Effects of Medicaid Case Manager's Communication Competence and Stress on Their Job Satisfaction

PURPOSE: This study was conducted to identify effects of Medicaid Case Manager's communication competence and stress on their job satisfaction. METHODS: The current work is descriptive research, and the participants were 154 medicaid case managers. Data were collected between May and July, 2017 through Embrain, a specialized research organization. The data were analyzed using independent t-test, ANOVA, and multiple regression. RESULTS: The mean communication competence of the medicaid case managers was 3.61, stress 1.76, and their job satisfaction 2.74. Age and average monthly compensation brought significant differences in their job satisfaction. Their communication competence was correlated with stress (r=−.35, p<.001), but not with their job satisfaction. The stress was the most influential factor in job satisfaction (β=−.45). CONCLUSION: The results of this work show that the medicaid case managers' communication competence was not an influence factor of their job satisfaction, which is different from implications from the previous studies and needs confirmation through future research. In addition the results of this study also suggest that stress management can be a useful approach to the improvement of medicaid case managers' job satisfaction.

The Death Anxiety and Depressive Symptoms among Poor Older Women in Rural Areas: The Moderating Effect of Social Support

PURPOSE: This study was conducted to identify the moderate effect of social support on the relationship between death anxiety and depressive symptoms among poor older women in rural areas. METHODS: This was a secondary analysis of the data from 209 women who were participated in the intervention study to evaluate the effectiveness of depression prevention program. Data were collected between April and September 2012. The data were analyzed using moderate multiple regressions. RESULTS: Among these poor older women, depressive symptoms were associated with death anxiety and social support. Self-esteem support had a moderating effect on the relationship between death anxiety and depressive symptoms. CONCLUSION: The results indicate that the self-esteem support was effective in decreasing depressive symptoms and death anxiety in poor older women. In order to reduce their depression and make positive changes in their lives, self-esteem improvement programs are needed.

The Effect of Knowledge, Attitudes and Prevention Behaviors for Tuberculosis Infection in Nursing Students

PURPOSE: This study aimed to identify the relationship among knowledge, attitudes and prevention behaviors (PB) on tuberculosis (Tb) infection in nursing students. METHODS: 268 subjects were recruited from two universities located in C·D cities of Korea and data were collected utilizing self-reported questionnaires. RESULTS: The mean scores of knowledge, attitudes and PB on Tb infection were 64.83, 3.18 and 2.97. The knowledge differed according to gender (t=-3.16, p=.002), grades (F=32.19, p<.001), educational experience about Tb (EETb) (F=10.59, p<.001), learning information about Tb (t=3.08, p=.002) and getting Tb: self or others (t=2.78, p=.006). The attitudes differed according to grades (F=7.71, p<.001) and EETb (F=2.68, p=.047). The PB differed according to grades (F=7.02, p<.001) and EETb (F=4.55, p=.004). Significant correlations were found between knowledge and PB (r=.20, p=001), attitudes and PB (r=.33, p<.001). The most significant factor influencing PB was attitudes with R2 value of 13.9% (F=11.81, p<.001). CONCLUSION: These findings indicate that knowledge and attitude adjustment may be necessary to improve PB for Tb infection in nursing students. Moreover further study is necessary to find out the ways to reinforce the level of attitudes. The results of the study can be utilized in educational programs for preventing Tb infection in nursing students.

The Effects of a Positive Psychology Improvement Program on Elders' Depression and Death Anxiety

PURPOSE: This study was conducted to investigate the effects of a positive psychology improvement program on elders' depression and death anxiety. METHODS: This was conducted as a quasi-experimental study with non-equivalent control group pretest-posttest design. The participants were community elders aged over 65 recruited by convenient sampling. A total of 94 elders (32 in the individual experimental group, 32 in the collective experimental group, and 30 in the control group) participated. Data were collected between April and September, 2012 and analyzed by using SPSS/WIN 21. RESULTS: The individual and group approach experimental groups had significantly lower scores of depression than the control group after the treatment (F=7.50, p=.001). For death anxiety, however, only the individual experimental group had a significantly lower score compared to the control group (F=4.56, p=.013). CONCLUSION: These results indicate that the positive psychology improvement program was effective in decreasing depression and death anxiety in the elderly. Therefore, the program needs to be applied in a customized way fittingly to the characteristics of the elderly in community, and individually and/or collectively according to its purposes.

