Journal of Korean Academy of Nursing

Original Articles

The Effects of a Community Psychiatric Nursing Program on the Rehabilitation of Home-based Long-term Psychiatric Patients: Sook Lee; Journal of Korean Academy of Nursing 1999;29(5):1103-1112. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1999.29.5.1103

Abstract PDF: In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabiliation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care actively and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used . Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contracted by phone, the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition, elimination, dressing, leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.

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Development of a Critical Pathway for Patients with Coronary Artery Bypass Graft: Gi Yon Kim; Journal of Korean Academy of Nursing 1998;28(1):117-131. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.117

The purpose of this study was to develop a critical pathway for case management for patients who have received Coronary Artery Bypass Graft(CABG) because of Ischemic Heart Disease(IHD) which is a factor of rising medical expenses. For this study, a conceptual framework was developed through a review of the literature including six critical pathways which are currently being used in USA. In order to identify the overall service contents required by these patients and to draw up a preliminary critical pathway, 30 cases of medical records of patients who had CABG because of IHD between January, 1995 to June, 1996 at the Cardiovascular Center of Yonsei Medical Center in Seoul were analyzed. An expert validity test was done for the preliminary critical pathway and clinical validity test was also done using seven IHD patients with CABG between November 11 and 23, 1996. After these processes, the final critical pathway was developed. The results of this study are summarized as follows : 1. The vertical axis of the critical pathway includes the following eight items, nutrition medications, consultations, activity, assessments, treatments, education discharge planning and the horizontal axis includes the time from the start of hospitalization to discharge. 2. Analysis of the 30 medical records indicated that the average length of stay was 20.2 days with the average length of stay from hospitalization day to operation day being 6.2 days, and the average length of stay from operation day to discharge day was 13.9 days. Analysis of the service contents showed that the horizontal axis of the preliminary critical pathway was set from hospitalization to the 14th post operation day and the vertical axis was set to include eight items, the contents which ought to have occurred, according to the time frames of the horizontal axis. 3. As a result of the experts validity, it was found the among the total of 571 items, there was over 83% agreement for 482 items, less than 83% for 89 items, which were then deleted and a revision of the critical pathway was done. 4. A clinical validity test was done using seven, IHD patients with CABG. During the process, three patients were deleted because they were out of the criteria the investigator set. Finally, four patients were used. The result of study indicated that only one patient was discharged on the tenth post operation day. which was one day later than the expected day. Three patients were discharged later than the expected day from three days to nine days. All the cases progressed on schedule until the operation day and the first post operation day. but from the second post operation days, there were differences between the critical pathway and the actual practice. The differences came from tests, assessments, and treatments. 5. On the basis of the results of the clinical validity test, the following revisions in the final critical pathway were made : the transfer from ICU to step down ward would be the second post operation day, and the transfer to a general ward, the fifth post operation day, for patients who complained of lack of sleep from the fifth post operation day to discharge, a sleeping pill would be prescribed, skin observations would be performed routinely from immediately after the operation until the third post operation day, and would continue if there was a sign of skin injury on the fourth post operation day, and assessment of chest pain would be done from the third post operation day, and the "stairs climbing" item, expected to be done on the ninth post operation day would be deleted. In conclusion, this critical pathway is partially applicable to the care of patients with CABG but there are some parts needed to be further investigated.

Citations

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Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients
Yeo Ok Yun, Min Young Kim, Woo Jeong Kim, Young Joon Kang, Ju Ok Park, Kyung Hye Park
Journal of Korean Academy of Nursing Administration.2011; 17(1): 66. CrossRef
The Development of Nursing Standards for Coronary Artery Disease Patients Who Received Medical Treatment
Won Jung Noh
Journal of Korean Academy of Nursing Administration.2010; 16(3): 326. CrossRef
The Development and Effects of an Integrated Symptom Management Program for Prevention of Recurrent Cardiac Events after Percutaneous Coronary Intervention
Youn-Jung Son
Journal of Korean Academy of Nursing.2008; 38(2): 217. CrossRef

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Structural Equation Modeling on Case Management Outcomes and Factors Influencing Outcomes in the Community-dwelling Vulnerable Elders: Hyunjung Moon, In-Sook Lee; J Korean Acad Nurs 2013;43(6):791-800. Published online December 31, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.6.791

Abstract PDF

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.

