• Journal of Korean Academy of Nursing
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• v.44 no.4
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• pp.418-427
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• 2014

Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

• Journal of Korean society of Dental Hygiene
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• v.17 no.3
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• pp.527-537
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• 2017

Objectives: The purpose of this study was to examine the practice of oral hygiene behaviors and oral health status of long-term care facility residents and to analyze the factors related to salivary hemoglobin level which can predict active periodontal disease. Methods: From 30th October 2015 to 7th January 2016, a questionnaire was provided to 63 participants and their dental plaque and saliva samples were collected to assess the levels of salivary hemoglobin and dental plaque acidogenicity. In order to analyze the factors related to salivary hemoglobin level, multiple linear regression analysis was performed. Results: Toothbrushing was most frequently performed by the participants themselves (98.4%) and toothbrushing was performed after eating breakfast (81.3%). 68.8% of participants reported brushing their tongue. 35.9% of participants perceived having bad teeth, and 87.5% had high dental caries activity. The percentages of participants with hyposalivation and ${\geq}0.20{\mu}g/ml$ salivary hemoglobin level were 45.3% and 59.4%, respectively. The salivary hemoglobin level was significantly higher in the group in which stimulated salivary flow rate was ${\leq}0.70ml/min$, dental plaque acidogenicity was superior, and perceived having bad teeth (p<0.05). There was also a tendency for the salivary hemoglobin level to increase with age (p<0.05). Conclusions: Oral health status of the long-term care facility residents was still not improved, and the characteristics of salivary volume and dental plaque were important factors affecting salivary hemoglobin level. Therefore, it is necessary to operate an oral hygiene intervention program by oral health professionals in such facilities in order to provide residents with effective oral care aligned with their respective needs. Furthermore, it is necessary for caregivers to complete mandatory oral health education to improve the oral hygiene status of the long-term care facility residents.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.8
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• pp.5062-5069
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• 2014

In this study, professional oral care was provided and 3 times a day twice a week by a dental hygienist for 3 months from July 24 to October 25, 2011, to 43 long-term patients in a single nursing facility located at the city of D, and the number of mutans strepococci colonies within the saliva and the level of salivation were then analyzed after 3 samplings with an interval of 1 month to compare the intraoral conditions among the subjects and examine the effects of professional oral care on the Streptococcus mutans population in the intraoral region of long-term patients in a nursing facility. The level of salivation was elevated from 5.8 ml to 6.4 ml after one month and to 7.5mL after two months. The population of bacteria decreased from $6{\times}10^8CFU/ml$ to $3{\times}105CFU/ml$. In terms of the change in the bacterial population in accordance with systemic diseases, the patients with hypertension and diabetes showed a meaningful decrease in the population. As more dental charge and prosthesis are present, the number of bacteria decreased significantly. On account of the close relationship between a professional oral care and the population of Streptococcus mutans at the intraoral region of long-term patients in nursing facilities, various dental health programs should be researched and developed to consider the characteristics of long-term patients in nursing facilities and manage them continuously but effectively.

• International Journal of Human Ecology
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• v.2 no.1
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• pp.39-55
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• 2001

Concerns about paid-facilities for the elderly with dementia from middle and upper class families have been discussed lately in Korea. Small-scale, home-like group homes for the elderly with dementia were developed in Sweden in the 1980, but they have not been effectively introduced in Korea where they remain a comparatively new concept. The group home, however, would provide a good alternative to Koreans who feel guilty when they have to leave their frail parents in large-scale facilities or hospitals instead of caring for them at home. The aim of this paper is, first, to define the care of the demented elderly who come from upper and middle class families in Korea and, secondly, to discuss the need for group homes to help care for them. A survey was done by questionnaire and was answered by 577 respondents who belonged to middle and upper class families living in Korea in December 2000. Methods of analysis were frequency, mean, and Chi-square. The results of this study were as follows: 1) the traditional notion that the eldest son should be burdened with the primary responsibility for a demented parent has weakened remarkably; 2) a small-scale long-term care facility was considered the most desirable living environment for the demented elderly; 3) the facilities families needed for professional hospitals for victims of dementia, senior citizen centers, large and small-scale long-term care facilities, day-care centers, and short-stay and service housing. The study also revealed that there was low awareness of the group home. The most preferred type of structure for group homes was a single-family detached house, and the most preferred management system was small-scale that could create home-like atmosphere. Additionally the respondents wanted group homes to consist of 6-8 residents with 2-4 persons per room. The results of this study strongly suggest that policy makers should encourage the development of smallscale group homes as an alternative form of housing for the elderly with dementia.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.106-120
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• 1999

Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

• Research in Community and Public Health Nursing
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• v.28 no.4
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• pp.513-523
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• 2017

