• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.836-847
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• 2016

Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

• The Journal of the Convergence on Culture Technology
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• v.9 no.1
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• pp.383-393
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• 2023

We attempted to provide a way to improve job satisfaction by analyzing the relationship between the factors influencing job satisfaction directly or indirectly by the ecological system factors of long-term care worker who provide elderly care services at home benefit institutions. In this study, job satisfaction was confirmed to have a positive (+) correlation with all ecological factors except for social and cultural environmental factors by setting the causal relationship between the social and social characteristics of long-term care worker and job satisfaction as dependent variables. The factors with the highest correlation with job satisfaction were social support, followed by family support, job conditions, trust in welfare policies for the elderly, self-efficacy, and self-esteem. Therefore, it can be seen that nursing care workers who recognize positive support from the surrounding social network and family surrounding nursing care workers and positively recognize job conditions are generally positive.

• Proceedings of the KSCN Conference
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• 2003.11a
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• pp.1078-1079
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• 2003

우리나라 급식서비스프로그램에서는 도시저소득층 재가노인을 대상으로 사회복지관등을 통하여 몇 개의 지정된 장소에서 1일 1끼니(점심정도)의 집단급식서비스(congregate site service)를 제공하고 있다. 도시저소득층노인들의 경우 영양소 섭취상태가 매우 저조한 것으로 나타나 이러한 급식서비스는 노인들의 영양상태에 많은 영향을 끼칠 것으로 생각된다. 따라서 본 연구에서는 서울 수서지역에 거주하는 노인 273명(남: 61명, 여: 212명)중 적어도 최근 1년 동안 일주일에 5회 이상의 식사에 참여한 군을 급식춘(N=137)으로 하고 나머지를 비급식군(N=136)으로 하여 영양상태를 비교하였다. 급식군은 비급식군에 비해 독거노인의 비율이 유의하게 높았으며 교육수준이 낮고 식품비 사용액수가 적었다. 24시간 회상법으로 조사한 결과 급식군은 비급식군에 비해 동물성단백질(p < 0.001), 동물성지방(p < 0.01), 동물성칼슘(p <0.01), 동물성 철분(P <0.001), 아연(p <0.01), 비타민B$_2$ (p < 0.001), 비타민B$_{6}$ (p < 0.01), 콜레스테롤(p <0.001)섭취량이 유의하게 많은 것으로 나타났으며 MAR도 유의하게 높았으나(P <0.01) 급식, 비급식군의 MAR이 각각 0.59, 0.53으로 모두 식사의 질이 낮았다. 급식군은 점심 급식을 통하여 하루 총섭취량 중 에너지는 39.7%, 당질33.7%, 단백질 43.8%, 지방 52.0%, 칼슘 35.2%, 철분은 36.9%, 비타민E 55.7%를 섭취하고 있어 하루 총섭취량의 33-56%를 급식에 의존하고 있었다. 반면에 비급식군은 하루 총섭취량 중 18-31%의 영양소를 점심으로 섭취하고 있어 대조를 보였다. 급식군은 비급식군에 비해 키가 유의하게 작은 것(p<0.001)외에는 다른 신체 계측치에서는 유의차가 없었다. 급식군은 혈중 철분지표 중에서 유의하게 낮은 MCH(P < 0.05)와 유의하게 높은 TIBC를 보였으나(p <0.05) hemoglobin 수치에 의한 빈혈비율(여 < 12.0d/㎗, 남 < 13.5g/㎗)은 급식, 비급식군 각각 20.2%, 23.8%로서 유의한 차이가 없었으며 12문항을 사용하여 조사한 우울점수에서도 군 간의 유의한 차이가 없었다. 이상으로 보아 급식군은 비급식군에 비해 사회 경제적 수준이 낮으나 점심급식을 통하여 하루 필요영양소의 1/3-1/2를 섭취함으로써 비급식군에 비해 영양소섭취량이 높거나 비슷한 섭취량을 유지하고 있었으며 신체계측치와 빈혈비율 등에서 급식군에 비해 유의한 차이를 보이지 않았다. 그러나 급식과 비급식군 모두에서 MAR이 낮아 아직도 대부분의 섭취영양소가 권장량의 75%미만으로 나타나 저소득층노인에게서 급식의 확대와 함께 급식의 질을 좀 더 높일 수 있도록 정부와 자치단체에서 의 각별한 관심과 지원이 절실히 필요하다고 생각된다.

