PURPOSE: The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. METHODS: Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. RESULTS: Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. CONCLUSION: The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea.
Case Management* ; Cooperative Behavior ; Focus Groups ; Hospitalization* ; Humans ; Korea* ; Nursing ; Qualitative Research ; Vulnerable Populations

PURPOSE: This study was conducted to identify activities of daily living, depression and self-rated health and related factors for Korean Elderly. METHODS: Data from the survey for the Korean Longitudinal Study of Aging in 2010 were used. The data were analyzed using frequencies, weighted proportions, and hierarchical multiple logistic regression. RESULTS: Significant difference was observed in health status induced by socioeconomic status between men and women, but not among age groups. Socioeconomic status was strongly associated with self-rated health among male and female elders. Being unschooled and low net family asset were significantly related with dependency in activities of daily living and depressive symptoms among men. Only low net family asset was significantly related with depressive symptoms among women. Family support provides a slight decrease to the negative relationship between socioeconomic status and health status, especially depressive symptoms. CONCLUSION: This study suggests that interventions to reduce health inequalities should target elderly with lower socioeconomic status and with poor family support, using a gender-specific approach.
Activities of Daily Living* ; Aged* ; Aging ; Depression* ; Female ; Health Status Disparities ; Humans ; Logistic Models ; Longitudinal Studies ; Male ; Social Class* ; Socioeconomic Factors

PURPOSE: The purpose of this study was to integrate and synthesize findings from qualitative studies exploring male students' experiences of adapting to nursing education programs so as to obtain further understanding of the phenomenon. METHODS: The meta-synthesis process was primarily guided by Noblit and Hare's approach, which consists of four stages including searching, appraisal of an individual study's quality, data extraction for analysis, and meta-synthesizing the results. RESULTS: Findings from the literature reviewed were synthesized into six themes: 1) extraordinary choice based on job stability and gender scarcity; 2) unexpected feeling of marginalization as minority far apart from the mainstream; 3) assimilation and negotiation for relational adaptation through perspective shift; 4) fortifying the vision and identity as nursing students by meaning making for adapting to the nursing major; 5) mutual support among colleague male students; and 6) serving in the military as way of hiding out and achieving maturation. CONCLUSION: The findings illustrate that nursing education programs need practical changes promoting male students' adaptation to the program itself as well as preparation to be a professional nurse in the future.
Data Accuracy ; Education, Nursing* ; Humans ; Male* ; Military Personnel ; Negotiating ; Nursing* ; Qualitative Research ; Students, Nursing

PURPOSE: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. METHODS: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). RESULTS: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. CONCLUSION: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.
Caregivers ; Dementia* ; Diagnosis ; Emigrants and Immigrants ; Humans ; Methods ; Qualitative Research ; Shock