Nurses In Long-term Care Hospitals Research Articles

The influence of socio-cognitive mindfulness, moral sensitivity and dementia communication behaviors on dementia nursing performance of nurses in long-term care hospitals: a cross-sectional study

BackgroundBy incorporating socio-cognitive mindfulness which has been under-examined in the nursing field, this study investigated the relationships between socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance of nurses in long-term care hospitals. This study also examined the factors influencing nurses’ dementia nursing performance.MethodsA cross-sectional study was conducted with 209 nurses from long-term care hospitals in Korea. Data were collected between August 1 and August 31, 2022. Participants completed the questionnaire assessing their socio-cognitive mindfulness, moral sensitivity, dementia communication behaviors, and dementia nursing performance. Pearson’s correlation and hierarchical multiple regression analysis were performed for data analysis.ResultsDementia nursing performance of the nurses in long-term care hospitals was positively related to their socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors. Furthermore, nurses’ dementia communication behaviors, moral sensitivity, and total clinical career, in that order, were found to be the factors influencing their dementia nursing performance.ConclusionThe findings indicate that the higher socio-cognitive mindfulness, moral sensitivity, and dementia communication behaviors, the higher dementia nursing performance, and that higher dementia nursing performance is associated with better dementia communication behaviors, greater moral sensitivity, and more extensive clinical experiences. This study provides a foundation for developing effective interventions to enhance dementia nursing performance in the future. To improve dementia nursing performance of nurses in long-term care hospitals, it is necessary to improve dementia communication behaviors and moral sensitivity, and prepare multilateral countermeasures to maintain nurses’ clinical careers.

Concept analysis of end-of-life care competency of long-term-care-hospital nurses: Using a hybrid model

Purpose: This study identified the attributes and indicators of end-of-life nursing competency in long-term-care-hospital nurses and clarified the definition of the concept. Methods: The Competency Outcomes Performance Assessment model was used as a conceptual framework, and conceptual analysis was performed using the hybrid model presented by Schwartz-Barcott and Kim. In the theoretical phase, the attributes of end-of-life care competencies were explored through a literature review. In the fieldwork phase, focus group interview data were analyzed to derive the attributes of nursing competency at the end of life. In the final analysis phase, the attributes and indicators of end-of-life care competency were compared, analyzed, and integrated. Results: The attributes of end-of-life care competency among nurses in long-term care hospitals included comprehensive symptom management, effective communication, situational response, patient-centered care, information provision and education, resource management, demonstrating leadership, and professional development. Conclusion: End-of-life care competency in long-term-care-hospital nurses can be defined as a comprehensive set of competencies that includes symptom management, situational adaptation, effective communication, resource utilization, leadership, patient-centered care, meeting the needs of patients’ families through adequate information provision and education, and enhancing individual nursing capabilities through professional development. These results can serve as a foundation for developing tools to measure end-of-life care competencies among nurses in long-term care hospitals.

요양병원 밤번 전담간호사의 근무 경험에 대한 현상학적 연구

Objective : The purpose of this study was to conduct a qualitative study to understanding of the work experiences of night nurses in long-term care hospitals for the elderly. Methods : The interview questions began with the question, “What is your experience of working as a night nurse in long-term care hospitals?” to allow participants to speak naturally, and the Colaizzi phenomenological analysis methodology was used. Results : The study found six components: ‘working hours based on their own needs’, ‘burdened by night shift work’, ‘discomfort from communication gaps between the organization and others’, ‘fading mind and body’, ‘crutches that make them endure’, and ‘need for improved institutional treatment’. Conclusion : This study will contribute to the improvement of the quality of nursing care by providing a basis for the development of systems and strategies to improve the work environment and job satisfaction of long-term care hospitals night nurses.

