• 한국노년학
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• 제40권4호
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• pp.577-598
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• 2020

돌봄의 사회화가 급속히 진행되는 가운데 사회적 고립과 우울 등이 심한 노인을 위한 지역사회 차원의 정신건강 개입의필요성이 증가하고 있다. 2020년 「노인맞춤돌봄서비스」 개편에 맞추어, 2014~19년 시범사업으로 진행하였던 '독거노인 사회관계 활성화사업'이 「노인맞춤돌봄서비스」 내 별도의 특화 사업으로 확대 개편되었다. 고위험 노인 대상 정신건강 지원 및 사례관리 서비스를제공하는 것을 기본 골격으로 하는 「특화서비스」는 노인돌봄과 정신건강 서비스가 만난 고위험 노인돌봄의 새로운 실천모델이라고할 수 있다. 본 논문의 목적은 「특화서비스」에 대한 이해를 높이고 이것의 개념적 틀을 명확히 하는 것이다. 국내·외 관련 문헌, 그리고 「특화서비스」의 전신인 '독거노인 사회관계 활성화 시범사업'에 대한 분석을 포함한 「특화서비스」 제도화 과정 고찰을 통해 「특화서비스」의 특성 및 개입의 구조와 내용을 살펴보았다. 마지막으로 제도 초반 현장에서 발생하는 몇 가지 상황을 중심으로 향후 「특화서비스」가 의도한 대로 잘 진행되기 위해 고려할 것에 대해 논의하였다.

• 한국임상보건과학회지
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• 제4권3호
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• pp.603-614
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• 2016

Purpose. The purpose of this study was to provide basic data regarding the intention to use community care service based on special grading for dementia in the South Korean Society. Methods. A survey was conducted using a questionnaire adapted on the basis of literature review regarding the first to fourth grade under the long-term care insurance system for the aged from May 1 to 30, 2015 and a total of 272 questionnaires were statistically processed using SPSS 21.0. Frequency analysis, descriptive statistics, and cross-tabulation analysis were performed. The non-parametric type of test, ${\chi}^2$ test, was used for statistical testing. Results. This study obtained the following results: First, caregivers had greater intention to ask recipients to use daytime and nighttime care service. Second, there were statistically significant differences in caregivers' education, occupation, monthly average income, co-residence status, intimacy, and care-giving burden (emotional, financial, and social) and recipients' activities of daily living, instrumental activities of daily living, mental health status, dementia status, and intention to use community care service based on special grading for dementia. Conclusions. There are very few statistical data and academic materials regarding special grading for dementia, which has recently been established. The results of this study are therefore expected to help make a systematic analysis of the intention to use community care service by caregivers based on special grading for dementia.

• 보건의료산업학회지
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• 제6권4호
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• pp.99-109
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• 2012

The purpose of this study is to explore the factors that influence employer to rehire the mentally disabled. The participants of survey were 121 of employers' in Busan. Data were analyzed using ${\chi}^2$-test, t-test and logistic regression analysis with SPSS/WIN 18.0. According to this analysis, the results show that employer's rehiring intentions for the mentally disabled is a significantly related to gender, relationship with mental disabled person, industrial classification, experience of disabled employees, period of employment with mentally disabled people, subsidy for employment promotion, employment quota system, benevolence, community mental health ideology. Logistic regression analysis showed that relationship with mental disabled person, industrial classification, experience of disabled employees, period of employment with mentally disabled people, subsidy for employment promotion, employment quota system and benevolence. On the basis of results, program for encouraging employer's intention of rehiring the mentally disabled should be development and establish mediate strategies.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• 농촌의학ㆍ지역보건
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• 제34권1호
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• pp.34-46
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• 2009

