• Research in Community and Public Health Nursing
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• v.28 no.4
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• pp.513-523
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• 2017

Purpose: We evaluated the psychometric properties of a questionnaire on the acceptance of the quality improvement information system (QIIS) among long-term care workers (mostly nurses). Methods: The questionnaire composes of 21 preliminary questions with 5 domains based on the Technology Acceptance Model and related literature reviews. We developed a prototype web-based comprehensive resident assessment system, and collected data from 126 subjects at 75 long-term care facilities and hospitals, who used the system and responded to the questionnaire. A priori factor structure was developed using an exploratory factor analysis and validated by a confirmatory factor analysis; its reliability was also evaluated. Results: A total of 16 items were yielded, and 5 factors were extracted from the explanatory factor analysis: Usage Intention, Perceived Usefulness, Perceived Ease of Use, Social Influence, and Innovative Characteristics. The five-factor structure model had a good fit (Tucker-Lewis index [TLI]=.976; comparative fit index [CFI]=.969; standardized root mean squared residual [SRMR]=.052; root mean square error of approximation [RMSEA]=.048), and the items were internally consistent(Cronbach's ${\alpha}=.91$). Conclusion: The questionnaire was valid and reliable to measure the technology acceptance of QIIS among long-term care workers, using the prototype.

• Journal of Environmental Health Sciences
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• v.46 no.5
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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.

• Research in Community and Public Health Nursing
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• v.30 no.1
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• pp.99-107
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• 2019

Purpose: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. Methods: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the "before clean/aseptic procedure" moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (${\geq}65$). The collected data were analyzed using SPSS 22.0. Results: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the "after body fluid exposure risk" moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). Conclusion: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.

• Korean Medical Education Review
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• v.17 no.1
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• pp.10-14
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• 2015

The mission of the modern medical school includes education, research, and patient care. The clinical clerkship is an important part of the core curriculum, and hospital facilities are needed for the clinical clerkship. However, unfortunately, education has moved to the periphery during the past several decades because of the dominance of research and patient care. This may lead to obstacles in the education of future physicians in the long term. To promote their education mission, teaching hospitals need to recognize and share the importance of this mission. In addition to the certification of teaching hospitals, a new paradigm for teaching hospitals should be introduced to produce a high quality clinical clerkship and postgraduate medical education. The relevant government departments need to allocate and expand financial support to medical schools and teaching hospitals, and to unify supervision of basic and postgraduate medical education.

• 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 Hospice and Palliative Care
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• v.22 no.4
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• pp.145-155
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• 2019

Purpose: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment. Methods: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed. Results: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting. Conclusion: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

• Journal of Korean Academy of Nursing
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• v.41 no.6
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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.

• 한국노년학
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• v.30 no.1
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• pp.81-91
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• 2010

The purpose of this study was to test a validity and reliability of Cognitive Performance Scale(CPS), a cognitive measure generated from 5 items(comatose status, decision making, short-term memory, making self understood, and eating). Method: 393 patients in 2 hospitals for the elderly with dementia were measured with CPS by two nurses independently. The inter-rater agreement was tested by comparing two scores. The CPS score was compared with GDS, which was measured by doctors and nurses, and MMSE score which was drawn from the claim data of Health Insurance Review & Assessment Service. Result: The correlation coefficient between CPS and GDS was 0.742(p<0.0001), CPS and MMSE was -0.794(p<0.0001). The Cronbach's coefficient alpha of CPS was 0.742, Kappa value was 0.772~1.000. The CPS showed high validity and reliability in long term care hospitals of Korea.

• Korea Journal of Hospital Management
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• v.12 no.2
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• pp.25-42
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• 2007

To identify characteristics of elderly inpatients who had long term hospitalization in a general hospital, this study categorized into two groups who were hospitalized for less than 30 days and a group hospitalized for more than 30 days. To compare the groups the independent variables were the sociodemographical characteristics, the medical care utility characteristics, and the disease characteristics and finally analyzed factors affecting the hospitalization period. The data of 18,727 inpatients who were older than 65 years of age by the year 2005 were used and the data were analyzed using SPSS for Windows 12.0. With the results, it is necessary to provide intensive and positive management to elderly inpatients who belong to the more than 30 days group and also necessary to share roles and functions of hospital by medical network with local hospitals and clinics in order to manage long-term elderly inpatients and offer continuous post-management to discharged patients by encouraging them to use a long-term care center or by implementing an early discharge program. This study should provide many studies on how to manage the period of hospitalization efficiently on long-stay elderly inpatients in the future.

• Journal of Convergence for Information Technology
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• v.11 no.7
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• pp.288-297
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• 2021

The purpose of this study was to provide basic data for the development of end-of-life care program by analyzing the importance and performance of end-of-life care. Data were collected from 127 hospice team members currently working in hospice and palliative care units from six different university hospitals, general hospitals and hospice clinics. The data was collected throughout the time span of Dec. 1, 2020 to Feb. 15, 2021. Data were analyzed using descriptive statistics, t-tests, ANOVA, & IPA matrix. As a result of this study, 'physical care' and 'psychological care' were part of the first quadrant that requires maintenance and continuous enhancement. The 'spiritual care' appeared to be in the third quadrant area which entails long-term improvement. Based on the outcome of the study, it is evident that strategies are needed to continuously maintain and enhance physical and psychological care as well establish long-term plans for spiritual care when organizing the hospice team's end-of-life care performance training program.