• 가정간호학회지
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• 제23권2호
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• pp.243-252
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• 2016

Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

• 디지털융복합연구
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• 제11권11호
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• pp.463-470
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• 2013

이 논문은 지방공사의료원과 의료법인 간의 성과에 영향을 미치는 요인을 분석하여 지방공사의료원의 효율적인 경영을 재무적으로 파악하는데 있다. 연구자료는 국세청 공익법인 공시시스템에 공시되어 있는 67개 의료기관의 재무성과를 조사하였다. 병원 현황 및 의료기기 정보는 2012년 2분기 건강보험심사평가원의 자료와 대한병원협회 명부를 사용하였다. 일반적 특성으로 지방공사의료원은 의료법인보다 시나 군 지역에 많이 분포하였고, 간호등급 4등급 이하가 대부분을 차지하고 있었다. 지방공사의료원과 의료법인 간 의료이익, 당기순이익을 분석한 결과 지방공사 의료원이 의료법인에 비해서 적자병원이 많은 것으로 파악되었다. 대부분의 지방공사의료원이 의료이익, 당기순이익에서 적자를 보이고 있어, 수익성을 악화시키는 요인들을 개선할 필요가 있으며, 지금과 같이 의료법인과 경쟁관계를 지양하고, 필수공익의료를 제공하는 조직으로 병원구조를 변화시키도록 노력해야 할 것이다.

• 한국노년학
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• 제29권3호
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• pp.917-933
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• 2009

본 연구는 새롭게 도입된 노인장기요양보험제도 체계 내에서 공적보호서비스(시설보호서비스와 재가보호서비스)를 이용하게 되는 요인과 두 서비스유형간의 선택을 결정하게 되는 요인을 밝히고자 한다. Andersen의 행동모델에 기반하여 노인장기요양서비스 이용형태를 결정하는 소인요인과 자원요인, 욕구요인의 영향을 검증하는 연구모형을 구성하였으며, 노인장기요양보험 2차 시범사업의 서비스 이용권리가 있는 요양 1~3등급의 노인 5,497명의 서비스 이용자료와 개인적 특성 자료를 활용하여 다항 로지스틱 회귀분석을 실시하였다. 주요 분석결과는 다음과 같다. 첫째, 서비스 이용의 본인부담금을 나타내는 소득수준에 따라 서비스 이용형태에 차이가 나타났다. 국민기초생활보호대상자, 일반소득계층, 차상위계층의 순으로 서비스 이용이 높았으며, 재가보호서비스에 비해 시설보호서비스의 이용이 높게 나타났다. 둘째, 군지역에 비해 대도시와 중소도시가 시설보호서비스 또는 재가보호서비스를 이용할 확률이 높으며, 특히 중소도시의 경우 재가보호서비스보다는 시설보호서비스 이용이 높은 것으로 나타났다. 셋째, 요양 1~2등급이 3등급에 비해 시설보호서비스 또는 재가보호서비스 이용이 높으나, 등급에 따른 서비스 이용 유형간 차이는 나타나지 않았다. 넷째, 일상생활수행능력(ADL), 수단적 일상생활수행능력(IADL), 인지기능과 문제행동의 기능이 나쁠수록 시설보호서비스 이용이 높으며, 재가보호보다는 시설보호를 이용하는 것으로 나타났다. 그러나 간호처치영역은 기능상태가 나쁠수록 서비스 이용이 적고, 재활영역의 기능상태는 통계적 유의미성을 나타내지 못하였다. 이와같은 연구결과를 통해 현 노인장기요양보험제도의 본인부담금의 조정과 지역별 균형적인 서비스인프라 구축의 필요성을 제기하며, 또한 요양등급판정체계의 재검증의 필요성을 제기하는 바이다.

• 근관절건강학회지
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• 제29권1호
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• pp.41-49
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• 2022

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

• 지역사회간호학회지
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• 제21권2호
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• pp.263-272
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• 2010

Purpose: This study was to identify health needs of the elderly at nursing homes by long-term care grade. Methods: The health needs of 116 elders at two nursing homes in Seoul were measured with resident assessment protocols (RAPs), activities of daily living (ADL), and cognitive performance scale (CPS), and pain and depression were measured by resident assessment instrument (RAI). Results: With regard to RAPs, 11 out of 18 items had different distribution in the 3 groups significantly. The 1st-grade elders had a higher percentage of 9 items than the 2nd- and 3rd-grade ones but the 3rd-grade ones had the highest health needs related with activity. The 2nd-grade elders had similar health needs to the 1st-grade ones. In terms of functional level, the 1st-grade elders had the highest percentage of CPS and ADL but the 3rd-grade ones had the highest score of pain and depression out of the 3 groups. The standardized assessment instrument to identify specific health needs by the 3 groups should be developed. Therefore, care plans to meet health needs of the 3 groups will be made. Conclusion: It is suggested that nursing care is required to the elderly of the 1st- and 2nd-grade and safe activity and environment to the 3rd-graded ones.

