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.
Hypogonadism ; Insurance, Long-Term Care ; Long-Term Care ; Mitochondrial Diseases ; Morale ; National Health Programs ; Ophthalmoplegia ; Surveys and Questionnaires ; Statistics as Topic

PURPOSE: The purpose of this study was to examine nurses' cognition of the diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of the DRG system. METHOD: This study was a descriptive survey involving 161 nurses working in 12 long-term care hospitals located in Gwangju city and Chonnam area. Data were analyzed using the SPSS 18.0 version program. Data analyses utilized descriptive test, chi-square test, Fisher's exact probability test, t-test, and one-way ANOVA. RESULT: There was no change in cognition of DRG in 55.3% of the nurses, and 26.1% takes to 'change positively'. More than half of the respondents (57.8%) agreed to the application of DRG. After application of DRG, the nurses responded 'there were changes in nursing care' in 23 of the 25 care items. Two items had an increase in nursing care. CONCLUSIONS: No distinct changes in nursing care were evident after DRG application. Therefore, there is need to provide education programs related to DRG for nurse in long-term care hospitals.
Cognition ; Surveys and Questionnaires ; Diagnosis-Related Groups ; Long-Term Care ; Nursing Care ; Statistics as Topic

PURPOSE: This study was attempted to provide quality improvement and revitalization of visiting nurse services by Importance-Performance Analysis of persons being provided with the services. METHODS: The subjects were 350 people being provided with visiting nurse services from a long term home care institution in the kangwon Province during the period of data collection between Aug. 16 and Sep. 15, 2011. Data analysis was conducted through t-test, ANOVA, and IPA by using the SPSS/WIN 12.0 program. RESULTS: As a result of the Importance-Performance Analysis of visiting nurse services, it turned out that the strength on reliability, assurance, and empathy should be maintained with good work and the aspects of responsiveness appeared to be intensively improved, and the tangibility proved to be subject to improvement. CONCLUSION: For the activation of visiting nurse services, methods for improving the performance in the intensive care area and management strategy establishment which highlights the advantages of strength maintenance area are needed.
Community Health Nursing* ; Data Collection ; Empathy ; Home Care Services ; Humans ; Insurance, Long-Term Care* ; Critical Care ; Long-Term Care* ; Quality Improvement ; Statistics as Topic

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, χ² 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 (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.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.
Adult* ; Caregivers* ; Cognition ; Delivery of Health Care ; Depression ; Home Care Services* ; Humans ; Insurance, Long-Term Care ; Korea ; Long-Term Care ; Nurses, Community Health ; Social Control, Formal ; Statistics as Topic

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 (β=.42, p<.001), exposure to noise in the evening noise (β=−.20, p=.014), and gender (β=.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.
Behavioral Symptoms ; Caregivers ; Dementia* ; Depression ; Humans ; Korea ; Long-Term Care ; Noise ; Nursing ; Residential Facilities ; Statistics as Topic

PURPOSE: The purposes of this study were to assess the oral health knowledge of nursing staff in long-term care institutions and to identify predictors of oral health knowledge. METHOD: For this descriptive correlation study, a self-administered and structured questionnaire was used. Respondents were 111 nursing staff in two long-term care facilities and two long-term care hospitals located in G metropolitan area and C province in the Southern part of Korea. Descriptive statistics, t-test or ANOVA, and stepwise multiple regression analysis were used to analyze the data. RESULTS: Participants in this study did not have many opportunities to learn about oral health care for elders in long-term care institutions. The percentage of correct answer for oral health knowledge questionnaire was 64.5%. Predictors of oral health knowledge among nursing staffs were education on oral health in long-term care institutions, type of institution, and length of time working with elders. These three variables accounted for 24.2% of variance in oral health knowledge. CONCLUSIONS: Nursing staffs should make an effort to improve their knowledge of oral health. Moreover, oral health educational program for nursing staffs working with elders in long-term care institution is need to be developed and the effectiveness of this education needs to be evaluated.
Aged ; Surveys and Questionnaires ; Humans ; Korea ; Long-Term Care ; Nursing Staff ; Oral Health ; Statistics as Topic

OBJECTIVES: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). METHODS: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The mean scores of QOL among all the subjects was 55.4 +/- 15.62 (Grade I: 49.7 +/- 14.17, Grade II: 56.8 +/- 14.62, Grade III: 59.4+/-16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). CONCLUSIONS: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).
Activities of Daily Living/psychology ; Aged ; Depression/psychology ; Female ; *Health Status ; Humans ; Insurance, Long-Term Care/*statistics & numerical data ; Long-Term Care/*psychology/*statistics & numerical data ; Male ; *Mental Health ; Quality of Life/*psychology ; Residence Characteristics ; Socioeconomic Factors

