• 대한간호학회지
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• 제34권2호
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• pp.278-289
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• 2004

Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.

• 보건의료산업학회지
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• 제8권1호
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• pp.51-64
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• 2014

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.

• 대한간호학회지
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• 제48권2호
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• pp.143-153
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• 2018

Purpose: The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested. Methods: The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program. Results: Mean score for BPSD was 40.16. Depression (${\beta}=.42$, p<.001), exposure to noise in the evening noise (${\beta}=-.20$, p=.014), and gender (${\beta}=.17$, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model. Conclusion: To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.

• 한국보건간호학회지
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• 제36권2호
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• pp.212-226
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• 2022

Purpose: The purpose of this study was to explore nurses' experience of the role adaptation process and barriers in long-term care (LTC) facilities including nursing homes, daycare centers, and home visit nursing centers. Methods: After in-depth interviews with 13 nurses who were working at the LTC facilities in G province, the data were analyzed using Colaizzi's phenomenological methodology. Results: 17 themes with 6 theme clusters, and 2 categories emerged: nursing role adaptation process in the LTC (role expectation and readiness, role perception and performance, limits of role performance), and barriers to nursing role adaptation in the LTC facility (organizational, situational, and institutional-environmental barriers). Conclusion: The results showed that it is critical to establish the nurses' role in caring for the health of the elderly and maintaining the quality of care in the LTC facilities. In response to the growing demand for quality care in the LTC facilities, more institutional and environmental changes are needed to address the current barriers that prevent nurses from performing their appropriate roles.

• 경영과정보연구
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• 제31권4호
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• pp.57-82
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• 2012

최근 우리나라 의료복지 분야는 인구의 고령화, 만성질환의 증가, 교통사고, 각종 산업재해, 약물 오 남용, 의학의 발달, 국가복지재정의 악화 등 다양한 환경변화에 둘러싸여 있으며, 새로운 형태의 의료복지와 관련된 새롭고 다양한 서비스 개발의 필요성이 부각되고 있다(조만복, 2010). 국가의 경제적 수준이 높아질수록 사회복지에 대한 사회적 관심은 증가하는 추세이나 복지에 대한 국가의 역할 축소와 사회복지정책에 민간참여의 확대 등 사회복지 여건의 변화는 요양시설 사회복지사들에게 시설서비스의 효과성과 효율성 제고를 위해 다양한 새로운 지식과 기술 습득, 그리고 스스로 최고의 성과를 달성하고자 노력하는 정신자세의 정립을 요구하고 있다. 요양시설에서 서비스 제공자인 사회복지사는 시설클라이언트의 삶의 질에 직접적인 영향을 미치며 서비스의 효과성에 매우 중요한 영향을 미치게 된다. 그러나 양질의 서비스 제공이라는 중요한 책무성을 지니는 장애인 및 노인요양시설은 조직 및 직무환경에 있어서 직원개발 기회의 부족, 조직보상체계의 미흡, 조직의 폐쇄성, 직원자율성의 결여, 전문성의 부족 등의 다양한 문제를 경험하고 있다(이문휘, 2007; 신현석, 2006; 박정양, 2003; 김철용, 2009). 본 연구는 실천현장에서 요양시설조직 내에서 요양시설 사회복지사의 임파워먼트 영향요인인 직무의 특성, 조직의 특성 요인에 대한 인식과 임파워먼트 수준 그리고 직무만족도에 관해서 알아보고 이러한 변인들이 사회인구학적 특성 변인별로 차이가 있는가에 대해서 살펴보고자 한다. 또한 요양시설 사회복지사의 임파워먼트에 미치는 영향력을 분석하고, 직무의 특성, 조직의 특성 그리고 임파워먼트 수준이 직무만족에 미치는 영향을 분석하는데 연구 목적이 있다.

• 한국직업건강간호학회지
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• 제25권1호
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• pp.19-28
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• 2016

Purpose: This study was a descriptive research to identify the effects of communication skills, compassion satisfaction, compassion fatigue on burnout among staff of long term care insurance for the elderly in National Health Insurance Services in Korea. Methods: A descriptive cross-sectional design was used. The participants were 191 staffs of long-term care insurance in National Health Insurance Services. Data were collected via mail from the 24 branch offices which were randomly selected among the total of 226 centers of National Health Insurance Corporation. Stamm's professional quality of life (ProQOL) and Communication Skills Test tool were included in questionnaire to detect. SPSS/WIN 20.0 was used to conduct the descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression. Results: Compassion fatigue had a significant positive effect on burnout, while Compassion satisfaction had a negative effect on burnout. The explained variance for burnout was 69% and compassion fatigue was the most significant factor in burnout among staff of long term care insurance services. Conclusion: The results indicate that the factors influencing staffs' burnout are compassion fatigue, compassion satisfaction, and education level. Therefore, strategies to decrease compassion fatigue and improve compassion satisfaction are needed to decrease burnout for staffs of long-term care insurance in National Health Insurance Services.

