The Changes of Quality and Structural Provision of Domiciliary Care Coinciding with the Statute Long Term Care Insurance Policy-A Study of the Task and Responsibilities of Care Managers-

随着长期护理保险政策的实施，护理管理的结构主要基于需要此类服务的人的需求。事实证明，护理经理的存在和定位在这种护理管理中发挥着至关重要的作用。根据去年举行的研究，它发现，护理经理需要获得新的护理管理技能，以满足他们的要求。针对神奈川县内的护理经理进行了研究，收集了有关护理管理的基本数据，从中收集了408个有效答案-问答书面研究、有关工作时间内容的研究和口头（采访）研究。问答书面研究明确了护理经理的地位、护理管理的内容和负担。通过记录每个经理在一个月的工作时间内所做的具体工作内容，可以揭示和分析实际工作的水平，突出 ...更多信息 找出问题并提供可能的改进方案。此外，还进行了口头调查，以了解个人的工作条件，结果表明：最初持有的资格是：“保健护士/护士”-40%，“认证护理工作者”- 24.9%，“认证社会工作者”-8.1%。职业经理人所属的组织是：“社会福利基金会。“-36.4%，“医疗服务基金会”-23.3%，“私营公司”-23.3%。平均客户人数在40到59人之间。提出“护理管理的重要性”的护理经理人数最多？因为他们获得这个职位的原因是“注册社会工作者”。获得这种地位的最高年龄组是50岁以上。关于护理管理的实际内容，在“长期护理保险政策条款”、“护理管理人员的作用”和实际“合同”方面缺乏相互理解。那些不使用任何结构化测量评估-24%。那些承认客户的“非正式护理网络”-26%。那些完全了解客户的“财务状况”-35%。在实际工作时间内，在办公室打电话提供护理、获取信息和记录结果花费了很多时间，使得实际花费在拜访客户上的时间比最初预计的要少得多。采用陶氏职业倦怠量表对护理管理人员的主观负担进行测量，发现护理管理人员的主观负担包括情绪耗竭、个人成就感、去人格化和任务完成感4个因素。“少

With the implementation of the Long Term Care Insurance Policy, care management was structured based mainly on the needs of those in need of such services. The existence and positioning of the Care-Managers have proven to play a critical role of such care management. According to research held last year, it was found that Care-Managers need to acquire new care management skills to fulfill their requirements. Research was conducted toward the Care-Managers within Kanagawa Prefecture to gather basic data regarding care management from which 408 valid answers were gathered- question＆answer written research, research concerning the content of the working hours and verbal (interview) research.The question＆answer written research made apparent the status of Care-Managers, the content of care management and burden. By recording the specific content of work conducted during each Manager's working hours for one month, the level of work actually conducted can be revealed and analysed, highlighti … More ng problems and providing possible solutions for improvement. Further, verbal research was conducted to understand personal working conditions.The result showed that : The initial qualifications held are ; "Health Nurse/Nurse"-40%, "Certificated Care-Worker"- 24.9% "Certificated Social Worker"-8.1%. The organization to which the Care-Managers belong to are ; "Foundation for Social Welfare. " -36.4%, "Foundation for Medical Services"-23.3%, "Private Corporations"-23.3%. The average number of clients held ranged from 40 to 59.The highest number of Care-Managers that raised "significance of care management? as the reason for their acquisition of their position was "Certified Social Workers". The highest age-group that acquired such position was over 50 years old. In regard to the actual content of care management, there is a lack of mutual understanding in regard to the "Terms of the Long Term Care Insurance Policy", "Role of the Care-Managers" and the actual "Contract". Those that do not use any structured measurements for Assessment - 24%. Those that acknowledge the client's "Informal Care Network" - 26%. Those that fully understand the client's "Financial Status" - 35%. Within the actual working hours, the hours spent on the phone to provide care, to acquire information and to record such results at the office took much time making the actual time spent visiting the clients much less than initially anticipated. The subjective burden of care managers measured by the Tao's Burnout Scale were identified 4 factors, emotional exhaustion, personal accomplishment, depersonalization and task accomplishment." Less