Introduction

Background

As the proportion of the elderly population is increasing due to rapid population ageing, there is also a rapid increase in the number of dementia patients. As of 2024, in Korea, the number of dementia patients aged 65 or older is estimated to be approximately 984,600 with a dementia prevalence rate of 10.41% [1], and according to an epidemiological survey of dementia, the number of dementia patients aged 65 or older is projected to increase to 2,173,000 people in 2040 and 3,023,000 people in 2050 [2]. Since the symptoms of dementia include emotional and behavioral disorders and changes in personality along with impairment in overall cognitive functioning, dementia patients need continuous care and nursing, and as a result, the socioeconomic burden has been increasing exponentially with the increase of the number of dementia patients [3,4]. Therefore, the management of dementia should be carried out not by individuals, such as dementia patients or their families, but by national policies [3].

In Korea, since the announcement of the National Responsibility for Dementia in 2017, dementia care centers have been operated in public health centers nationwide to provide integrated dementia care services such as dementia prevention, counseling, early diagnosis, linkage to health and welfare resources, and education in order to suppress the aggravation of dementia and reduce social costs, ultimately contributing to improving the quality of life of dementia patients, their families, and the general public [5]. The personnel of dementia care centers consist of professionals such as doctors, nurses, social workers, occupational therapists, and clinical psychologists, and among the staff of dementia care centers, nurses account for the largest proportion at approximately 52% [6], and most of the staff perform most tasks together except for diagnostic tests for early dementia diagnosis.

As of 2024, the 4th Comprehensive Dementia Management Plan (2021-2025) is being implemented, and in order for an organization to efficiently adapt to various environmental changes, it is essentially needed to foster experts with competitiveness through the enhancement of the competencies of human resources [5,7,8]. For this purpose, it is necessary to effectively develop various training programs that are in line with the organizational goals. In particular, it is essential to develop programs that can reduce the theory-practice gap and enhance actual job performance capabilities [9].

Unlike clinical nursing that provides direct nursing care to patients, nurses working at dementia care centers directly lead and perform various roles such as dementia prevention, early screening, support for dementia treatment and management costs as well as the costs of tests for diagnosing dementia, dementia prevention education, tailored case management’, education for dementia patients and their families, and operation of cognitive programs for local residents [10]. As described above nurses working at dementia care centers handle a wide range of jobs and diverse tasks, and the nurses are required to have communication skills with workers in other professions as well as perform the role of nurses as professionals [11].

So far, previous studies on nurses have been mostly focused on clinical nurses working in medical institutions. However, as the function of care within the community is currently being emphasized, the role of nurses within the community should be gradually further strengthened and expanded. Regarding previous job analyses for the work of community nurses in Korea, prior studies carried out so far include a job analysis for visiting nurses [12], a job analysis for nurse care coordinators for chronic illness management in primary care settings [13], and a study on the work importance and work performance of nurses working at dementia care centers [14]. However, no domestic job analysis by applying a job analysis technique has been conducted to analyze the jobs of community nurses since around the time when the National Responsibility for Dementia started to be implemented. In order to successfully establish the dementia care project, it is essentially needed to conduct a multifaceted research on the jobs of nurses because nurses are the main human resources for implementing the dementia care project. In particular, it is necessary to analyze the work of nurses according to the continuously changing environment and establish a standardized framework for job duties and tasks. In addition, in a study on the dementia-specialized educational needs in employees of dementia-related institutions and future directions for improvement of dementia education in Korea [15], it was proposed that research such as job analysis for each occupation group should be conducted to clearly define the essential educational content tailored to the needs of the target group and establish the system of a standard specialized dementia education curriculum. In addition, related studies [16-18] also recommended that it is necessary to improve the effectiveness of education and strengthen the professionalism of dementia care workers in order to ensure a stable supply of skilled human resources.

