Purpose: This qualitative study explored multi-level factors determining the implementation of conservative urinary incontinence (UI) management in Korean long-term care hospitals, where practice frequently remains centered on routine absorbent-product application. Conservative management was defined as individualized, non-surgical approaches (e.g., tailored toileting plans, bladder training, timed voiding, intermittent catheterization when indicated, and diaper-free (toilet-based) activities) aimed at preserving patients’ residual function and dignity. Methods: In-depth, semi-structured interviews were conducted with 13 registered nurses, recruited through purposive and snowball sampling, from eight long-term care hospitals. To elicit insights into established organizational routines and clinical decision-making, participation was limited to nurses with at least three years of experience in long-term care settings. Interviews were conducted between February and May 2020 (face-to-face, n=9; telephone, n=4) and transcribed verbatim. Data were analyzed applying Elo and Kyngäs’s inductive qualitative content analysis, progressing through preparation, organizing, and reporting phases to derive codes, subcategories, and overarching categories. Results: Three main categories, nine subcategories, and 19 codes were identified. First, “Physical and Human Resource Constraints” served as major barriers; high workload, chronic shortage of caregiving staff, limited access to urology specialists and equipment, spatial constraints, and insufficient continence-care training often necessitated time-scheduled diaper changes over individualized care. Second, “Dilemmas in Implementing Incontinence Care” reflected barriers such as the misalignment between accreditation standards and clinical reality, symbolic compliance with government-led initiatives, and tensions between bladder training and fall prevention. Third, “Experience of Incontinence Care” encompassed both barriers (e.g., a routine preference for indwelling catheters and the delegation of continence monitoring to caregivers) and facilitators (e.g., a dignity-centered mindset and ward-level nursing leadership). Overall, structural barriers included staffing shortage, spatial constraints, and policy-practice misalignment promoting efficiency-driven routines and framed UI care as hygiene work. However, facilitators such as proactive leadership and a dignity-oriented perspective enabled the sustainability of conservative continence care by redistributing staff tasks and prioritizing functional preservation despite structural constraints. Conclusion: Conservative UI management in Korean long-term care hospitals is influenced by a complex interplay of staffing constraints, reimbursement structures, and leadership-led workflows. Improving the quality of UI care requires aligning policy incentives with patient-centered outcomes and promoting the nursing workforce’s assessment capacity. This study provides a foundational understanding for developing institutional protocols that support individualized, dignity-oriented conservative UI management in long-term care settings.

서 론
    1. 연구의 필요성
    2. 연구목적
연 구 방 법
    1. 연구설계
    2. 연구참여자
    3. 자료수집
    4. 자료분석
    5. 연구의 엄격성
    6. 윤리적 고려
    7. 연구자 준비
연 구 결 과
    범주 1. 물리적 및 인적 자원 제약
    범주 2. 요실금 관리 적용의 딜레마
    범주 3. 요실금 관리 경험
논 의
결 론 및 제 언
REFERENCES

• 임승화(동신대학교 간호학과 조교수) | Lim Seoung-Wha (Assistant Professor, Department of Nursing, Dongshin University, Naju, Korea)
• 노준화(광주기독병원 비뇨의학과 부장) | Noh Joon Hwa (Director, Department of Urology, Kwangju Christian Hospital, Gwangju, Korea)
• 서민숙(상지대학교 간호학과 부교수) | Seo Min Sook (Associate Professor, Department of Nursing, Sangji University, Wonju, Korea)
• 이정(목포가톨릭대학교 간호학과 조교수) | Lee Jeong (Assistant Professor, Department of Nursing, Mokpo Catholic University, Mokpo, Korea) Corresponding author