• The Journal of the Convergence on Culture Technology
• /
• v.4 no.1
• /
• pp.153-163
• /
• 2018

The purpose of this study was to investigate nurses' ethical dilemma and professionalism in long-term care hospitals. Participants in this study were 210 nurses working in 14 long-term care hospitals. Data analysis was done using SPSS / WIN 24.0 program. As a result of this study, the ethical dilemma of the nurse was moderate. The highest sub-area was 'nurse-patient relationship' and 'respect of life and human rights' was the lowest sub-area. The professionalism of the subjects was moderate, and the score of 'sense of mission' area was the lowest. Nursing ethics guidelines should be developed that reflect the ethical dilemma of nurses in long-term care hospitals, and will provide the right values for the ethical dilemma that nurses face in their workplace. When planning the nurses' professionalism education, it is necessary to have a strategy to enhance the sense of mission by emphasizing beliefs and values about nursing care.

• Health Policy and Management
• /
• v.12 no.1
• /
• pp.21-53
• /
• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Health Policy and Management
• /
• v.17 no.2
• /
• pp.52-67
• /
• 2007

Korean government is preparing the long-term care financing and delivery system in order to cope with rapid population aging. The system should be designed to provide demented patients with an appropriate services that the patients want to take, and considered to be necessary for them. In this regard, this study aims to analyse empirically a relationship between the types of long-term care services that demented patients wanted to take and they actually received during 2004. The caregivers of 609 dementia patients, who were randomly selected in a manner of proportional allocation from a nationwide claim database of the Korean National Health Insurance Corporation, were interviewed in September, 2005. Independent variables include socio-demographic characteristics, Activities of Daily Living(ADL) and Instrumental Activities of Daily Living(IADL). To explore the correspondence of the types of long-term care services that demented patients wanted to take and that they actually received, and its affecting factors, we conducted chi-square test and logistic regression analysis. Main findings are as follows. First, while only 20% of study subjects wanted home services as a long-term care services, those who wanted to use the long-term care facilities and general hospital were 37%, 43% respectively. Second, the correspondence rate was just 38% on average, and extremely low in the demented patients who wanted to use long-term care facilities. Third, the demented patients who resided in urban areas and received relatively high level of education showed high correspondence rate. Fourth, the high ADL score was closely related to low correspondence rate.

• Health Policy and Management
• /
• v.26 no.1
• /
• pp.39-50
• /
• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.10
• /
• pp.458-470
• /
• 2016

The purpose of this study was to understand and describe nurses' recognition regarding successful aging of hospitalized elderly in long-term care hospitals. Data were collected using focus group interviews in 2016. Three focus group interviews were held in three long-term care hospitals, and a total of 14 nurses participated. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. A total of 25 concepts were identified, 15 subcategories, and five major categories emerged from the analysis. The five categories of the nurses' recognition about successful aging of hospitalized elderly in long-term care hospitals were "adjusting themselves to a lifestyle of long-term care hospital," "living positively in each situation," "communicating with each other and making a relationship," "obtaining interest and support of their families," and "maintaining economic independence". Therefore, further qualitative study will be performed and compared with this study results on successful aging of hospitalized elderly in long-term care hospitals. Moreover, based on these study results, it is necessary to develop and apply programs for successful aging of hospitalized elderly in long-term care hospitals.

• Journal of Korean Public Health Nursing
• /
• v.35 no.1
• /
• pp.5-18
• /
• 2021

Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.31 no.1
• /
• pp.77-88
• /
• 2024

Purpose: This study aimed to develop and assess the impact of an integrated infection control education program on the awareness, attitudes, and performance of infection control among caregivers in long-term care facilities. Methods: Participants were recruited from two long-term care facilities with 25 caregivers in both the experimental group and the control group. This study used non-equivalent control group quasi-experimental pre-post design. The effectiveness of a developed Integrated Infection Control Education Program was evaluated based on infection control awareness, attitudes, and performance. Data were analyzed using SPSS/WIN 28.0 through descriptive statistics, chi-square tests, Fisher's exact tests, and independent t-tests. Results: There was a statistically significant difference in the degree of awareness (t=-5.00, p<.001), attitude (t=-4.91, p<.001), and performance (t=-6.66, p<.001) of infection control between the two groups. Conclusion: Given these results, the integrated infection control education program significantly improved infection control awareness, attitudes, and performance among caregivers in long-term care facilities. This study is noteworthy because it provided comprehensive education on infection control practices to caregivers in environments that are particularly susceptible to infections, especially following COVID-19. This educational program is actively utilized and validated in practice, it would enhance the infection control performance of caregivers, thereby reducing infection rates within facilities, shortening the length of stay for elderly residents in long term care facilities, and contributing to the reduction of healthcare costs.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.6
• /
• pp.334-344
• /
• 2018

This study was conducted to identify the relationship between knowledge, attitude, and compliance regarding infection preventive behaviors among long-term care hospital staff during a Middle East Respiratory Syndrome (MERS) epidemic. The subjects were 211 staff members of a long-term care hospital in J province evaluated using a structured survey. Data were collected between June 15 and July 15, 2015 and analyzed using SPSS/WIN 24.0 based on an independent t-test, ANOVA, and Welch test, while post-hoc tests were conducted using the Scheffe test and the Grames-Hawell test. The MERS knowledge score of the staff at the long-term care hospital was high for nurses and nurse aids, who had experienced infection management when they received influenza vaccine in the previous year and were provided with easy access to hand sanitizers. Attitude towards MERS was more positive for nurses than nurse aids and caregivers. The degree of execution of infection preventive behaviors in terms of daily activity was high when influenza shots were received in the prior year; in terms of caring for patients, it was high when influenza shots were received in the previous year and they had easy access to hand sanitizers. The relationship between knowledge, attitude, and infection preventive behavior regarding MERS was such that high knowledge and positive attitude led to a higher degree of execution of infection preventive behavior. Therefore, during periods of high prevalence of newly infectious diseases such as MERS, it is important for the long-term care hospitals to conduct infection management education including the characteristics of the MERS disease, its transmission, and its prevention to enhance knowledge regarding MERS and induce positive change in attitude to improve the level of infection preventive behaviors.

• Journal of Hospice and Palliative Care
• /
• v.19 no.4
• /
• pp.322-330
• /
• 2016

Purpose: This study investigated long-term care hospital nurses' knowledge and practice of pain management and their attitudes towards the job with an ultimate aim to provide fundamental information for development of a pain education program. Methods: A cross-sectional survey was carried out with 120 nurses from four long-term care hospitals. Nurses' knowledge of and attitudes towards pain management was measured using a tool developed by Watt-Watson. To examine their pain management practice, an instrument was developed based on the pain management guidelines used by the long-term care settings. Results: For pain management knowledge, the participants gave an average of 26.2 (${\pm}13.10$) correct answers out of 40 questions. The most frequently missed question was one about subjectivity of pain, "Patients' physiological and behavioral reactions to pain hint at the presence and intensity of pain" (89.2%), and 56.7% of the nurses believed that increasing tolerance for a narcotic analgesic means addiction. Regarding attitudes towards and practice of pain management, 80.2% of the nurses used placebos to patients who complain about pain often. Conclusion: This study revealed poor level of pain management knowledge of and attitude among long-term care hospital nurses. This might negatively affect their pain management practice. From the educational perspective, nurses should be provided with education on pain management education with emphasis on the nature of pain and misuse of placebo drugs.

• Korea Journal of Hospital Management
• /
• v.25 no.3
• /
• pp.78-86
• /
• 2020

Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.