The Influence of Attitude toward Dementia and Nursing Practice Environment on Person-centered Care in Long-term Care Hospital Nurses

Objectives: The purpose of this study was to identify the influence of attitude toward dementia and nursing practice environment on person-centered care in long-term care hospital nurses.Methods: Data were collected from September 1 to September 30, 2021 using a structural questionnaire, which was completed by 150 nurses working in eleven long-term care hospitals in D and K city. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Pearson’s correlation and stepwise multiple regression analysis using SPSS 22.0.Results: As a result of analyzing the correlation between the subject’s dementia attitude, nursing practice environment, and person-centered care, it was found that the more positively the nursing practice environment was perceived, the higher the awareness of person-centered care. The factor that had the greatest influence on person-centered care was the nursing practice environment (β= 0.48, <i>p</i>< 0.001), followed by the number of patients in charge of 20 to 39 (β= -0.28, <i>p</i>= 0.015) and more than 40 (β= -0.33, <i>p</i>= 0.004). These influencing factors were found to explain 27.0% of person-centered care.Conclusions: In order to provide high-quality nursing services in long-term care hospitals, it is necessary to improve the nursing practice environment. Through these efforts, we can expect to provide active person-centered care by nurses in long-term care hospitals.

Development and effectiveness of the stepwise handoff protocol based on the SBAR for long-term care hospital nurses: A nonequivalent control-group pre-posttest design

Purpose: This study aimed to develop and examine the effectiveness of the stepwise handoff protocol based on the situation, background, assessment, recommendation (SBAR) application for long-term-care hospital nurses. Methods: A nonequivalent control group pre-posttest design was used for this study. There were 23 subjects in the experimental group and 23 subjects in the control group. Using SPSS Statistics 21.0, data were analyzed by descriptive statistics, independent t-test, and repeated measure ANOVA. Results: The effectiveness of the stepwise handoff protocol based on the SBAR for long-term-care hospital nurses showed a difference in the communication self-efficacy by group (F=8.81, p=.005), by time (F=11.43, p<.001), the interaction effect of group point and time (F=9.67, p<.001), the communication clarity by group (F=10.05, p=.003), by time (F=5.74, p=.005), interaction effect between group point and time (F=3.37, p=.039), and the quality of handoff by group (F=12.48, p=.001), by time (F=7.03, p=.010), and interaction effect between group point and time (F=4.29, p=.042). Conclusion: The stepwise handoff protocol based on the SBAR is expected to improve the work by systematically implementing the transfer of long-term-care hospital nursing to increase nurses’ job efficiency.

Perceptions of Healthcare Safety Nets among Tertiary Hospital and Long-Term Care Hospital Nurses during the COVID-19 Pandemic: A Q-Methodological Approach.

This study was conducted to identify the types of perceptions toward healthcare safety nets. This study applied a Q-methodology. From a Q-population of 91 samples that included a review of the related literature and interviews with five tertiary hospital nurses and five long-term care (LTC) hospital nurses, 33 Q-samples were selected. The data were analyzed with the PC-QUANL program. We recruited 32 nurses in a tertiary hospital and 33 nurses in an LTC hospital. The perceptions of the healthcare safety net of tertiary hospital nurses were categorized into four types: (1) systematic system request; (2) realistic work support; (3) government support; and (4) emotional support. The perceived subjectivity of the healthcare safety net of LTC hospital nurses were categorized into four types: (1) reward system and facility environmental support; (2) realistic work support; (3) social prevention infrastructure support; and (4) government support. This study provides basic data for these different hospital settings, as well as to inform future government policy and system improvements in an era characterized by infectious diseases. Specifically, this study presents the types of perceptions of healthcare safety nets of nurses in two hospital settings that deliver care for patients.

요양병원 간호사의 치매간호수행과 치매지식, 치매태도, 간호전문직관의 관계

요양병원 간호사의 치매간호수행과 치매지식, 치매태도, 간호전문직관의 관계

The influence of professional competency, professional commitment, and nursing organizational culture on the person-centered practice of nurses in long-term care hospitals: A cross-sectional study