Effects of Autogenic Training on Stress Response and Heart Rate Variability in Nursing Students

PURPOSE: This study was undertaken to confirm the effects of autogenic training (AT) on stress response and heart rate variability in nursing school students experiencing stress related to clinical training. METHODS: The study was carried out from September 2012 to April 2013 in a quasi-experimental nonequivalent control group using a pretest-posttest design. The participants were 40 nursing students in their third year at either of two nursing colleges. All consented to participate. Nineteen nursing students at one college were assigned to the experimental group and underwent the 8-week AT program, and the other 21 were assigned to the control group and did not undergo any training. Stress response was assessed by questionnaire and HRV was measured three times, that is, before the program, at the end of the program, and 6 months after the end of the AT program. RESULTS: A significant time/group interaction was found for stress response (F = 4.68, p = .012), a subjective indicator. However, no significant interaction was found for the objective indicators of heart rate variability, normalized low frequency (F = 2.59, p = .090), normalized high frequency (F = 2.59, p = .090), or low frequency to high frequency ratio (F = 1.38, p = .257). CONCLUSION: The results suggest that AT provides an acceptable approach to stress reduction in nursing students.

The Relation between Interpersonal Attitude and Communication Competence of New Visiting Nurses in Community Health Center / 한국직업건강간호학회지

PURPOSE: This study was to identify the relations of interpersonal attitude and communication competence of new community health nurses. METHODS: The research design was a correlational study. The data were collected from 136 visiting nurses using a structured questionnaire and analyzed using independent t-test, Pearson's correlation coefficient, and multiple regression with the SPSS/WIN 20.0 program. RESULTS: The type of interpersonal attitude in subjects was I+U+ and the score of communication competence was 3.6. Among 15 sub-dimensions, the highest score was responsiveness and the lowest was assertiveness. There were no significant differences in communication competence by general characteristics. Factors influencing on communication competence in new visiting nurses were interpersonal attitude I+(I am OK) (beta=.34) and I-(I am not OK) (beta=-.28). CONCLUSION: Education program, stressing the self-awareness, is necessary to increase positive interpersonal attitude and communication competence for reemployment of community health nurses. Furthermore, in order to reinforce assertiveness, institutional support should be accompanied with the efforts of individual level.

Factors Affecting Aggression in South Korean Middle School Students

PURPOSE: The study was undertaken to assess levels of aggression, and to determine factors affecting aggression among South Korean middle school students. METHODS: A descriptive study was conducted using self-report questionnaires. The participants were 340 girls and boys from two middle schools and 302 questionnaires were used for the final data analysis. Aggression, academic stress, depression, self esteem, decision-making competency, and happiness were measured. Data were analyzed using descriptive statistics including t tests, one-way analysis of variance, Pearson's correlation coefficients and multiple regressions. RESULTS: Aggression had significant correlations with academic stress (r = .21, p < .001), depression (r = .43, p < .001), self esteem (r = -.25, p < .001), decision-making competency (r = -.25, p < .001), and happiness (r = -.21, p < .001). Mean score for aggression was 2.49 out of 5. Significant explanatory variables for aggression were grade (t = 4.39, p < .001), academic stress (t = 2.78, p = .006), and depression (t = 5.03, p < .001). The explanatory power of these factors was 26.9%, and this was statistically significant (F = 16.06, p < .001). CONCLUSION: Findings indicate that depression, academic stress, and grade (second grade) influence aggression. To decrease aggressive behavior, it is necessary to provide systematic and political programs in schools and local communities that can ameliorate negative emotional factors like depression and academic stress. Additionally, development of positive factors such as self esteem, decision-making skills, and happiness in middle school students is important to reduce aggression.

Trend Analysis of Experimental Research Papers on Community Health Nursing: Based on Researches Published in the Journal of Korean Academy of Community Health Nursing, 1989~2012

PURPOSE: The objective of this study is to analyze systematically the trends of experimental researches in the area of community health nursing. METHODS: This is a study based on literature review, which analyzed 137 experimental research papers in the Journal of Korean Academy of Community Health Nursing, from the first issue in 1989 to those in 2012. RESULTS: 1) The proportion of experimental researches in the total published papers was 14.9%. 2) The mainly used research method was quasi-experiment, which was 60.6% of them, and there was no RCT. 3) Convenient sampling was used in 95.6% of the researches. 4) Only 5.1% were reviewed for keeping the ethical standards for the study objects by the IRB. 5 When classified by the Omaha Classification System, psycho-social researches were most frequent, which were followed by physiological, health-related behavioral, and environmental ones in order of frequency. CONCLUSION: This study found that the proportion of experimental research papers was increasing in the 2000s and ethical standards were required more rigorously. However, it was suggested that the research design be more elaborated and sampling methods be manifested to reduce research bias and errors.