• 지역사회간호학회지
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• 제29권2호
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• pp.231-243
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• 2018

Purpose: This study tries to explore experiences with a special rating dementia service among family caregivers of elderly people with dementia. Methods: The participants were 11 family caregivers of elderly people with dementia and had used a day-care service from the special rating dementia service for more than 3 months. Data were collected through individual in-depth interviews and analyzed using content analysis. Results: Three categories emerged: "reminiscence of an entangled life", "feeling relieved from a stifled life", and "hope for a better life through help and support" with 8 sub-categories and 23 codes. By using the special rating dementia service, the participants experienced relief from the burden of caring for their elderly family member with dementia and restored their social relations or family relationships. They experienced a positive transition in which their caring for elderly family members with dementia was integrated into their daily lives, and they expressed their desires for better policies. Conclusion: These findings imply the importance and necessity of the special rating dementia service. Practical and systematic family support programs are necessary and proactive publicity activities by the government and public agencies are suggested to ensure that family caregivers can easily use the special rating dementia system.

• 대한간호학회지
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• 제40권1호
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• pp.139-149
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• 2010

This study aimed was done to analyze recent trends in nursing research published in the Journal of Korean Academy of Nursing by focusing on the content of nursing interventions and their level of evidence. Methods: A total of 209 studies published between 2007 and 2008 were reviewed using analysis criteria developed by the researchers. Results: The number of quantitative studies was greater than that of qualitative studies. There was a slight increase in the number of qualitative studies and studies including elderly populations, which reflects the recent population trend in Korea. More randomized controlled trials with a low risk of bias were needed to support more evidence-based nursing practice. Concerning the low rate of ethical consideration, stricter application of research ethics needs to be encouraged. Conclusion: The findings of this study suggest the recent trends in nursing research and the direction of nursing research and review in the Journal.

• 임상간호연구
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• 제21권3호
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• pp.277-292
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• 2015

Purpose: The purpose of this study was to develop a Clinical Ladder System (CLS) model for staff nurses working in inpatient units of tertiary care hospitals in Korea. Methods: The study was carried out in 2 steps. First, a nursing competence evaluation scale was developed. Second, evaluation of the nursing competences, qualifications, and professional activities of 230 nurses from five tertiary care hospitals was done by 49 head nurses between Feb. and Dec., 2014. Nurses were selected by head nurses according to their clinical experience and expected behavioral characteristics at each level of the ladder. Results: A nursing competence scale was developed consisting of 5 subcategories (clinical practice, ethical practice, education, leadership, and professional development) and 11 elements, and 5 levels of behavioral indicators for each element. Cronbach's alphas for the entire tool and subcategories were over .853 and stability of the scale was confirmed. There were significant differences in nursing competence according to the 5 levels of the ladder. Conclusion: The findings indicate that the proposed CLS model with a standard score for nursing competence, recommended or obligatory criteria for qualifications and professional activities provides a good tool for developing nurses' competences and retaining excellent nurses in clinical practice.

• 한국병원경영학회지
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• 제15권3호
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• pp.1-16
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• 2010

As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses' awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses' performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses' awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses' job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.

• 한국산학기술학회논문지
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• 제19권10호
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• pp.194-205
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• 2018

본 연구에서는 요양병원 간호보조인력 즉 간호조무사, 요양보호사의 환자안전에 대한 지식, 태도 및 환자안전활동 정도를 파악하여, 요양병원 환자안전관리 역량증진 및 간호보조인력을 위한 교육과정 개발의 기초자료로 활용하고자 시도된 서술적 조사연구이다. 자료 수집은 2017년 3월 2일부터 3월 26일까지 B광역시 소재 요양병원 중 2013년 적정성평가 2등급 이상, 200병상 이상의 6곳에서 근무하는 간호보조인력 230명을 대상으로 구조화된 설문지를 이용하여 수집하였다. 수집된 자료는 SPSS/WIN 20.0 프로그램을 이용하여 실수와 백분율, 평균, 표준편차, t-test, ANOVA, $Scheff{\acute{e}}$ test, 상관관계분석 및 다중회귀분석을 실시하였다. 본 연구의 결과, 요양보호사보다 간호조무사가, 고학력일수록, 환자안전교육을 받은 횟수가 많을수록 환자안전활동 정도가 높은 것으로 나타났다. 또한 환자안전에 대한 지식이 태도에 영향을 미치고, 태도는 환자안전활동에 영향을 미치는 것으로 나타났다. 따라서 바람직한 태도 개선을 위해 직종별 차별화된 교육과 연간 5회 이상의 실제적이고 지속적인 교육 프로그램의 제공이 필요하고 적절한 근무시간 등의 제도개선 또한 필요할 것으로 사료된다. 이 결과를 토대로 요양병원 간호보조인력의 환자안전관리 역량증진 및 환자안전에 대한 지식 향상과 바람직한 태도개선을 위한 교육과정 개발의 기초 자료로 활용할 수 있을 것이다.