• 대한간호학회지
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• 제41권6호
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• pp.780-787
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• 2011

Purpose: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. Methods: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. Results: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. Conclusion: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

• The Journal of Korean Physical Therapy
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• 제20권2호
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• pp.43-48
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• 2008

Purpose: The purpose of this study is to investigate the importance of grade decision and role of physical therapist which follows enforcement of elderly long-term residential care insurance system. Methods: One of the data from grade decision meeting in Bukgu, Busan on 2007 which was 88 case of attached finding of doctor was compared with findings of visited investigator. Result: Eighty-four investigation subjects had 186 diseases that included stroke and arthritis, requiring the need for physical therapeutic approaches. In addition, the results of the door-to-door research project in the northern district of Busan showed that there was no match out of 88 subjects who submitted the viewpoint of the doctor. Such a result was produced as the doctors did not diagnose the patient directly, but rather the diagnoses were obtained from guardians and a door-to-door researcher who had a poor understanding of geriatric motion and function. Conclusion: To enforce long-term care successfully, a re-investigation should be performed for the welfare of the aged.

• 대한간호학회지
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• 제48권2호
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• pp.143-153
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• 2018

Purpose: The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested. Methods: The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program. Results: Mean score for BPSD was 40.16. Depression (${\beta}=.42$, p<.001), exposure to noise in the evening noise (${\beta}=-.20$, p=.014), and gender (${\beta}=.17$, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model. Conclusion: To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.

• 한국산학기술학회논문지
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• 제15권2호
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• pp.940-951
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• 2014

본 연구는 요양병원의 간호 인력의 간호행위 수행 실태를 파악한 조사연구이다. 연구 자료는 설문지를 이용하여 15곳의 요양병원에 근무하는 131명의 간호사를 대상으로 2013년 3월 7일부터 6월 30일까지 수집하였다. 자료 분석은 SPSS 17.0프로그램을 이용하여 기술통계 및 t-test, ANOVA를 시행하였다. '간호진단하기', '간호목표 설정하기', '환자평가표 작성'을 제외한 88항목의 간호행위를 다양한 범위 내에서 간호사와 간호조무사가 함께 수행하고 있는 것으로 나타났으며 기관의 총 환자 수와 간호사 수에 따라 간호조무사의 간호업무 수행정도는 유의한 차이가 나타났다(p<.001). 따라서 요양병원의 간호업무 중 위임할 수 있는 업무와 위임할 수 없는 업무를 분류하고, 위임에 대한 알고리즘 개발이 필요하며, 위임에 대한 법적, 제도적 규정을 마련할 필요가 있다.

• 문화기술의 융합
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• 제4권1호
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• pp.153-163
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• 2018

본 연구는 요양병원에 근무하는 간호사들을 대상으로 윤리적 딜레마와 전문직업성 정도를 파악하여 윤리적 딜레마를 해결하기 위한 방안과 전문직으로서의 성장을 통한 질적인 간호를 제공하기 위한 자료를 마련하고자 시도하였다. 연구대상자는 14곳의 요양병원에 재직 중인 간호사 210명을 대상으로 하였고, 자료분석은 SPSS/WIN 24.0 프로그램을 이용하여 통계처리 하였다. 본 연구결과 요양병원 간호사의 윤리적 딜레마는 중간정도로 나타났고, 하위 영역 중 간호사와 대상자 영역이 가장 높았으며, 생명존중 및 건강의 권리 존중 영역이 낮게 나타났다. 대상자의 전문직업성은 중간정도로 나타났고, 소명의식 영역의 점수가 가장 낮은 것으로 나타났다. 요양병원 간호사들의 윤리적 딜레마 상황을 반영한 간호윤리 지침서를 개발하여 간호사들이 실무현장에서 겪게 되는 윤리적 딜레마상황에 대한 올바른 가치관을 심어주기를 제언한다. 또한 요양병원 간호사들의 전문직업성 교육을 계획할 때 간호직에 대한 신념과 가치관을 강조하여 소명의식을 높일 수 있는 전략이 필요하다.

• 보건행정학회지
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• 제22권2호
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• pp.183-206
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• 2012

Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

• 대한간호학회지
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• 제49권2호
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• pp.203-214
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• 2019

Purpose: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. Methods: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an ${\chi}^2-test$, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. Results: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). Conclusion: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

• 한국환경보건학회지
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• 제46권5호
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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.

• 가정간호학회지
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• 제30권1호
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• pp.26-36
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• 2023

Purpose: This study investigated the organizational culture in hospital for infection control, moral sensitivity, and the degree of infection control among long-term care hospital nurses, and to identified the factors associated with infection control perfomance. Methods: 186 nurses who directly care for patients at seven Long-Term Care Hospitals in D Metropolitan City participated in the survey. Data were collected using self-reported questionnaires and analyzed using the IBM SPSS 26.0 software. Results: Moral sensitivity showed statistically significant differences in age (F=5.473, p=.065), clinical experience (F=8.890, p=.031), nursing hospital work experience (F=6.520, p=.038), religion (t=-2.01, p=.046) and position (t=-2.96, p=.003). Correlation analysis revealed that with moral sensitivity and effect of organizational culture on infection control, there was a positive correlation between infection control and patient-centered nursing (r=.201, p<.006), professionalism (r=.149, p<.042), benevolence (r=.303, p<.001), infection control organizational culture (r=.556, p<.001). Benevolence of moral sensitivity (β=.21, p=.001) and infection control organizational culture (β=.54, p<.001) were associated with infection control perfomance. Moral sensitivity (including patient-centered nursing, professionalism, and benevolence) and infection control organizational culture explained 33.8% of the variance in infection control (F=24.57, p<.001). Conclusion: It is important to improve the moral sensitivity of nurses and a positive organizational culture for better infection control. We need to develop intervention strategies and establish systematic and administrative support.

• Journal of Yeungnam Medical Science
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• 제36권1호
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.