• 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.

• Research in Community and Public Health Nursing
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• v.31 no.2
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• pp.199-211
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• 2020

Purpose: The purpose of this qualitative study was to describe the essence and the meaning of nurses' experiences of end-of-life care (EOLC) for elderly patients in the long-term care hospitals (LTCHs). Methods: Data were gathered from 12 nurses who had been working at LTCHs in Korea through one-on-one interviews and the data were analyzed by Colaizzi's phenomenological method. Results: The emergent 5 themes were 'Doing the best for protecting patients' life', 'Providing a comfortable dying process for patients', 'Supporting a family's keeping on patient's death', 'Reflecting on life' and 'Desiring for the establishment of a humanity end-of-life care environment'. Conclusion: The end-of-life care for the elderly patients includes supporting elderly patients' comfortable dying process and helping the family keep the death of the elderly. The results indicated that physical facilities and end-of-life nursing capacity should be established in LTCHs for improving the quality of EOLC.

• Journal of Korean Public Health Nursing
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• v.23 no.2
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• pp.232-250
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• 2009

Purpose: This study was designed to define the roles, tasks, and activities of home visiting nurses aimed at enhancing the quality of nursing care under the long-term care insurance regulation for the elderly introduced on July 1, 2008 in Korea. Methods: A review of domestic and foreign literature was used to formulate the proposed roles, tasks, and activities of visiting nurses, which were subsequently modified and complemented by the agreement of home visiting nurse experts and acceptance of 127 nurses. Data was collected from 04 June - 17 September 2008 and analyzed concerning frequency and percentile using SPSS ver. 15.0. Results: The established functions of home visiting nurses were direct nursing service provider, case manager, patient educator, decision maker, care coordinator, and research worker. These functions involved 27 different tasks and 167 activities. Conclusion: The roles, tasks, and activities of visiting nurses, established based upon the guidelines of the Long-term Care Insurance Act for the elderly, were verified for their applicability by nurses involved in home care delivery. These parameters will provide a useful tool in developing an assessment to enhance the quality of home-based care for the elderly in Korea.

• The Journal of Korean Physical Therapy
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• v.20 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.48 no.2
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.2
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• pp.940-951
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• 2014

This study was to investigate of nursing activities performed by nursing staffs in long-term care hospitals. A survey of was conducted with 131 nurses who were working in 15 geriatric hospitals using a structural questionnaire. Data were collected from March 7 to June 30, 2013 and analyzed with SPSS 17.0, using descriptive statistics and t-test, ANOVA. This survey confirmed that the 88 activities except to 'making nursing diagnosis', 'setting nursing goals', and 'writting patient evaluation checklist' had been practiced in a wide range of nurses with nurse assistants. The degree of performance by nurse assistant was significantly different among nurses group according to the total number of patient and number of nurse(p<.001). Therefore, it is necessary to establish the legal and institutional regulation and development of algorithm for delegation, classify the impossible nursing task and work that can be delegated long-term care hospital.

• 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.

• Health Policy and Management
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• v.22 no.2
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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.

• Journal of Korean Academy of Nursing
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• v.49 no.2
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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.

• 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.