Approaches to Care
Using Structural Equation Model (SEM) in Analyzing Day Care Service in the Community for the Older Adults’ Quality of Life Improvement
Paper Presentation in a Themed Session Nattapat Sarobol
This research study analyzes the service design in Day Care Center to enhance the quality of life for the older adults. The study was conducted in the areas of two sub-district municipalities in Thailand. The participants were the older adults and the stakeholders involved with Day Care Center provided by two local administrative organizations. Collected data includes both qualitative and quantitative research methodologies. The results from an interview revealed the positive impacts on the quality of life in 4 areas as follows: 1) Well-being: it was found that some older adults have better physical and mental health, 2) Being happy: all of the older adults participated in the Day Care Center reported that they were happier, 3) Having a good society: the findings indicated that the older adults engaged more in social activities, 4) Living in a good environment: the study showed that the older adults learned how to live in a clean, safe place that is suitable for their age. Regarding the quantitative data, they were analyzed by using Structural Equation Model (SEM), which revealed that the model had a good fit (91, N = 233) = 112.383, p = 0.064, = 1.235, CFI = 0.992, TLI =0.988, RMSEA = 0.032, SRMR = 0.035. Based on these findings, it is recommended that local administrative organizations should implement this service design from SEM analysis to enhance the community participation and the capacities of professional care in the provision of Day Care Center for the older adults.
Advantages and Value of a Four-Year University Care Worker Program in Japan View Digital Media
Paper Presentation in a Themed Session Hiromi Watanabe
In Japan, the Social Worker and Care Worker Law was enacted in 1987. Currently, there are four pathways to becoming a government-certified care worker: 1. Course study route 2. Specific high school route 3. Work experience route 4. Economic Partnership Agreement (foreign national acceptance route). In this paper, I introduce the educational content of the care worker program at Japanese universities and discuss the advantages and value of a four-year education. This is achieved by analyzing published data and presenting examples of four years’ worth of educational content. The total number of certified care workers in Japan was 1,940,317 in 2023. Of the 66,771 newly certified care workers that year, 86% entered the profession through the work experience route, while 14% followed the course study route. Among these, only 1% (n=684) studied at a four-year university. Fifty-three universities offer certified care worker courses in Japan in 2023. These universities also offer certified social worker education. The advantages for university students are as follows: 1. Simultaneous learning of care work and social work. 2. Bachelor’s degree in social welfare studies. 3. Diplomas for certified care workers. 4. Diplomas for certified social workers. The value of this education lies in familiarizing students with the development of caring philosophy, from “Maid-Servant Syndrome Care” to “Person-Centered Care.” Additionally, students acquire the latest care knowledge, skills, and technology.
Effects of Nurse Practitioners’ Full Practice Authority on Long-term Care Services
Paper Presentation in a Themed Session Brenda Gannon
Many U.S. states have granted nurse practitioners (NPs) the right to practice and prescribe drugs without physician oversight, increasing the number of independent primary care providers. While existing studies show that full practice authority (FPA) increases access to primary care, thereby reducing the use of hospital services, less is known about its impacts on long-term care services. Using the Health and Retirement Study (HRS), we examine whether granting NPs full practice authority affects long-term care utilization. Exploiting the staggered adoption of states’ Scope-of-Practice laws during 1998-2018, we find that NP full practice authority has no significant impacts on nursing home use but individuals living in states with no practice restriction are less likely to use home care services. In FPA states, we find that individuals living in medically underserved areas experience a larger reduction in the use of long-term care services and inpatient care than the same individuals living in states with no primary care shortages. Regarding health outcomes, we find evidence that individuals living in states with FPA are less likely to report being in poor health and have fewer functional limitations. These findings indicate that granting NPs full practice authority does not have any negative health consequences. This is also suggestive evidence that FPA can help improve population health in medically underserved areas and achieve cost-saving through reductions in costlier services.
