BACKGROUND AND OBJECTIVES

With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.

The study utilized a descriptive design using qualitative methods of data collection namely key informant interviews (KIIs) and focus group discussions (FGDs). Participating institutions and their designated representatives were purposively sampled as key informants. OPs and carers from select barangays in NCR and Region IVA participated in the FGDs. Guided by the interpretivism approach, thematic analysis was performed. A trained research assistant coded the FGD and KII transcripts through the Nvivo PRO plus software and verified by the first author. Themes were reviewed and validated by the multidisciplinary team.

A total of 15 KIIs and two FGDs were conducted. The participating institutions and organizations were found to have varied roles and initiatives relevant to LTC; from strategic planning, development of policies and standards of care, training and capacity-building, and up to the actual implementation of LTC services. Identified challenges include implementation issues, financial issues, lack of political and stakeholder support, OPs and familial issues, and lack of knowledge on LTC.

Participants shared their description on what LTC is, an LTC facility, and the conditions of those in LTC facility. OPs expressed their willingness to utilize LTC services and identified several factors related to their preferred LTC arrangements. Carers identified various topics related to taking care of OPs that they would like to learn.

The roles, initiatives, and awareness of relevant stakeholders, older persons, and carers towards LTC were found to greatly vary. Policy makers, health workforce, families, communities, and the older persons themselves should have a better understanding of longterm care before they can provide or utilize the system. With the current landscape of LTC provision, the country still has a long way to go in achieving the integrated continuum of LTC appropriate to promote healthy aging. Promoting awareness, integrating LTC in the current programs and services for older persons in the country, capacitating the formal and non-formal caregivers, and strengthening collaborations are recommended.

Further research on quantitative measures of readiness for long-term care with focus on the health system and in-depth studies on the varieties or models of long-term care are recommended.

Background and Objectives With the global population aging, there is an emerging need for access to quality longterm care (LTC) services. Many countries have developed LTC systems while others are at the infancy stage. This paper aimed to provide an overview of the country’s readiness for LTC based on the perspectives of relevant stakeholders. Specifically, it described the roles, initiatives, and challenges of relevant organizations and community leaders for LTC provision. It also described the older persons (OPs) and carers’ perspectives towards LTC including their awareness, capacity, and preferences.
Home Care Services ; Long-Term Care ; Nursing Homes ; Philippines

PURPOSE: The purpose of this study is to investigate the impact of transitional care by a nurse-led multidisciplinary team (MDT) on clinical outcomes and quality of life of patients with ankylosing spondylitis. METHODS: A randomized control study design was used. Subjects were allocated randomly to an experimental group and a control group. The experimental group received intensive transitional care by a nurse-led MDT, whereas the control group received routine nursing care. Disease activity, spinal mobility, comprehensive function, health service utilization, and quality of life were assessed at the baseline and at six months with the Bath Ankylosing Spondylitis Metrology Index, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), a health service utilization questionnaire and version 2 of the Short Form-36 health survey. RESULTS: Compared with the baseline, the BASDAI, BASFI, emergency visits, hospitalizations, hospitalization days, and bodily pain, vitality, mental health, total score, and average score of version 2 of the Short Form-36 health survey were improved in the experimental group (p < .05), whereas only bodily pain, vitality, and role-emotional were improved in the control group p < .05). At six months, the experimental group exhibited significantly more improvement on the BASDAI, BASFI, hospitalizations, all domains except Role-physical as well as total score and average score p < .05) compared with the control group. CONCLUSION: A MDT-based nurse-led transitional care improves clinical outcomes and quality of life of patients with ankylosing spondylitis. Future research should be carried out on modes of follow-up and family support.
Baths ; Emergencies ; Follow-Up Studies ; Health Services ; Health Surveys ; Hospitalization ; Humans ; Mental Health ; Nursing Care ; Patient Care Team ; Quality of Life ; Spondylitis, Ankylosing ; Transitional Care