• Communications for Statistical Applications and Methods
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• v.17 no.3
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• pp.423-440
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• 2010

The purpose of this paper is to prepare the department creation and the staff increase of education institution by forecasting the demand of health and welfare workers according to execution of the elderly's long-terms treatment insurance system in July, 2008. We estimated confirmors of the elderly's long-terms treatment and the demand of professional workers of health and welfare field due to the increase of care insurance users in facilities treatment organization, care at home service facilities, and family allowance facilities for 2010-2030. The numbers of social welfare professional worker are estimated as 16,624 workers in 2020 and 24,688 workers in 2030. The numbers of nurses are forecasted as 11.287 in 2020 and 16,624 in 2030, we expect that the increase of the demand be accelerated. The demand of necessary care probation worker is 44,824 in 2009, but we already trained over around 500,000 workers in 1,078 education institutions through one year in Aug. 31, 2009, which excesses over the numbers of workers demanded as much as 10 times.

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.139-167
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• 2009

A new public insurance for long-term care was introduced in July 2008 to provide for the rising demand for long-term care as the population is aging rapidly. The demand for long-term care is expected to rise further because more and more elderly are living alone or in households with only other elderly, such as his/her spouse, without informal care of their adult children. Even when the elderly are living together with their adult children, daughters and daughters in law, once the main informal care-givers, are not available because they choose to become economically active and work more over time. Experiences of countries such as Japan and Germany with similar public long-term care insurance scheme highlight the importance of detailed analysis on the demand for long-term care for the financial stability of the insurance scheme. Countries which had underestimated the demand for long-term care at the time of adopting the scheme went through financial instability of insurance schemes. This study analyzes the determinants of the demand for long-term care using data from the second demonstration project (April 2006~April 2007) of the long-term care insurance scheme for the elderly in Korea. Taking full advantage of detailed data on the long-term care, this paper analyzes the eligibility for the long-term care insurance scheme and its use. According to study results, even when common diseases among the elderly such as cancer, diabetes, arthritis, dementia, hypertension, etc. are controlled together with other individual and socioeconomic factors, limitations the elderly are faced with in their twelve activities of daily living significantly affect the eligibility for the Korean Long-term Care Insurance Scheme. This means that limitations in daily living activities are more critical than common diseases among the elderly are to the eligibility for the Korean Long-term Care Insurance Scheme. Bathing and toileting problems have been found to be the most important factor affecting the eligibility for the insurance scheme, followed by eating, dressing and moving around inside the house. Moreover, the choices of whether to use long-term care and which to use between home care and institutional care are found to be significantly influenced by health status and various socioeconomic factors of the elderly. In particular, those with more limitations in daily living activities and the female elderly are more likely to use long-term care and institutional care rather than home care. As for home care users, those living alone or with adult children and those with monthly household income of more than 500,000 won are more likely to use home care. Most importantly, even when the monthly household income of the elderly is controlled, the elderly recipients of the National Basic Living Security, who are not charged for long-term care, are more likely to choose home care. This implies that price as well as income is a critical factor for the decision to use long-term care. Further study on the duration of long-term care use will surely enhance the long-term care policy, when panel data is available for simultaneous analysis of the likelihood of long-term care use and its use duration.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.76-89
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• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• The Journal of the Korea Contents Association
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• v.20 no.7
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• pp.149-160
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• 2020

The purpose of this study is to analyze factors affecting a grade maintenance of the non-graded group by LTCI(Long-Term Care Insurance, NHIS). The predictors were examined grade maintenance of the non-graded group(non-grade of A, B, C). The results were as follows: this study found that predisposing factors of the grade maintenance of non-graded of LTCI were significantly related to age, sex, death. Enabling factors of the grade maintenance of non-graded of LTCI were significantly related to household state, income level. Need factors of the grade maintenance of non-graded of LTCI were significantly related to dementia, grade of first grading, retry of applying for long-term care assessment. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• Research in Community and Public Health Nursing
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• v.27 no.4
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• pp.388-398
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• 2016

Purpose: To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care. Methods: This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC. Results: All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years. Conclusion: The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.

• Korean Institute of Interior Design Journal
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• v.16 no.4
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• pp.62-71
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• 2007

Due to the shortage of elderly care services in urban areas, multi-functional welfare facilities are proven to be very effective for delivering various service needs of elderly in Japan. Introduction of new longterm care policy for elderly in Korea would change many aspects of elderly care service facilities. Especially elderly home care services like adult daycare centers will expand drastically after beginning of elderly longterm care insurance. The purpose of this research is to study and analyze multi-functional welfare facilities in Japan focusing on the types of day service in those facilities. Planning of daycare centers in multi-functional welfare facilities for the elderly can be classified to 8 types. Those types are daycare centers with senior housing, longterm care insurance facilities, senior centers, small multi-function facility, medical facilities, educational facilities, community facilities and general housing projects. Each type has different benefits for the networking of services for the elderly. Design of daycare centers in multi-functional welfare facilities have distinctive features in entrance and user approach, space allocation and circulation planning. The study of daycare centers and multi-function planning should be followed to make better home care environments for the elderly in Korea.