• 대한간호학회지
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• 제44권1호
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

• 한국콘텐츠학회논문지
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• 제14권10호
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• pp.649-660
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• 2014

최근 급증하고 있는 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식과 수행 정도를 평가하고자 본 연구는 실시되었다. 광주와 전라남도의 7곳의 요양병원에서 간호사 84명과 간호조무사 72명을 표출하여 자료를 수집하였다. SPSS/WIN 21.0 프로그램을 사용하여 기술통계, 독립 t-검정, one-way ANOVA, 피어슨 상관 계수, 단계적 다중회귀분석을 실시하였다. 분석 결과, 대상자의 지식은 30점 만점에 16.84점으로 나타났고, 수행의 평균평점은 4점 만점에 2.88점이었다. 대상자들의 지식은 교육 수준, 직업, 암성 통증관리지침 존재 여부 인식에 따라 차이가 있었다. 수행에서는 교육 수준, 직종, 병상 수, 암성 통증관리지침 존재 여부 인식, 암성통증 임상실무지침서 비치 여부에 따라 차이가 관찰되었다. 지식은 수행과 정적 상관관계를 보였으며, 수행에 영향을 미치는 요인은 지식, 병상 수, 암성통증 임상실무지침서 비치 여부였다. 향후 요양병원 간호사와 간호조무사의 암성 통증관리에 대한 교육 프로그램을 실시할 때 이러한 변수들을 고려해야 할 것이다.

• 한국병원경영학회지
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• 제28권2호
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• pp.9-20
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• 2023

Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.428-440
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• 2016

본 연구는 요양병원 요양보호사의 감정노동, 직무스트레스, 소진과 이직의도의 정도와 그 관계를 파악하며 이직의도에의 영향요인을 규명하기 위하여 시도되었다. K대학교 기관생명윤리위원에서 승인을 받았으며 자료수집 기간은 2015년 8월 12일부터 9월 30일까지이며, 자료는 SPSS/WIN 18.0 프로그램을 이용하여 분석하였다. 대상자는 B광역시와 G도 소재 10개 요양병원에 근무하는 요양보호사 200명으로 구조화된 자기기입형 설문지를 통해 자료를 수집하였다. 자료는 기술적 통계, t-test, ANOVA, Pearson's correlation coefficients, Stepwise multiple regression으로 분석하였다. 연구결과, 요양보호사의 이직의도는 감정노동(r=.372, p<.001), 직무스트레스(r=.471, p<.001), 소진(r=.411, p<.001)과 통계적으로 유의한 양의 상관관계를 보였으며, 단계적 회귀분석 결과, 이직의도에 영향을 미치는 요인은 직무스트레스(${\beta}=.29$, p<.001), 소진(${\beta}=.24$, p<.001), 취업형태(${\beta}=.19$, p<.001), 감정노동(${\beta}=.16$, p=.017)으로 확인되었고, 이 변인들은 요양병원 요양보호사의 이직의도를 총 32.6% 설명하는 것으로 나타났다. 본 연구결과를 토대로 요양병원 요양보호사의 이직의도를 감소시키기 위해서는 직무스트레스를 감소시킬 수 있는 적절한 근무환경 개선 및 명확한 직무기술이 요구되며, 소진 및 감정노동의 경감을 위한 적극적인 심리사회적 중재 개발 및 적용이 필요하다고 하겠다.

• 한국임상약학회지
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• 제28권4호
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• pp.300-307
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• 2018

Objective: As the demands of healthcare environment change, it is necessary to advance human health care by improving students' essential competencies including knowledge, skills, abilities, inter-professional collaboration and patient centered care. This study identified long term accomplishment and improvement of the essential competencies in clinical pharmacy practice education (CPPE) at Korean hospitals over time. Methods: This study was conducted for pharmacy students who completed CPPE evaluation related to tertiary hospitals and secondary hospitals located in Seoul and Gyeonggi-do regional area from 2014 to 2018. Results: Over the past 5 years, overall results of student evaluation on the essential competencies in CPPE at both tertiary and secondary hospitals showed a decreasing trend or did not change. Essential competency in CPPE at tertiary hospitals had been identified as superior on 'Learn clinical knowledge in the treatment of diseases' to secondary hospitals [average number of students (%): 210 (72.9%) vs 68 (68.0%)]. On the other hand, essential competencies in CPPE at secondary hospitals had been identified as better at 'inter-professionals collaborative teamwork and direct patient care' than tertiary hospitals [average number of students (%): 64 (64.0%) and 56 (56.0%) vs 121 (42.0%) and 90 (31.3%)]. A total of 176 (61.1%) students in tertiary hospitals and 66 (66.0%) in secondary hospitals evaluated that 'patient-centered care' education was good. Conclusion: In tertiary hospitals, all six essential competency outcomes have not been improved, whereas four essential competency outcomes showed an increasing trend in secondary hospitals. It will be necessary to develop outcome-based CPPE education program to better reflect the essential competencies.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.26-35
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• 2021

Purpose: The purpose of this study was to determine the effects of awareness of good death and end-of-life care attitudes on end-of-life care performance in long-term care hospital nurses. Methods: This study used a cross-sectional study design. The participants were 147 nurses working at six long-term care hospitals with more than 200 beds in B city, South Korea. Data were collected using self-reported questionnaires, and analyzed with descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and multiple stepwise regression analysis using IBM/SPSS 26.0 for Windows. Results: The participants' awareness of good death, end-of-life care attitudes, and end-of-life care performance were positively correlated. The factors affecting end-of-life care performance were age, education level, awareness of good death, and end-of-life care attitudes; these variables explained 19.0% of end-of-life care performance. Conclusion: In order to improve long term care hospital nurses' end-of-life care performance, continuing education and training should be provided regarding awareness of good death and end-of-life care attitudes.

