• 지역사회간호학회지
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• 제32권3호
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• pp.382-395
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• 2021

Purpose: The purpose of this qualitative study was to explore the transition experiences of the elderly from long-term care hospitals to their homes. Methods: The participants were eight elderly medicaid beneficiaries, who had been the subjects from the community care project in Korea. The data were collected with one-on-one interviews from April to November in 2020, and analyzed by phenomenological steps. Results: The seven themes derived in this study were 'Space to escape', 'Reliable supporter opened the way to discharge', 'Comfortable life at home', 'Obstacles to independent life', 'Struggling to live alone', 'Fence for community life', and 'Energizing in daily life' Conclusion: The results revealed the positive aspects of Community Care program in Korea. However, it is suggested that active communication between hospitals and community care institutions, and improvement of home environment to live in the community before discharge should be required. And system revision is needed to adjust activity in their home and support health problems of the elderly in the early stage of discharge. The results of this study can be referred to as the foundation of transitional care for the elderly.

• Tuberculosis and Respiratory Diseases
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• 제83권3호
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• pp.242-247
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• 2020

Background: The purpose of this study was to evaluate the long-term survival rates of very elderly (age ≥80) critically ill patients admitted to a medical intensive care unit (MICU) at a regional tertiary-care hospital in Korea. Methods: We retrospectively analyzed data from patients who survived after discharged from the MICU of our hospital. Survival rates at 90 days, 1 year, 2 years, and 3 years were assessed between patients age ≥80 and those age <80. Survival status was evaluated using the National Health Insurance Service data. Results: A total of 468 patients were admitted, 286 (179 males, 97 females; mean age, 70.18±13.2) of whom survived and were discharged soon after their treatment. Among these patients, 69 (24.1%) were age ≥80 and 217 (75.9%) were age <80. The 90-day, 1-year, 2-year, and 3-year survival rates of patients age ≥80 were significantly lower than those in patients age <80 (50.7%, 31.9%, 15.9% and 14.5% vs. 68.3%, 54.4%, 45.6%, and 40.1%, respectively) (p<0.01). The Kaplan-Meier survival curves showed significantly lower survival rates in patients age ≥80 than in those age <80 (p=0.001). Conclusion: The poor rates of long-term survival in very elderly (age ≥80) and critically ill patients admitted to an ICU should be considered while managing and treating them.

• 한국실내디자인학회논문집
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• 제26권4호
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• pp.22-29
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• 2017

This paper investigates the evaluation criteria in order to manage healing environment of long-term care elderly hospital. Elderly hospital evaluation tool developed by Korean Government is used to assess elderly hospital facilities to check the hospital facility and maintain its quality. However, the evaluation indicators and questions mainly focusing on safety indicators. Some questions are too vague for precise evaluation. In this paper, we discuss the advantages and disadvantages of the present evaluation criteria to establish new assessment tool for precise evaluation. The literature research was conducted tp set up the new evaluation criteria. From this research, we developed an elderly focusing on healing environment checklist for elderly care hospital which contains 7 factors as the primary hierarchy structure (Safety, Accessibility, Amenity, Sensibility, Friendly to nature, Territory, Interaction) and 23 factors as the secondary hierarchy structure. This evaluation criteria will help healthcare facility designers and healthcare organizations to build the healthcare facilities.

• 한국노년학
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• 제31권2호
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• pp.371-380
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• 2011

본 연구는 노인장기요양보험제도 도입 전후 의료기관 가정간호사업소 수 및 이용량 변화를 파악하고자 하였다. 건강보험심사평가원으로부터 노인장기요양보험제도 도입 직전 1년(2007.7.1~2008.6.30)과 제도도입 후 혼란기인 6개월 후 1년(2009.1.1-12.30)간 의료기관 가정간호 기본방문료(AN100)가 청구된 자료를 받아 분석하였다. 노인장기요양보험제도 도입 후, 약 40개 의료기관 가정간호사업소가 문을 닫았고, 사업소가 한 곳도 없는 시군구가 전체 시군구 중 53%에서 59%로 증가하였다. 또한, 노인의 의료기관 가정간호 이용은 물론(이용자수 13.4% 감소, 방문건수 20.9% 감소), 비노인의 이용도 감소하였다(이용자수 3.5% 감소, 방문건수 3.9% 감소). 비노인의 가정간호 이용감소는 가정방문 간호사업소의 감소로 가정간호에 대한 접근이 낮아져 나타난 결과로 유추할 수 있다. 가정간호사업소 당 총 수입액은 2009년 1년간 평균 121,850천원으로 최소 인력인 가정전문간호사 2인의 인건비를 감안하면 수익이 크지 않은 것으로 확인되었다. 이 연구결과를 통해 노인의 의료기관 가정 간호 이용감소는 노인장기요양보험 방문간호로 대체된다고 하더라도, 비노인의 가정간호 접근성을 높이기 위해서는 의료기관 가정간호사업소를 확대할 필요가 있다.