Job analysis is performed to provide accurate information about the work performed by the workers of an occupation group by clearly presenting the descriptions and characteristics of the jobs of a specific occupation group as well as the skills and qualifications required for the jobs [19]. At the organizational level and at the level of human resource management, job analysis is an activity to identify competencies required for employees to successfully carry out tasks, establish a compensation system for job performance, motivate employees to perform job behaviors, and determine how to utilize the compensation system to satisfy employees’ needs [20]. Among the job analysis methods, the DACUM (Developing a Curriculum) method involves the participation of field experts who are most knowledgeable about the field, and it has been evaluated as a very effective approach in performing the process of job analysis or conceptual analysis [21]. The DACUM method is used to overcome serious risks and inefficiencies, keep the curriculum relevant and up-to-date, and provide a basis for a structured program [22]. This technique can be employed as a useful method when developing education programs or reviewing existing education programs by quickly identifying important tasks for successfully performing specific job duties.

Thus, this study aimed to provide a basis for developing an appropriate and valid standard education curriculum through job analysis for nurses working at dementia care centers, and thereby contribute to the enhancement of their competencies as professionals in the dementia care project.

Aims and objectives

The main aims of this study were to define the latest job duties of nurses working at dementia care center by applying the DACUM technique and to identify the frequency, importance, and difficulty of their duties and tasks. The specific objectives of this study are as follows:

1) To define the latest jobs of nurses working at dementia care centers;

2) To derive the duties and tasks of nurses working at dementia care centers;

3) To identify the importance, frequency, and difficulty of the duties and tasks of nurses working at dementia care centers;

4) To prioritize the duties and tasks of nurses working at dementia care centers according to the importance, frequency, and difficulty of the duties and tasks.

Methods

Study design

This study is a descriptive survey research that attempted to analyze the latest job duties of nurses working at dementia care centers, develop a job description, and evaluate the importance, frequency, and difficulty of the developed tasks.

Participants

The participants were selected from nurses working at dementia care centers in 25 autonomous districts of Seoul (229 people as of 2023) by applying a stratified sampling method. More specifically, the population was divided into the two strata of team leaders and team members, based on job positions, and then samples were extracted from each stratum. In Korea, dementia care centers are operated in accordance with the Dementia Management Act and Dementia Policy Project Guide of the Ministry of Health and Welfare. Since Seoul was the city where the first dementia care center in Korea was opened, and the projects and operation model of the dementia care centers of Seoul were expanded and applied nationwide, the participants of this study were recruited from dementia care centers in Seoul. Regarding the inclusion criteria for the participants, this study selected participants primarily among the nurses working at a dementia care center for at least 5 years, who were considered experts in their field, according to Benner’s definition [23]. However, in the case of districts where there were no nurses with at least 5 years of experience in their job, participants were selected from skilled nurses with at least 3 years of experience in their job, and nurses with less than 3 years of experience were excluded. In districts without a nurse team leader, the deputy director (nurse) of a dementia care center was included among the potential participants. The deputy director of a dementia care center is a manager and a position higher than the team leader. As a result, the participants of this study consisted of a total of 54 people who agreed to participate in the study, and 50 of them (21.8% of the target population) were finally included in the analysis by excluding one nurse whose career duration was less than 3 years and 3 nurses who did not complete the survey.

Procedures

In order to prepare and design job analysis, after creating a plan for the DACUM process, data collection was conducted, and a DACUM committee was organized. Then, the definition and description of the job of nurses working at dementia care centers were determined through consensus during the DACUM workshop. Then, a DACUM chart showing the lists of specific duties and tasks performed by nurses working at dementia care centers was developed. To evaluate the validity of this developed DACUM chart, the degrees of importance, frequency, and difficulty for each duty and task were examined, and key tasks were derived to prioritize duties and tasks (Figure 1).

1. Preparation and design of job analysis

In preparation for the job analysis workshop, preliminary work, such as a literature review, creation of a plan for the DACUM process, and data collection, and the organization of the DACUM committee, were conducted. The form for data analysis was developed with reference to the 2024 main projects of dementia care centers of the Ministry of Health and Welfare. Regarding the selection criteria of the members of the DACUM committee, 5 people who had at least five years of experience in dementia care, a good understanding of the duties of dementia care center nurses, and good communication skills were selected as the final members. Specifically, the DACUM committee was composed of a total of five members, who included the director of the Seoul Metropolitan Center for Dementia and four deputy directors of dementia care centers in the autonomous districts of Seoul Metropolitan City. The committee members included three people with at least three years of experience as practitioners at dementia care centers (A: 3 years, B: 4 years, C: 10 years).

