• 보건의료산업학회지
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• 제5권1호
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• pp.45-60
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• 2011

The purpose of this study is ultimately to contribute to enhancing quality of patients' life, by grasping quality level of care-giving service that is recognized by inpatients of long-term care hospital, and by pursuing a plan for improving quality of care-giving service based on this. For this, targeting 500 patients who entered 40 long-term care hospitals in Daejeon Metropolitan City, the quality of service was multi-dimensionally grasped by using SERVQUAL scale. As a result of research, the quality of care-giving service, which is recognized by patients as survey subjects, tended to be relatively high with about 4 points as a whole out of 5-point perfection. By item, reliability was indicated to be the highest with 4.56 points. The next was surveyed to be in order of tangibility, empathy, responsiveness, and assurance.

• 한국노년학
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• 제30권3호
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• pp.855-869
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• 2010

본 연구는 노인장기요양보험 도입이후 장기요양시설과 요양병원의 효율적 연계방안을 모색하기 위한 기초조사 연구이다. 본 연구는 문헌고찰을 기반으로 국민건강보험공단 노인장기요양운영센터를 이용 장기요양시설 192곳과 요양병원 168곳 시설관계자(시설장, 병원장 및 이용자 등)에게 운영현황과 효율적 연계방안에 대해 면접조사를 실시 분석하였다. 자료분석은 기술통계, χ²검증 등을 SPSS 13.0으로 분석하였다. 연구결과 운영현황에서는 요양시설과 요양병원 모두 본인부담의 차이가 미미하나 식대에 대한 편차가 크게 나타났다. 경영수지적자에 대해서는 양 기관 모두 수가보전에 문제점을 지적하고 있으며, 교통과 환경요인이 입지조건을 좌우하는 것으로 파악되었다. 둘째 이용행태면에서는 양 기관 모두 비용할인 경험이 높은 것으로 나타났고, 면회를 오지 않는 경우가 많은 것으로 파악되었다. 반면, 요양시설이 사망 시까지 있는 경우가 요양병원에 비해 더 높게 나타나고 있다. 셋째, 기관의 서비스제공문제점으로는 일률적인 서비스제공, 가족의 지지나 방문 부족 등을 들 수 있다. 끝으로 양 기관의 효율적 연계방안으로는 수가현실화, 간병비 지급, 복합시설 허용, 판정기준 강화, 주치의, 요양병원의 장기요양보험 관리 방안 등을 제시하였다.

• 대한간호학회지
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• 제33권2호
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• pp.275-283
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• 2003

Purpose: This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea. Method: This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids. Result: The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001). Conclusion: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.

• 대한지역사회영양학회지
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• 제20권3호
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• pp.220-235
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• 2015

Objectives: The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians. Methods: Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas. Results: The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship). Conclusions: There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

• 지역사회간호학회지
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• 제31권1호
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• pp.34-42
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• 2020

Purpose: The objective of this study was to identify whether spirituality mediates the relationship between empathy and elderly care performance among Long Term Care (LTC) hospitals nurses in Korea. Methods: The data collection was performed July 1st to August 31th, 2018. Participants were 119 nurses from three long-term care hospitals in Korea. Self-reported questionnaires were administered to assess general characteristics, empathy, spirituality and elderly care performance. The data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and three-stage simple and multiple regression analysis as proposed by Baron and Kenny. Results: The level of elderly care performance of participants was significantly different based on age (F=3.92, p=.010) and nurse's position (t=-2.18, p=.031). Spirituality had a significant mediating effect on the relationship between empathy and elderly care performance (Z=3.64, p<.001). Conclusion: As spirituality completely mediates the relationship between empathy and elderly care performance, it is necessary to develop a nursing education program that applies spirituality and empathy and supports religious activities at an institutional level.

