• Korean Journal of Child Studies
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• v.33 no.1
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• pp.93-109
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• 2012

The purpose of this study is to explore how children aged four, in institutional care, perceive and express basic emotions, such as happiness, sadness, anger, surprise, through a role play program using dolls. This study selected two children who were both aged four years old and are currently in child institutional care. The children were observed during six role play trials using dolls and were questioned after the trials. The results were : 1) The children aged four in institutional care best perceived and expressed the emotion of happiness. 2) The children aged four in institutional care were able to positively change their feelings of sadness and expressive behavior through the intimate relationships they formed with the researcher. 3) The children aged four in institutional care expressed the emotion of anger throughout the entire role play using dolls and were positively changed the instructions and coaching given by the researcher. 4) The children aged four in institutional care had the most difficulty in expressing the emotion of surprise. The results of this study could be used as basic data for creating a program intended to help children aged four in institutional care develop their emotions.

• Journal of Families and Better Life
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• v.23 no.1 s.73
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• pp.19-29
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• 2005

The purpose of this study was to investigate ego-resilience and social adaptability of the children and adolescents in institutional care. The study also investigated the protective factors and the risk factors on ego-resilience and social adaptability and their relationship. The subjects in this study were 140 children and adolescents in institutional care. The research data were analyzed using Frequency, Pearson's Correlation, Stepwise Multiple Regression Analysis and T-Test in SPSS WIN 10.0 program. The major findings were as follows. First, ego-resilience of the children and adolescents in institutional care was related to locus of control, depression and anxiety and unsatisfaction of institutional care. Result of stepwise multiple regression analysis showed that depression and anxiety and locus of control in the order had significant effects on ego-resilience. Second, social adaptability of the children and adolescents in institutional care was related to social support and parent-child bond. Unsatisfaction of institutional care and social support in the order had significant effects on social adaptability by stepwise multiple regression analysis. Third, the children and adolescents who had higher level of ego-resilience reported better social adaptability. The overall research results revealed that the risk factors such as unsatisfaction of institutional care and depression and anxiety than the protective factors had more significant effects on ego-resilience and social adaptability of children and adolescents in institutional care. This finding suggested that elimination of risk factors rather than development of protective factors was a more important task for the welfare of children and adolescents in institutional care.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• Health Policy and Management
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• v.19 no.4
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• Journal of Korean Ophthalmic Optics Society
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• v.5 no.2
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• pp.73-78
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• 2000

The purpose of our study was investigation for the status of eye health in Taejon area. I chose the age of eight to under eighteen 61 institutional care children, and I examed the first visual acuity examination ophthalmoscopy and non-criterion interview. Among 61 institutional care children (primary school student 40.98%, secondary school student 59.01%), 56.74% children were emmetropia, 44.46% were ametropia. Unaided visual acuity 0.7, 0.8 were 37.03% of these children. As refractive errors, 31.14% were myopia. 26.23% were compound myopic astigmatism and only 1.64% institutional care children wearing the glasses. In children, early eye examination is essential for their eye health. Therefore attention to early eye examination and wearing correct glasses seem to be very important especially for institutional care children. I propose that we have to concerned about eye health and concrete plan for institutional care children.

• Journal of the Korean Home Economics Association
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• v.39 no.1
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• pp.81-90
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• 2001

This study focuses on the type of elder care arrangements and its consequences for mental health among physically frail elderly. Based on data from 410 frail older people, this study reveals the following results: (1) Frail elderly in family caregiving situation shows better mental health in terms of depression and psychological well-being than those in self-care or public institutional situation, (2) but this positive effect of family caregiving on mental health, especially depression, among older people is partly explained by the differences in income and marital status among older people in different caregiving situations, (3) the factors which are significantly related to mental health of older people are income in family caregiving situation, and education in both self-care situation and institutional situation. The results of the study emphasize the importance of family resources in family caregiving situation and of personal resources in self7are or institutional situation.

• Journal of East-West Nursing Research
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• v.6 no.1
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• pp.23-36
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• 2001

The purpose of this study was to discover knowledge about the sources and meanings of the children's living who is under the care of welfare institution. Participants were high school girls in Kwangju who offered unstructured description of their experience through interviews. The research was performed from March 2001 to September 2001. The results, analyzed and interpreted according to Gorgi's method of phenomenology, describe the structure of the phenomenon "living experience of the children under the institution care" with a relational perspective. The analysis revealed seven core themes : (1) anguish of heart against custom of institution, (2) resistance against their livelihood, (3) mortification on the distorted prejudice, (4) desire to escape, (5) fearfulness for the unreliable future, (6) self-pity, (7) challenge to the future. The foregoing argument suggest that children under the institutional care be supported by more mental health intervention and nurses be disciplined by supportive conversation technique.

• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.388-398
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• 2016

Purpose: To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care. Methods: This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC. Results: All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years. Conclusion: The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.

• Health Policy and Management
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• v.21 no.3
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• pp.457-492
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• 2011

The primary goal of our study was to investigate the vast transformations of the healthcare sector in Korea during the past half century. Official data reported in the Korean statistical yearbooks and secondary data suggested by previous studies were used for institutional analysis of healthcare environment. Information on hospital released by the Korean Hospital Association was also used for ecological analysis. Institutional analysis: We identified three distinctive eras based primarily on changes in institutional logics, institutional actors, and governance structures : 'professional dominance (1952-1976)', 'government involvement (1977-1999)', and 'coexistence of competing institutional logics (2000-present)'. During the first era, physician association supported by Korean government comprised the primary governance regime. During the second era, the government became a major actor as a regulator and purchaser in health care sector, introducing of the 'mandatory national health insurance'. During the third era, making healthcare system sustainable and providing health care efficiently was overarching goals although it was hard to find a single central logic dominating this period. Ecological analysis: Evidence from the analysis of hospital population suggested that the expansion of the bed capacity was made from different processes, shifting from the ecological process in 1980s to the adaptive process in 1990s. And Korean hospitals had changed following both 'directional process' and 'stabilizing process' over time. Based on our results, we concluded that more studies to compare more organizational populations other than hospitals and to empirically test the effects of institutional changes on organizational changes and vice-versa, need to be conducted.

• Journal of the Korean Institute of Rural Architecture
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• v.18 no.3
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• pp.9-16
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• 2016

This study aimed to clarify the multifunctional services and space composition in the process of developing a multifunctional long-term care program in small elderly care facilities in Japan. We collected data about multifunctional long-term care at small facilities from the Community Life Support Center (CLC), a Japanese non-profit corporation, and conducted an interview survey of the members of the CLC's secretariat in 2014. Furthermore, we selected 3 Japanese pioneering care facilities (known as takurosho), and conducted interview surveys and data collection to clarify in detail the space composition and process of development of multifunctional long-term care at small facilities. Four distinct results were found. First, the facilities had gradually increased non-institutional services, including visitation, overnight stays, and long-term stays, to fit the needs of users and their families. Secondly, in the 1990s, they could offer both non-institutional and institutional services at the same facility, but after the long-term care insurance system began in 2000, non-institutional long-term stay services were not allowed. Third, the facilities had built extensions or extra rooms in response to increases in multifunctional services and users. These rooms had common characteristics, with sitting rooms at the center of the facility. Lastly, the maximum number of service users at each of the 3 facilities was limited to 15, to maintain a small scale. However, as the size of facilities was increased through building extensions or remodeling, the overall amount of area available to users increased.