2. Implementation of job analysis

Based on the classification of the 2024 main projects of dementia care centers of the Ministry of Health and Welfare, a DACUM Committee workshop was held and consensus was derived through group discussions. During the DACUM Committee workshop, the researcher, who had studied the job analysis guidelines of the Korea Research Institute for Vocational Education & Training, served as the DACUM coordinator. The duties and tasks were classified according to the classification of the 2024 main projects of dementia care centers presented by the Ministry of Health and Welfare, and the duties and tasks were revised and supplemented based on practical experience. The details about the classification of duties and tasks derived through the coordination of opinions were organized considering their suitability, and the classification results of duties and tasks were finally determined through a unanimous decision process.

The workshop was held on May 16. At the beginning of the workshop, explanations about the directions and objectives of job analysis were given to the participants and the DACUM job analysis method was shared during the orientation process. During the workshop, the job activities actually currently performed were listed, and agreements on the duties and tasks were derived. More specifically, in the initial stage of the workshop, 8 duties and 44 tasks were reviewed and revised and supplemented through a repetitive review process until an agreement was reached, and the DACUM chart was completed through the process.

Through the validation process by the five experts who attended the workshop, 10 duties and 66 tasks were finally derived in this study. The validity of the job analysis tool was evaluated by the same five experts to determine whether the measurement method included all the key elements that it was intended to measure. To secure accuracy and reliability, validity verification was performed at least one week after the workshop. In the first evaluation of validity, the content validity ratio (CVR) was calculated as 1.0, indicating that all the experts responded that each item was essential. In the secondary evaluation of validity, among the content validity indexes (CVI), the item-level CVI (I-CVI) value was calculated as 1.0, indicating good content validity, so the job analysis tool comprised of 10 duties and 66 tasks was finally completed.

3. Evaluation of job analysis

A questionnaire using a 5-point scale was developed to measure the degrees of the importance, frequency, and difficulty of the 10 duties and 66 tasks derived for the job description developed in this study. The degree of importance refers to the degree to which a duty or task is perceived as important, the degree of frequency refers to how frequently a duty or task is actually performed, and the degree of difficulty refers to the degree of difficulty in learning and performing a duty or task. A higher score indicates a higher level of importance, frequency, and difficulty, respectively. However, the respondents who did not currently perform the task in question were asked to evaluate the importance, frequency, and difficulty of the task based on their subjective judgement about the importance and difficulty of the task. Based on the results of this survey, key duties and tasks were derived.

The survey was conducted from August 2 to 19, 2024, and data was collected anonymously in a non-face-to-face manner by a web-based survey (via a URL link to the online survey).

Data analysis

The collected data was analyzed using the SPSS 22.0 program. In order to identify high priority duties and tasks, the collected data was coded, and the mean, standard deviation, and percentage were calculated to analyze the importance, frequency, and difficulty of the duties and tasks of nurses working at dementia care centers.

In order to derive the core tasks of dementia care center nurses, an analysis method using a tree structure diagram [24,25] was used. This analysis technique uses the degrees of importance, frequency, and difficulty to prioritize tasks, and normally rounds off the average of the values obtained through a survey to the nearest integer.

In this study, the degrees of importance, frequency, and difficulty of tasks were measured on a 5-point scale, and the arithmetic means of the scores obtained through a survey of the participants were rounded off to the nearest integers and then entered into a tree structure diagram for analysis. In the analysis of the survey results, the levels of difficulty, importance, and frequency were classified into high, medium, and low by dividing the mean scores for difficulty, importance, and frequency into high, medium, and low by categorizing 4 and 5 points as high, 3 points as medium, and 1 and 2 points as low. The final rankings of tasks for prioritization were determined by arranging the tasks based on the levels of difficulty, importance, and frequency for each of these three factors by sequentially considering the three factors in the order of difficulty, importance, and frequency. In this analysis, only the duties or tasks ranked first to third were considered. For example, if a task is found to have a high degree of difficulty (5 or 4 points on a 5-point scale), a high degree of importance (5 or 4 points), and a high frequency (5 or 4 points) by the analysis method applied in this study, then the task is determined as the highest priority. When the final rankings of tasks are determined, the first and second highest priorities are determined as the key tasks for the job and they are selected as the targets of education and training.

