• 한국주거학회논문집
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• 제11권1호
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• pp.57-68
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• 2000

This study has been performed to review critical issues affecting continuous residence in profit(self-paid) assistant living facilities for the elderly in the United States. There are three factors influencing continuous residence of frail elderly in the facilities as long as they want without involuntary discharge : Financial ability, behavioral aspects, and facility management situation. Regarding financial ability, income, purchase of insurance policy, cashable assets, willingfulness to pay, and health status were found to be crucial determinants of continuous residence. Overall, 40-50% of those aged 65+ are financially able to stay in the assistant facilities as long as they want, without involuntary discharge. As for behavioral aspects, extroversions, congeniality, culture & life style, conscientiousness, preference for person, and physiological habits were found to be crucial determinants of continuous residence. As for the management situation, it is essential that facilities reach nature level of self-governing rights of the older residents and good local images, and conflicts among the residents and managing parties be resolved on the agreeable standards of inspectors. finally in this study, it is proposed that in Korea, national pension authority offer a liability package for assistant residence, for the case of individual bankruptcy.

• 대한지역사회영양학회지
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• 제5권2호
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• pp.201-207
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• 2000

This study was performed to assess the nutritional status of nursing home residents and to assess the effect of nutrition intervention. The subjects were 123 people aged over 60 years from 5 different nursing homes. The nutrition intervention study was carried out by supplementing their diet with multivitamin-minerals for 2 months. The mean intakes of most nutrients did not meet the RDA, Though the nutrient content of the menus provided by the facilities were satisfactory. Nutrients of which intakes fell below 75% of the RDA were protein, Ca, Fe, vitamin A vitamin B$_1$, and vitamin B$_2$. The BMIs of male and female subjects were 22.0kg/$m^2$ and 24.6kg/$m^2$ and the WHRs were 0.92 and 0.90, respectively. The percentage of subjects with hypertention (BP$\geq$140/90mmHg) and with anemia(Hb$\leq$13mg/100$m\ell$ in men, Hb$\leq$12mg/100$m\ell$ in women) were 34.6% and 41.9%, respectively. The serum cncentrations of albumin, total protein, triglyceride, total cholesterol, HDL-cholesterol, and total lipid fell within normal ranges. However, 27.5% of the subjects showed a high serum cholesterol level of over 250mg/100$m\ell$. The concentration of C3 was 81.2mg/100$m\ell$, IgG, 1343mg/100$m\ell$, and IL-2, 0.766mg/$m\ell$. after 2 months of vitamin-mineral supplementation, the levels of blood glucose and total cholesterol were significantly decreased and triglyceride was significantly increased. The vitamin-mineral supplementation had no effect on the mean levels of vitamin A and E, IgG, IL2, and C3. However, the intervention resulted int he improvement of serum vitamin A and E levels when the subject\`s serum levels were low before the supplementation.

• 한국임상약학회지
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• 제32권4호
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• pp.321-327
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• 2022

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists' medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. 'Continued use or regular daily use of hypnotics' was the most highly detected item (9 cases) followed by 'multiple prescriptions within each class of hypnotics/sedatives' (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권4호
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• pp.7-20
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• 2023

Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

• 한국지역사회생활과학회지
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• 제18권1호
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• pp.71-85
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• 2007

This study investigates differences by type of caregiving using data on three groups of caregivers, 177 from home stay situations, 189 from day care centers, and 138 from nursing homes. First, the result shows that characteristics of both caregivers and elders differ by type of caregiving. Second, caregivers in the home stay situation have the highest caregiving burden of the three groups. Third, from examination of the related variables, the caregiving burden of home stay caregivers is affected by family income, caregivers' health, type of job, and whether or not the elder has symptoms of dementia. Also, the study reveals that emotional services for elders reduce the aggravation of family relations and economic burden, but that instrumental services highly increase economic burden. It reveals that caregivers of elders in day care centers, especially those who are in bad health, are more likely to experience feelings of constriction, aggravation of family relations and economic burden. On the other hand, caregivers who receive more emotional services have better experiences in family relations, including relations with the elder. In case of the elders of nursing homes, if the main caregiver is a daughter-in-law, aggravation of family relations is higher than if the main caregiver is a spouse. Finally, the caregiver's burden is affected by their own health and income, and by whether the elder has symptoms of dementia or stroke.

