• 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.

• 한국노년학
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• v.30 no.4
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• pp.1239-1261
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• 2010

The main purposes of the study were to identify factors affecting health-related quality of life of elderly stroke survivors, and to suggest social work interventions for improving their quality of life. The participants were 328 elderly stroke survivors over 55 years old recruited from 18 long-term care hospitals and 13 nursing care facilities in Chung-Nam Province, Korea. The data was collected through a direct survey method from Dec. 16, 2008 to Jan. 17, 2009. Statistical analysis revealed that the overall health-related quality of life among participants was relatively low, especially in the social relationships domain. As a result of hierarchical multiple regression analysis, depression emerged as the most significant predictor of elderly stroke survivors' health-related quality of life, followed by financial burden in future, activities of daily living, acceptance of disability, comorbidity, and major financial supporter(spouse). Health-related quality of life of elderly stroke survivors in long-term care facilities was affected by a variety of variables from disease-related factors to environmental ones. Particularly psychosocial variables were the most powerful factors to predict HRQOL of elderly stroke survivors. Based on the results, social work implications were discussed in the context of developing clinical strategies to alleviate elderly stroke survivors' health-related quality of life in long-term care facilities. Living with chronic illness and disability is a great challenge to the elderly. Most of all long-term residence in care facilities can cause deterioration of quality of life in old age. From now on, studies on health-related quality of life of elderly with chronic illness and disability should be activated in social work field.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.319-329
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• 2010

Objectives: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). Methods: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. Results: The mean scores of QOL among all the subjects was $55.4{\pm}15.62$ (Grade I: $49.7{\pm}14.17$, Grade II: $56.8{\pm}14.62$, Grade III: $59.4{\pm}16.36$), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). Conclusions: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

• The Korean Journal of Health Service Management
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• v.2 no.1
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• pp.125-136
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• 2008

Government came to enforce long-term care insurance system in preparation for the rapid aging society. Whether this system is successful or not depends on the professionalism of long-term care-givers who are professional population in charge of care service. Currently in the early stage of enforcement, such problems as a race cutting fee resulted from numerical increase of educational facilities, insolvent operation, degradation of education level resulted from unprofessional instructor, are pointed out. As a mean of manpower-training on long-term care insurance system, this study is to research public-private-university network model of the Academy of Continuing Education attached to Ko Sin University which is the case of Yong Do Gu Busan city. Networking between the vision and development strategy of Yong Do Gu on continuing education city, education system on community manpower-training supported by Ko Sin University, and service field of welfare for the elderly can not only contribute to the professionalism of long-term care-givers but also play an ideal role in manpower-utilization and arrangement of community. Through this networking, high quality of education level and circumstance, using the existing infra, manpower-training and utilization for continuing education of Yong Do Gu can be accomplished. Additionally, the connection with facilities related with welfare for the elderly can contribute to professionalism and accountability of manpower-networking.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.237-247
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• 2004

Objectives: The purpose of this study is to estimate the needs of long-term care in S-city Gyeonggi-do according to ADL and IADL. Methods: We surveyed to investigate the needs of 397 study samples which had been selected by stratified randomized sampling, 2.7% in each Dong of S-city. We estimated the disability of elderly by using standards based on ADL and IADL of OECD and Korea Institute for Health and Social Affairs. Results and Conclusions: According to standards of OECD, the elderly with severe disability were 4,712(31.2%). According to standards of Korea Institute for Health and Social Affairs, the severe disabled elderly with helper were 3,776(24.9%) and the severe disabled elderly without helper 2,130(14.1%) So We concluded that the long-term care beds estimated by need were from 2,130 to 4,712. To estimate the long-term care beds, we have to consider together physical, mental, nutrition, and cognition status, existence of helper, helper characteristics, and emotional relationship between elderly and helper. But we considered only disability grades of physical states and existence of helper in this study. So it will be useful to conduct study to consider these other factors in future. At the same time this study is of value to estimate objectively long-term care needs based on physical needs in one region.

• Research in Community and Public Health Nursing
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• v.32 no.3
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• pp.382-395
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• 2021

Purpose: The purpose of this qualitative study was to explore the transition experiences of the elderly from long-term care hospitals to their homes. Methods: The participants were eight elderly medicaid beneficiaries, who had been the subjects from the community care project in Korea. The data were collected with one-on-one interviews from April to November in 2020, and analyzed by phenomenological steps. Results: The seven themes derived in this study were 'Space to escape', 'Reliable supporter opened the way to discharge', 'Comfortable life at home', 'Obstacles to independent life', 'Struggling to live alone', 'Fence for community life', and 'Energizing in daily life' Conclusion: The results revealed the positive aspects of Community Care program in Korea. However, it is suggested that active communication between hospitals and community care institutions, and improvement of home environment to live in the community before discharge should be required. And system revision is needed to adjust activity in their home and support health problems of the elderly in the early stage of discharge. The results of this study can be referred to as the foundation of transitional care for the elderly.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.278-289
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• 2017

Purpose: This study was designed to investigate whether there were differences among three oral care protocols on participants' oral health status (oral status, dry mouth, halitosis, saliva pH, microorganism growth in oral cavity) and tooth stain. The three protocols were: 1) oral solution of 4% normal saline, 2) 0.1% Chlorhexidine and 3) Tantum. Methods: A nonequivalent control group pretest-posttest design was utilized. A total of 55 elderly patients residing at long-term care facilities(19 in the 4% normal saline group, 17 in the 0.1% Chlorhexidine group, 19 in the Tantum group) received oral care daily for four weeks. Data were analyzed using SPSS/WIN 22.0 program. Results: The halitosis (${\chi}^2=10.71$, p=.005) and saliva pH (${\chi}^2=6.84$, p=.033) scores were significantly improved after the oral care with 4% normal saline. Conclusion: These findings indicate that if elderly patients in long-term care facilities have complaint of the discomfort of using Chlorhexidine or Tantum, 4% normal saline is as effective at the other two. This can also be cost effective as there were no differences among the protocols in oral status, dry mouth, tooth stain or microorganism growth in oral cavity.

• Health Policy and Management
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• v.22 no.4
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• pp.522-537
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• 2012

The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.441-451
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• 2016

This study was conducted to determine the influence of satisfaction, self-esteem, and depression on adjustment of elderly patients in long-term care hospitals. The subjects were 116 elderly patients in 15 long-term care hospitals in B and K city. Data were collected from February 14 to March 30, 2015, and analyzed by t-rest, ANOVA, Scheff's test, Pearson correlation coefficients, and stepwise multiple regression. According to the results, there were significant differences in adjustment by religion, marital status, economic status, and perceived level of difficult problems. Adjustment was positively related to satisfaction and self-esteem. In addition, a negative correlation was observed between adjustment and depression. Meaningful variables that influenced the adjustment of elderly patients were depression, satisfaction, self-esteem, and religion. These factors accounted for 53.5% of the total variance in adjustment of the elderly patients in long-term care hospitals, and depression was the most influential factor. In conclusion, development and implementation of effective programs and strategies to reduce depression and to increase satisfaction with care and self-esteem is needed in order to enhance the adjustment of elderly patients in long-term care hospitals.

• Health Policy and Management
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• v.30 no.4
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.