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Perceived Barriers to Rural Elderly Women’s Health-Promoting Behaviors: An Ecological Perspective
Hyunjung Moon, Sunkyung Cha, Eunyoung Park
International Journal of Environmental Research and Public Health.2020; 17(17): 6107. CrossRef

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Multilevel Analysis of Health Care Service Utilization among Medical Aid Beneficiaries in Korea: Yang Heui Ahn, Ok Kyung Ham, Soo Hyun Kim, Chang Gi Park; J Korean Acad Nurs 2012;42(7):928-935. Published online December 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.7.928

Abstract PDF

Abstract Purpose

The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling.

Methods

Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis.

Results

Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization.

Conclusion

The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/ or promotion of community awareness.

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Factors Affecting Emotional · Behavioral Problems in Early Adolescence: A Multilevel Model Study
Hee Young Park, Yeon Hee Choi
Journal of Korean Academy of Community Health Nursing.2017; 28(4): 482. CrossRef
Equity of access under Korean national long-term care insurance: implications for long-term care reform
Ju Moon Park
International Journal for Equity in Health.2015;[Epub] CrossRef
Ecological Correlates of Cardiovascular Disease Risk in Korean Blue-collar Workers: A Multi-level Study
Won Ju Hwang, Yunhee Park
Journal of Korean Academy of Nursing.2015; 45(6): 857. CrossRef
Prevalence and Predictors of Polypharmacy among Korean Elderly
Hong-Ah Kim, Ju-Young Shin, Mi-Hee Kim, Byung-Joo Park, Terence J. Quinn
PLoS ONE.2014; 9(6): e98043. CrossRef

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Validation of a Needs Assessment Tool for Case Management in Korean Medical Aid Beneficiaries: Yang Heui Ahn, Eui Sook Kim, Ok Kyung Ham, Soo Hyun Kim, Soon Ok Kim, Myung Kyung Song; J Korean Acad Nurs 2012;42(4):549-558. Published online August 31, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.4.549

Abstract PDF

Purpose

The purpose of this study was to validate the Needs Assessment Tool for Case Management (NATCM) for use with Korean medical aid beneficiaries.

Methods

Psychometric testing was performed with a sample of 645 Korean medical aid beneficiaries, which included 41 beneficiaries who were selected using proportional sampling method, to examine intraclass correlation coefficients (ICC). Data were evaluated using item analyses, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach's alpha, and ICC.

Results

Through psychometric testing the final version of NATCM was found to consist of two subscales: 1) Appropriateness of Health Care Utilization (5 items) and 2) Self Care Ability (6 items). The two subscale model was validated by CFA (RMSEA=.08, GFI=.97, and CFI=.93). Internal consistency measured by Cronbach's alpha was .82, and subscale reliability ranged from .79 to .84. The ICC of the NATCM between case managers was .73 and between case managers and health care professionals. .82.

Conclusion

This study suggests that the final version of NATCM is a brief, reliable, and valid instrument to measure needs of Korean medical aid beneficiaries. Therefore, the NATCM can be effectively utilized as an important needs assessment as well as outcome evaluation tool for case management programs in Korea.

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Trends of Research on the Case Management of Medicaid Beneficiaries in Korea
Soon Ock Kim, Jeonghyun Cho
Journal of Korean Public Health Nursing.2015; 29(3): 412. CrossRef
Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases
Yang Heui Ahn, Yeonok Suh, Ok Kyung Ham, Hee Kyung Kim
The Korean Journal of Rehabilitation Nursing.2015; 18(2): 98. CrossRef

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Role Transition from Clinical Nurse to Case Manager for Medical-aid Beneficiaries: Taking Root in a Barren Land: Eun-Jun Park, Chunmi Kim, Seung Joo Lim; J Korean Acad Nurs 2012;42(2):149-160. Published online April 30, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.2.149

Abstract PDF

Purpose

The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea.

