Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

Yeon-Hwan Park; Hwal Lan Bang; Ga Hye Kim; Seieun Oh; Young-Il Jung; Hongsoo Kim

doi:10.7469/kjan.2015.27.4.418

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Park, Bang, Kim, Oh, Jung, and Kim: Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

Original Article

Korean J Adult Nurs 2015;27(4):418-427.

Published online: NaN August 2015

DOI: https://doi.org/10.7469/kjan.2015.27.4.418

Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

Yeon-Hwan Park¹, Hwal Lan Bang², Ga Hye Kim¹, Seieun Oh³, Young-Il Jung⁴, Hongsoo Kim⁴

^¹College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul

^²Department of Nursing, College of Industry, Sangmyung University, Cheonan

^³Department of Nursing, College of Health Sciences, Dankook University, Cheonan

^⁴Graduate School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, Korea

Corresponding author: Kim, Hongsoo Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-752, Korea. Tel: +82-2-880-2723, Fax: +82-2-762-9105, E-mail: hk65@snu.ac.kr

Received 11 May 20158 July 2015 Accepted 14 July 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents.

Methods

A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014.

Results

The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'.

Conclusion

The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents.

Keywords: Aged, Nursing homes, Health, Health services

REFERENCES

1.Sunoo D. Quality evaluation of long-term care facilitation in Korea: results and implications. Seoul: Korea Institute for Health and Social Affairs;2014. p. 1–8.

2.Lee TW., Cho E., Ko YK., Whang Y., Kim BN., Lim ES, et al. Development of the quality indicators in long term care service. Journal of Korean Academy of Nursing Administration. 2012. 18(1):106–17.

3.Lee Y., Kim S. A study on the systematization of service quality management system of long-term care (LTC). Korea Institute for Health and Social Affairs. 2012. 32(4):66–93.

4.Kwon S. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy and Planning. 2009. 24(1):63–71. http://dx.doi.org/10.1093/heapol/czn037.

5.Saltman RB., Dubois HF., Chawla M. The impact of aging on long-term care in Europe and some potential policy responses. International Journal of Health Services. 2006. 36(4):719–46.

6.OECD. Long-term care for older people [Internet]. 2005. Paris: OECD Publishing;2005. [cited 2015 August 16]. Available from:. http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/long-term-care-for-older-people_9789264015852-en#page1.

7.Yoo H-J. Characteristics of senile diseases: geriatric syndromes. Korean Journal of Medicine. 2009. 77(4s):S1073–6.

8.Lee K., Im M. A study on the level of demand for nursing service for the old people resident in the nursing home. Nursing Science. 2002. 14(2):45–56.

9.Boorsma M., Langedijk E., Frijters DH., Nijpels G., Elfring T., van Hout HP. Implementation of geriatric assessment and decision support in residential care homes: facilitating and impeding factors during initial and maintenance phase. BMC Health Services Research. 2013. 13(8):1–9. http://dx.doi.org/10.1186/1472-6963-13-8.

10.Kim Y., Lee J., Kim H., Hwang J. A comparison of nursing problems identified through RAI-FC and by nurses caring for nursing home residents. Journal of Korean Gerontological Nursing. 2011. 13(1):58–68.

11.Lee TW., Chung J. Structural factors influencing the quality management activities in nursing homes. Journal of Korean Academy of Nursing Administration. 2010. 16(2):162–71.

12.Morgan DL. Focus groups as qualitative research. Sage;1997.

13.Krueger RA. Focus groups: a practical guide for applied research. Sage;2009.

14.Braun V., Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006. 3(2):77–101. http://dx.doi.org/10.1191/1478088706qp063oa.

15.Hsieh H-F., Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005. 15(9):1277–88. http://dx.doi.org/10.1177/1049732305276687.

16.Weman K., Kihlgren M., Fagerberg I. Older people living in nursing homes or other community care facilities: registered nurses' views of their working situation and co-operation with family members. Journal of Clinical Nursing. 2004. 13(5):617–26. http://dx.doi.org/10.1111/j.1365-2702.2004.00906.x.

17.Kwon YJ. The 2 years experience and vision of long-term care system: seeking direction for performance oriented development of long term care insurance. The symposium of second anniversary of long term care insurance. Seoul: Ministry of Health and Welfare;2010.

18.Murphy K. Nurses' perceptions of quality and the factors that affect quality care for older people living in long-term care settings in Ireland. Journal of Clinical Nursing. 2007. 16(5):873–84. http://dx.doi.org/10.1111/j.1365-2702.2006.01633.x.

19.Rapp MP. Opportunities for advance practice nurses in the nursing facility. Journal of the American Medical Directors Association. 2003. 4(6):337–43. http://dx.doi.org/10.1097/01.jam.0000095253.60570.43.

20.June KJ., Lee JY., Yoon JL. Effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health services for older people. Journal of Korean Academy of Nursing. 2009. 39(3):366–75. http://dx.doi.org/10.4040/jkan.2009.39.3.366.

21.Sunoo D., Kim CW., Im HY., Kim SO., Seo DM., Yang YA, et al. Public long-term care insurance for the elderly in Korea: status and challenges. Seoul: Elderly Information Center;2012.

22.Boorsma M., Frijters DH., Knol DL., Ribbe ME., Nijpels G., van Hout HP. Effects of multidisciplinary integrated care on quality of care in residential care facilities for elderly people: a cluster randomized trial. Canadian Medical Association Journal. 2011. 183(11):E724–32. http://dx.doi.org/10.1503/cmaj.101498.

23.Harrington C., Zimmerman D., Karon SL., Robinson J., Beutel P. Nursing home staffing and its relationship to deficiencies. Journals of Gerontology: Social Sciences. 2000. 55(5):S278–87.

24.Kim H., Jung YI., Sung M., Lee JY., Yoon JY., Yoon JL. Reliability of the interRAI long term care facilities (LTCF) and interRAI home care (HC). Geriatrics & Gerontology International. 2015. 15:220–8. http://dx.doi.org/10.1111/ggi.12330.

25.Boumans NP., Berkhout AJ., Vijgen SM., Nijhuis FJ., Vasse RM. The effects of integrated care on quality of work in nursing homes: a quasi-experiment. International Journal of Nursing Studies. 2008. 45(8):1122–36. http://dx.doi.org/10.1016/j.ijnurstu.2007.09.001.

26.Ryden MB., Snyder M., Gross CR., Savik K., Pearson V., Krich-baum K, et al. Value-added outcomes: the use of advanced practice nurses in long-term care facilities. The Gerontologist. 2000. 40(6):654–62.

27.Park HU. Nurses' knowledge and attitude toward the elderly in medical welfare facilities for old people. [master's thesis]. Gwangju: Chonnam National University;2007.

28.Dellefield ME. Implementation of the resident assessment ins-trument/minimum data set in the nursing home as organization: implications for quality improvement in RN clinical assessment. Geriatric Nursing. 2007. 28(6):377–86. http://dx.doi.org/10.1016/j.gerinurse.2007.03.002.

Table 1.

Identified Themes by the Focus Group Interviews

Theme	Sub theme
Minimal health care services that left personal care needs unmet	- Stereotyped and fragmented care by types of care providers
	- Medically-oriented health care services
	- Health care services mixed with social or recreational programs
Barriers to proper and timely care in nursing homes	- Unmet care needs due to cognitive dysfunction or lack of expression
	- Care guides or tools not suitable for long-term care facilities
	- Health care needs that are beyond the facility's care boundary
	- Care delay due to lack of understanding on the older adult's status

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