PURPOSE: The purpose of this study was to investigate empathy ability, communication, and nursing performance among registered nurses (RN) and nursing assistants (NA) in long-term care hospitals. METHODS: Participants were 155 nursing personnel (RN 80 and AN 75) who worked in 8 long-term care hospitals in G city and J Province. Data collection was conducted from July 6 to August 6, 2016. Descriptive statistics, independent t-test, one-way ANOVA, and stepwise multiple regression were used with SPSS/WIN program version 23.0 for data analysis. RESULTS: Nursing performance of RN was significantly influenced by communication ability (β=.88, p<.001) and university graduation (β=.25, p=.025). Nursing performance of NA was influential by communication ability (β=.77, p<.001) and marriage (β=.42, p=.018). CONCLUSION: Findings show that communication ability of RN and NA is important in nursing performance. Therefore, there is a need to develop programs to improve communication ability and validate the effectiveness of the programs in improving nursing performance of nursing personnel working at long-term care hospitals.
Communication* ; Data Collection ; Empathy* ; Humans ; Long-Term Care* ; Marriage ; Nurses' Aides ; Nurses* ; Nursing* ; Statistics as Topic ; Task Performance and Analysis

BACKGROUND: Physical activity (PA) is critical for maintaining the health and well-being of older people in community and also institutional settings. The purpose of this study was to examine the current status of PA and related individual and organizational factors among older nursing home residents with and without dementia. METHODS: This is a secondary data analysis study of a nationwide survey of 92 long-term care facilities in Korea, and the study sample includes older residents with dementia (n=753) and without dementia (n=480). The level of PA was measured by PA time and whether or not residents had an outdoor activity over the past 3 days. Multi-variate, multi-level analyses were conducted. RESULTS: More than half of the sample in both groups had no or less than 1 hour of PA. About one out of four older people in our sample had no outdoor activity over the past 3 days regardless of whether or not they had dementia. Among the people without dementia, several individual-level factors were associated with PA, including dependency for activities of daily living, social activity participation, and caregivers' belief in the functional improvement of residents. Unlike the non-dementia group, individual- and organizationallevel factors including staffing level and having the relevant equipment for PA were associated with PA among those with dementia. CONCLUSION: Study findings provide evidence on the lack of PA among older nursing home residents, and the importance of institutional capacity with regard to human resources and physical equipment for promoting PA among people with dementia, in particular. Policies and supports are needed to promote the implementation of healthy aging programs including PA for older nursing home residents. Such programs should be person-centered with consideration to the physical and cognitive status of individual residents.
Activities of Daily Living ; Aging ; Dementia ; Humans ; Korea ; Long-Term Care ; Motor Activity ; Nursing Homes ; Nursing ; Statistics as Topic

BACKGROUND: Preventing the need for long-term care (LTC) by identifying physical function risk factors are important to decrease the LTC burden. The objective of this study was to investigate whether grip strength and/or walking speed, which are components of the frailty definition, are associated with LTC in community-dwelling older and oldest people. METHODS: The participants were 1098 community-dwelling older and oldest people who had not received LTC at the baseline. The endpoint was receiving LTC after the baseline survey. The independent variables were grip strength and walking speed, and participants were divided into two groups based on these variables. The confounding factors were age, sex, the Japanese version of the Montreal Cognitive Assessment (MoCA-J), hypertension, diabetes mellitus, stroke, joint diseases, living alone, body mass index, and serum albumin. We calculated the hazard ratio of receiving LTC using the Cox proportional hazard model. RESULTS: Among the 1098 participants, 107 (9.7%) newly received LTC during the follow-up. Regarding the physical function, only slow walking speed was significantly correlated with LTC after adjusting for all confounding factors except the MoCA-J score (HR = 1.74, 95% CI = 1.10-2.75, P = .018). However, slow walking speed was still a risk factor for LTC after adjusting for the MoCA-J score and other confounding factors (HR = 1.64, 95% CI = 1.03-2.60, P = .037). CONCLUSIONS The findings from this study may contribute to a better understanding of slow walking speed as a factor related to LTC, which might be a criterion for disability prevention and could serve as an outcome measure for physical function in older people.
Aged ; Aged, 80 and over ; Exercise ; Female ; Humans ; Independent Living ; statistics & numerical data ; Japan ; Long-Term Care ; statistics & numerical data ; Male ; Proportional Hazards Models