Methods

Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory.

Results

'Taking root in a barren land' was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs' role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families.

Conclusion

NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs' employment and career stability.

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Experience of Clinical Adaptation among Nurses in Intensive Care Unit
Jin Young Hong, Sue Kyung Sohn
Journal of Korean Critical Care Nursing.2024; 17(1): 1. CrossRef
Perceived barriers to implementing case management for medical‐aid beneficiaries in South Korea
Jeonghyun Cho, Chongwon Park, Jinah Lee, Jiyoung Park
Health & Social Care in the Community.2022; 30(1): 372. CrossRef
Effects of Medicaid Case Manager's Communication Competence and Stress on Their Job Satisfaction
Seung Joo Lim
Journal of Korean Academy of Community Health Nursing.2019; 30(2): 195. CrossRef
Case management effectiveness for managing chronic illnesses in Korea: a systematic review
J.Y. Joo, M.F. Liu
International Nursing Review.2019; 66(1): 30. CrossRef
Experience of Hospital Administrative Nurses' Work Adjustment
Hyun-Ju Lee, Jae-Hyun Ha, Yun-Seo Jung, Jungmi Yun
Journal of Korean Academy of Nursing Administration.2019; 25(5): 424. CrossRef
The Coping Experience of Nursing Students in Clinical Practice: Trying to be a Meaningful Presence
Doo Nam Oh, Young-Rhan Um, Chunmi Kim, Sejin Ju, Jung Hyun Choi, Myung Sook Park
The Journal of Korean Academic Society of Nursing Education.2016; 22(4): 430. CrossRef

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Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People: Kyung Ja June, Ji Yun Lee, Jong Lull Yoon; J Korean Acad Nurs 2009;39(3):366-375. Published online June 29, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.3.366

Abstract PDF

Purpose

To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people.

Methods

All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP).

Results

Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410).

Conclusion

Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

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Yeon-Hwan Park, Hwal Lan Bang, Ga Hye Kim, Seieun Oh, Young-Il Jung, Hongsoo Kim
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Claudia Stolle, Annika Wolter, Günter Roth, Heinz Rothgang
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Evan Mayo-Wilson, Sean Grant, Jennifer Burton, Amanda Parsons, Kristen Underhill, Paul Montgomery, Hemachandra Reddy
PLoS ONE.2014; 9(3): e89257. CrossRef
Structural Equation Modeling on Case Management Outcomes and Factors Influencing Outcomes in the Community-dwelling Vulnerable Elders
Hyunjung Moon, In-Sook Lee
Journal of Korean Academy of Nursing.2013; 43(6): 791. CrossRef
Effects of the Resident Assessment Instrument in home care settings
C. Stolle, A. Wolter, G. Roth, H. Rothgang
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Yun-Jung Choi, Mi-Ra Won
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The Effects of a Case Management Program of Customized Home Visiting Health Service for Clients with Arthritis
Soon-Ok Yang, Myung Soon Kwon, Yong-Jun Choi, Seung-Hee Lee
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Effects of Community-based Case Management Program for Clients with Hypertension: Ae-Young So, Yun-Mi Kim, Eun-Young Kim, Chang-Yup Kim, Cheol-Hwan Kim, Hee-Gerl Kim, Eun-Young Shin, Weon-Seob Yoo, Ggod-Me Yi, Kyung-Ja June; J Korean Acad Nurs 2008;38(6):822-830. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.822

Abstract PDF

Purpose

The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.

Methods

The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.

Results

Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.

Conclusion

The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

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Ângela Taís Mattei da Silva, Maria de Fátima Mantovani, Ricardo Castanho Moreira, Juliana Perez Arthur, Roberto Molina de Souza
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Jung-Soon Chung, Sun-Ock Lee
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Young-Joo Park, Nah-Mee Shin, Ji-Won Yoon, Jiwon Choi, Sook-Ja Lee
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Case Management Process identified from Experience of Nurse Case Managers: Eun-Jun Park, Chunmi Kim; J Korean Acad Nurs 2008;38(6):789-801. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.789

Abstract PDF

Purpose

The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea.

