THE STRUCTURE OF CARE MANAGERS’ PRACTICE RESPECTING THE AUTONOMY OF THE FRAIL ELDERLY IN JAPAN

Abstract

The objectives of current study are to clarify the structure of practice respecting the autonomy of the frail elderly under the Long-Term Care Insurance system in Japan and to discuss the related factors to the practice. The mailed self-administered questionnaire survey was conducted on 1398 care managers who working in In-Home Long-Term Care Support Providers in A City in Osaka with the condition that “office with multiple care managers engaged and one care manager with more than 5 years’ experience”. The response rate was 51.0% (713persons) and no missing data 615 (44.0%) was analyzed. Analysis was carried out using Mplus.ver8. The structure of practice respecting the autonomy of the frail elderly and the rerated factors were examined as a causal model using structural equation modeling. As the result, it was confirmed the goodness of fit to the data (RMSEA=0.049, CFI=0.927). By the confirmatory factor analysis, the care manager’s practice respecting the autonomy of the elderly was confirmed associating with three-factors structure; (1)data collection and assessment, (2) strength perspective and (3) professional relationship. Furthermore the practice was significantly affected by self-esteem of care-managers performance (β=0.494) and self-reflection to own work (β=0.269). In conclusion, the current study supported the hypothetical consideration in which self-esteem and self-reflection in care manager’s practice significantly affected the practice respecting the autonomy of the frail elderly.