• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.37-45
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• 2017

Purpose: The purpose of this study was to identify the relationships between death anxiety and terminal care performance of nurses at long term care hospitals. Methods: Data were collected from 148 nurses working at 12 long term care hospitals in Busan from March 16, 2016 through May 16, 2016. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, $Scheff{\acute{e}}$ test and Pearson's correlation coefficient with SPSS 18.0 for Windows. Results: Terminal care performance was positively correlated with anxiety about other people's death (r=0.310, $P{\leq}0.001$) and that of their own death (r=0.250, P=0.002). Conclusion: It appears necessary to develop a systematical educational program for terminal care nurses of to reduce their death anxiety and improve their terminal care performance.

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

• Journal of the Korean Data and Information Science Society
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• v.26 no.3
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• pp.715-727
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• 2015

This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

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

• Journal of Hospice and Palliative Care
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• v.22 no.3
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• pp.125-133
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• 2019

Purpose: The purpose of this study was to investigate the relationship between end of life care competencies and terminal care stress of nurses in long term care hospitals. Methods: For this study, 140 nurses were sampled among those that have over 6-month end of life care experience and were working at long term care hospitals located in A city and C city of Chungcheongnam-do. Using a questionnaire, data were collected from January 2018 through March 2018. Data were analyzed using the SPSS, Windows version 21.0, according to the purpose of the study and analyzed by descriptive statistics, t-test, one way ANOVA, $Sch\acute{e}ffe^{\prime}s$ test, and Pearson's correlation coefficient. Results: The mean score on terminal care stress of nurses was above the normal level. The scores on end of life care competencies significantly varied by age, total career at hospitals, death/hospice and palliative care education, and bereavement experience. The mean score of end of life care competencies was negatively correlated with the mean score of lack of knowledge and skills among the subitems of the terminal care stress category (r=-0.260, P=0.002). Conclusion: To decrease the terminal care stress of long term care hospital nurses, it is suggested to carry out end of life care education tailored to nurses characteristics.

• The Korean Journal of Health Service Management
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• v.9 no.3
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• pp.95-106
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• 2015

Objectives : The purpose of this study was to identify levels of turnover intention of nurses in long-term care hospitals, and to explore influential factors on turnover intention. Methods : Data were collected with a structured questionnaires from 165 nurses. The data were analyzed with SPSS/WIN 21.0. Results : First, the average score for the practice environment cognition, job satisfaction, reward importance, and turnover intention were $3.14{\pm}0.21$, $3.18{\pm}0.32$, $4.02{\pm}0.53$, and $3.29{\pm}0.67$, respectively. Second, there were significant differences in the turnover intention according to the average monthly wage, total clinical career, present clinical career, work form, average monthly night shift and turnover experience. Third, the significant predictors of turnover intention were monthly salary, practice environment cognition, reward importance, monthly night shift and type of work explaining 67.0%. of the variance. Conclusions : It is necessary to conduct continuous and systematic research and to find ways that can prevent the resignation of nurses and improve cognition in the practice environment in long-term hospitals nurses.

• Korea Journal of Hospital Management
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• v.29 no.2
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• pp.37-47
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• 2024

Purpose: This study aimed to determine the effect of adjusted out-of-pocket maximum rules in the 'differential co-payment ceiling', which means having a higher burden of co-payment, that expanded to the entire ceiling level in long-stay admission patients in long-term care hospitals(LTCH). Methodology: We used health insurance claim data between January 1, 2022, and December 31, 2022 received from the National Health Insurance Service. The study populations were inpatients in long-term care hospitals more than 1 days during the study period. We performed the difference in characteristics of the LTCH patient of the differential and general ceiling by the chi-square test. We estimated the change of the population, cost, and co-payments per person under the assumption of restructuring. Finding: Based on adjusted out-of-pocket maximum rules in 2023, it was expected that the number of benefits decreases at the high-income level while increasing at the low-income level. The burden of health expenditure after reimbursement of co-payment ceiling, is expected to increase by 65.1% in the highest medical necessity, whereas the low medical necessity would decreases compared to 2022. Practical Implications: The results demonstrate that the current out-of-pocket maximum rules do not reflect the needs of medical necessity. This study suggested the need to reflect the medical necessity in LTCH on the out-of-pocket maximum rules in the future.

• Journal of Home Health Care Nursing
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• v.23 no.2
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• pp.121-128
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• 2016

Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.

• The Journal of the Korea Contents Association
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• v.18 no.6
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• pp.180-192
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• 2018

Purpose: This study is aimed to identify the ethical issues and needs for ethical education of nurses in long-term care hospitals. Methods: Data were collected in 2015. Participants were 142 nurses working in nine long-term care hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS WIN 24.0. Results: The degree of experienced ethical issues was 1.23 out of 3, and 'Providing care with a possible risk to your health' was an ethical problem most frequently experienced in nurses. In addition, the ethical problem that the nurse most disturb was identified by 'Determining when death occurs'. The degree of needs for ethical education was 3.11 out of 4, and the highest ethical topic was 'Legal/ethical issues in the use of restraints'. Ethical issues and needs for ethical education were not statistically significant differences according to the characteristic of participants. Conclusion: In this study, we identified the ethical problems and necessity of ethics education experienced by nurses working in long-term care hospitals. The results of this study can be used as basic data for the development of customized ethical education contents for nurses in long-term care hospitals.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.441-451
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• 2016

This study was conducted to determine the influence of satisfaction, self-esteem, and depression on adjustment of elderly patients in long-term care hospitals. The subjects were 116 elderly patients in 15 long-term care hospitals in B and K city. Data were collected from February 14 to March 30, 2015, and analyzed by t-rest, ANOVA, Scheff's test, Pearson correlation coefficients, and stepwise multiple regression. According to the results, there were significant differences in adjustment by religion, marital status, economic status, and perceived level of difficult problems. Adjustment was positively related to satisfaction and self-esteem. In addition, a negative correlation was observed between adjustment and depression. Meaningful variables that influenced the adjustment of elderly patients were depression, satisfaction, self-esteem, and religion. These factors accounted for 53.5% of the total variance in adjustment of the elderly patients in long-term care hospitals, and depression was the most influential factor. In conclusion, development and implementation of effective programs and strategies to reduce depression and to increase satisfaction with care and self-esteem is needed in order to enhance the adjustment of elderly patients in long-term care hospitals.