• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.

• Korea Journal of Hospital Management
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• v.15 no.1
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• pp.49-69
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• 2010

The major purpose of this study is to find out relevant factors affecting utilization of Long Term Care Hospitals since the Elderly Long Term Care Insurance System was adopted in Korea. The sample hospitals of this study are 5 long term care hospitals located in 4 big cities and 1 local area. The research data were collected with structured questionnaire from 247 patients and patients' protectors in 5 sample hospitals. Analyzing methods are descriptive statistics, factor analysis and multiple regression with SPSS(version 12.0). Major results of this study are as follows. 1) Utilization and recommendation of patients is affected significantly by the level of hospital facilities (0.043), fee level(0.026), level of staff (0.000), and discomfort of services(0.001). 2) Level of staff is very positively correlated with utilization and recommendation of patients. 3) Discomport of services is very negatively correlated with utilization and recommendation of patients. On the basis of results this study conclude that the management of Long Term Care Hospitals is required conclude to improve the level of staff and facilities and to solve discomport problems of services for patients' marketing. And also more in-depth study on the utilization factors of long term care hospital in Korea is required.

• Journal of East-West Nursing Research
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• v.26 no.1
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• pp.28-38
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• 2020

Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.

• 한국노년학
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• v.31 no.1
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• pp.97-109
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• 2011

The purpose of this work is to examine how work stressors are related to the burnout among staff in long-term care facilities for the elderly. This study offers some responses to a growing stress and burnout for the long-term care workers. The demand for long-term care workers is set to rise in light of an increasing share of older people and dependent elderly. Long-term care workers provide long-term care services to persons with a reduced degree of functional, physical or cognitive capacity. Cross-sectional survey data were collected from 216 staff in long-term care facilities. The standardised Maslach Burnout Inventory(MBI) was used to assess levels of burnout in long-term care workers. The MBI consists of 22 items using a 5-point Likert scale, measuring three sub-scales of burnout; Emotional exhaustion, Depersonalization, and Personal accomplishment. Data were analyzed using regression. This study is empirically tested the degree of association between burnout and its antecedents. The majority of differences in burnout could be explained by work stressors such as client relationship, job overload, job role conflict, and conflicts with clients' family. The study also identified workers' perceptions of their image in society and emotional support as predictors of burnout. Therefore long-term care facilities are encouraged to review their practices so that workers well-being is supported. The study findings suggest attention for organizational oriented initiatives to cope with burnout.

• Korea Journal of Hospital Management
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• v.20 no.4
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• pp.50-61
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• 2015

Advances in healthcare technology and rapid economic growth lead to the increased life expectancy and consequently the size of elderly population. Korea is one of the countries that are rapidly aging. Thus, it is particularly important to prepare for the aging society. Recently, the number of healthcare institutions for the elderly citizens has increased. The purpose of selecting a hospital for the elderly is, in general, maintenance of health rather than improvement of health receiving proper treatment. Unlike choosing a hospital for treatment, customers of a long term care hospital have a different set of factors to consider. Especially, when choosing a long term care hospital, the influence of patient's family is greater than the patient. This study examines the factors they consider for long term care hospital. A total of 198 questionnaires were collected from the families of actual patients of long term care hospitals. Twelve questionnaires were found to be non-usable because of missing and unsatisfactory responses. Consequently, 186 questionnaires were used for the analyses. Findings of this study are as follows. First, seven factors have been identified to consider when choosing a long term care hospital for the elderly. They include convenience of facilities, costs variety of facility programs, service hours, reputation, accessibility, quality of medical staff, medical facilities, and facility size. Second, This study measured both importance and satisfaction with these attributes and analyzed the difference between them. Satisfaction was lower than importance in the categories of convenience of facilities, costs, and programs, and accessibility. On the other hand, satisfaction was higher in terms of service hours, reputation, and quality of medical staff. Finally, the current study found positive impact of accessibility and quality of medical staff on reuse intention of a long term care hospital.

