• 한국실내디자인학회:학술대회논문집
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• 한국실내디자인학회 2005년도 춘계학술발표대회 논문집
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• pp.187-190
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• 2005

As the population of the elderly has increased and the nuclear family has become popular, the demands of long-term care services for the elderly have arisen. However, a lot of patients, who need long-term care services, are in general hospitals because existing facilities for the elderly are not sufficient in terms of both quality and quantity. In this study, it is considered a good alternative to set geriatric wards, offering long-term care services for the elderly, in general hospitals. This study shows an analysis of geriatric wards in general hospitals, especially, based on the case of N hospital, and suggests the spacial elements of geriatric wards, which is different from other wards in the aspects of space program and operating system.

• 대한치과보철학회지
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• 제46권1호
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• pp.83-91
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• 2008

문제제기 : 2007년 4월 '노인장기요양보험법'이 국회를 통과하였고 노인수발행위에 치과의사의 참여가 확정되어 2008년 7월부터 법이 시행되면서, 고령화가 급속이 진행되고 있는 한국사회에서 치과분야가 담당해야 할 역할은 커질 수밖에 없다. 목적 : 본 논문은 한국의 두 노인시설에 대한 설문조사를 바탕으로 일본의 노인요양보험법과 비교를 통해 앞으로 시행되는 노인장기요양법의 구강위생서비스의 역할 및 방향을 수립하는데 기여하고자 한다. 연구재료 및 방법 : 2005년 한국의 두 노인요양시설에서 책임 있는 직무자 또는 실제 간호의 내용을 파악하고 있는 분을 대상으로 15개 항목의 설문조사를 시행하였다. 결과 : 두 시설 모두 각각의 특징을 살려 매우 기능을 잘 하고 있었으나, 구강위생 및 이에 대한 직원의 인지도는 낮았으며 정기적인 진료나 관리는 소홀했다. 고찰 : 일본에서는 2000년 노인요양보험이 도입 후 체계화된 방법론을 기초로 시행되고 있다. 현재 '노인장기요양' 법안에 치과의사 참여가 보장된 것과 관련하여 앞으로 치과의사의 적극적인 참여가 필요하고, 시설 및 재택 방문 진료가 가능하도록 하는 법정비용을 통해 치과분야의 진료영역을 넓힐 수 있는 움직임이 필요하다고 볼 수 있다.

• 한국노년학
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• 제29권1호
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• pp.177-194
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• 2009

본 연구는 일차적으로 노인장기요양보험 급여방식 중 현물급여와 현금급여의 선택에 있어서 비공식 가족수발자들의 현금급여 선호도를 알아보고, 이에 영향을 미치는 요인을 파악함으로써 현금급여 도입의 필요성을 인식하는데 목적이 있다. 이차적으로는 조건부 가치측정법을 이용하여 비공식적 가족수발에 대한 적정 현금급여액을 추정함으로써 미래 현금급여 도입 시 수가산정을 위한 기초 자료로 제시하고자 한다. 본 연구를 위한 조사는 서울시 소재 3차 의료기관 3곳에서 현재 환자를 돌보고 있는 환자의 보호자 300명을 대상으로 하였다. 경증과 중증 두 가지 유형의 가상의 시나리오 및 구조화된 설문지를 제시한 후 현금급여를 수용할 최소한의 보상금액(Willingness-To-Accept, WTA)을 이중경계 양분선택형 질문으로 구하였으며, 일대일 직접 면접법을 이용하였다. 연구결과, 경증노인에 대해서는 52.7%가, 중증노인에 대해서는 26.0%만이 현금급여 서비스를 선호하였다. 경증노인에 대한 적정 현금급여액은 월 평균 62.8만원, 중증 노인에 대한 적정 현금급여액은 월 평균 107.2만원인 것으로 나타났다. 본 연구는 비공식적 수발자가 직면하는 각기 다른 상황에 대한 실제 현금급여 선호도를 확인함으로써 현금급여 도입의 필요성을 인식하였으며, 잠재적 가족수발자들의 시간손실 보상액으로서 수발자가 받아들일 수 있는 주관적 수발비용을 적정 현금급여액으로 추정함으로써 현행 특별현금급여액의 적정성을 평가하는데 보다 현실적인 기준을 마련하였다는데 함의가 있다고 하겠다.

• 보건행정학회지
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• 제21권1호
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• pp.115-131
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• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• 한국환경보건학회지
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• 제46권5호
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• pp.599-609
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• 2020

Objectives: Coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan, China, and has rapidly become a global pandemic with over 26.4 million confirmed cases and approximately 871,000 fatalities worldwide as of this writing. In the Republic of Korea, disease clusters frequently occurred in long-term care hospitals where the majority of residents are elderly with underlying medical conditions. Despite the fact that public health authorities and local community health centers have put tremendous efforts into preventing the spread of disease, positive cases have continued to occur. Thus, the Korea Centers for Disease Control & Prevention rapid response team decided to conduct an environmental investigation of a long-term care hospital to identify whether environmental contamination has remained and contributed to the spread of COVID-19. Methods: An environmental investigation was conducted at Hospital A. The characteristics of the facility and its HVAC system were assessed by checking the layout and interviewing the people in charge. A total of 64 surface samples were collected from areas of concern, including patient rooms, toilets, elevators, and nurses' station. These samples were tested by a regional health and environmental research institute using real-time reverse transcription polymerase chain reaction. Results: All samples from Hospital A were confirmed to be negative. Through interviews with high-level personnel at the regional community health center, we found that extensive disinfection is frequently performed on potentially contaminated areas in Hospital A in accordance with government guidelines. Conclusion: The environmental control measures implemented in Hospital A had been sufficient for mitigating the risk of further infection, suggesting that such measures may also be effective for other long-term health care facilities.

• 가족자원경영과 정책
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• 제21권3호
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• pp.121-139
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• 2017

This study aimed to explore the moderating effect of social support resources on the life satisfaction and caregiving burden of family caregivers taking care of the elderly in long-term care services. The study participants were selected from among the family caregivers utilizing 30 home care centers in Seoul, Korea. Of the candidates who agreed to participate in the study, 250 caregivers who had supported the elderly at home for at least 6 months were selected. The data collected were analyzed using SPSS ver. 21.0. The study findings were as follows. First, the whole family caregivers' caregiving burden of family caregivers was found to be slightly higher than the median value. More specifically, the physical burden was the heaviest, followed by the family relationship burden, the social activity burden, the emotional burden, and the financial burden. Social support resources and life satisfaction were found to be a little bit higher than the median value. Second, the variables that statistically significantly increased life satisfaction, starting with the strongest effect, were a lower psycho emotional burden, greater informational support resources, a lower economical burden, greater emotional support, a younger caregiver age, a higher monthly income, and a shorter care period. Third, informational support resources were found to have a moderating effect on the relationship between the support burden and life satisfaction. The more the participants used the informational support resource subcategory of the social support resources, the narrower the life satisfaction decrease, even though the caregivers felt a support burden. Informational support resources appear to have a statistically significant buffering effect.

• 한국보건간호학회지
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• 제24권2호
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• pp.285-301
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• 2010

Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.

• 보건행정학회지
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• 제24권1호
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• pp.71-84
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• 2014

Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

• 지역사회간호학회지
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• 제10권1호
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• pp.106-120
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• 1999

Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

• 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.