[Case management process identified from experience of nurse case managers]

Area of Science:

• Nursing
• Healthcare Management
• Sociology

Background:

• Case management (CM) is crucial for vulnerable populations.
• Understanding the experiences of nurse case managers is essential for effective practice.
• Medical Aid enrollees in Korea represent a specific population requiring tailored support.

Purpose of the Study:

• To develop a substantive theory of case management (CM) practice.
• To investigate the experiences of nurse case managers caring for Medical Aid enrollees in Korea.

Main Methods:

• Grounded theory approach utilized.
• In-depth interviews conducted with 12 experienced nurse case managers.
• Qualitative data analysis to identify core themes and processes.

Main Results:

• Empowerment identified as the core category of CM practice.
• Five distinct phases of CM practice identified: inquiring, relationship building, critical thinking facilitation, healthcare service utilization enhancement, and relationship maintenance.
• Phases are dynamic, circular, and influenced by client, manager, family, and resource factors.

Conclusions:

• The study provides a nuanced understanding of nursing CM practice.
• Empowerment and the five identified phases should be integrated into future CM programs.
• Recommendations for nurse leaders and policymakers to enhance CM delivery for Medical Aid enrollees.