This study purports to investigate the determinant of job satisfaction among workers working at Long-term care hospitals. The independent variables contain three groups of determinants: organizational characteristics variables(job autonomy, job variety, distributive justice, role conflict, supervisor support, job suitability, job significance, job security, organizational support, job growth, promotional opportunity), environmental variables(job opportunity), and psychological variables (met expectation, job efficacy, positive affectivity, and negative affectivity). The sample used in this study consisted of 250 workers from 4 Long-term care hospitals nationwide. Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of the study are as follows: 1) the following variables, listed in order of size, have significant effects on job satisfaction: negative affectivity(-), job significance(+), job growth(+), age(+), positive affectivity(+), organizational support(+), job opportunity(-). 2) the variance of job satisfaction explained by the variables used in the study are 53.8%. When demographic variables added to Model I, job satisfaction explained by variables are 55.4%. 3) the results of this study indicate that three variables of negative affectivity, job significance, job growth are especially important for improving the level of job satisfaction among workers at Long-term care hospitals.
Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.
After elderly long term care insurance implementation (July 1, 2008), the elderly medical and welfare facilities covered by medical insurance continuously increases 30 to 63% sanction annually. Rapid growth of senior citizen welfare facilities arises in a poor residential environment issues. In most cases, it is the legal minimum criteria tailored for 4 persons accommodated in nature, such as the hospital. Therefore, 'Hometown-style traditional Korean House' is needed to rest comfortable for elderly people. Research goal is to provide direction and design materials by developing a type of architectural planning for the elderly welfare facilities unit care of the atmosphere of a traditional Korean House. The following two elements are applied to the elderly welfare facilities. Senior citizen welfare facilities in the main living space are applied to modern residential space of the elderly-friendly atmosphere of a traditional Korean House. It is applied for the Korean lifestyle and residential culture are through an analysis of Japan's leading development unit care system.
Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.
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.
Purpose: This study was done to compare the comprehension and knowledge about delirium in nurses working at long-term care hospitals (NLH) with nurses working at a general hospital (NGH). Method: The participants were 191 nurses from a general hospital and 7 long-term care hospitals in Chungnam. The tool for comprehension consisted of the needs and importance of delirium education and the confidence of management for early detection, caring and prevention of delirium. The tool for knowledge of delirium developed by the author consisted of causing factors, symptoms, caring and prevention of delirium. Result: The comprehension of need and importance of delirium education was higher than the confidence for delirium management in participants. NLH nurses had a higher level in comprehension of the need and importance of delirium education and a lower level in confidence of delirium management than NGH nurses. The mean for delirium knowledge was 75.32% for all participants. The knowledge of NLH nurses was significantly lower than those of NGH nurses. All nurses showed low scores in confidence and knowledge of delirium prevention. Conclusion: A systematic educational program for nurses to enhance the ability for assessment, early detection and prevention of delirium for institutionalized elderly patients needs to be developed.
Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.
The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.
Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.
Purposes: The purpose of this study is to analyze the factor of affecting on job satisfaction by mediating attitude of care service. Methodology: (1)Identify socio-demographic characteristics, work characteristics, the elderly support period, the presence of education related to the elderly, the presence of service associated with the elderly, and significant factors of the research subjects. (2)Identify changes in the number of education and services before and after obtaining a caregiver qualification. (3)Identify the attitude of providing care services and job satisfaction according to the characteristics of the research subjects. (4)Identify the direct and indirect factors influencing job satisfaction by mediating the service attitudes of the research subjects. Findings: First, age factors have positive effects and the volunteering experience have negative effects on job satisfaction by mediating attitude of care service. Although the number of education class has increased after qualification, educational factors had no significant effect. Second, the longer elderly support period had a positive effect on job satisfaction. Practical Implications: This study is meaningful in that it identifies the direct and indirect impacts on job satisfaction through care attitudes. In the future, it will be necessary to pay attention to improving the quality of long-term care services by analyzing the influence factors more.
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