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Moon and Lee: Structural Equation Modeling on Case Management Outcomes and Factors Influencing Outcomes in the Community-dwelling Vulnerable Elders
Original Article

Journal of Korean Academy of Nursing 2013; 43(6): 791-800.

Published online: 31 December 2013

DOI: https://doi.org/10.4040/jkan.2013.43.6.791

Structural Equation Modeling on Case Management Outcomes and Factors Influencing Outcomes in the Community-dwelling Vulnerable Elders

Hyunjung Moon1, In-Sook Lee2

1Department of Nursing, Far East University, Eumseong, Korea.

2College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.

Address reprint requests to: Lee, In-Sook. College of Nursing, Seoul National University, 28 Yeongeon-dong, Chongro-gu, Seoul 110-799, Korea. Tel: +82-2-740-8828, Fax: +82-2-741-1574, lisook@snu.ac.kr

Received 1 September 2013       Accepted 20 November 2013

© 2013 Korean Society of Nursing Science

Abstract

Purpose

This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders.

Methods

Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0.

Results

The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect.

Conclusion

These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.

Keywords: Case management, Vulnerable population, Aged

Figures and Tables

Figure 1
Hypothetical model.
jkan-43-791-g001
Figure 2
Path diagram for the hypothetical model.
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Table 1
General and Health related Characteristics of the Participants (N=309)
jkan-43-791-i001

BSN=Bachelor of science in nursing; RN-BSN=Registered nurse to bachelor of science in nursing.

Table 2
Descriptive Statistics of the Observed Variables (N=309)
jkan-43-791-i002
Table 3
Effects of Predictive Variables on Endogenous Variables in the Model
jkan-43-791-i003

CMP=Case management practice; β=Standardized regression weight; C.R.=Critical ratio; SMC=Squared multiple correlation (R2).

*p<.05; †p<.01; ‡p<.001.

Notes

This manuscript is based on a part of the first author's doctoral dissertation from Seoul National University.

This study was supported by Sigma Theta Tau International, Honor Society of Nursing Lambda Alpha Chapter-at-Large (Korea) in 2011.

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