• 한국융합학회논문지
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• 제10권6호
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• pp.355-363
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• 2019

본 연구의 목적은 요양병원 간호사를 대상으로 윤리적 딜레마, 임종간호스트레스 및 소진의 관계와 윤리적 딜레마와 임종간호스트레스가 소진에 미치는 영향을 파악하고자 함이다. 본 연구의 대상자는 경상남도에 위치한 7개 노인요양병원에 근무하고 임종간호 경험이 한 번 이상 있으며 연구의 목적을 이해하고 연구 참여에 동의한 간호사 143명을 대상으로 구조화된 설문지를 이용하여 설문조사하였다. 본 연구결과 연령과 직위, 임종간호교육, 임종간호스트레스가 요양병원 간호사의 소진에 영향을 미치는 요인으로 확인되었다. 따라서 요양병원간호사의 소진을 예방하고 완화시키기 위해 임종간호 관련 교육과 함께 스트레스를 관리하는 체계적인 중재프로그램이 필요할 것이다.

• 성인간호학회지
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• 제28권5호
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• pp.572-584
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of job stress among nurses working in long-term care hospitals. Methods: A phenomenological approach was used for the study. Data were collected from May to June, 2016 using open-ended questions during in-depth interviews. Participants were nurses working in long-term care hospitals and had reported experiences of stress. Six nurses participated in this study. Results: Six themes emerged from the analysis using Colaizzi's method: (a) Heavy workload and responsibility due to nurse shortage, (b) Getting exhausted by caring for cognitively impaired patients, (c) Feeling pressure due to conflict with patients' family, (d) compassion for patients who are getting worse, (e) Low value in being a long-term hospital nurse, and (f) Efforts to overcome stress. Conclusion: Sufficient labor supply, environmental improvements, program for improving interpersonal skills, education and counseling on end-of-life care, and recognition improvement about long term hospital are suggested to reduce the job stress of long-term hospital nurses.

• 한국치위생학회지
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• 제15권3호
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• pp.411-416
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• 2015

Objectives: The purpose of this study is to identify oral health status and oral health care needs of elderly patients in long-term care hospital. Methods: Oral health examination was carried out by a dentist and questionnaire was completed by direct individual interview by a dental hygienist for 245 elderly patients in seven long-term care hospitals in Daegu from March 12 to April 16, 2011. Results: Those who need dental care were 188(76.7%) and was done by oral health examination by a dentist. 93 patients(38.0%) wanted dental care and 63 patients(25.3%) need dental care. The most important dental service in the elderly patients was denture and prosthetic service. As demand for denture and prosthetic service exceeds the supply, but only 35.9 percent of the elderly received the dental care service by the estimation of the caregivers. Conclusions: It will be necessary to establish the customized dental care service for the elderly patients in long term care hospitals. The oral health education for the caregivers is very important and the continuing education program must be implemented in the future.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 한국콘텐츠학회논문지
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• 제17권3호
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• pp.350-358
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• 2017

본 연구의 목적은 노인요양병원에 종사하는 사회복지사의 직무소진 정도를 살펴보고, 대처전략과 직무효능감이 직무소진에 미치는 영향을 확인하는 것이다. 이를 위해 노인요양병원협회 회원으로 등록된 전국 528개(2015년 9월 기준) 노인요양병원 중 병상의 규모가 100병상 이상인 병원의 사회복지사 138명을 대상으로 설문조사를 실시하였다. 분석 결과 근무시간, 외재화 전략, 자기 효능감, 집단효능감이 직무소진과 유의한 영향을 보이고 있었다. 즉, 근무시간이 길수록 소진의 정도가 심각해지는 반면, 외재화 전략, 자기효능감, 집단효능감이 높을수록 직무소진이 경감되었다. 본 연구결과를 토대로 노인요양병원 사회복지사의 직무소진을 경감시키기 위해 슈퍼비전 체계의 구축. 소진 경감 프로그램의 개발, 그리고 보수 교육 제공 등과 같은 개입 방안들을 제안하였다.