호
• /
• pp.451-461
• /
• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• 보건의료산업학회지
• /
• 제13권3호
• /
• pp.39-51
• /
• 2019

Objectives: This study aimed to investigate the effect of satisfaction among convalescent hospital staff members on patient safety and quality of care after the certification of the medical institution. Methods: A survey was conducted on seven convalescent hospitals in Gwangju, South Jeolla Province, and North Jeolla Province, which were certified as medical institutions for convalescent hospitals by the end of May 2017, The study period lasted from July 24, 2017 to August 22, 2017. Results: There was a statistically significant correlation between staff member satisfaction and patient safety and quality of care (r = 0.586, p<0.001). Regression analysis showed that staff member satisfaction (${\beta}=0.531$, p<0.001) had a statistically significant effect on patient safety and quality of care and showed 46.9% explanatory power. Conclusions: The satisfaction of the convalescent hospital staff after the certification of the medical institution positively affected patient safety and quality of care.

• Journal of Hospice and Palliative Care
• /
• 제24권3호
• /
• pp.154-164
• /
• 2021

Purpose: The purpose of this study was to examine the effects of a death preparation education program for nurses working in convalescent hospitals on death anxiety, death attitudes, and attitudes toward end-of-life care. Methods: This was a quasi-experimental study with a non-equivalent control group, pre-test and post-test design. Among 53 participants, 26 were assigned to the non-equivalent experimental group and 27 to the control group. The program was performed in the formats of lectures, video-watching, group discussions, and sharing, and consisted of 10 sessions held twice a week, for 5 weeks (90 minutes per session). Data were analyzed using descriptive statistics, the t-test, and the chisquare test in SPSS version 21.0. Results: Significant differences between the experimental and control groups were observed in death anxiety (t=7.62, P<0.001), death attitudes (t=-7.58, P<0.001), and attitudes to end-of-life care (t=-10.30, P<0.001). Conclusion: It was confirmed that the death preparation education program reduced death anxiety and had a positive effect on death attitudes and attitudes toward end-of-life care. Based on the results of this study, it is expected that specialized and systematic education that can increase the implementation and stability of death preparation education in various fields, including nursing, will have a positive effect on both hospice patients and members of society more broadly.

• 디지털융복합연구
• /
• 제18권8호
• /
• pp.293-299
• /
• 2020

본 연구는 요양병원의 간호사의 간호역량에 미치는 융복합적 영향을 파악하기 위하여 시도되었다. 구조화된 자기보고식 설문지를 사용하여 2019년 7 월부터 2019년 8월까지 D 시 8개 요양병원 간호사 161명으로부터 자료를 수집하였다. 자료분석은 SPSS / WIN 25.0 프로그램을 활용하여 Descriptive statistics, Independent t-test, One-way ANOVA, Scheffé 사후검증, Pearson's correlation coefficient, Multiple regression을 적용하였다. 단계적 다중회귀분석에서 요양병원 간호사의 일가치감, 조직커뮤니케이션 만족, 대학원(교육수준), 휴직경험 없음, 2 교대 근무형태가 간호역량을 55% 설명하는 것으로 나타났다. 이에 요양병원 간호사의 간호 역량을 증진시키기 위해서는 일에 대한 가치감과 조직커뮤니케이션 만족을 증진하고 전문적인 교육기회와 재취업간호사를 위한 교육프로그램을 제공할 필요가 있음을 논의하였다.

• 한국간호교육학회지
• /
• 제22권2호
• /
• pp.202-209
• /
• 2016

Purpose: The purpose of this study was to examine the effects of hand massage on depression, self-esteem and vitality in elderly patients in convalescent hospitals. Methods: This study employed a nonequivalent control group pretest-posttest design. The subjects were 24 elderly patients in the experimental group and 25 in a control group in a convalescent hospital located in G city. Data were collected using a questionnaire that relied on the geriatric depression scale (short form) by Sheikh and Yesavage; the self-esteem scale by Rosenberg; and the vitality scale used by Johnson and revised by Oh. The experimental group were treated with a general hand massage using only carrier oil on both hands for 10 minutes a day for seven days. The control group was given no treatment. The collected data were analyzed using t-test, $x^2$-test, and Fisher's exact test with SPSS Win Version 18.0. Results: The results are as follows: The experimental group showed a significant improvement in depression, self-esteem and vitality than the control group. Conclusion: The results showed that hand massage was an effective intervention program for depression, self-esteem and vitality of elderly patients in convalescent hospitals.

• 의료법학
• /
• 제18권2호
• /
• pp.195-218
• /
• 2017

요양병원에 대한 진료비의 증가폭이 비정상적으로 늘어나고 있어 건강보험재정에 막대한 부담을 주고 있다. 이는 요양병원 특수성이 급속한 노령화라는 사회적인 현상과 맞물리면서 나타나게 된 현상인데, 이 중 요양병원에 대하여 입원일당 정액수가제에 의하여 비용이 지급되는 점은 일부 요양병원이 환자를 돈벌이 수단으로 이용하는 유인이 되었다. 이러한 요양병원들은 일당정액수가를 지급받고도 그에 합당한 진료비용의 지출을 줄이기 위해 의도적으로 입원 환자를 타병원에서 정기적으로 진찰을 받게 하거나 주요 약제를 처방받게 하는 등 건강보험재정이 이중으로 지출되게 하였다. 이러한 재정누수를 방지하기 위하여 심사평가원은 위와 같은 환자들에 대하여 기존의 환자군을 부정하고 '신체기능저하군'으로 환자군을 조정한 다음 요양급여비용을 삭감하였다. 그렇지만 위결정은 규정상근거가 없음을 이유로 법원으로부터 취소판결을 받았다. 그러나 위 사건을 계기로 요양병원 수가제도의 문제점을 도출하고 제도를 정비하는 기회가 될 수 있다고 생각한다. 현재의 정액수가제를 수정하여 약제비 및 진료자체에 대한 행위별 청구를 일부 도입하면 요양병원의 의료적 기능을 강화할 수 있다고 생각한다. 또, 현재의 환자군 중 비슷한 군들은 통합하고 신체기능저하군은 입원이 부적절하므로 환자군에서 제외하는 것이 타당하다고 보인다. 다만, 사회적 필요에 의해 신체기능저하군을 입원대상으로 인정하게 된다 하더라도 장기요양대상과의 형평성, 건강보험재정의 건전성 등을 고려하여 건강보험대상에서는 제외되어야 한다고 생각한다.

• 대한영양사협회학술지
• /
• 제20권4호
• /
• pp.257-274
• /
• 2014

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.