이 연구는 비교적 간단하면서도 객관성과 타당성이 높다고 평가되는 자료와 산출방식을 적용하여 보건사업의 가중치를 산출함으로써 지방자치단체 보건사업의 자원 배분과 평가에 용이하게 활용할 수 있는 계량적 기준을 제시하고자 하는 목적으로 수행되었다. 이를 위해 먼저 HP 2010에서 제시한 중점과제를 기초로 선행연구의 결과와 보건복지부 사업담당자들의 의견을 반영하여 분류안을 구성하였다. 다음으로 선행연구 결과들을 검토하여 각 보건사업과 관련된 질병부담 자료를 수집하였고, 전문가 의견 조사를 실시하여 각 보건사업과 관련된 문제의 심각도와 사업의 추정 효과를 파악하였다. 그리고 이와 같은 과정을 통해 수집된 자료들을 BPRS 방식에 적용하여 보건사업의 가중치를 산출하였다. 수집된 자료들을 BPRS 공식에 대입하여 가중치를 산출한 결과 전염성질환이 58.97%로 가장 높았고, 금연이 14.07%로 두 번째로 높았다. 그 다음은 고혈압(3.87%), 당뇨(3.40%), 암(2.90%), 심 뇌혈관질환(2.86%), 운동(2.10%), 절주(2.07%), 건강검진(1.92%), 정신건강증진(1.72%), 중증정신질환(1.62%), 영양(1.52%), 구강위생관리(1.15%), 구강질환(1.10%), 중독(0.73%) 순으로 나타났다. 이 연구의 결과는 중앙정부가 지방자치단체 보건사업에 자원을 배분할 때 계량적 기준으로 활용할 수 있으며, 평가점수 산정 시 상대적으로 더 중요한 사업에 더 높은 점수를 부여하여 사업의 효과성을 정책적으로 향상시킬 수 있을 것으로 기대된다.

• 지역사회간호학회지
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• 제7권2호
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• pp.203-215
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• 1996

Social security is concerned with ensuring all citizens maintain basic needs, community health nursing maintains and promotes health for all community members. Lately, This new area of community health nursing, concern social welfare has increased. The objectives of this study are, first, to analysis the activities of nurses at community social welfare institutes, second, to estimate nursing demand for social welfare areas. The study methods used were as literature review, an analysis of statistical data and case study etc. The analytical framework also included a demand analysis of nursing manpower in community social welfare areas. The major results are as follows; 1. Employees which work at social welfare institutes number 55,464, nursing manpower (including nurse aids) number 1,458 and this is 3% of the total employees. Within nursing manpower, nurses number 780, nurse aids number 670. 2. The rates of nurses among total employees were high in institutes for mental disorders and institutes for the age. 3. The salary level of nurses was lower than average and the rates of retirement showed a roughly middle level in welfare institutes. 4. The satisfaction level of nursing services was high, and it is the trend that nurses substitute for nurse aids which retire at social welfare institutes. 5. Nurse demand that follows legal criteria is 2,221, but only 35% are working. It is therefore insufficient from the minimum of 733 to a maximum 1433. 6. The sufficiency rates by institution were high at institutes for vagrants, aged and the handicapped. In conclusion, the conditions are of nurses which are working in with the social welfare institutes are poor. Also the number of nurses compared rates of demand were in surplus. But, the basic direction of welfare policy is universal-preventive and provision of the family and of community centered service, and nursing service demand in the social welfare institute will increase continuously, we predict. Therefore, we will need a positive plan such as the development of an inservice education program and the construction of an information collection system etc.

• 수면정신생리
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• 제28권1호
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• pp.34-42
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• 2021

Objectives: This study investigated sleep quality in female full-time homemakers and evaluated the relationship of sleep disturbance with psychological and socio-environmental factors. Methods: This cross-sectional study adopted a structured survey and sequential recruitment method for randomized participation of community-dwelling full-time female homemakers. Sleep quality and mental health were measured using the Korean version of the Pittsburgh Sleep Quality Index (K-PSQI), Korean version of the Beck Depression Inventory-II (K-BDI-II), Korean version of the Beck Anxiety Inventory (K-BAI), and Korean version of the Beck Hopelessness Scale (K-BHS). The willingness-to-pay (WTP) method was selected to measure the self-evaluated monetary value of household service work. The relationship among the main relevant factors was statistically analyzed through a mediation model. Results: A total of 166 participants were analyzed and classified having poor versus good sleep quality (poor : 24.1%, n = 40 ; good : 75.9%, n = 126 ; cut-off point = 9 on the K-PSQI). Significant between-group differences were observed in mental health status (K-BDI-II, p < 0.001 ; K-BAI, p < 0.001 ; K-BHS, p = 0.003). The moderated mediation model was verified, indicating that depression may mediate the association between nurturing burden and sleep disturbance. The path from nurturing burden to depression may be moderated by average monthly household income. Conclusion: A relatively high portion of full-time female homemakers may suffer from sleep disturbance and interactions between psychological and socio-environmental factors might determine sleep quality, suggesting the need for public health policies targeting improvement of sleep quality and mental health among full-time homemakers.