Purpose: This study aimed to examine the influence of professional competency, professional commitment, and nursing organizational culture on the person-centered practice of nurses in long-term care hospitals. Methods: A total of 131 nurses in seven long-term care hospitals in Daegu city and Kyeongsang province participated in the study. Professional competency, professional commitment, nursing organizational culture, and person-centered practice were measured using the Nurse Professional Competence Short-Form, Professional Commitment Questionnaire, Nursing Organizational Culture scale, and Korean Measure of Person-Directed Care. Hierarchical multiple regression analysis was used to analyze the data. Results: Nurses in long-term care hospitals had mean scores of 4.77±0.84 for professional competency and 4.27±0.89 for professional commitment out of a 1~7 scale and 3.45±0.44 for person-centered practice out of a 1~5 scale. Regarding nursing organizational culture, nurses had the highest score in relation-oriented organizational culture and the lowest score in task-oriented culture. Nurses’ professional competency (β=.59, p<.001) and innovation-oriented culture (β=.36, p<.001) were the factors influencing person-centered practice, which explained the variance of 52.5%. Conclusion: To improve person-centered practice in long-term care hospitals, it is necessary to implement strategies for improving nurses’ professional competency and innovation-oriented nursing organizational culture.

The effect of nursing work environment on slow nursing among long-term care hospital nurses: A descriptive study

Purpose: This study aimed to examine the impact of the nursing work environment on slow nursing care by nurses in long-term care hospital. Methods: The participants in this study were 117 nurses who had worked for more than 6 months in long-term care hospitals in Daegu city or Gyeongbuk province. Data were collected from February 10 to 28, 2023, comprising general characteristics, slow nursing care, and nursing work environment. Data were analyzed using descriptive statistics, a t-test, one-way ANOVA, Pearson's correlation, and multiple regression analysis using the IBM SPSS 22.0 program. Results: A significant positive correlation was observed between slow nursing care and the nursing work environment (r=.42, p<.001). In a hierarchical regression analysis, the nursing work environment accounted for 33% (F=8.12, p<.001) of the variance in slow nursing care among nurses in long-term care hospitals. Conclusion: The findings suggest that an optimal nursing work environment is crucial to enhance the delivery of slow nursing care in long-term care hospitals. Hence, it is recommended to develop an educational program

The Influence of Long-term Care Hospital Nurses' Nursing Professionalism and Knowledge of COVID-19 on Nursing Intentions for COVID-19 Patients

Purpose: This study attempted to identify the influence of long-term care hospital nurses' nursing professionalism and knowledge of coronavirus disease 2019 (COVID-19) on nursing intentions for COVID-19 patients.Methods: Data were collected from nurses who had worked for at least 6 months at long-term care hospitals with more than 100 beds located in North Gyeongsang Province from July 15 to 31, 2021. In total, 207 questionnaires were analyzed using the t-test, one-way analysis of variance, Pearson correlation coefficients, and multiple linear regression with SPSS for Windows version 25.0.Results: Among the sub-factors constituting nursing professionalism, self-concept of the profession (r=.22, <i>p</i>=.001) and professionalism of nursing (r=.23, <i>p</i>=.001) were correlated with nursing intention for COVID-19 patients, whereas there no correlation was found between knowledge of COVID-19 and nursing intention for COVID-19 patients. In addition, among the sub-factors of nursing professionalism, the only factor influencing nursing intention for COVID-19 patients was professionalism of nursing, which could explain approximately 6.0% of variance in nursing intention for COVID-19 patients (β=.58, <i>p</i>=.049).Conclusion: It is important to strengthen professionalism of nursing among various aspects of nursing professionalism in order to improve long-term care hospital nurses’ nursing intention for COVID-19 patients.

Comparison of Terminal Care Stress and Terminal Care of Long-term Care Hospital Nurses and Nursing Staff

Comparison of Terminal Care Stress and Terminal Care of Long-term Care Hospital Nurses and Nursing Staff

Experiences of Nurses with COVID-19 Infection Management in General Hospitals and Long-term Care Hospitals

The purpose of this study was to understand and describe the experiences of nurses in general and long-term care hospitals in infection management related to COVID-19. The participants were 10 nurses working at general and long-term care hospitals located in G province. Data were collected through interviews with three focus groups conducted from June to July 2021. All interviews were audiotaped and transcribed verbatim. The collected data were analyzed using qualitative content analysis. As a result, 62 codes, 9 subcategories, and 4 categories were extracted. The four themes were as follows: (1) the sudden emergence of COVID-19 and the unending uncertainty, (2) various efforts to prevent and manage COVID-19, (3) facilitators and barriers in managing COVID-19, and (4) suggestions for strengthening infection management. Based on the results, an educational program to enhance the infection management competency of nurses should be developed and applied considering the characteristics of general and long-term hospitals. Moreover, practical policies such as preparing a network for infection management should be prepared.