Influence of Interpersonal Attitude on Communication Competence in Care Workers for Frail Elderly / 한국직업건강간호학회지

PURPOSE: The purpose of this study was to identify the influence of interpersonal attitude (I+, I-, U+, U-) on communication competence in care workers for frail elderly. METHODS: This study was a cross-sectional survey. The data were collected from 153 care workers for frail elderly using a structured questionnaire. The data were analyzed using multiple regression with the SPSS/WIN 20.0 program. RESULTS: The interpersonal attitude style of subjects was I+U+, and the score of communication competence was 3.53. There were significant differences in interpersonal attitude (I+, I-), and communication competence depending on age, education level, experience of personality type test (yes). Factors influencing on communication competence in care workers were interpersonal attitude (I+, I-, U+) and experience of personality type test with R2 value of 48.5% (F=23.47 p<.001). The most influencing factor was I+ (beta=.36), followed by I- (beta=-.22), U+ (beta=.20), and experience of personality type test (yes) (beta=.16). CONCLUSION: It is needed to maintain the interpersonal attitude style (I+U+) of care workers. Continuing education program is needed for increasing communication competence especially for those fifties and over, and experienced care workers. Giving an opportunity for personality test is helpful to increase communication competence in care workers.

Role Transition from Clinical Nurse to Case Manager for Medical-aid Beneficiaries: Taking Root in a Barren Land

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.

Effects of Continuing Education for Healthcare Manager on Knowledge, Attitude, and Skills / 한국직업건강간호학회지

PURPOSE: This study was to examine the effects of 3 domains of continuing education (CE) for healthcare managers. METHODS: A group of 20 healthcare managers, attending 3 levels of CE, were the subjects. The data were collected by structured questionnaires before and after each education. The data were analyzed by Friedman test, Wilcoxon Signed Ranked Test, and Bonferroni correction. RESULTS: After completing CE, there was significant improvement on the scores of knowledge, attitude, and skills. CONCLUSION: This study suggests that CE for healthcare managers is an effective strategy to promote the competency of healthcare managers, who take care of the chronically ill patients.

Reliability and Validity of the Decision-Making-Competency Inventory (DMCI) in Korean Adolescents

PURPOSE: This study was done to verify the reliability and validity of the Korean version of DMCI in Korean adolescents. METHODS: A methodological study design was used with Cronbach's alpha for reliability, and an exploratory factor analysis and contrasted groups approach for construct validity. DMCI was translated into Korean and tested with a sample of 406 adolescents in Korea. The data were analyzed using Cronbach's alpha, item correlation with total, principal component factor analysis, and t-test. RESULTS: The translated content of the DMCI was validated by nursing faculty members and translation equivalency was obtained. The Cronbach's alpha of the DMCI simplified with 18 items was .78. The factor analysis revealed three factors explaining 41.5% of total variance and the corresponding factors were self-observation (21.6%), self-judgement (11.4%), and self-confidence (8.6%). The mean score for the DMCI in the aggression group was significantly lower than the non-aggression group. CONCLUSION: Results of this study suggest that the Korean version of DMCI can used as a reliable and valid measure to assess decision making competency in Korean adolescents.

The Relationship among Knowledge, Attitudes, Skill, Self-efficacy, and Job Satisfaction of Healthcare Managers / 산업간호학회지

PURPOSE: The purpose of this study was to identify the differences and relationships among knowledge, attitudes, skill, self-efficacy (SE), and Job satisfaction (JS) of healthcare managers (HMs) participated in the 4 kinds of continuing education. METHODS: The subjects were 152 HMs. Data were analyzed by Mann-Whitney U test, Kruskal-Wallis H test, and partial correlation. RESULTS: There were significant differences in knowledge according to the amount of healthcare management experience (HME) and the training program level (TPL); in the attitudes according to gender, age, and the TPL; in the skill according to the amount of HME and the TPL; and in SE according to gender and the TPL. There was no significant difference in JS according to general characteristics. There were significant positive correlations among knowledge, attitudes, skill, SE, and JS. CONCLUSION: The TPL was identified as a significant common variable that affects all variables apart from JS. According to these results, knowledge, attitudes, skill, and SE are considered as intrapersonal constructs, whereas JS is considered as an organizational construct. Therefore, in order to improve the quality of healthcare management, organizational strategy to enhance job satisfaction of HMs are recommended.

The Effects of Case Management for Medicaid on Healthcare Utilization by the Medicaid System

PURPOSE: This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system. METHODS: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. RESULTS: The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system. CONCLUSION: CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries' outpatient healthcare utilization with the designated doctor system.

Change in Healthcare Utilization by Disease Severity after Case Management for Medicaid

PURPOSE: This study examined change in healthcare utilization by disease severity after case management (CM) for Medicaid. METHODS: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare change in healthcare utilization between the CM group and the non-CM group. The subjects were 528 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. RESULTS: In beneficiaries having fewer than 3 among the 11 notified diseases, the CM group showed a significantly larger decrease in outpatient day, outpatient expense, medication day, and medication expense than the non-CM group. In beneficiaries having 3 or more among the 11 notified diseases, however, there was no significant difference in healthcare utilization between the CM group and the non-CM group. CONCLUSION: CM worked effectively on Medicaid beneficiaries outpatient healthcare utilization for mild diseases. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, a future study is needed to develope strategies to reduce hospitalization and care for Medicaid beneficiaries with severe diseases.