The Formation Pathways of Care Dignity among Long-Term Care Workers from a Relational Ethics Perspective : A Directed Qualitative Content Analysis of Public Documents

Abstract

As Korean society has entered a super-aged phase, the inner maturity of long-term care workers has emerged as a key factor in shaping the dignity of care—a form of dignity that can be realized only when the dignity of the care worker and that of the older adult receiving care are both protected. Although prior research has statistically verified the effects of empathy, vocational calling, and human rights awareness on the quality of care services, the micro-level mechanisms through which these effects emerge have received relatively little qualitative attention. To interpretively complement these established statistical relationships, this study employs a directed qualitative content analysis of publicly available secondary data, including policy reports, collections of practice cases, training materials, survey reports, statistical sources, and prior qualitative studies containing interview excerpts from care recipients and care workers. Primary case material was clearly distinguished from contextual material, and purposive sampling was used to deliberately include negative and deviant cases in which the expected pathways did not occur. Meaning units in the primary material were analyzed directly through theory-directed coding, axial coding, and categorization; in addition, three de-identified composite vignettes are presented not as objects of analysis but as illustrative devices for communicating the derived categories and pathways. The findings suggest that inner maturity is structured along three tentative relational pathways: “empathy → trust,” “human rights awareness → autonomy,” and “integration of empathy, human rights, and calling → recovery.” Crucially, the negative-case analysis revealed that these pathways are not realized automatically through the individual dispositions of workers; rather, they are conditional processes that are facilitated or hindered by ‘structural conditions’, such as relational continuity, time and staffing resources, and organizational support. This study reinterprets the quality of care as a relational and ethical process rather than as a technical performance, and it offers exploratory implications—pending further verification—for long-term care worker training, institutional evaluation, and guidelines for human rights protection.