Measurement Invariance and Latent Mean Differences in the Nurses' Emotional Labour Scale.

The measurement invariance and latent mean differences in emotional labor across different hospital and monthly salary levels among registered nurses have never been confirmed for the Emotional Labour Scale. These issues may influence the application and efficacy of this scale in practice. This study was developed to evaluate the factor structure of the nurses' Emotional Labour Scale and to examine the measurement invariance and latent mean differences for this scale across different hospital and monthly salary levels. Data were collected from 461 registered nurses working in four general hospitals and 12 long-term care hospitals. Confirmatory factor analysis and a multigroup confirmatory factor analysis were performed to determine the internal structure and measurement invariance of the Emotional Labour Scale. The results of the confirmatory factor analysis indicate that the factor structure model proposed by the original scale fits well with our data as well as configural invariance, factor loading invariance, intercept invariance, and uniqueness invariance. Moreover, factor variance/covariance invariance across two hospital levels as well as configural invariance, factor loading invariance, and intercept invariance across two monthly salary levels were supported. The mean score for emotional control effort in the profession of general hospital nurses was lower than that for long-term care hospital nurses. No statistically significant latent mean differences were found across monthly salary levels. The findings show the Emotional Labour Scale to be a valid and reliable tool for assessing registered nurses and also comparing the mean score for emotional labor across hospital and monthly salary levels to be feasible. The scale may contribute to the development of human resource strategies.

Factors influencing professional quality of life of nurses in long-term care hospitals: A cross-sectional study

Purpose: The purpose of this study was to identify factors related to the professional quality of life of nurses in long-term care hospitals. Methods: A descriptive survey was conducted among 144 nurses with more than 3 months of work experience in five long-term care hospitals in B metropolitan city. Data were collected from April 15 to 30, 2022 and analyzed using the independent t-test, one-way ANOVA, Mann-Whitney test, Pearson’s correlation coefficients, and stepwise multiple regression. Results: The regression model explained 51% of the variance of long-term care hospital nurses' compassion satisfaction (F=35.72, <i>p</i><.001). Significant factors were dementia attitude (β=.23, <i>p</i>=.001), professional self-concept (β=.51, <i>p</i><.001), marital status (married) (β=.16, <i>p</i>=.019) and more than 10 years of clinical experience at a long-term care hospital (β=-.29, <i>p</i><.001). The regression model explained 36% of the variance of long-term care hospital nurses' compassion fatigue (F=12.93, <i>p</i><.001). Significant factors were dementia attitude (β=-.27, <i>p</i>=.001), burden on behavioral psychological symptoms of dementia (β=.38, <i>p</i><.001), women (β=.20, <i>p</i>=.005), more than 10 years of clinical experience at a long-term care hospital (β=.20, <i>p</i>=.004) and experience in education about dementia (yes) (β=-.16, <i>p</i>=.029). Conclusion: This study revealed several factors that are correlated with the professional quality of life of long-term care hospital nurses. To improve their quality of life, hospitals should help nurses have a positive attitude toward dementia, reduce the burden of behavioral psychological symptoms of dementia, and provide dementia care training.

Predictors of Nursing Competency of Nurses in Long-term Care Hospitals: A Descriptive Study

Purpose: This study aimed to identify the predictors of nursing competency of nurses in long-term care hospitals.Methods: The subjects of this study were 119 nurses working at long-term care hospitals in Gyeongsangnam-do and Gyeongsangbuk-do. Data were collected from September to December 2021 and analyzed using descriptive statistics, t-test, one-way analysis of variance, Pearson's correlation, and hierarchical regression by SPSS/WIN 21.0.Results: The most potent predictors of nursing competency of nurses in long-term care hospitals were meta-cognition (β=.34, p=.002), clinical experience (β=-.32, p=.001), and emotional intelligence (β=.24, p=.025), which explained 40.0% of the variance.Conclusion: The results suggest that strategies for improving nursing competency of nurses in long-term care hospitals should focus on meta-cognition and emotional intelligence improvement, and a differentiated education program according to clinical experience is needed.