• 보건행정학회지
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• 제27권2호
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• pp.177-185
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• 2017

Background: The mental problems of the elderly are at issue as a serious social phenomenon. The purpose of this study is to identify risk factors affecting the mood disorders of the elderly. Methods: The subjects were 1,779,236 aged ${\geq}65$ and participated in health screening. Dependent variable was mood disorders. Independent variables were consisted of community level (regional deprivation index and healthcare resources) and individual level (sex, age, insurance type, disability, smoking, alcohol, physical activity, body mass index, and healthcare utilization). Multilevel logistic regression was performed. Results: At the individual level, women, employed insured, severely disabled people, heavy alcohol drinkers, high-intensity physical activity, body mass index, and patients who had chronic disease and severe disease were significantly associated with mood disorders. As the age has increased, it has let increase of mood disorders. At the community level, as the regional deprivation index has increased by 1, mood disorders has been increased by 1.005 times. The intra-class coefficient was 7.04%. Conclusion: We found individual and community level factors are associated with mood disorders. Systematic approach is essential to reduce mood disorders.

• 한국콘텐츠학회논문지
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• 제13권1호
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• pp.221-233
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• 2013

본 연구는 부산지역의 사회복귀시설의 사례관리자를 대상으로 사례관리과정에 대한 인식과 사례관리과정이 실제 어떻게 수행되고 있는지를 탐색함에 있다. 사회복귀시설의 사례관리자 12명을 대상으로 포커스 그룹 인터뷰를 실시하여 얻은 자료를 심층분석하였다. 접수는 다양한 휴먼서비스 조직에서의 의뢰가 많고, 클라이언트 중심의 인테이크와 계약이 이루어지고, 사정은 정신장애인의 기능보다는 서비스 욕구중심으로, 기획은 자원발굴과 확보에 어려움을 느꼈다. 개입단계는 직접서비스 위주로 진행되고 여러 기관에서 접근 시에 사례관리에 대한 책임소지가 불분명했다. 점검단계는 주로 매달 시설 내에서 점검이 이루어지고 현실적인 슈퍼비전에 대한 욕구가 높았다. 종결에서는 성과평가 위주였고, 사례관리를 잘 나타낼 수 있는 개별화된 평가척도에 대한 기대를 나타내었다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.4-14
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• 2023

This study aimed to discuss mental health services for children and adolescents that are being implemented as initiatives of the Korean government and to review the functions and roles of these projects during the COVID-19 pandemic. Three government departments are in charge of providing mental health services for children and adolescents: Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare. The Ministry of Education has implemented several policies to facilitate the early detection of mental health issues among school students (from preventive interventions to selective interventions for high-risk students). The Ministry of Gender Equality and Family additionally serves out-of-school children and adolescents by facilitating early identification of adolescents in crises and providing temporary protection or emergency assistance (as required) through the Community Youth Safety-Net Project. Furthermore, the Ministry of Health and Welfare operates relevant mental health agencies for individuals of all ages including children and adolescents. Any high-risk students who have been screened through the projects of the Ministry of Education are supported through referrals to the following institutions for appropriate treatment of their symptoms: specialized hospitals, the Youth Counseling and Welfare Center operated by the Ministry of Gender Equality and Family, the National Youth Healing Center, the Mental Health Welfare Center operated by the Ministry of Health and Welfare, the Suicide Prevention Center, and the Child Welfare Center. To assist students who are facing any psychological difficulties because of the COVID-19 pandemic, the Ministry of Education has established a psychiatric support group for providing emergency mental health care; furthermore, schools are promoting psychological surveillance (e.g., provision of non-face-to-face counseling services that are centered around the Wee Center). The Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare have provided varied mental health support services in order to address the challenges faced by children and adolescents during the pandemic. Nevertheless, the mental health services operated by each ministry do show some limitations because their service provision system is insufficiently collaborative. The present study discussed the positive effects of each initiative as well as its limitations; furthermore, it suggested improvements for facilitating the healthy development of children and adolescents' mental health.