OBJECTIVES: Home-based nursing care services have increased over the past decade. However, accountability and privacy issues as well as security concerns become more challenging during care provider visits. Because of the heterogeneous combination of mobile and stationary assistive medical care devices, conventional systems lack architectural consistency, which leads to inherent time delays and inaccuracies in sharing information. The goal of our study is to develop an architecture that meets the competing goals of accountability and privacy and enhances security in distributed home-based care systems. METHODS: We realized this by using a context-aware approach to manage access to remote data. Our architecture uses a public certification service for individuals, the Japanese Public Key Infrastructure and Health Informatics-PKI to identify and validate the attributes of medical personnel. Both PKI mechanisms are provided by using separate smart cards issued by the government. RESULTS: Context-awareness enables users to have appropriate data access in home-based nursing environments. Our architecture ensures that healthcare providers perform the needed home care services by accessing patient data online and recording transactions. CONCLUSIONS: The proposed method aims to enhance healthcare data access and secure information delivery to preserve user's privacy. We implemented a prototype system and confirmed its feasibility by experimental evaluation. Our research can contribute to reducing patient neglect and wrongful treatment, and thus reduce health insurance costs by ensuring correct insurance claims. Our study can provide a baseline towards building distinctive intelligent treatment options to clinicians and serve as a model for home-based nursing care.
Asian Continental Ancestry Group ; Certification ; Computer Security ; Delivery of Health Care ; Electronic Health Records ; Health Information Exchange ; Health Personnel ; Health Smart Cards ; Home Care Services ; Home Health Nursing ; Humans ; Information Dissemination ; Insurance ; Insurance, Health ; Methods ; Nursing ; Nursing Care ; Privacy ; Social Responsibility

PURPOSE: The aim of this study was to identify the relationship between gratitude disposition, organizational intimacy, and organizational well-being among nurses on comprehensive nursing service units. METHODS: This study was a descriptive correlation study. Participants were 150 nurses working in comprehensive nursing service units. Data were analyzed using SPSS 21.0 program. RESULTS: Gratitude disposition correlated positively with organizational intimacy (r=.53, p<.001) and organizational well-being (r=.59, p<.001). Gratitude disposition and organizational intimacy were factors affecting organizational well-being. CONCLUSION: The results of this study suggest organizational well-being can be increased by enhancing gratitude disposition and organizational intimacy. Further study is needed to develop and test for application, a gratitude and organizational intimacy promotion program for nurses on comprehensive nursing service units.
Nursing Services ; Nursing ; Statistics as Topic

PURPOSE: In this study, the hospice nursing research trend in 1998~2017 was investigated by analyzing research articles on hospice nursing. METHODS: Literature search was performed with keywords of ‘nursing’ and ‘hospice on an academic research information service. Also reviewed were all articles published in the Korean Journal of Nursing Science and its 8 subcategory journals, the Korean Journal of Hospice and Palliative Care and the Korean Hospice Association from 1998 through 2017, except thesis papers. RESULTS: In 2013~2017, 79 articles (31.0%) were relevant, up over 7% from 61 articles (23.9%) in 2008~2012. The most studied field was psychology (92 papers, 36.2%) in the Korean Journal of Hospice and Palliative Care. Enrolled in most papers were patients with end-stage cancer (75, 29.5%), which is overwhelmingly high. Most studies used quantitative methods (183, 72.0%). Recognition was the most studied theme (62, 24.4%), and 16 of them focused on recognition of death (6.3%). Intervention studies totaled 34 (13.4%), and most of them (7, 2.8%) were conducted for palliative education. CONCLUSION: Most hospice nursing studies were quantitative studies, conducted with patients, and hospice nursing intervention programs were similar to each other. Thus, more studies with hospice patients and their families are needed. And more experimental and qualitative studies are needed to build an evidence-based nursing study environment. Considering how most studies examined psychological factors, physiological factors such as pain, a major issue in hospice care, should be analyzed in experimental studies to construct a pain intervention program for hospice patients.
Education ; Evidence-Based Nursing ; Hospice and Palliative Care Nursing ; Hospice Care ; Hospices ; Humans ; Information Services ; Nursing Research ; Nursing ; Palliative Care ; Psychology