Ethical considerations

Data collection was conducted after receiving approval from the Institutional Review Board of the Catholic University (IRB No.: MC24QASI0067). The participants were recruited through the cooperation of dementia care centers in each autonomous district of Seoul, and the survey URL was delivered to the participants by the manager of each institution. On the first page of the URL link to the online survey, the participants were provided with explanations about the purpose and method of the study, the possibility of withdrawal from the study depending on the intention of the participant, confidentiality of the collected information, voluntary participation and the possibility of withdrawal from the study without any disadvantages at any time, the time required to complete the questionnaire, security of the survey data, and the procedure of data disposal after the completion of the research. The contact information of the researcher was also provided to the participants so that they could contact the researcher at any time to make inquiries during the data collection and survey process. Written informed consent to participate in the study was obtained from the participants through the survey URL, and the research was conducted anonymously.

Results

General characteristics of the participants

The general characteristics of the participants are shown in Table 1. The mean age was 42.16±7.44 years, and the average duration of career in a dementia care center was 86.62±44.05 months. The participants were mostly women (49 people, 98.0%), and regarding education level, people with a bachelor’s degree accounted for the largest proportion (35 people, 70.0%). As for the current position in a dementia care center, the participants consisted of 25 team members (50.0%), 18 team leaders (36.0%), and 7 deputy heads (deputy directors) of dementia care centers (14.0%).

Duties and tasks of nurses working at dementia care centers

The main jobs of dementia care center nurses were classified into 10 duties and 66 tasks, and the 10 duties derived in this study were as follows: ‘consultation and registration management’, ‘dementia screening’, ‘tailored case management’, ‘cognitive health program and short-term shelter for dementia patients’, ‘supporting service for dementia’, ‘support for families and carers of dementia patients’, ‘improvement of awareness and public relations for dementia’, ‘strengthening community resources’, ‘public guardianship project for dementia’, and ‘project planning and evaluation.’ Each duty consisted of three to ten tasks, and the duty composed of the largest number of tasks was ‘dementia screening’ (Table 2).

Levels of importance, frequency and difficulty of the duties and tasks of nurses working at dementia care centers

The levels of importance, frequency, and difficulty of the finally derived 66 tasks are shown in Table 2, and the average score of each factor was 4.35±0.36 points for importance, 2.64±0.76 for frequency, and 3.74±0.38 points for difficulty.

‘Public guardianship project for dementia’ was rated as the most important duty by the participants, and other duties included in the five most important duties were ‘dementia screening’, ‘consultation and registration management’, ‘project planning and evaluation’, and ‘cognitive health program and short-term shelter for dementia patients.’ Regarding to the degree of frequency of each duty, ‘consultation and registration management’ was found to be the most frequently performed duty, and other duties included in the five most frequently performed duties were ‘dementia screening’, ‘tailored case management’, ‘supporting services for dementia’, and ‘support for families and carers of dementia patients.’ As to the level of difficulty, the most difficult duty was found to be ‘dementia public guardianship project’, and the following duties were included in the six most difficult duties: ‘project planning and evaluation’, ‘strengthening community resources’, ‘improvement of awareness and public relations for dementia’, ‘support for families and caregivers of dementia patients’, and ‘tailored case management.’

Priority rankings of the duties and tasks of nurses working at dementia care centers according to the levels of importance, frequency, and difficulty (Derivation of core duties and tasks)

The top priority duties of dementia care center nurses were identified as ‘consultation and registration management’, ‘tailored case management’, and ‘support for the families and guardians of dementia patients.’ The key duties and tasks derived in this study are shown in Table 3.

Discussion

This study derived the latest duties and tasks of nurses working at dementia care centers by applying the DACUM technique, and analyzed the degrees of importance, frequency, difficulty of duties and tasks to determine the priority rankings of duties and tasks.