Methods

A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory.

Results

Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources.

Conclusion

This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

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Association of Medicaid coverage with emergency department utilization after self-harm in Korea: A nationwide registry-based study
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Experiences of Transitional Care for Medicaid Case Managers
Yunhee Hwang, Gaeon Lee
Journal of Korean Academy of Nursing.2023; 53(5): 556. CrossRef
Perceived barriers to implementing case management for medical‐aid beneficiaries in South Korea
Jeonghyun Cho, Chongwon Park, Jinah Lee, Jiyoung Park
Health & Social Care in the Community.2022; 30(1): 372. CrossRef
Effects of Medicaid Case Manager's Communication Competence and Stress on Their Job Satisfaction
Seung Joo Lim
Journal of Korean Academy of Community Health Nursing.2019; 30(2): 195. CrossRef
Case management effectiveness for managing chronic illnesses in Korea: a systematic review
J.Y. Joo, M.F. Liu
International Nursing Review.2019; 66(1): 30. CrossRef
Social Network, Self-Care Agency and Quality of Life of High-risk Beneficiaries in Case Management of Medicaid
Ju Young Park, Jung Tae Son
Journal of Korean Academy of Community Health Nursing.2017; 28(4): 421. CrossRef
Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases
Yang Heui Ahn, Yeonok Suh, Ok Kyung Ham, Hee Kyung Kim
The Korean Journal of Rehabilitation Nursing.2015; 18(2): 98. CrossRef
Trends of Research on the Case Management of Medicaid Beneficiaries in Korea
Soon Ock Kim, Jeonghyun Cho
Journal of Korean Public Health Nursing.2015; 29(3): 412. CrossRef
Case Management for Medical Aid Beneficiaries in Korea: Findings from Case-control Study
Hee-Sun Shin, Jin-Joo Oh
Asian Nursing Research.2014; 8(4): 274. CrossRef
Utilization of long-term care services under the public long-term care insurance program in Korea: Implications of a subsidy policy
Hongsoo Kim, Soonman Kwon, Nan-He Yoon, Kyung-Rae Hyun
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Role Transition from Clinical Nurse to Case Manager for Medical-aid Beneficiaries: Taking Root in a Barren Land
Eun-Jun Park, Chunmi Kim, Seung Joo Lim
Journal of Korean Academy of Nursing.2012; 42(2): 149. CrossRef
Change in Healthcare Utilization by Disease Severity after Case Management for Medicaid
Seung Joo Lim
Journal of Korean Academy of Community Health Nursing.2010; 21(3): 321. CrossRef

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Task Analysis of Korean Geriatric Care Managers: Pok Ja Oh, Il Ok Kim, Young Hye Kim, Sung Rae Shin, Kyoung Soon Lee, Suk Jung Han; Journal of Korean Academy of Nursing 2006;36(5):770-781. Published online August 31, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.5.770

Abstract PDF

Purpose

This study was designed to create a job description for Korean geriatric care managers and examine performance frequency, importance, and difficulty of task elements.

Method

The sample consisted of 38 geriatric care managers and professors who performed duties related to geriatric care management at community based-facilities in Korea. A survey method was used, and the questionnaire included frequency, importance, and difficulty of task elements in job descriptions using the DACUM method. Using SPSS WIN 10.0, descriptive statistics such as frequency distribution, means, and standard deviation were conducted to examine the subject's general characteristics, frequency, importance, and difficulties of task performance.

Result

The job descri ption of geriatric care managers revealed 10 duties, 34 tasks, and 105 task elements. On all ten duties, the average performance frequency, importance, and difficulty was 2.55, 2.21 and 2.43 respectively.

Conclusion

The job description of geriatric care managers includes duty, task, and task elements and the definition of a completed job. Thus we recommend a data based trial to confirm and validate the information gathered.

Citations

Citations to this article as recorded by

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