• 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.

• 한국콘텐츠학회논문지
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• 제12권4호
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• pp.282-291
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• 2012

본 연구는 요양보호사의 직무만족이 서비스 질에 미치는 영향을 분석하여 요양보호사의 직무만족 향상과 보다 나은 질적 서비스를 제공하기 위한 자료로 활용하는데 그 목적이 있다. 부산시 소재 6개구 소재 16개 기관에서 근무하는 요양보호사에게서 회수된 설문지 250부 중 216부를 SPSS 12.0 을 이용하여 설문문항의 신뢰도 검증, 상관관계 분석, 회귀분석을 실시하였다. 요양보호사 직무만족 요인이 서비스 질에 미치는 영향을 알아보기 위해 회귀분석을 실시한 결과, 요양보호사의 업무자체 만족도가 높을수록, 직업안전성에 대한 만족도가 높을수록 서비스 질에 긍정적인 영향을 미치고, 요양보호사의 업무부담, 직무환경에 관한 만족은 서비스 질에 유의미한 영향을 미치지 않는 것으로 나타났다. 요양보호사의 업무자체만족도 수준과 직업안정 관련 구조 개선을 충족시킬 수 있는 여건들이 조성된다면 보다 양질의 요양보호 서비스 제공을 기대할 수 있다는 것을 보여주는 것이다.

• 가정∙방문간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 지역사회간호학회지
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• 제9권1호
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.

• 한국콘텐츠학회논문지
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• 제13권5호
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• pp.234-242
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• 2013

2007년 노인장기요양보험법이 제정되었고 이 법은 질병 및 장애가 있는 노인들에 대한 요양비용을 사회구성원들이 함께 부담하는 체계를 구축하여 노인 및 그 가족구성원의 삶의 질을 향상시키는데 그 목적이 있다. 노인장기요양보험제를 실현하기 위해 요양보호사제도가 마련되었다. 요양보호사란 거동이 불편한 노인을 시설에서 돌보거나 또는 노인이 거주하는 가정을 방문하여 보호활동을 벌이는 사람들을 말한다. 그런데 최근 발표된 국가인권위원회의 조사에 의하면 요양보호사들의 근무환경이 매우 열악한 것으로 드러났다. 저임금, 포괄임금의 남용, 장기간 근로, 인력배치기준 및 휴게시설 미비, 요양보호서비스 이외의 노무제공, 수급자에 의한 성희롱 등의 문제가 있는 것으로 나타난 것이다. 인구의 고령화가 빠른 속도로 진행되고 있고 노인들에 대한 요양보호의 중요성과 요양보호사들의 역할이 증대되고 있는 상황을 고려한다면 이들의 업무환경에 대한 개선이 절실히 필요하다. 이러한 견지에서 이 논문은 국가인권위원회가 발표한 자료를 바탕으로 노동인권의 측면에서 요양보호사들이 겪고 있는 문제점들을 살펴보고 효과적인 개선방안에 대해 논의 해본다. 결국 요양보호사들이 직면한 문제들을, 정부의 철저한 관리 감독과 요양보호사의 처우 개선 그리고 수급자의 인식 개선 등을 통해 바로잡는다면 더 나은 노동환경에서 요양보호사들이 질 높은 서비스를 제공할 수 있을 것으로 기대한다.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.285-293
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• 2017