Experiences of nurses responding to the COVID-19 outbreak at a long-term care hospital in Korea: A qualitative study

Background: The COVID-19 pandemic revealed the fundamental vulnerability of long-term care hospitals (LTCHs) related to infection control and prevention (ICP). We examined the experiences of nurses who worked at a hospital where a COVID-19 outbreak occurred from February 24 to March 16, 2021. Method: This qualitative research was performed with 9 nurses who were engaged during the COVID-19 outbreak. We prepared a semistructured questionnaire based on the main question, “How was the experience among the nurses during the outbreak, and what difficulties did they encounter while resolving the situation?” The data were collected through in-depth, individual interviews from May to August 2021 after the approval of the institutional review board, and the results were analyzed thematically. Results: The average age of the participants was 52.1 years, and they had an average of 15.2 years of clinical experience. We extracted 4 themes and 16 subthemes from the results. The first theme, “sudden onset of the outbreak,” included the following subthemes: (1) found myself accustomed to COVID-19 and desensitized; (2) unavoidable occurrence despite compliance with ICP guidelines; (3) LTCHs are gradually recognized as a breeding ground for COVID-19 by the public; and (4) fear of spreading the infection in the hospital and of becoming a spreader. The second theme, “heavier workload,” included (1) daily overtime and extra shifts in violation of self-quarantine recommendations due to the shortage of nurses; (2) a barrage of phone calls from family members, other departments, public health centers, and hospitals where confirmed cases were transferred; (3) nursing assistants and private caregivers who do not have ICP knowledge as well as patients who do not cooperate due to cognitive impairment; and (4) accomplishing additional tasks while wearing personal protective equipment with some suffocation. The third theme, “emotions and lessons,” included (1) unsatisfied with the initial responses; (2) awareness of the entire infectious disease; (3) increased compassion and attachment for patients; and (4) take pride in the job and the profession as a nurse. The fourth theme, “necessary support and attention,” included (1) need to install isolation rooms and replenish infection control supplies; (2) need for ICP specialists in LTCHs; (3) need for continuous national-based monitoring on ICP for LTCHs; and (4) need to improve working environment and acknowledge nurses in LTCHs. Conclusions: Overall, participants expressed their experiences with the insufficient infection control and response system toward COVID-19 in the LTCH. To enhance ICP in LTCHs, customized policies, regulations, and financial support for infection control activities and ICP professionals must be established.Funding: NoneDisclosures: None

Factors influencing the dementia care behavior of long-term care hospital nurses

This is a descriptive research study for examining influencing factors on person-centered dementia care behaviors of nurses working in long-term care hospitals. In March 2021, data were collected from 13 care hospitals located in Seoul and Gyeonggi-do. The subjects include a total of 180 long-term care hospital nurses who have the experience to care for elderly people with dementia. Descriptive statistical analysis, t-test, ANOVA, Scheffé-test, Pearson’s correlation, and hierarchical multiple regression analysis of the data collected were conducted using IBM SPSS 25.0. The dementia care behaviors of long-term care hospital nurses had statistically significant correlations with caring efficacy (r=.49, p<.001), nursing professionalism (r=.43, p<.001) and job resources (r=.37, p<.001), and influencing factors on dementia care behaviors had the final explanation of 36.7% (adj R²=.367, F=14.253, p<.001). Ultimately, the most significant influencing factor on dementia care behaviors of long-term care hospital nurses was identified as nurses’ caring efficacy, followed by nursing professionalism, and nurses’ age and job resources. The higher the nursing professional intuition, the older the nurse's age, and the higher the job resource, the more important the person-centered dementia care behaviors. This study is meaningful in identifying the factors affecting person-centered dementia care behaviors of long-term care hospital nurses and providing basic data to improve dementia care behaviors.

