Aged ; Dental Health Services ; standards ; Health Services for the Aged ; standards ; Humans ; Nursing Homes ; Oral Health ; Singapore

To construct a competency model for junior caregivers for the elderly and to provide a reference for the selection, evaluation and training for the junior caregivers for the elderly.
 Methods: Firstly, we drafted the primary competency model for junior caregivers for the elderly through literature review. Then, we used Delphi method to carry out 2 rounds of questionnaire survey for 20 experts to optimize the indicators for primary model. The weight of each indicator is determined by analytic hierarchy process (AHP) and expert sequencing method.
 Results: The effective recovery rates of the two-round questionnaire were 87% and 100%, respectively. The expert authority coefficient was 0.70-0.93, and the average authority coefficient was 0.80. The final version of the competency model for junior caregivers for the elderly included 4 first-grade indexes, 11 second-grade indexes and 37 third-grade indexes.
 Conclusion: The competency model for the junior caregivers for the elderly is reliable and can be used as the reference standard for the selection, evaluation and training for the junior caregivers for the elderly.
Aged ; Caregivers ; standards ; Clinical Competence ; Delphi Technique ; Health Services for the Aged ; standards ; Humans ; Medical Staff, Hospital ; standards ; Reference Standards ; Surveys and Questionnaires

Adult ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; standards ; Male ; Middle Aged ; Occupational Health ; statistics & numerical data ; Occupational Health Services ; standards ; Young Adult

PURPOSE: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. METHODS: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. RESULTS: The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. CONCLUSION: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Health Services for the Aged/standards ; Hospitals ; Humans ; Long-Term Care/*standards ; Male ; Outcome Assessment (Health Care) ; Prevalence ; *Quality of Health Care ; Urinary Incontinence/*therapy

PURPOSE: The purpose of this study was to evaluate the service satisfaction for families who have someone with mental illness, and are using community mental health centers in Gyeonggi Province. METHODS: The participants in this study were 796 family members. Data were collected using Family satisfaction survey questionnaire developed by the author (23 items on family service and 15 items on client service). RESULTS: The total satisfaction level for the service with family and client resulted in above average scores. Of the 23 service items, data showed the highest level of satisfaction was with professional skills and attitude, and day rehabilitation programs, and the lowest for professional activities for advocacy and social welfare benefits, emergency & crisis intervention, medical expense subsidies. Of the 15 service items, job and housing related service had the lowest level of satisfaction. CONCLUSION: It is recommended that psychiatric emergency & crisis intervention programs and system development be accelerated. Also, there is a need to develop medical expense subsidy programs for older family caregivers, job and housing focused rehabilitation programs and community facilities for the client, as well as more active and powerful professional advocate activities for persons who have mental disabilities and their families.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Attitude of Health Personnel ; Caregivers/economics/*psychology ; Community Mental Health Services/*standards ; Female ; Health Services Needs and Demand ; Humans ; Male ; Middle Aged ; *Personal Satisfaction ; Questionnaires

PURPOSE: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. METHODS: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). RESULTS: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (beta=-.533) was the most significant predictor of nursing service need. CONCLUSION: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Geriatric Assessment ; *Health Services Needs and Demand ; Health Status ; Humans ; Interviews as Topic ; Male ; *Needs Assessment ; *Nursing Homes ; *Nursing Services/standards ; Predictive Value of Tests ; Quality of Health Care ; Questionnaires

PURPOSE: This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds. METHOD: The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale. RESULT: There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was 'the responsiveness', and in the perceived performance, the highest was the 'assurance'. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction. CONCLUSION: To improve the nursing service quality at small-medium hospitals, strengthening the 'assurance' factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.
Adolescent ; Adult ; Attitude of Health Personnel ; Female ; Hospital Bed Capacity ; *Hospitals, General ; Humans ; Korea ; Male ; Middle Aged ; Nursing Services/*standards ; Nursing Staff, Hospital/*psychology ; *Patient Satisfaction ; *Quality of Health Care