• 보건행정학회지
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• 제15권4호
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• Journal of the Korean Data and Information Science Society
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• 제27권3호
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• pp.773-789
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• 2016

본 연구는 노인요양병원 입원노인의 수면양상 및 영향요인을 파악하여 이들의 수면의 질 향상을 위한 중재프로그램 개발 시 기초자료로 활용하고자 시도된 서술적 조사연구이다. G시 노인요양병원에 입원한 65세 이상의 노인환자 142명을 대상으로 구조화된 설문지와 24시간 수면기록지를 사용하여 자료 수집하였다. 요양병원 입원노인의 일일 평균 수면시간은 10.7시간이었으며 낮 수면시간은 평균 3.9시간, 밤 수면시간은 평균 6.8시간 이었다. 총 수면규칙성은 71.7%였고, 낮 수면규칙성은 평균 58.1%, 밤 수면규칙성은 평균 80.5%였다. 요양병원 입원노인의 수면시간에 영향을 주는 예측요인은 병실 내 치매환자 유무로 10.3%의 설명력을 나타냈고, 수면 규칙성에 영향을 미치는 예측요인은 통증, 병실 내 치매환자 유무, 신체기능으로 16.1%의 설명력을 나타냈다. 따라서 요양병원 입원노인의 수면양상에 영향을 미치는 추가요인 규명을 위한 후속 연구의 필요성과, 본 연구에서 확인된 요양병원 입원노인의 수면에 영향을 미치는 요인을 고려한 중재프로그램 개발 및 적용이 필요하다.

• 보건행정학회지
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• 제22권2호
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• pp.183-206
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• 2012

Changing social conditions have resulted in a situation where elderly patients are no longer cared for by family and where medical care hospitals play a more prominent role. In this study, the unique elements of the medical service required from a long term care hospital were identified using conventional and exploratory analysis, and the causal relationship between medical service quality, relationship quality, and Revist intent was confirmed. The intermediary role and the quantitative importance of relationship quality (including trust and commitment) were also characterized. This study identifies the key points and indicators that the administrators of a long term care hospital can use to effectively plan their medical service offering in order to secure the commitment of customers through relationship quality. The theoretical indications of this study are set out below. First, four factors are selected as being the key elements determining service quality: medics, administrative service, healthcare environment, and subsidiary facilities. Second, it seems that medics, administration service, and the healthcare environment have some effect on the evaluations made in relation to trust and satisfaction (subsidiary facilities are not considered to be a key element). Third, patient satisfaction has a positive impact on trust and commitment and can be regarded as a key element for establishing connections. Fourth, commitment is likely to be strengthened when trust is significant. Fifth, as trust and commitment increase, revist intent strengthens. Lastly, this study illustrates how the levels of trust and commitment play a modulating role between patient satisfaction and revist intention. There are many practical indications from the findings of this study. First, the influences of medics, the administrative service, and the healthcare environment on trust and satisfaction vary. Especially, the healthcare environment is likely to be more important than medics. Accordingly, it is essential to establish an elderly-friendly environment, to improve a hospital's structure, and to maintain a clean environment. Second, medics must show compassion to their patients and be patient when providing explanations to elderly patients who often lack powers of concentration. Third, in order to establish patient trust, it is essential that medics provide an excellent medical service. Ultimately, these elements of relationship quality may strengthen the revist intention of elderly patients.

• 간호행정학회지
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• 제21권2호
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• pp.174-183
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• 2015

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.441-451
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• 2016

본 연구는 요양병원 입원노인의 간호만족도, 자아존중감 및 우울이 적응에 미치는 영향을 규명하기 위한 서술적 조사연구이다. 대상자는 B시와 K시 소재 15개 요양병원 입원노인 116명이며, 자료수집기간은 2015년 2월14일에서 3월31일 까지였다. 수집된 자료는 t-test, ANOVA, Scheff's test, Pearson's correlation coefficients와 multiple regression으로 분석하였다. 연구결과, 대상자의 간호만족도 정도는 평균평점이 $3.92{\pm}0.60$으로 비교적 높게 나타났다. 자아존중감 정도는 평균평점이 $2.83{\pm}0.47$로 중간보다 높게 나타났으며, 우울정도는 평균평점이 $0.38{\pm}0.25$로 비교적 낮게 나타났다. 대상자의 적응정도는 평균평점이 $3.45{\pm}0.64$로 비교적 높게 나타났다. 대상자의 적응 정도는 제 특성 중종교, 배우자 유무, 지각된 경제상태, 지각된 힘든 문제에 따라 통계적으로 유의한 차이가 있었다. 간호만족도와 적응과의 관계와 자아존중감과 적응과의 관계는 각각 중간정도의 양의 상관관계가 있었고 통계적으로 유의하였다. 우울과 적응과의 관계는 강한 음의 상관관계가 있었고, 통계적으로 유의하였다. 적응을 설명하는 유의한 변수는 우울, 간호만족도, 자아존중감, 종교 순이었으며, 전체 설명력은 53.5%이었다. 따라서 요양병원 입원노인의 적응을 높이기 위해서는 우울을 감소시키고, 간호만족도와 자아존중감을 높일 수 있는 간호중재의 개발을 위한 구체적인 노력이 필요하다.

• 지역사회간호학회지
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• 제30권1호
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• pp.99-107
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• 2019

Purpose: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. Methods: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the "before clean/aseptic procedure" moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (${\geq}65$). The collected data were analyzed using SPSS 22.0. Results: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the "after body fluid exposure risk" moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). Conclusion: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.