A Structural Model for Burnout and Work Engagement of Nurses in Long-term Care Hospitals: Application of the Expanded Job Demand-Job Resources Model

Purpose: This study aimed to develop and test a structural model for burnout and work engagement of nurses in long-term care hospitals. The hypothetical model was constructed on the basis of the expanded Job Demand-Job Resources Model by Xanthopoulou, Baker, Demerouti, and Schaufeli and previous studies related to nurses’ burnout and work engagement.Methods: The study participants included 232 nurses working in seven long-term care hospitals with over 100 bed located in Jeollanam-do and Jeollabuk-do. Data were collected from February 6 to February 16, 2020. Data were analyzed using descriptive statistics, Pearson’s correlation, and structural equation modeling by SPSS 21.0 and AMOS 21.0 programs.Results: The final model showed a good fit to the empirical data: The factors that influenced burnout of nurses in long-term care hospitals were resilience (β=-.37), emotional demands (β=.29), work overload (β=.24), organization-based self-esteem (β=-.19), and social support (β=-.18) explaining 60.5% of the variance. The factors that influenced work engagement for nurses in long-term care hospitals were resilience (β=.44), burnout (β=-.32), and career-growth opportunity (β=.18) explaining 66.4% of the variance.Conclusion: The model constructed in this study is recommended as a model to explain and predict the burnout and work engagement of nurses in long-term care hospitals. The results suggest that strategies for decreasing the burnout of nurses in long-term care hospitals should focus on resilience, emotional demands, work overload, organization-based self-esteem, and social support. In addition, strategies for increasing nurses’ work engagement should focus on resilience, burnout, career-growth opportunity, and social support.

Effects of the Resilience of Nurses in Long-Term Care Hospitals during on Job Stress COVID-19 Pandemic: Mediating Effects of Nursing Professionalism.

Purpose: To investigate nursing professionalism as a mediating factor in the relationship between resilience and job stress levels for nurses working in long-term care hospitals during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted from January to March 2021 in seven long-term care hospitals in the Seoul metropolitan area to measure resilience, nursing professionalism, and job stress among nurses. Simple and multiple regression analyses along with the Sobel test were performed to verify the mediating effect of nursing professionalism. Results: Data from 200 nurses were included in the final analysis. Results showed that individual and occupational characteristics could lead to differences in nurses’ resilience, job stress levels, and nursing professionalism. Nursing professionalism had a significant mediating effect on the relationship between resilience and job stress levels. The effect of resilience on job stress levels was significant (β = −0.16, p = 0.024). After controlling for nursing professionalism, the effect declined and was not statistically significant (β = −0.09, p = 0.251). Conclusion: There is a need to increase individual resilience and nursing professionalism through intervention programs and policy proposals to manage job stress among long-term care hospital nurses during the COVID-19 pandemic.

Factors Influencing Self-Confidence in Performance of Infection Control for Multi-Drug Resistant Organisms among Nurses in Long-Term Care Hospitals

Purpose: This was a descriptive research survey study to assess support for resources, organizational culture, knowledge, and self-confidence in the performance of infection control of multidrug-resistant organism (MDROs) perceived by nurses in long-term care hospitals, and to confirm influencing factors of such perception on self-confidence in performance.Methods: The participants were 192 nurses in 11 long-term care hospitals located in Daejeon Metropolitan City. Data collection was done from January 8 to February 17, 2020. Collected data were analyzed using independent sample t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis with the IBM SPSS statistics 25.0 program.Results: Organizational culture for infection control (β=.22), knowledge on MDROs infection control (β=.19), and experiences in education on MDROs infection control within the last year (β=.15) were found to be the factors most influencing self-confidence in performance of the nurses for MDROs infection control, and explained about 14.5%.Conclusion: In order to increase self-confidence in performance of MDROs infection control, it is suggested a positive organizational culture be developed with regularly monitoring and feedback, and to develop an MDROs infection control theory and practical training intervention program.