• 한국생활과학회지
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• 제22권3호
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• pp.493-509
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• 2013

This study investigated the sitting areas preferred to use by assisted living residents in the U.S., compared the perceptions of staff and residents, and analyzed the effects of residents' and spatial characteristics on the preference for use of main sitting areas such as lounge, dining area, activity room and outdoor area. A total of 102 participants(66 residents and 36 staff) from eight facilities in the seven counties of southern Texas were asked about two sitting areas residents like to spend time at. The results of the study were as follows: The most frequently mentioned sitting areas were the activity and outdoor area as per the residents, but the dining area and lounge as per the staff. It might be due to that the view of staff might have been limited to sitting areas usually used by the severely frail residents. Residents using higher level of mobility assistance such as wheelchairs and walkers, or living in the facility having more dispersed sitting areas were less likely to prefer to use the lounge. The residents who were younger or having good centralized outdoor area were more likely to prefer to use the outdoor area. The preference for use of dining area was affected by its proximity from the residents' individual rooms. Diverse survey methods need to be developed for a more in-depth collection and analysis of data from functionally frail older residents and staff caring for them.

• 보건행정학회지
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• 제33권2호
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• pp.141-156
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• 2023

Background: As the population rapidly ages, older adults are increasingly likely to experience mobility problems. This study aims to explore the characteristics related to an elderly person's willingness to live in a nursing home if they have mobility problems Methods: This study analyzed data from 9,917 older adults (5,976 young-old and 3,941 old-old) obtained from the 2020 National Survey of Older Koreans. The dependent variable was the intended place of residence for older adults with mobility problems. Independent variables included various characteristics: (1) sociodemographic and social support, (2) health and functional status, and (3) residential environment. Rao-Scott chi-square tests and survey logistic regression analyses were performed for the young-old and old-old, respectively. Results: The intention to live in a nursing home was significantly different between the young-old (30.4%) and the old-old (34.7%) (p=0.009). According to fully adjusted multivariable analyses, for the young-old, the odds ratio of intending to live in a nursing home was significantly higher in social security benefit recipients (1.45; 95% confidence interval [CI], 1.06-1.97) compared to other individuals. The odds ratio was higher in unmarried (divorced, separated, widowed, or never-married) individuals for both young-old (1.41; 95% CI, 1.22-1.63) and old-old (1.34; 95% CI, 1.09-1.65) age groups, compared to their respective married counterparts. Conclusion: The results of this study suggest that in an aging society, health and social policies should be designed considering the different characteristics of the elderly to improve their health, function, and quality of life.

• 한국노년학
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• 제41권2호
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• pp.217-240
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• 2021

본 연구는 요양보호사의 고용특성과 시설장에 대한 변혁적 리더십 인식이 서비스 질에 미치는 영향을 위계적 선형모형(Hierarchical linear model)을 통해 검증하고자 하였다. 이를 위해 서울시에 위치한 45개의 노인 장기요양시설에 거주하는 노인 240명과 장기요양서비스를 제공하는 요양보호사 200명을 대상으로 설문자료를 수집하고, SPSS 26.0과 HLM 8.0을 사용하여 자료를 분석하였다. 분석결과, 시설장에 대한 변혁적 리더십 인식은 서비스 질에 정(+)적 영향을 미치는 것으로 나타났지만 요양보호사의 고용특성 중 고용형태와 근무시간은 부(-)적 영향을 미치는 것으로 나타났다. 즉, 요양보호사가 정규직인 경우, 근무시간이 적을수록, 요양보호사들이 인식하는 시설장의 변혁적 리더십이 높을수록 서비스 질이 높아지는 것으로 나타났다. 반면, 임금, 총경력, 근속기간은 서비스 질에 유의한 영향을 미치지 않는 것으로 나타났다. 이러한 연구결과를 바탕으로 다음과 같은 정책적 제언을 제시하였다. 첫 번째, 요양보호사의 시급제 비정규직의 지위를 월급제 정규직화하기 위한 인센티브제 활용 및 급여체계 개편과 관련예산 확보, 나아가 전문성 강화를 바탕으로 근본적인 직업적 가치 인정을 통한 고용안정 강화 노력이 필요할 것이다. 장기요양의 공공성 강화 및 거점 공공장기요양시설 설립을 통한 지향 모델 제시 또한 방안으로 제시될 수 있을 것이다. 두 번째, 근로기준법상 요양보호사의 근로시간, 휴게시간, 연차 사용 등을 준수하는 등 적정 근로시간 유지 및 야간 근무자에 대한 수당 강화와 근무시간 감소 노력이 필요하다. 세 번째, 시설장의 변혁적 리더십 고취를 위한 교육과 개입이 필요하며, 시설장의 자격 기준을 강화해야 할 것이다. 본 연구에서 제안한 요양보호사의 고용안정 및 근무시간에 대한 정책적 지원과 시설장의 변혁적 리더십 증진을 위한 정책적 지원은 정책 입안자들뿐만 아니라 현장의 종사자들이 서비스 질 제고를 위한 방안으로 활용할 수 있다는 측면에서 중요한 의미가 있다고 할 수 있다.