Duties and tasks of nurses working at dementia care centers

In this study, some duties derived in this study were newly identified ones. In the present job analysis, a duty refers to a group of tasks, which consist of specific meaning units of the work performed by an occupation group. In a previous study [14] based on the 2017 and 2018 projects, the duties of nurses working at dementia care centers were derived as follows: ‘consultation, registration and classification’, ‘case management’, ‘dementia diagnosis and screening’, ‘dementia patient management project’, ‘dementia prevention and management project’, ‘consultation of families of dementia patients and care support project’, ‘administrative work and community capacity enhancement’, and ‘employee capacity enhancement and welfare management.’ Meanwhile, in this study, the main duties of nurses working at dementia care centers were derived as follows: ‘consultation and registration management’, ‘dementia screening’, ‘tailored case management’, ‘cognitive health program and short-term shelter for dementia patients’, ‘supporting services for dementia’, ‘support for families and guardians of dementia patients’, ‘improvement of awareness and public relations for dementia’, ‘strengthening community resources’, ‘public guardianship project for dementia’, and ‘project planning and evaluation.’ In a previous study [14] , ‘cognitive health program and short-term shelter for dementia patients’ and ‘supporting service for dementia’ were included in the ‘dementia patient management project’, but in this study, they were analyzed as separate duties. Moreover, in a previous study [14], ‘improvement of awareness and public relations for dementia’, ‘strengthening community resources’, and ‘project planning and evaluation’ were included in ‘administrative work and community capacity enhancement’, but in this study, they were classified as separate duties. In addition, the ‘public guardianship project for dementia’ is a project that began to be implemented in accordance with Article 12-3 of the Dementia Management Act (in effect since September 20, 2018) and was newly identified as one of the latest duties in this study.

Due to the rapid increase in dementia patients since 2020, it is required to establish a comprehensive national dementia management plan that allows active and proactive responses to public health environmental changes, and discussions on the measures for the improvement of the roles of dementia care centers have been carried out. In particular, regarding the improvement of the role of dementia care centers, improvement measures proposed in previous studies include methods such as ‘promoting linkage with various private resources in the local community by establishing regional dementia care centers as central hub institution and supplementing dementia care services to meet the needs of users’, and ‘elimination of negative perceptions about dementia and discovery of public guardians for dementia’ [26]. In this connection, the newly derived latest duties are thought to show that nurses involved in dementia care reflected their duties in line with policy directions in the job analysis of this study.

Importance, frequency, and difficulty of the duties and tasks of dementia care center nurses

In this study, the ‘public guardianship project for dementia’ was derived as the most difficult and important duty, and these results indicate that dementia care center nurses are having difficulty in carrying out the project. Due to the nature of the public guardianship project for dementia, partnerships between experts, including the discovery and linkage of community resources, are important in the performing the duty, and building partnerships between experts is an important core competency required of nurses who are public health personnel in the community and perform routine tasks as public officials at public health institutions [27]. This means that in order to actively discover dementia patients or those at risk for dementia and provide them with related services, it is necessary to provide dementia care center nurses with practical training that approaches community health nursing from a population- and problem-centered perspective to ensure that the nurses can perform their work from an integrated perspective for the identification of community resources and linkage of dementia patients and their families with appropriate resources. In addition, ‘project planning and evaluation’ was derived as a duty with a high degree of difficulty and importance, and the tasks belonging to this duty include ‘writing a project plan,’ ‘writing a project outcome report,’ and ‘analyzing project operation performance.’ The capabilities for resource utilization, quality management, and evaluation needed for community health project planning are basic core competencies required of community nurses, and writing project plans and project outcome reports is essential for data analysis, evaluation, and performance management [27]. Therefore, in addition to developing a training program for nurses working at dementia care centers, it is necessary to explore ways to strengthen nurses’ competencies for the practice of community health nursing from the time of setting learning objectives of community health nursing in the department of nursing in a university.

A previous study reported that among nurses’ job duties, ‘early dementia screening’ was derived as the most important duty, followed by ‘consultation and registration management’, and ‘dementia prevention and management’ [14]. However, in this study, ‘public guardianship project for dementia’ was derived as the most important duty, followed by ‘dementia screening’, and ‘consultation and registration management.’ In addition, regarding the frequencies of duties, a previous study reported that the most frequently performed work was ‘early dementia screening’, followed by ‘consultation and registration management’ [14], but this study found that ‘consultation and registration management’ was the most frequently performed duty, followed by ‘dementia screening’, and ‘tailored case management.’ The analysis results of the degrees of importance and frequency of duties and tasks indicate that nurses working at dementia care centers in local communities are aware of and implementing the basic project direction of dementia care centers, which is to ‘provide customized services or link subjects with related services according to the cognitive health status of community residents’, as well as the directions of the 4th Comprehensive Dementia Management Plan, which are to ‘establish a public-private cooperative system for dementia care in the region and strengthen tailored dementia patient management in the community’ [26]. In addition, the results of this study are in alignment with a prior study [26], which suggested that regions with abundant resources such as Seoul City need to strengthen community resources and services rather than the dementia screening function, differentiating their operational direction from the existing operation model of dementia care centers. However, since ‘dementia screening’ is still an important duty for the early detection of dementia, more systematic education for this duty is required so that it can be established as a unique task of nurses.