• 지역사회간호학회지
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• 제19권2호
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• pp.260-269
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• 2008

Purpose: The purpose of this study was to identify differences in health status and the utilization of long-term care service between urban and rural aged residents in Korea. Methods: Through convenience sampling, 1,405 elders (829 from urban areas and 576 from rural areas) were selected during March 1 to May 31 in 2004. All the subjects agreed to participate and filled out the survey questionnaire after signing the consent form. The instruments utilized in this study were the impairment of physio-sensory function, ADL IADL, cognitive function, and psycho-social function scale. This instrument was developed by modifying the scab developed by Gurland & Wilder (1984). Data was analyzed using the SPSS Win program. Results: There were significant differences in economic status, duration of living and type of medical insurance between rural and urban elderly(p<.05). Physio-sensory functions (t=4.53. p<.001), ADL (t=3.61. p<.001), IADL (t=2.45, p=.014), cognitive functions (t=-2.63. p=.024) and psycho-social functions (t=3.69. p<.001) were significantly different between the two groups. The utilization of long-term care facility in the urban elderly was significantly higher than that in the rural elderly ($x^2=10.14$, p<.001). Conclusion: Considering these findings. the need for long-term care should be assessed by residence characteristics. Because of different utilization of long term care facility according to the elderly's needs, long-term care services should be considered the residence characteristics.

• 대한지역사회영양학회지
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• 제18권2호
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• pp.142-153
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• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• 한국노년학
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• 제37권3호
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• pp.747-762
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• 2017

본 연구는 서비스의 질에 중요한 영향을 미치는 치매관련(장기요양시설) 종사자들의 직무만족 및 인권옹호행동과 직무스트레스, 사회적 지지의 구조적 관계를 파악하고자 진행되었다. 이를 위해 경기도 내 노인요양시설, 주야간보호시설, 방문요양센터 등에 근무하는 치매관련 종사자 300명을 대상으로 설문지를 배부 후 210부를 회수하였고 부실응답 설문지 13개를 제외한 후 197명의 응답자료를 AMOS와 SPSS 21.0을 활용하여 분석하였다. 분석결과, 직무스트레스는 사회적 지지에 직접적인 영향(-.276)을 유의하게 미치는 것으로 나타났다. 대부분 사회적 지지도 역시 직무만족에 직접적인 영향(.315)을 유의하게 미치는 것으로 나타났다. 인권옹호에서도 직무만족에 직접적인 영향(.175)을 미치고 간접적인 영향(.102)을 미치므로 .277의 총 효과가 있는 것으로 나타났다. 이로써 사회적 지지가 인권옹호와 직무만족을 부분매개 하는 것을 알 수 있었다. 직무스트레스는 직무만족에 -.217의 직접적인 영향을 미치고 .095의 간접적인 영향을 미치므로 -.122의 총 효과가 있는 것으로 나타났으며 사회적 지지가 직무스트레스와 직무만족을 부분매개 하는 것을 알 수 있었다. 이러한 연구 결과를 놓고 볼 때 치매관련종사자들의 직무만족을 높이기 위해서는 사회적 지지를 인식할 수 있는 환경에서 인권옹호행동을 증대하고 직무스트레스를 줄여줄 수 있는 방안이 필요하다는 것을 시사한다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.511-513
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• 2022

디지털 헬스케어는 첨단 정보통신기술과 의료기술·비의료기술의 융합으로 질병치료에서 예방관리로 의료서비스의 패러다임 변화에 따라 지역을 기반으로 예방 및 모니터링 기반 건강관리의 중요성을 강조하고 있다. 4P(Predictive, Preventive, Personalized, Participatory)는 예측적, 예방적, 개인적, 참여적 헬스케어 서비스로 말할 수 있다. 기존의 노인장기요양 급여의 복지용구 품목 중심의 제한적 산업에서 벗어나 최신 기술을 활용한 AI·IoT·빅데이터 등 4차 산업혁명 기술과 접목을 통한 새로운 서비스를 제공할 필요성이 여러 분야에서 대두되고 있으며 돌봄 로봇, 웨어러블 등 신기술 개발 뿐 아니라 실증을 통한 상용화가 필요한 상황이다. 향후 빅데이터·인공지능 등 미래 신기술과 연계하여 다양한 서비스 창출이 가능하다.