OBJECTIVE: To obtain scores in a community-dwelling population over 60 using the SF-36, to assess the reliability and validity of this general health questionnaire, and to analyze the difference in dimension scores among the elderly Chinese in Changsha. METHODS: We randomly selected 602 elders, aged 60 to 91 years, in multi-phases. All the subjects had resided in Changsha for at least one year. The reliability of the SF-36 was assessed by split-half reliability and Cronbach's alpha coefficient and the validity through factor analysis and correlation analysis, etc. The dimension scores of different people were obtained by analysis of variance and independent-samples t-test. RESULTS: The split-half reliability was 0.72 and the Cronbach's alpha coefficients of all the 8 dimensions were more than 0.8; the Pearson correlate coefficients of all the items to their dimensions were more than 0. 59. SF-36 contained 8 domains and 2 summary scales in the factor analysis. Health-related quality was different in different elders. CONCLUSION The SF-36 is practical in studying the quality of life among community-dwelling elders.
Aged ; Aged, 80 and over ; Community Health Services ; Female ; Geriatric Assessment ; Humans ; Male ; Middle Aged ; Quality of Life ; Reproducibility of Results ; Sampling Studies ; Surveys and Questionnaires ; standards

OBJECTIVES: This study aimed to develop a health needs assessment (HNA) tool for persons with brain disorders and to assess the unmet needs of persons with brain disorders using the developed tool. METHODS: The authors used consensus methods to develop a HNA tool. Using a randomized stratified systematic sampling method adjusted for sex, age, and districts, 57 registered persons (27 severe and 30 mild cases) with brain disorders dwelling in Seoul, South Korea were chosen and medical specialists investigated all of the subjects with the developed tools. RESULTS: The HNA tool for brain disorders we developed included four categories: 1) medical interventions and operations, 2) assistive devices, 3) rehabilitation therapy, and 4) regular follow-up. This study also found that 71.9% of the subjects did not receive appropriate medical care, which implies that the severity of their disability is likely to be exacerbated and permanent, and the loss irrecoverable. CONCLUSIONS: Our results showed that the HNA tool for persons with brain disorders based on unmet needs defined by physicians can be a useful method for evaluating the appropriateness and necessity of medical services offered to the disabled, and it can serve as the norm for providing health care services for disabled persons. Further studies should be undertaken to increase validity and reliability of the tool. Fundamental research investigating the factors generating or affecting the unmet needs is necessary; its results could serve as basis for developing policies to eliminate or alleviate these factors.
Adult ; Aged ; Brain Diseases/*physiopathology ; Disabled Persons/rehabilitation/*statistics & numerical data ; Female ; Health Services Needs and Demand/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Needs Assessment/*standards

INTRODUCTIONAssertive Community Treatment (ACT) provides community-based treatment to patients with severe and persistent psychiatric illnesses, so that they may continue to live and function in the community as they receive psychiatric care. This study aimed to examine the effects of ACT on the outcome of patients over a 1-year period in an Asian population.

MATERIALS AND METHODSThis naturalistic and retrospective cohort study examined the effects of ACT on 100 patients who had completed 1 year of ACT. Parameters used to measure primary outcome were i) number of admissions (NOA) and ii) total length of stay (LOS) in days. Secondary outcome compared the employment status of patients before and after ACT. Paired sample analyses were performed using SPSS.

RESULTS AND DISCUSSIONThe mean reduction in NOA 1 year post-ACT was 57.1%. The mean reduction in LOS 1 year post-ACT was 61.9%. The median reduction for NOA and LOS were both statistically significant (P <0.01). Thirty-seven patients were employed compared to 6 before the programme, a statistically significant effect on employment (odds ratio 9.69, P <0.01).

CONCLUSIONSACT appears effective in reducing the frequency and duration of admissions for patients in Singapore. The employment status of patients also showed improvement over the course of study.

Adult ; Cohort Studies ; Community Mental Health Services ; methods ; standards ; Community Psychiatry ; standards ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders ; therapy ; Middle Aged ; Outcome Assessment (Health Care) ; methods ; Retrospective Studies ; Severity of Illness Index ; Singapore ; Social Adjustment