Purpose: We evaluated the psychometric properties of a questionnaire on the acceptance of the quality improvement information system (QIIS) among long-term care workers (mostly nurses). Methods: The questionnaire composes of 21 preliminary questions with 5 domains based on the Technology Acceptance Model and related literature reviews. We developed a prototype web-based comprehensive resident assessment system, and collected data from 126 subjects at 75 long-term care facilities and hospitals, who used the system and responded to the questionnaire. A priori factor structure was developed using an exploratory factor analysis and validated by a confirmatory factor analysis; its reliability was also evaluated. Results: A total of 16 items were yielded, and 5 factors were extracted from the explanatory factor analysis: Usage Intention, Perceived Usefulness, Perceived Ease of Use, Social Influence, and Innovative Characteristics. The five-factor structure model had a good fit (Tucker-Lewis index [TLI]=.976; comparative fit index [CFI]=.969; standardized root mean squared residual [SRMR]=.052; root mean square error of approximation [RMSEA]=.048), and the items were internally consistent(Cronbach's ${\alpha}=.91$). Conclusion: The questionnaire was valid and reliable to measure the technology acceptance of QIIS among long-term care workers, using the prototype.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.599-609
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• 2020

Objectives: Coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan, China, and has rapidly become a global pandemic with over 26.4 million confirmed cases and approximately 871,000 fatalities worldwide as of this writing. In the Republic of Korea, disease clusters frequently occurred in long-term care hospitals where the majority of residents are elderly with underlying medical conditions. Despite the fact that public health authorities and local community health centers have put tremendous efforts into preventing the spread of disease, positive cases have continued to occur. Thus, the Korea Centers for Disease Control & Prevention rapid response team decided to conduct an environmental investigation of a long-term care hospital to identify whether environmental contamination has remained and contributed to the spread of COVID-19. Methods: An environmental investigation was conducted at Hospital A. The characteristics of the facility and its HVAC system were assessed by checking the layout and interviewing the people in charge. A total of 64 surface samples were collected from areas of concern, including patient rooms, toilets, elevators, and nurses' station. These samples were tested by a regional health and environmental research institute using real-time reverse transcription polymerase chain reaction. Results: All samples from Hospital A were confirmed to be negative. Through interviews with high-level personnel at the regional community health center, we found that extensive disinfection is frequently performed on potentially contaminated areas in Hospital A in accordance with government guidelines. Conclusion: The environmental control measures implemented in Hospital A had been sufficient for mitigating the risk of further infection, suggesting that such measures may also be effective for other long-term health care facilities.

• Korean Journal of Social Welfare
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• v.65 no.3
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• pp.155-182
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• 2013

The purpose of this study is to examine how the long-term care effects the elderly that adapt themselves to the caring facility, what their experiences are and what kinds of behavioral characteristics they present. We have analyzed the research conducted on 15 elderly individuals who are living in an elderly long-term care facility, by using the grounded theory approach of Strauss and Corbin (1998). As a result, 170 concepts, 42 sub-categories, and 15 categories were set by the open coding process. During the adaptation process in a long-term care facility, the primary experience or feeling by the elderly is that they had been 'deserted'. However, when consolidating the casual conditions, contextual conditions, intervening conditions, the action/interaction strategy, and consequence, the primary experience was that the elderly came to an 'acceptance'. Such acceptance was then sub-categorized into a destiny-resignation type, reality-acceptance type, and voluntary-selection type. Based on the results of this study, we recommend practical alternatives which will improve surrounding circumstances including caring facilities, its employees, relationships with other elderly individuals, and family support.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.1
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• pp.26-34
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• 2010

Purpose: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. Method: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. Results: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. Conclusion: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

• Journal of dental hygiene science
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• v.15 no.5
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• pp.569-576
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• 2015

The aim of this study was to assess the oral health knowledge, attitude and behavior among geriatric care workers in long-term care facilities. A self-administered questionnaire was obtained from 212 geriatric care workers attending a professional education program of 2014 dementia pilot project. The questionnaire consisted of 4 parts of the training experience (2 items), knowledge (16 items), attitude (13 items), and behavior (4 items) on oral health care. Collected data were analyzed by frequency analysis, independent t-test, and one-way ANOVA using SPSS Statistics ver. 20.0. The percentage of educational experience on oral care was 27.9% and most respondents answered that they have received the education about denture cleaning (98.3%) and brushing method (91.4%). The average knowledge score was $10.88{\pm}1.70$, and respondents showed high-level agreement in 8 of the 10 items in attitude questions. They revealed difficulties in providing oral care to the elderly people because of their lack of knowledge. The deficiencies of knowledge about oral care would have a decisive effect on not only oral and general health, but also quality of life of the elderly people. Therefore, it is required to develop professional oral care training programs for geriatric care workers and support systems should be legalized.