The average frequency of the 66 tasks was 2.64±0.76 points, and this relatively low frequency may be attributed to the fact that some tasks are intensively performed in specific situations or at specific times. Although ‘public guardianship project for dementia’ and ‘cognitive health program and short-term shelter for dementia patients’ were derived as important duties, their performance frequencies were found to be somewhat low. These results can be attributed to the fact that other occupational groups such as social workers and occupational therapists are mainly in charge of or share the duties. In this regard, it is suggested that dementia care centers nurses as professionals should manage the health of the population group through the provision of various services and linkage to community resources according to the cognitive health status of dementia patients, high-risk groups for dementia, families and caregivers, and local residents in the health care system [27,28]. Additionally, it is necessary to help the nurses to acquire core competencies such as the program planning ability and the ability for building community partnerships [27,28]. Further, there is a need to develop and establish the above-described duties related to community health management as the professional work areas of community nurses, and help dementia care center nurses to acquire capabilities as leaders within the community. The above-described measures are expected to serve as effective strategies for the prevention and management of dementia in the community.

Priority rankings of the duties and tasks of nurses working at dementia care centers according to the degrees of importance, frequency and difficulty (Derivation of core duties and tasks).

This study conducted a priority analysis using a tree structure diagram [24,25] to derive the core duties and tasks of nurses working at dementia care centers. The derived core duties, which were identified as top priority duties, were ‘consultation and registration management’, ‘tailored case management’, and ‘support for the families and guardians of dementia patients’, and 31 types of core tasks were derived. It is noteworthy that all the five tasks of ‘consultation and registration management’ were selected as top priority tasks, and ‘dementia screening’, which has been traditionally performed by the nurses of dementia care centers, was derived as a second highest priority.

‘Consultation and registration management’ is one of the main projects that dementia care centers have carried out to identify the needs of community residents and provide services in order to provide various services required according to the cognitive health status of community residents. ‘Tailored case management’ involves directly providing supporting services for dementia or performing linkage and monitoring of external services by establishing a plan that meets the needs of dementia patients and their families based on evaluations. This duty is designed to eliminate blind spots in the care of dementia patients, maintain their stable continued aging in place (AIP), and improve their quality of life. ‘Support for families and guardians of dementia patients’ is a duty that includes activities such as providing education to improve the caregiving capacities of family caregivers and providing programs to support emotional and information exchanges among family caregivers, and this duty contributes to preventing the social isolation of families and caregivers. As described above, the core duties that were identified as top priorities are important for dementia care centers to fulfill their roles as key regional dementia care organizations, and thus, it is considered a significant result that they were identified as priority duties for nurses, who are professional personnel.

In order to plan and operate projects that are suited to the characteristics of the local community, it is essentially needed to apply appropriate education/training methods. Therefore, systematic professional education should be provided based on the results of this study to ensure that nurses working at dementia care centers will be able to properly perform their duties. In the specialized training curriculum for dementia care implemented in the U.S., Japan, and France, training tailored to specific tasks is provided for some tasks, and specific training for the care of dementia patients is provided in line with the policies and characteristics of the relevant institutions [9]. In Korea, education for dementia care workers has been implemented at the Central Dementia Center and Regional Dementia Centers, but this education is carried out in the form of short-term online or classroom training [15]. It is thought that if the analysis results of education/training priorities are reflected in the education for dementia care workers, the quality of nursing can be improved by applying more systematic and professional education/training methods.