PURPOSE: This study was conducted to design services for improving the quality of care of hospitalized children with acute diseases.METHODS: The service design process had four phases: discovery, definition, development, and delivery. The participants were 23 mothers of hospitalized children with an acute disease, and seven nurses and three doctors working at a pediatric hospital. Data were collected through self-report questionnaires, in-depth interviews, and observations. The data were analyzed using content analysis and descriptive statistics.RESULTS: The participants reported needs for explanations about the treatment, skillful nursing, and environmental improvements. The concept of the services was familiarity and enjoyment, aimed at solving the problems of unfamiliarity and boredom. A six-guideline was presented for improving the quality of care of hospitalized children with acute diseases: improvement of awareness, development of educational materials, improvement of skills, environmental improvements, play activities, and evaluations of user satisfaction.CONCLUSION: These findings indicate that nursing services should deliver familiarity and enjoyment to hospitalized children and their families. The findings of this study emphasize that the service design methodology can be used to improve the quality of care of hospitalized children with acute diseases.
Acute Disease ; Boredom ; Child ; Child, Hospitalized ; Hospitals, Pediatric ; Humans ; Mothers ; Nursing ; Nursing Service, Hospital ; Nursing Services ; Quality of Health Care ; Recognition (Psychology)

PURPOSE: The role of registered nurses is expanding in scope as the healthcare paradigm shifts from acute, hospital-based care to community and population-based care. Given this paradigm shift, this study explores the legal aspects of the role of a registered nurse.METHODS: We used document analysis for extracting laws and legal orders related to nursing from the entirety of Korean law. Using textualism approach, we examined the contents utilizing a framework that was developed based on the role classification of community nurses by Clark in this study.RESULTS: A total of 119 items related to nursing were derived from 64 laws. Of these, 71.4 % can be performed by people in multiple types of occupations including nurses. As a result of analyzing required qualifications, 45.4% of 119 items required additional qualifications besides registered nurse license. Analysis of workplace and activity type demonstrated that 26.1% of the 119 items were related to medical institutions, with nurses performing mostly “Client-oriented role.” More than half (68.9%) were non-medical institutions, with nurses performing mostly “Delivery-oriented role.” Some, however, did not stipulate the nurse's roles clearly.CONCLUSION: Therefore, to match the enhanced scope and responsibilities of registered nurses and to appropriately recognize, guide, and hold these nurses accountable, laws and policy must reflect these changes. In doing so, these updated laws and policies will ultimately serve as a basis for improving the quality and safety of nursing services.
Classification ; Delivery of Health Care ; Humans ; Jurisprudence ; Legislation, Nursing ; Licensure ; Nurse's Role ; Nurses ; Nursing ; Nursing Services ; Occupations ; Republic of Korea

PURPOSE: The objective of this study was to investigate the patients' needs on integrated supportive service programs for the abortion women. METHODS: The 49 participants in this study were abortion experienced women in 2 infertility hospitals. Data were collected using a structure self-report questionnaire including medical treatment and nursing after abortion, symptom recognition and sexual problems after abortion, management in daily care after abortion and supportive system after abortion. RESULTS: Participants had an average score 3.54 for the need of medical treatment and nursing after abortion, 3.50 for the need of symptom recognition and sexual problems after abortion, 3.27 for the need of management in daily care after abortion and 3.28 for the need of supportive system after abortion. CONCLUSION: In order to effectively conduct integrated supportive service programs for the abortion women, it is necessary to understand appropriate nursing care for women after abortion.
Comprehensive Health Care ; Female ; Health Services Needs and Demand ; Humans ; Infertility ; Needs Assessment ; Nursing Care ; Nursing ; Pregnancy Complications

PURPOSE: The purpose of this study was to review the literature on intervention studies for abused children and adolescent in residential facilities in South Korea (ACARF-K). The goal was to understand the problems they experience, to evaluate the content and effectiveness of interventions applied to them, and to develop evidence-based nursing intervention programs. METHODS: We used four electronic databases to search for relevant articles. 18 studies according to Whittemore and Knafl's integrative review method to synthesize the literature. RESULTS: The ACARF-K experienced problems in biophysical, psychological, and sociocultural domains related to attachment impairment. Effective intervention strategies were building trust through empathy and fulfillment of needs, encouraging ACARF-K to express themselves and helping them to clarify emotions in an unthreatening environment, and improving their self-concept through activities in which they experienced achievement. CONCLUSION: Interventions are needed to help restore attachment damage among ACARF-K. The interventions in this study utilized emotional, cognitive, relational, and behavioral therapeutic tools to improve their psychological and social capacities. Future intervention programs for ACARF-K should include these key elements.
Adolescent ; Child Abuse ; Child Protective Services ; Child ; Domestic Violence ; Emergency Shelter ; Empathy ; Evidence-Based Nursing ; Group Homes ; Humans ; Korea ; Methods ; Residential Facilities