• 제목/요약/키워드: Korean Long-term Care Insurance

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요양보호사의 긍정심리자본이 서비스 질에 미치는 영향과 직무만족의 매개효과 검증 (Effects of Positive Psychological Capitals on Service Quality and Mediating Effect of Job Satisfaction in Professional Care Workers)

  • 이문재;조춘범;김정화
    • 한국노년학
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    • 제39권3호
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    • pp.531-548
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    • 2019
  • 본 연구는 장기요양보호 현장요양보호사들의 심리적 요인과 서비스 질, 직무만족 간의 관계를 실증분석을 통해 파악하여 서비스 질 향상의 기초자료를 제공하는데 그 목적이 있다. 이를 위해 경기도 안산시, 안양시, 부천시, 광명시에 소재하는 노인요양시설에 근무하는 요양보호사에게 총 430부의 설문지를 배부하였으며, 미회수 및 불성실한 응답을 제외한 393부의 설문지를 분석에 활용하였다. 본 연구에서 밝혀진 주요결과는 다음과 같다. 첫째, 긍정심리자본은 서비스 질에 정(+)의 영향을 미치는 것으로 나타났다. 둘째, 긍정심리자본이 서비스 질에 미치는 영향을 직무만족이 매개하는 것으로 나타났다. 이상의 결과를 토대로 다음과 같이 제언하였다. 첫째, 제도적 차원에서의 인적자원관리를 통한 긍정적 심리자원과 역량강화에 도움이 될 수 있는 정책이 요구된다. 둘째, 긍정심리자본이 직무만족과 서비스 질에 효과적이라는 사실을 인지하고 시설운영에 접목시킬 수 있는 기관 환경변화가 필요하다.

국내 노인 파킨슨병 환자에서의 잠재적으로 부적절한 약물사용 현황에 대한 연구 (Assessment of Potentially Inappropriate Medication Use in Korean Elderly Patients with Parkinson's Disease)

  • 서미경;배민경;이인향;전성실;윤정현
    • 한국임상약학회지
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    • 제25권4호
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    • pp.254-263
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    • 2015
  • Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

지역사회 거주 노인의 허약선별도구 타당도 평가 (Validation of Instruments to Classify the Frailty of the Elderly in Community)

  • 이인숙;박영임;박은옥;이순희;정인숙
    • 지역사회간호학회지
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    • 제22권3호
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    • pp.302-314
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    • 2011
  • Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ${\alpha}$. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long.term care insurance grade as a gold standard. Results: The Cronbach's ${\alpha}$ was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

복지국가와 장애인 복지정책의 발전 - 노인장기요양보험제도를 통한 방문재활서비스 도입방안 - (Welfare State and Development of the Welfare Policy for the Disabled - Inclusion of Home-based Rehabilitation Services in the Long Term Care Insurance -)

  • 윤태형;김태훈
    • 대한지역사회작업치료학회지
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    • 제1권2호
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    • pp.45-59
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    • 2011
  • 목적 : 본 연구는 복지국가의 개념과 사회복지영역을 살펴보고, 우리나라 장애인복지정책의 발전을 비교 분석해 보기 위함이다. 연구방법 : 문헌고찰을 통하여 복지국가의 개념과 사회복지의 영역을 기술하였고, 우리나라의 사회복지정책과 장애인정책을 각 정부별로 비교 분석하였으며 마지막으로 노무현 정부의 장애인정책을 분석하였다. 결과 : 경제성장과 더불어 복지정책과 장애인복지정책은 '선택적 복지'에서 '보편적 복지'의 형태로 발전하였다. 사회복지정책의 영역에 있어서도 과거 이승만 정부시절의 '최소한의 보장'에서 노무현 정부의 '참여복지'에 이르기까지 영역의 확대가 이루어지고 있으며 이러한 현상은 장애인 복지정책에서도 나타나는 현상이다. 결론 : 지역사회 작업치료사는 오늘날 '보편적 사회복지'의 큰 틀에서 등록 장애인 뿐 만 아니라 지역사회의 드러나지 않는 장애를 지닌 일반인과 노인을 위한 방문재활서비스와 같은 미 충족 작업치료서비스를 발견하고 제공해야 할 것이다.

