• Research in Community and Public Health Nursing
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• v.23 no.2
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• pp.117-126
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• 2012

Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

• Health Policy and Management
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• v.27 no.1
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• Korean Journal of Occupational Health Nursing
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• v.21 no.3
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• pp.247-257
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• 2012

Purpose: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. Methods: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. Results: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. Conclusion: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.

• 한국노년학
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• v.34 no.2
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• pp.369-386
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• 2014

The purpose of this study was to develop the classification of home-based long-term care activities and to test its validity. In this study, the taxonomy of long-term care activities was structured according to the service domain and process. Two expert groups participated in making a draft of the taxonomy that was composed of 7 service domains, 22 care needs, 22 service objectives, and 114 activities. Reliability and validity of the taxonomy was tested in a sample of 152 elderly subjects who used the home-based long-term care services. Based on the factor analysis of 114 activities, 21 factors were extracted from 114 activities. Internal consistency of the factors was high. Content validity was confirmed by the CVI. Long-term care insurance grade was used to assess the criterion validity. Among 21 care needs, 12 cares needs were significantly different from their grade. The classification of home-based long-term care activities demonstrated reliability and validity. In conclusion, the use of this classification is recommended while communicating with the elderly subjects, service providers, and the 3rd party payers.

• 한국노년학
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• v.37 no.3
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• pp.549-565
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• 2017

A high-quality workforce is essential to delivering the high-quality care for the older people who are beneficiaries of long term care insurance. Providing adequate education and ongoing training opportunities could be one answer that may lead to the ultimate goal of improving the quality of long-term care services. Thus this study aimed to examine a workforce crisis and difficulties that care workers face in current education system, especially in contents and administration aspects and draw out suitable solutions or improvement measures. The focus group interview approach was chosen to reflect opinions of long-term care workers, directors of the education system in long-term care facilities and managers. The findings from the focus group interviews were analyzed by theme and classified into several categories by common subjects:'Training contents', 'Training environment', 'Administrator', 'Compulsory training', 'Care givers supply', 'Working condition'. Also, four content areas were presented as follows:'Job training', 'Dementia care training', 'Administration system', 'Workforce'. The caregivers demand very practical training programmes and trainers with a lot of field experience. Improving the working condition and treatments for them leeds to expand the opportunity of the on-going training.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.4
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• pp.428-436
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• 2020

The purpose of this study is to analyze the needs for developing a curriculum for strengthening the long-term care service expertise and job competency. Specifically, the researchers analyzed previous studies on national long-term care services and national policy data, and conducted focus group interviews with 14 experts from related agencies. Activity theory was applied as a framework for analysis and a questionnaire about the importance and difficulty of subjects from 25 long-term service employees was administered for validating the results of the qualitative data analysis. The upper part of the subject-goal-tool of the activity system was considered the main area of action, and the following rule-community-division was divided into contextual parts for action, and the implications for demand analysis and future operation of the online curriculum are summarized. In total, six courses were required for development. These courses could be applied to as a learner-centered flip learning for long-term care service workers and various educational methods of collective education and supplementary education have been proposed. Based on the study results, implications in the educational field for effective management of courses were suggested at the end of the study.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.836-847
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• 2016

Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.108-116
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• 2005

The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• 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.