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Factors Impacting the Physical Function of Older Adults in Korean Long-Term Care Hospitals

  • Lee, Ji-Yun (Department of Nursing, Kangwon National University) ;
  • Kim, Eun-Young (Department of Nursing, Dong-A University) ;
  • Cho, Eun-Hee (Nursing Policy Research Institute, College of Nursing, Yonsei University)
  • Received : 2011.05.03
  • Accepted : 2011.12.19
  • Published : 2011.12.30

Abstract

Purpose: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. Methods: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. Results: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. Conclusion: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

Keywords

References

  1. Ang, Y. H., Au, S. Y. L., Yap, L. K. P., & Ee, C. H. (2006). Functional decline of the elderly in a nursing home. Singapore Medical Journal, 47, 219-224.
  2. Barberger-Gateau, P., Fabrigoule, C., Amieva, H., Helmer, C., & Dartigues, J. F. (2002). The disablement process: A conceptual framework for dementia-associated disability. Dementia & Geriatric Cognitive Disorders, 13(2), 60-66. doi: 10.1159/000048635
  3. Bostick, J. E., Rantz, M. J., Flesner, M. K., & Riggs, C. J. (2006). Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association, 7(6), 366-376. doi: 10.1016/j.jamda.2006.01.024
  4. Buttar, A., Blaum, C., & Fries, B. (2001). Clinical characteristics and six-month outcomes of nursing home residents with low activities of daily living dependency. The Journals of Gerontology, 56A(5), M292-M297.
  5. Centers for Medicare and Medicaid Services. (2001). Report to congress: Appropriateness of minimum nurse staffing ratios in nursing homes. Phase II Final report. Baltimore, MD: Author.
  6. Cho, S. H., Hwang, J. H., & Kim, J. Y. (2008). Nurse staffing and patient mortality in intensive care units. Nursing Research, 57, 322-330. doi: 10.1097/01.NNR.0000313498.17777.71
  7. Cohen, J. (1998). Statistical power analysis for the behavioral science (2nd ed.). New Jersey: Lawrence Erlbaum Associates.
  8. Collier, E., & Harrington, C. (2008). Staffing characteristics, turnover rates, and quality of resident care in nursing facilities. Research in Gerontological Nursing, 1, 157-170. doi: 10.3928/00220124-20091301-03
  9. Harrington, C., Woolhandler, S., Mullan, J., Carrillo, H., & Himmelstein, D. U. (2001). Does investor ownership of nursing homes compromise the quality of care? American Journal of Public Health, 91, 1452-1455. https://doi.org/10.2105/AJPH.91.9.1452
  10. Hong, S. P., Yi, J. J., & Yi, S. W. (2007). A factors related to activities of daily living (ADL) among patients in geriatric hospitals. Journal of Korean Society of Occupational Therapy, 15(2), 79-89.
  11. Horn, S. D., Buerhaus, P., Bergstrom, N., & Smout, R. J. (2005). RN staffing time and outcomes of long-stay nursing home residents: Pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care. American Journal of Nursing, 105(11), 58-70; quiz 71. https://doi.org/10.1097/00000446-200511000-00028
  12. Kim, E. K., Chang, H. S., Oh, J. H., & Bae, S. K. (2003). Reserch on the actual condition and operation plan of long-term care hospitals. Seoul: Korean Health Industry Development Institute.
  13. Kim, S. M., Park, J. Y., & Han, C. H. (2010). Influential factors on rehabilitation exercise practice in elderly limited activities of daily-living: An analysis based on the theory of planned behavior. Journal of Korea Contents Society, 10, 271-281. https://doi.org/10.5392/JKCA.2010.10.3.271
  14. Korea Development Institute. (2010). Challenges of the long-term care insurance. Symposium conducted at the meeting of the Korea Development Institute. Seoul: Author.
  15. Korea Ministry of Goverment Legislation. (2010). Medical treatment law. Retrieved December 1, 2010, from http://www.law.go.kr/main.htm
  16. Korea National Statistical Office. (2011). Estimated population by age. Retrieved July 1, 2011, from http://kosis.kr/themes/themes_02List.jsp# jsClick
  17. Lee, C. I., Park, D. M., & Park, R. J. (2005). The effect of muscle enforcement exercise program on posture balance of the institution old. Journal of Dae-gu University, 1, 539-565.
  18. Lee, J., & Rantz, M. J. (2008). Admission factors influencing activities of daily living in nursing home residents admitted from acute care hospitals. Journal of Korean Gerontological Nursing, 10(1), 68-76.
  19. Lee, J. Y., Yoon, J. Y., & Jang, S. R. (2008). A study of validity and reliability of a patient assessment instrument for long-term care hospitals. Journal of Korean Gerontological Nursing, 10(1), 7-19.
  20. Lee, J. Y., Yoon, J. Y., Kim, A. R., & Kim, C. M. (2008). Development of quality management system and indicators of long term care hospitals. Seoul: Health Insurance Review and Assessment Service.
  21. Lee, S. H. (2009). Multi-level analysis of factors related to quality of services in long-term care hospitals. Journal of Korean Academy of Nursing, 39, 409-421. doi: 10.4040/jkan.2009.39.3.409
  22. Lee, S. Y., Park, E. K., Yoon, J. Y., & Song, S. H. (2007). The current status of long-term care hospital. Seoul: Health Insurance Review & Assessment Service.
  23. McCusker, J., Cole, M., Dendukuri, N., Belzile, E., & Primeau, F. (2001). Delirium in older medical inpatients and subsequent cognitive and functional status: A prospective study. Canadian Medical Association Journal, 165, 575-583.
  24. Moineddin, R., Matheson, F. I., & Glazier, R. H. (2007). A simulation study of sample size for multilevel logistic regression models. BMC Medical Research Methodology, 7, 1-10. doi: 10.1186/1471-2288-7-34
  25. Morris, J. N., Murphy, K., & Nonemaker, S. (2004). RAI-FC assessment manual version 2.0. Baltimore: Center for Medicare and Medicaid Services.
  26. Peres, K., Verret, C., Alioum, A., & Barberger-Gateau, P. (2005). The disablement process: Factors associated with progression of disability and recovery in French elderly people. Disability & Rehabilitation, 27(5), 263-276. doi: 10.1080/ 09638280400006515
  27. Phillips, C. D., Shen, R., Chen, M., & Sherman, M. (2007). Evaluating nursing home performance indicators: An illustration exploring the impact of facilities on ADL change. The Gerontolotist, 47, 683-689. https://doi.org/10.1093/geront/47.5.683
  28. Rantz, M. J., Hicks, L., Grando, V., Petroski, G. F., Madsen, R. W., Mehr, D. R., et al. (2004). Nursing home quality, cost, staffing, and staff mix. Gerontologist, 44(1), 24-38. doi: 10.1093/geront/44.1.24
  29. Spilsbury, K., Hewitt, C., Stirk, L., & Bowman, C. (2011). The relationship between nurse staffing and quality of care in nursing homes: A systematic review. International Journal of Nursing Studies, 48, 732-750. doi: 10.1016 /j.ijnurstu.2011.02.014 https://doi.org/10.1016/j.ijnurstu.2011.02.014
  30. Wu, A. W., Yasui, Y., Alzola, C., Galanos, A. N., Tsevat, J., Phillips, R. S., et al. (2000). Predicting functional status outcomes in hospitalized patients aged 80 years and older. Journal of the American Geriatrics Society, 48(5 Suppl), S6-S15. https://doi.org/10.1111/j.1532-5415.2000.tb03142.x

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