• 보건행정학회지
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• 제4권2호
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• pp.27-57
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• 1994

The objective of running a long-term care institution is to provide services helpful for maintaining, supporting, and improving elderlies' optimum level of physical, mental, and psychosocial functioning. For the purpose of analyzing the current situations of institutional long term care facilities in Korea, 27 facilities were selected proportionately from each of the cities and provinces, out of the total 152 facilities. About 20% of those who were institutionalized during 25 August through 2 Qctober 1993, the 391 elderlies were chosen on a systematic random basis. The instrument of this study was developed by modifying the tools of CARE, MAI and PCTC. A multivariate approach of discriminant analysis and clustering technique were employed for this study. The Stiudy reveals that there is no clear differentiation of goals and functions among the longterm care institutions in Korea. Staffing patte군 of long-term care facilities shows a shortage of nurses, physical therapists, and dieticians. The linkage between acute care facilities and long-term care is weak, and administration of long-term care faciltiy is carried out by non-professionals. They are responsible for assessing health status before entering the facility, and evaluating elderlies' care. Therefore, it is not surprising to find that most of the facilities have accommodated agede regardless of their real needs and health status. Based upon findings of the analysis, this study has classified long-term care facilities into four types : Type I is to help elderlies maintain independence in daily living activities. Type II facilities have the objective of maintaining and improving the current level of elderlies' function. Type III is to maintain maximum independence of elderlies in activities of daily living. And Type IV is identified for the group of facilities designed to restore or improve functional abilities of elderlies. In conclusion, the following suggestions are made : the need for long-term care should be assessed by multidimensional measurement. Institutional long-term care facilities should be classified and developed in response to type of type of care and service need. Both acute and long-term care facilities should be linked together in order to support the evaluation of service operation and program development.

• 문화기술의 융합
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• 제9권5호
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• pp.669-674
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• 2023

본 연구는 목민심서 애민육조와 진황육조의 분석으로 조선시대 사회복지정책의 구체적 내용을 살펴보고 이에 대한 오늘날 사회복지정책의 연계성을 파악하였다. 그 결과 애민육조에서는 양로(養老)에서 노인복지법과 노인 복지서비스의 기초내용을 담고 있었고, 자유(慈幼)에서는 유아 및 아동과 관련한 복지정책 서비스, 관질(寬疾)을 통해 장애인 복지의 가치계계과 정책 방향을 확인하였으며 구재(救災)에서는 사회적 위기와 재난대응에 대한 사회통합을 요구하고 있음을 알수 있었다. 이는 또한 이는 사회복지정책지표를 통해서도 가족안전, 소득보장, 건강정책, 사회통합 등의 사회복지정책의 주요영역이 강조되어왔음을 확인하였다. 또한 진황육조의 분석을 통하여 비자(備資), 규모(規模), 보력(補力) 등에서 사회보장제도와 사회보험제도의 기초 이념과 가치뿐만 아니라 구체적 정책 시행 내용까지 담고 있음을 살펴보았다. 사회복지 시설을 구비하여 각 대상별 체계적 사회복지서비스를 시행하고 있는 오늘날 사회복지정책 및 사회서비스 정책 등은 진황육조를 통하여 그 근간을 확인할 수 있었다. 이는 현재 정책 시스템인 사회복지정책지표를 통해서도 사회통합과 소득보장 부분의 강조가 진황육조에서 두드러지게 나타남을 확인하였다.

• 지역사회간호학회지
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• 제25권1호
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• pp.1-11
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• 2014

Purpose: The purpose of this study is to obtain information of use of complementary and alternative medicines (CAMs) and any reported adverse effects of them on vulnerable elders in a community. Methods: 1,837 elderly subjects aged 65 or higher with health problems were selected from those who were enrolled in a public health care center and received visiting health management services. A proportional stratified sampling method was used. Data collection was completed by face to face interviews using a structured questionnaire. The descriptive statistics and ${\chi}^2$-test were used to analyze the data. Results: The prevalence of CAM use last year was 57.5%, and 10.4% of the subjects reported adverse effects of the therapies. The mean score of the subjects' attitudes towards CAM was $4.1{\pm}3.44$ (range 1~10). The major sources of advice and exposure to CAM therapies were most likely to be from family and friends (72.5%). The primary reason for choosing CAM was to manage symptoms and relieve pain (86.6%). Conclusion: These findings suggest the need to develop nursing strategies for reducing and preventing adverse effects of CAM use by promoting awareness of using safe and appropriate CAM therapies.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 디지털융복합연구
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• 제13권4호
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• pp.25-38
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• 2015

최근 우리나라의 경우 빠른 고령화로 독거노인의 추세 또한 사회적, 경제적, 국가적인 다양한 문제를 야기시키고 있다. 특히 나 홀로 사는 노인계층의 건강수명관리, 독거노인의 안전, 길어진 노령시기의 쾌적하고 행복한 삶유지 등이 사회적 이슈로 부각되고 있으며, 범정부차원에서 다양한 서비스 제공을 위한 실천과제를 모색하고 있으나, 실질적으로 노인의 일상생활지원 및 서비스 정보접근 향상을 위한 구체적 대안은 매우 부족한 실정이다. 본 연구는 ICT 기술기반의 독거노인복지서비스 제공을 목적으로, 개방된 공개정보를 적극 활용하고 노인계층의 정보 접근을 향상 및 독거노인의 여러 상황조건에 부합하는 "ELA 서비스 모델"을 제시한다. 이는 독거노인의 기본 욕구에 따른 단계별 자가생활지원 서비스 모델로 현재 제공되거나 계획 중인 서비스의 편중 또는 과부족을 해결하고, 독거노인의 요구수준에 맞는 실질적 서비스 제공을 목표로 일상생활지원에 균형 잡힌 서비스 정책 수립에 기여할 것으로 기대한다.