• 농촌의학ㆍ지역보건
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• 제45권4호
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• pp.235-244
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• 2020

본 연구는 경북지역의 코로나19 확진자의 발생률과 사망률을 분석하고 관련된 위험요인을 파악하기 위해 경상북도 도민 중 2020년 2월 19일 코로나19 최초 확진자가 발생한 시점부터 4월 31일까지 보고된 확진자 및 사망자의 사례조사서를 분석하여 다음과 같은 결론을 얻었다. 경북지역의 코로나19 확진자는 2월 19일 처음으로 발생하여 4월 30일까지 확진자는 총 1,323명, 사망자는 58명 이었다. 성별에 따라 발병률은 여자가 821명(57.7%)으로 높았고, 사망률은 남성이 30명(51.7%)이 높았으며, 연령별 분포는 발병률은 20-29세가 327명(23.0%)으로 가장 높았지만, 사망률은 80세 이상이 34명(58.6%)으로 가장 높았다. 거주형태에 따른 확진자 및 사망자 분포는 집단시설 확진자 297명 중 40명(69.0%)이 사망하여 가장 많았으며, 기저질환이 있는 확진자 443명 중 47명(81%)이 사망한 것으로 나타났다. 감염경로에 따라 종교와 관련 확진자가 557명(42.1%)으로 가장 많았고, 사망자는 집단시설 관련 사망자가 41명(70.7%)으로 가장 높게 나타났다. 확진일 부터 퇴원일 까지 평균 입원기간은 29.7(±16.8)일 이었고, 사망일까지 평균 입원기간은 12.6(±13.6)일 이었다. 경상북도 지역 확진자들의 발생 및 사망 관련요인을 비교한 결과 연령별(p<0.001), 기저질환유무(p<0.001), 거주형태(p<0.033)에서 유의한 차이가 있었고, 연령별로 40세 이하 보다 60-69세는 7.5배, 70-79세는 9.9배, 80세 이상은 15.8배 사망할 확률이 높았고, 기저질환이 없는 경우에 비해 기저질환이 있는 경우 사망할 확률이 1.9배 높았으며, 거주형태에 따라 자가에 비해 집단시설에서 1.2배 사망할 확률이 높게 나타났다. 이상의 결과로 볼 때 경북지역 확진자들의 사망률에 영향을 미치는 개인적 요인(연령, 성별, 기저질환)과 지역수준 요인(거주형태) 등이 복합적으로 작용하는 것으로 나타났다. 따라서 각 지자체에서는 개인 및 지역수준 요인을 고려한 방역대책을 수립하기 위한 노력뿐만 아니라 노인환자 비율, 의료자원의 차이, 의료기술과 의료진의 수준과 같은 공중보건 대응정책의 차이에 대한 심층적 연구를 통해 감염병의 추가확산을 차단하고 확진자 발생 시 신속한 대응체계를 마련하여 코로나19 환자 발생률 및 사망률에 대한 지역별 차이를 최소화하기 위한 노력이 필요하다.

• 사회복지연구
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• 제49권2호
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• pp.181-209
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• 2018

본 연구의 목적은 대도시 거주 중고령자의 물리적 환경과 우울증상의 관계에 사회적 자본과 통합성의 매개효과가 존재하는지에 대해 탐색적으로 검증하는 것이다. 분석을 위해 서울시의 각 동주민센터와 노인복지시설 및 중고령층을 위한 교육시설을 방문하거나 이용한 중고령층을 대상으로 설문을 실시하였다. 총 331부의 설문이 회수되었고 주요변수에 대한 무응답 사례를 제외한 309부의 자료가 분석에 활용되었다. 물리적 환경의 직접 및 간접효과를 확인하기 위해 구조방정식 모형 분석을 실시하였다. 결과는 다음과 같다. 첫째, 물리적 환경은 대도시에 거주하는 중고령층의 우울증상에 직접적인 영향을 주지 않는 것으로 나타났다. 둘째, 물리적 환경은 통합성을 매개로 우울증상에 간접효과를 나타내었다. 즉 안전성, 쾌적성, 접근 편의성, 보행친화성과 같은 근린환경에 대한 주관적 만족도가 높은 사람은 통합성이 높고, 통합성이 높은 사람은 낮은 우울증상을 가질 것으로 예측되었다. 결과를 바탕으로 중고령층의 우울수준을 개선하기 위한 실천적 정책적 방안을 논의하였다.