• 한국콘텐츠학회논문지
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• 제21권1호
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• pp.710-721
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• 2021

본 연구의 목적은 요양병원 간호사가 경험하는 임종간호 대처 경험의 구조를 규명하여 경험의 의미를 파악, 기술하고 이해하는 것이다. 현상학적인 연구 방법을 이용하여 요양병원에 근무하는 간호사 16명의 임종간호 대처 경험을 심층적으로 면담하였고, Colaizzi가 제시한 방법으로 분석하였다. 요양병원 간호사의 임종간호 대처 경험은 3개의 범주와 15개의 주제모음으로 구조화하여 규명할 수 있었다. 참여자들의 임종간호 경험의 세 범주는 '임종환자를 돌보는 요양병원 간호사의 태도', '임종간호 스트레스', '임종간호 대처'이었다. 요양병원 간호사의 임종간호 태도를 긍정적으로 변화시키고, 임종간호 스트레스를 줄이기 위한 실제적이고 체계적인 교육이 필요하다. 더불어 대처 능력을 향상할 수 있는 프로그램이나 전문가 상담과 같은 프로그램의 운영을 제언한다.

• 보건의료생명과학 논문지
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• 제10권2호
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• pp.265-274
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• 2022

본 논문은 건강보험심사평가원 환자표본자료 2018년 고령환자 데이터셋을 활용하여 요양병원에 입원한 환자의 260,425건의 내역서를 이용하여 요양병원을 필요인력확보, 요양병원간호사2/3이상 확보 수가적용 여부에 따라 요양병원 가산유형을 분류하여 이용한 병원유형별 특징을 분석하였다. '필요인력확보 요양병원' 이용자는 78.9%, '필요인력 및 간호사2/3이상 확보 요양병원'이용자는 15.6%, '필요인력 및 간호사2/3 이상 미확보 요양병원'이용자는 5.5%였으며, 필요인력 및 간호사2/3이상 확보 요양병원은 호흡계통의 질환과, 의료경도의 환자가 가장 많이 입원하였다. 하지만 요양병원 간호사 2/3이상확보, 필요인력확보 수가는 상대가치점수가 산정되지 않아, 13년째 동일한 금액을 유지하고 있어 수가의 개정이 이루어 져야 할 것이다.

• 한국치위생학회지
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• 제17권5호
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• pp.791-803
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• 2017

Objectives: Oral health management is important to improve the quality of life among the elderly. This study investigated the performance of elderly oral health management among some care workers in long-term-care hospitals. Methods: The study subjects were 174 care workers in 10 long-term-care hospitals. Data on general characteristics of care workers, attitude, recognition and knowledge of elderly health, performance of elderly oral health management were collected by a self-administered questionnaire. Data were analyzed through descriptive analysis, t-test, ANOVA, correlation and multiple regression analysis by using a SPSS version 23.0 statistical program. Results: The performance score of oral health management was $4.34{\pm}0.64$ on the 5-point Likert scale. The subjects who exercised more than 2 times a month were significantly higher in their performance of elderly oral health management compared to subjects who did not exercise (${\beta}=0.232$, p=0.035). And, the subjects who cared 10-19 persons were significantly higher in performance of elderly oral health management compared to subjects who cared more than 20 elderly (${\beta}=0.246$, p=0.020). The oral health behavior of care worker (${\beta}=0.271$, p<0.001) and the knowledge of oral health care (${\beta}=0.055$, p=0.008) were positively related to the performance of elderly oral health management. Conclusions: The educational program designed to improve knowledge of care workers in accordance with the standard textbook for training care workers should be developed, and the long term education program should be reinforced to improve the performance for elderly oral health care. If care workers can care a proper number of old persons, they will give oral health care to them.

• 기본간호학회지
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• 제15권4호
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• pp.428-437
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• 2008

Purpose: The purposes of this study were to assess the oral health knowledge of nursing staff in long-term care institutions and to identify predictors of oral health knowledge. Method: For this descriptive correlation study, a self-administered and structured questionnaire was used. Respondents were 111 nursing staff in two long-term care facilities and two long-term care hospitals located in G metropolitan area and C province in the Southern part of Korea. Descriptive statistics, t-test or ANOVA, and stepwise multiple regression analysis were used to analyze the data. Results: Participants in this study did not have many opportunities to learn about oral health care for elders in long-term care institutions. The percentage of correct answer for oral health knowledge questionnaire was 64.5%. Predictors of oral health knowledge among nursing staffs were education on oral health in long-term care institutions, type of institution, and length of time working with elders. These three variables accounted for 24.2% of variance in oral health knowledge. Conclusions: Nursing staffs should make an effort to improve their knowledge of oral health. Moreover, oral health educational program for nursing staffs working with elders in long-term care institution is need to be developed and the effectiveness of this education needs to be evaluated.