본 연구는 노인요양시설 요양보호사의 이직의도에 영향을 주는 직무스트레스, 피로, 직무만족도의 인과관계를 파악하기 위함이다. 자료수집은 2014년 9월 15일부터 9월 30일까지였으며 구조화된 무기명 자기기입식 설문지(self-administrated questionnaire)를 통해 이루어졌다. 연구대상자는 D시 내 노인요양시설 및 노인요양공동생활가정에 근무하고 있는 여성 요양보호사 232명이었다. 분석은 SPSS WIN ver 21.0과 AMOS (Analysis of Moment Structure) ver 21.0 프로그램을 이용하였다. 요양보호사의 이직의도에 영향을 미치는 변수들 간의 인과관계를 추정하기 위하여 공분산 구조분석을 실시한 결과는 다음과 같다. 본 연구의 모형에 포함된 변수들이 피로는 직무스트레스에 의해 4.9% 설명되었고. 직무만족도는 직무스트레스, 피로에 의해 54.6% 설명되었으며 이직의도는 직무스트레스, 피로, 직무만족도에 의해 46.2% 설명되었다. 즉, 직무스트레스, 피로 및 직무만족도가 요양보호사의 이직의도에 직, 간접적인 효과를 미치고 있었음을 알 수 있었다. 결론적으로, 직무스트레스, 피로, 직무만족도가 이직의도에 영향을 미치고 있음을 확인하였다. 따라서 요양보호사의 이직의도를 감소시키고 안정된 평생직장에서 업무를 충실히 수행할 수 있도록 근무환경 및 근로조건 개선을 위한 정책적 전략이 필요할 것으로 사료된다.

• 한국콘텐츠학회논문지
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• 제12권7호
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• pp.215-222
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• 2012

본 연구는 노인복지 종사자 중 죽음과 가장 밀접한 관계에 있는 요양보호사에게 웰다잉을 위한 교육을 실시하여 요양보호사의 죽음불안과 죽음에 대한 수용에 미치는 영향을 분석하고자 하였다. 이를 통해 요양보호사들이 죽음과 죽음과정, 죽음관련요인을 이해하여 노인의 편안한 임종을 도울 수 있도록 하기 위해 광주지역에 소재한 J요양원에 근무하는 요양보호사들을 대상으로 웰다잉에 관한 교육을 실시하였다. 프로그램은 주 1회 총 9회기가 진행되었고, 수집된 교육 전후 요양보호사들의 변화 자료는 SPSS 15.0 프로그램을 활용하여 신뢰도 분석, 기술통계분석, t-test, ANOVA 분석을 하였으며, 본 연구의 결과는 다음과 같다. 첫째, 웰다잉을 위한 프로그램에 참여한 대상자들은 죽음불안이 감소하였다. 둘째, 웰다잉을 위한 프로그램에 참여한 대상자들은 죽음수용정도가 증가하였다. 이를 통해 웰다잉을 통한 교육이 노인복지종사자 중 요양보호사의 죽음불안 감소와 즉음수용정도 증가에 긍정적 영향을 미쳤음을 알 수 있었다.

• 한국생활과학회지
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• 제8권2호
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• pp.419-435
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• 1999

The purpose of this article was to develop an interdisciplinary program for the aged living welfare in College of Home Economics. This program was developed through the analysis of gerontology curriculum in Korea, Japan, and America, and survey research with social workers who were working in the welfare institutes for the elderly in Korea. Moreover, an interdisciplinary program for the aged living welfare was designed based on the professional role of elderly care and the scope of educational context which were identified. Particular note was that this program could be most effectively implemented in the College of Home Economics. Recommendations for the development and implementation of the program were highlighted.

• 산업융합연구
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• 제20권7호
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• pp.107-113
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• 2022

본 연구는 요양보호사의 직무환경이 조직몰입에 미치는 영향을 파악하고 이를 토대로 직무만족의 매개효과를 검증하는 것을 목적으로 한다. 자료수집은 경기지역 노인요양시설을 중심으로 요양보호사 300명을 대상으로 설문조사를 하였고, 회수되지 않은 설문지와 이상치를 제거하고 최종 267명을 연구대상으로 선정하였다. 자료분석은 SPSS WIN 23.0, PROCESS Macro V3.5를 통해 결과를 도출하였고, 직무만족의 매개효과 검증을 위해 Hayes(2013)의 Macro Model Number 4를 적용하였다. 분석결과, 요양보호사의 직무환경이 조직몰입에 미치는 영향에서 직무만족 변인의 부분매개효과를 확인하였다. 분석결과를 토대로 요양보호사의 직무환경 개선과 직무만족 증가를 위한 실천적·정책적 제언과 본 연구의 한계를 극복하기 위해 후속 연구를 제안했다.

• 가정∙방문간호학회지
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• 제27권2호
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• pp.198-209
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• 2020

Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.