• 디지털융복합연구
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• 제11권10호
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• pp.17-29
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• 2013

본 연구에서는 정보화 사회를 살아가는 노인의 또 다른 적응요소를 생활과업 측면에서 고려하고, 대표적으로 컴퓨터나 인터넷 활용도, 핸드폰 소유정도를 통해 정보기기 접근 수준이 우울감이나 자살생각 즉, 정신건강 영역에 영향을 미치는 지를 분석하였다. 분석은 2011년 노인실태조사 원자료로 60세 이상 노인 6,774명을 대상으로 추출하여 평균과 표준편차, 빈도와 백분율, 다중회귀분석과 로짓분석 등의 방법으로 이루어졌다. 분석결과 남성노인이, 젊은 노인들이, 교육수준과 경제적 생활수준이 높고, 배우자와 함께 살고 있는 노인들의 경우 정보기기 접근 수준이 양호한 것으로 나타나 이들과는 다른 인구사회적 배경을 지닌 대상들은 정보화에 있어 소외계층이 될 가능성이 있음을 알 수 있었다. 더불어 정보기기 접근 수준이 양호하지 않은 노인들은 우울수준과 자살을 생각하는 비율도 높게 나타났다. 회귀분석과 로짓분석 결과 정보기기 접근 수준은 우울감에 유의미하게 영향을 미치는 요인들로 검증되었으며, 노인의 자살생각에는 영향을 미치지 않음을 확인할 수 있었다. 이러한 연구결과는 사회적으로 소외되고 있는 노인들의 정신건강 증진을 위한 사회 지지서비스 개발과 정보화 정책 수립에 중요한 개입요소를 제공하고 있다.

• 한국임상약학회지
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• 제26권1호
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• pp.24-32
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• 2016

Objective: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. Methods: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. Results: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. Conclusion: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

• The Journal of Korean Physical Therapy
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• 제20권4호
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• pp.61-69
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• 2008

Purpose: We evaluated caregivers' understanding of patients' diseases and disuse syndrome, the understanding of exercise and massage related to rehabilitation and the necessity of education about these, the difference in education and realities of the care-giving field, and the extra services needed in the field. Methods: The survey using questionnaires was performed from June 2008 to August 2008 with 220 people participated in caregive education programme in daegu city and area near dagu city. Among the 220 submitted questionnaires, 184 which were faithfully answered were selected and they were analyzed by i-STATistics statistical program. Results: The educational focus of the first and second level caregivers, as defined by the second clause of the 29th article of the Elderly Welfare law, is on basic knowledge of diseases such as dementia, stroke, and depression. However, other diseases are not covered and the information does not include information on decreased function, complications, functional rehabilitating exercises, or preventing disuse syndrome for long term patients. The most common diseases, in order of prevalence, are stroke, dementia, diabetes mellitus, Parkinson disease, arthritis, and geriatric inertness. The general level of awareness about disuse syndrome was low, and patients, while understanding the need for massage and rehabilitative exercise, receive little education about the proper methods and therefore cannot use them. Patients also did not understand how participating in these activities could reduce medical fees, indicating that further education on massage and rehabilitative exercise is needed. Caregivers desired to include positive rehabilitation, massage, and exercise-related services in their services. Finally, differences in caregiver education and reality resulted from a lack of diversity in education. Conclusion: We suggest providing education on disuse atrophy and improving the lack of diversity in the care-giving education system.

• 대한영양사협회학술지
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• 제20권3호
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• 융합정보논문지
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• 제12권5호
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• pp.159-167
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• 2022

2018년 11월 보건복지부가 지역사회 돌봄 사업을 제20대 국정과제로 채택하였음에도 프로젝트의 성과나 동향을 보고하는 체계적인 검토가 이루어지지 않았다. 본 연구는 커뮤니티 케어 시범사업과 관련한 기존 근거를 체계적으로 검토하였으며, 그 결과 원저 18편과 평론 43편이 최종 선정되었다. 원저의 경우 수요조사(n=4) 및 모델제안(n=4), 터치포인트 활용(n=3), 공간설계 및 건축모델(n=3), 인력양성 및 역할 설정(n=2), 우선 순위 목표(n=1) 및 연구 동향 연구(n=1)등이 있었으며, 리뷰 문헌의 경우 노인에 대한 문헌이 가장 많았고(n=12), 장애인 및 정신질환에 관한 문헌은 상대적으로 적었다(n=2). 지역사회 돌봄 시범사업이 시행된 지 1년 정도밖에 되지 않아 본 사업과 관련된 근거가 부족하고 사업의 성과를 정량적으로 보고한 연구가 부족한 실정이다. 본 연구는 노인뿐만 아니라 장애인, 정신질환자, 노숙자에 대해서도 더 많은 연구가 필요함을 시사한다.