Training is divided into four types: classroom training (CT), job aids (JA), on-the-job training (OJT), and retraining (RT), which are presented in connection with the education/training methods in the list of education/training courses and subjects [29]. Classroom training (CT) is used when a task is difficult and very frequently performed and there are serious consequences if the task is not performed properly. Job aids (JA) are not used frequently but they are used when the task involves multiple steps and needs to be performed at an appropriate speed and with high accuracy. On-the-job training (OJT) is required in the training for field workers and used when tasks have a low degree of difficulty. Meanwhile, retraining (RT) is used when tasks have a high degree of difficulty and a low frequency. Among the top priority duties derived in this study, ‘tailored case management’ had a high level of difficulty and a relatively low frequency, so retraining (RT) is required for this duty. On the other hand, ‘Consultation and registration management’ had a low level of difficulty but a high frequency, so on-the-job training (OJT) is an appropriate training method for this duty. ‘Support for families and guardians of dementia patients’ was found to have a high level of difficulty and it involves multiple steps when it is performed, so this duty requires the provision of job aids (JA).

As suggested by a previous study regarding a limitation of the current domestic dementia education [9], it is required to differentiate educational stages or levels from each other without the overlapping of the educational content between curriculums according to the methods of applying education and training and the standard curriculum. In the U.S. and Japan, there are educational programs to train instructors for professional dementia education, and the educational content includes teaching strategies, teaching methods, production and development of educational materials, and information about local systems and regulations [9]. In view of the educational methods applied in other countries, it is thought that more in-depth discussions on dementia education for dementia care workers are required to ensure that a professional dementia education curriculum will be operated more effectively in Korea and thus contribute to securing professional human resources and stabilization of policies.

Since the study population was limited to nurses working at the dementia care centers located in a single city, there are limitations in generalizing the research results because the characteristics of the population in each region as well as the community health needs of each region were not reflected. However, in the sample selection process, we considered the fact that when the National Responsibility for Dementia was introduced, the dementia care projects and operation model of the target city of the present research were extensively applied nationwide. In addition, we divided the population into two strata, team leaders and team members, and extracted samples from each stratum to avoid focusing on a particular stratum. Despite these limitations, the present study is meaningful in in that this job analysis is the first research that has provided a basis for developing an appropriate and valid standard education curriculum through job analysis in order to enhance the professional competencies of nurses working at dementia care centers as professionals in charge of the dementia care project. In addition, the method used for job analysis in this study can be more useful, compared to the Importance-Performance Analysis (IPA) method that compares importance and performance or the Borich model used to investigate the differences between educational objectives and achievement levels [30]. In other words, it can be differentiated from other job analysis research methodologies in that it can present a basis for developing an educational curriculum by entering data in a tree structure diagram and deriving a tree structure diagram that reflects the statistical measurement results about the degrees of importance, frequency, and difficulty of duties and tasks.

Conclusions

This study aimed to identify the latest duties of nurses, who account for the largest proportion of the personnel of dementia care centers, and present key duties that should be primarily considered in determining the directions of education and training for improving job performance and professionalism of nurses working at dementia care centers in order to ensure the effectiveness of curriculum development.

Based on the analysis results, in selecting the direction of education for nurses working at dementia care centers, it is considered necessary to primarily consider the following core duties of the nurses: ‘consultation and registration management,’ ‘tailored case management,’ and ‘support for families and guardians of dementia patients. In addition, the results of this research suggest that ‘dementia screening’, which should be maintained as a unique duty of nurses, requires more systematic education and training, and that there is a need to strengthen the competency for ‘project planning and evaluation’, which is a duty for community health project planning. Furthermore, the findings of this study also suggest that basic education for fostering competencies required of nurses at dementia care centers should be provided through the nursing education programs of the department of nursing at a college or university.

In addition, it is suggested to provide the detailed content of education and training appropriate for and applicable to each duty, based on the application methods of education and training presented in this study, in order to enhance the professional competencies of dementia care center nurses and ensure that education and training for nurses can contribute to providing effective dementia care services to dementia patients and their families. Additionally, it is necessary to explore measures to promote nurses’ self-management and thus encourage them to cultivate their ability to utilize related job resources and fulfill job demands so that they will have the appropriate qualifications to smoothly carry out their duties. Such measures are expected to further contribute to strengthening the stability and professionalism of the organizational operations of dementia care centers.

Figure 1.

Flowchart depicting the study design

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