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고령자 주택개조 관련 제도 현황 분석 (Analysis on the Home Modification related System for the Elderly)

  • 권오정;김진영;이용민
    • 한국실내디자인학회논문집
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    • 제27권2호
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    • pp.24-36
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    • 2018
  • Implementing a home modification to enable elderly's safe and independent living is the key plan to realize their aging in place. South Korea in which had entered an aged society is not yet vitalized in home modification for the elderly compared to that of welfare-developed countries, and South Korea provides support that is limited to the low-income elderly. Therefore, this purpose of this study was to analyze the laws related to the home modification, the present condition of home modification support, the standards and guidelines in home modification, the support in house modification cost, and supporting organization and working force in the home modification. Through the analyzing process, this study examined the current situation and problems of institutional support in the home modification for elderly and the proposed plan for institutional improvement. The suggestions based on the results are as in the following. 1) Home modification support law(act or regulation) is required to be improved 2) Home modification support system correspondent to aging process should be provided regardless of their income levels. 3) Delicate plan standard and guideline are necessary for a process of implementing the home modification for the elderly. 4) Information on life behavior is in need for the implementation of elderly-customized home modification. 5) Cost for the home modification should be considered to cover by the Act on Long-Term Care Insurance for the Aged. 6) Housing Welfare Center and Housing Welfare Professional should be actively utilized for the home modification support institution and work force.

대구소재 한 노인요양병원 입원환자들의 구강상태와 저작능력에 관한 연구 (A Study on Dental Health and Chewing ability of Patients Hospitalized in Geriatric Hospital of Daegu)

  • 박수철;정명희;최성미
    • 대한치과기공학회지
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    • 제33권3호
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    • pp.237-246
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    • 2011
  • Purpose: This study investigates dental health and chewing ability of patients hospitalized in geriatric hospital, and compares the chewing ability for each factor that can be used as data for dental healthcare of senior citizens and basic data for denture insurance for the elderly. Methods: The 101 subjects of this study were selected from 178 patients hospitalized in a geriatric hospital located in Daegu Metropolitan City, excluding 77 patients who were being treated in the intensive care unit and who were unable to communicate. The chewing ability of the patients were measured using an evaluation scale based on foods consisting of 10 different hardnesses. Results: Patients with less than 21 teeth, those with dentures and patients who were less than satisfied with their dental conditions had difficulties in chewing hard food such as dried squid and radish kimchi, and the Chewing ability increased proportionally to the number of remaining teeth(p<0.001), appropriateness of the maxillary and mandibular dentures(p<0.005) and the level of dental satisfaction(p<0.001). Conclusion: This study is limited as the subjects were selected from a single hospital and the authors estimate that various studies will be necessary to investigate the Chewing ability of patients hospitalized in long-term hospitals. The subjects of this study did not receive any dental treatment while staying in the hospital and many of the subjects had bad fit denture or didn't have dentures or did not use dentures, although they have dentures, which calls for denture construction and prosthetics through dental treatment.

요양시설 노인과 요양보호사에 있어 식사의 의미 (Meaning of a Meal among Nursing Home Elderly and Staff)

  • 이경희
    • 한국노년학
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    • 제36권4호
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    • pp.1157-1176
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    • 2016
  • 본 연구는 요양시설 노인과 요양보호사에게 있어 식사의 의미를 이해하고자 일상생활방법론을 활용하여 참여 관찰과 심층면담을 적용하여 주제 분석하였다. 연구결과 노인에게 있어 요양시설 식사는 개인의 다양성에 대한 철학이 없는 획일의 식사문화로 인식한 것과 같이 요양보호사 역시 요양시설 노인에게 있어 식사는 편의적 논리에 따른 운영으로 나타났다. 노인에게 있어 식사는 없어서는 안 될 공기와 같은 필수 요소로 건강 회복의 염원을 담고 있었으나 요양보호사는 단지 생존을 위한 수단으로 아무 의미가 없이 생명 연장을 실현하고 있었다. 노인에게 간식은 권력 및 일상의 탈출이었으나 요양보호사에게 있어 간식은 또 다른 통제 수단이었다. 본 연구의 결과를 토대로 노인장기요양보험의 시행 법령 및 요양시설 운영진의 입장이 아닌 요양시설에서 생활하고 있는 노인의 다양성을 반영한 실질적인 식사 운영 지침의 개발과 노인 존중과 이해에 대한 지속적인 교육의 필요성을 제시하였다.

