• The Journal of the Convergence on Culture Technology
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• v.5 no.4
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• pp.99-104
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• 2019

The purpose of this study is to investigate the effect of emotional labor behavior of employee at geriatric long-term care(LTC) facilities on job burnout and service quality focusing on the emotional leadership of superior to improve the working environment of LTC employee and provide the high-quality service to seniors. First, it is appeared that between emotional labor behaviors deep acting has a negative effect on job burnout, in contrast surface acting has a positive effect on job burnout. and, emotional labor behavior has positive influence on service quality. Second, self efficacy has partial mediating effect of tangibility, reliability, assurance and empathy on service quality only for the deep acting between emotional labor behaviors. Third, between emotional labor behavior, emotional leadership has moderating effect on emotional depletion and deterioration of personal accomplishment. In contrast, moderating effect of emotional leadership is not appeared on surface acting and depersonalization. In conclusion, further study is required to improve service quality of elderly in LTC facility and working environment of LCT facility workforce.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.27-40
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• 2016

Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

• 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.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• The Korean Journal of Community Living Science
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• v.18 no.3
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• pp.369-378
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• 2007

This study purposed to examine elderly welfare facilities by type, to analyze their local variations, and ultimately to contribute to the expansion of elderly welfare infrastructure. The results are expected to help inspect elderly welfare infrastructure for providing the aged with social services before the execution of 'the insurance for elderly long term care' and establish welfare facilities by area in the future. For these purposes, we used the national data "The Current State of Elderly Welfare Facilities in 2007" produced by the Ministry of Health and Welfare. We digitized elderly welfare facilities in 163 cities and counties by type and analyzed them by area. We also examined the differences in the local distribution of representative elderly welfare facilities such as elderly welfare centers, home based facilities (home helper centers), asylums for the aged and elderly care facilities in 16 cities and provinces. Furthermore, we analyzed differences and problems in their local distribution urban areas, mixed areas of urban and rural communities, and rural areas. In addition, we studied the current state of institutionalized care and home based care, which are two major directions of current elderly welfare policies, based on the local distribution of facilities and analyzed differences in the trends according to area. According to these results, the urban had more home based care facilities than the rural. However, the rural had more institutionalized care facilities than urban. Also, each local self-governing body showed unique characteristics. Therefore, these results suggest that we need to establish elderly welfare policies based on the distribution of facility types by area.

• Safety and Health at Work
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• v.9 no.4
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• pp.408-415
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• 2018

Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

• KIEAE Journal
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• v.7 no.2
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• pp.77-85
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• 2007

Korean society expects to be changing into aged society more rapidly than any other countries due to low birthrate and increase in life expectancy. Increasing number of elderly and social problems of aging society have provoked increase in research on elderly environment. Elderly housing facilities and living conditions are significantly related to the quality of life for older persons. The purpose of this study is to systematically analyze empirical studies on elderly physical environments in Korea, find out research streaming and understand social backgrounds and to suggest future research problems. For this study, contents analysis was conducted. Articles of four academic peer reviewed journals published from 1986 to 2005 were units of analysis. Using a keyword through library database systems, the articles were systematically selected. As results, trends of research according to 4 periods were defined. Among them as major trends, expansion of the quantity, expansion to interior design features for older persons, more facility types for dependent elderly(assisted living facilities, facilities for elderly with dementia, long term care facilities) have appeared. This result showed some directions and implications on elderly facility planning and development.

• Health Policy and Management
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• v.27 no.2
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.6
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• pp.531-540
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• 2019

The purpose of this study was to establish the relationship between social support(MOS-SSS) and cognitive impairment(MMSE-K) to the elderly in long-term care facilities. The study subjects were 372 aged 65 and older who were admitted to care facilities located in D metropolitan city. Data were collected through a personal interview conducted by interviewers who visited each care facility in October 2018. As a result, the levels of cognitive impairment(MMSE-K) was significantly higher in the group with lower social support(MOS-SSS) scores. In correlation to the cognitive impairment and social support, the cognitive impairment score showed a significant positive correlation between the social support score (r=0.250, p<0.001). Therefore, the lower the social support level, the higher the level of cognitive impairment. In result of the logistic regression, the risk ratio of critical cognitive impairment increased significantly from 2.8 times (ORs=2.75, 95% CI=1.40 to 5.79) in the low group(Q1) than in the very high group(Q4) of social support scores. A hierarchical multiple regression analysis shows that the lower the social support, the higher the cognitive impairment. As such research suggests that the cognitive impairment of the elderly in care facilities increases with lower social support, it is necessary to seek concrete measures to improve social support as part of the measures to enhance the recognition capability of the elderly in care facilities.

• Korean Journal of Social Welfare Studies
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• v.42 no.4
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• pp.187-216
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• 2011

This study examined the effects of elderly care facility social workers' work environment (role conflict, role ambiguity, role overload, and adequacy of the reward system) and personal tendency (emotional empathy, cognitive empathy, external attribution, and internal attribution) on their burnout (emotional burnout, low personal achievement, and depersonalization about clients) and suggested strategies for preventing burnout in social workers at elderly care facilities. For this purpose, we conducted a questionnaire survey of social workers working at institutions designated as elderly long-term care facilities and collected a total of 312 questionnaires. According to the results of analyzing the data using a structural equation model, among the sub-factors of work environment, role ambiguity had a significant positive effect on low personal achievement and depersonalization about clients, role conflict on emotional burnout, and role overload on depersonalization about clients. Among the sub-factors of personal tendency, cognitive empathy and internal attribution had a significant negative effect on low personal achievement, and external attribution had a significant positive effect on emotional burnout and depersonalization about clients. This study is meaningful in that it illuminated social workers' burnout not only from the aspect of work environment but also from that of personal tendency.