• Journal of Korean Academy of Nursing
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• v.34 no.2
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• pp.278-289
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• 2004

Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.

• The Korean Journal of Health Service Management
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• v.5 no.1
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• pp.147-158
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• 2011

This study compares the degree of satisfaction and the causes of selecting facilities for stroke patients in the senior specialized hospitals and other senior care facilities. The research results are followed. First, The patients who held the level of senior long-term care used senior specialized hospitals, while the patients who had the level of 2 or 3 degree used senior care facilities. The patients helped by cooperative care service used senior care facilities, and the patients helped by private service or family service used senior specialized hospitals. Second, The patients in senior specialized hospitals had affirmative attitude for their service system, while the patients in senior care facilities preferred their various service systems. In the satisfaction of the facilities, the patients in senior care facilities felt more satisfaction to staff, environment, service, and other factors than the patients in hospitals did. Third, in the result of logistic analysis, the patients had an affirmative attitude in case that they had spouse, experience of senior specialized hospitals or senior care facilities, without senior long-term care insurance. They also valued the service standard and the staff quality. As this study points out, the overall preference is higher in the senior care facilities. So, the stroke patients recognized the new role between the hospitals and the facilities after the establishment of long-term senior medicare system. This research had some limitation for the research areas and numbers. So the data analysis for the types of facility and the responses may not be generalized. However, the standard of choosing facility and satisfaction will be a guideline for establishing a new future role between hospitals and facilities. This result will be used as a basic data for the renovation of long-term senior medicare insurance.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.18-31
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• 2000

Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

• Journal of muscle and joint health
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• v.26 no.2
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• pp.90-101
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• 2019

Purpose: This study was aimed to describe older adults' experiences of living with urinary incontinence and using diapers for its management in long-term care facilities. Methods: Qualitative data were collected through in-depth interviews with 22 participants in long-term care facilities. Content analysis was used to analyze the data. Results: Three themes and six categories were emerged. Participants navigated through those three categories as stages, including the initial stage of confronting the unacceptable reality, transitional stage of physical and emotional suffering, and adaptive stage of accepting the diaper usage as a part of life and hoping improvement. Six categories were feeling terrible with unavoidable use of diapers, being frustrated by nursing staff shortage and unsatisfactory care for urinary incontinence, physical discomfort from of wearing diapers and remaining unchanged, emotional difficulties due to using diapers, accepting and adapting to diaper usage as a part of life, hope for gender-specific quality care for urinary incontinence. Conclusion: The findings suggest that using diapers should not be mandatory to manage older adults' urinary incontinence in long-term care facilities. It is also critical to establish policies to address issues of nursing shortage and financial support for qualitative care to manage urinary incontinence in long-term care settings.

• Research in Community and Public Health Nursing
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• v.30 no.3
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• pp.295-306
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• 2019

Purpose: There has been a growing recognition that person-centered care enhances the quality of life of nursing home residents with dementia. This study was conducted to develop a person-centered dementia care online education program for direct care staff in long-term care facilities. Methods: Delphi method with expert group was used to validate contents. We developed 61 draft items based on literature review. Twenty experts participated in consecutive three round surveys including 5-point Likert scale questions and open-ended questions. Based on experts' opinions, the content validity ratio for content validity and the coefficient of variation for stability were calculated. Results: Three-round Delphi surveys and additional feedback from the expert panel established a consensus of core contents: 1) dementia (7 categories), 2) person-centered care (6 categories), 3) communication (8 categories), and 4) behavioral and psychological symptoms of dementia (6 categories). Specific sub-categories in each category were differentiated according to the job qualifications (65 sub-categories for registered nurses, 64 sub-categories for nursing aids, and 41 sub-categories for personal care workers). Conclusion: This delphi study identified person-centered dementia education curricula, in which the person-centered approach should be a key policy priority in Korean long-term care system. Now it is urgently needed to develop education programs utilizing online platforms that enable efficient and continuous learning for long-term care staff, which can contribute to behavior changes in the person-centered dementia care approach and improvement of care quality in long-term care facilities.