마케팅 믹스에 의한 사회복지시설 후원자 개발에 관한 연구 (A Study on the development of sponsors of social welfare facilities through marketing mix)

  • 조우홍
    • 한국컴퓨터정보학회논문지
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    • 제14권5호
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    • pp.195-200
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    • 2009
  • 본 연구는 마케팅 믹스에 의한 사회복지시설 후원자 개발에 관한 연구를 하고자 한다. 오늘날 사회복지 현장에서도 경제논리의 시대에 도래하였다. 2008년 7월 노인장기요양보험제도가 시행되면서 그동안 정부 재원에 의지한 많은 사회복지시설들이 다양한 자원 획득을 위해 경쟁이 이루어지고 있으나, 여전히 대부분의 사회복지시설들은 매우 심각한 재정난을 겪고 있다. 이러한 부족한 재원에 대한 보완적인 방법으로 사회복지시설의 실정에 맞는 후원자를 개발하고 관리하는 방법을 체계화하여 재원을 확보할 수 있는 방안을 모색하여야 한다. 이러한 측면에서 마케팅 믹스에 의한 사회복지시설 후원자 개발을 위해 Fine(1992)의 7P모델 제품(Product), 가격(Price), 홍보(Promotion), 장소(Place), 생산자(Producer), 구매자(Purchaser), 조사(Probing) 등 7개 요인으로 후원자 개발을 위한 전략적 방안을 제시해 보고자 한다.

국소 진동자극이 편마비 뇌졸중 환자의 팔 뻗기 수행에 미치는 영향에 대한 운동학적 분석 (Kinematic Analysis in Reaching Depending on the Localized Vibration Duration in Persons With Hemiparetic Stroke)

  • 유은영;박지혁;권재성;조상윤;이보미;김영조;김재남;김선호
    • 재활치료과학
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    • 제7권3호
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    • pp.79-88
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    • 2018
  • 목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 환측 상지에 진동자극을 적용했을 때, 팔 뻗기 수행에서 나타나는 팔꿈치 움직임의 운동학적 변화를 관찰하기 위함이다. 연구방법 : 연구 설계는 단일집단 교차실험설계(one-group cross-over trial design)를 사용하였으며, 10명의 만성 뇌졸중 환자를 대상으로 하였다. 대상자의 환측 위팔두갈래근(biceps brachii)에 국소 진동자극을 5분, 10분, 20분 동안 무작위로 70Hz로 적용한 후, 3차원 동작분석 시스템을 통해 팔 뻗기 수행의 운동학적 움직임을 분석하였다. 종속변수에는 팔꿈치 움직임에서 나타나는 최대 각 속도, 최대 각속도까지의 시간, 움직임 단위를 포함하였다. 결과 : 팔 뻗기를 수행함에 있어서 팔꿈치의 움직임은 20분 동안 국소 진동자극을 적용하였을 때 보다 빠르고 부드러워졌으며, 효율적으로 나타났다. 팔꿈치 움직임의 최대 각속도는 증가하였고(p<0.05), 최대 각속도까지의 시간과 운동단위는 유의하게 감소하였다(p<0.05). 결론 : 국소 진동자극은 편마비 뇌졸중 환자가 팔 뻗기 움직임을 수행함에 있어 발생하는 운동학적 구성요소를 향상시킬 수 있는 효과적인 방법일 될 수 있다.

저소득층 방문간호 관리를 위한 제안 - 강북구 방문간호 대상자를 중심으로- (A Proposal on a Management Model Applicable to Visiting Nursing Program for a Low-income Group)

  • 고미자
    • 한국보건간호학회지
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    • 제10권1호
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    • pp.118-138
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    • 1996
  • Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.

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