• 한국치위생학회지
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• 제17권3호
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• pp.527-537
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• 2017

Objectives: The purpose of this study was to examine the practice of oral hygiene behaviors and oral health status of long-term care facility residents and to analyze the factors related to salivary hemoglobin level which can predict active periodontal disease. Methods: From 30th October 2015 to 7th January 2016, a questionnaire was provided to 63 participants and their dental plaque and saliva samples were collected to assess the levels of salivary hemoglobin and dental plaque acidogenicity. In order to analyze the factors related to salivary hemoglobin level, multiple linear regression analysis was performed. Results: Toothbrushing was most frequently performed by the participants themselves (98.4%) and toothbrushing was performed after eating breakfast (81.3%). 68.8% of participants reported brushing their tongue. 35.9% of participants perceived having bad teeth, and 87.5% had high dental caries activity. The percentages of participants with hyposalivation and ${\geq}0.20{\mu}g/ml$ salivary hemoglobin level were 45.3% and 59.4%, respectively. The salivary hemoglobin level was significantly higher in the group in which stimulated salivary flow rate was ${\leq}0.70ml/min$, dental plaque acidogenicity was superior, and perceived having bad teeth (p<0.05). There was also a tendency for the salivary hemoglobin level to increase with age (p<0.05). Conclusions: Oral health status of the long-term care facility residents was still not improved, and the characteristics of salivary volume and dental plaque were important factors affecting salivary hemoglobin level. Therefore, it is necessary to operate an oral hygiene intervention program by oral health professionals in such facilities in order to provide residents with effective oral care aligned with their respective needs. Furthermore, it is necessary for caregivers to complete mandatory oral health education to improve the oral hygiene status of the long-term care facility residents.

• 한국산학기술학회논문지
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• 제15권8호
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• pp.5062-5069
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• 2014

본 연구는 전문가구강관리가 요양병원 장기입원환자들의 구강내 Streptococcus mutans 수에 미치는 영향을 파악하기 위하여 D광역시에 소재한 일개 노인 요양병원 장기입원환자를 대상으로 2011년 7월 24일 부터 10월 25일 까지 3개월간 연구대상자 43명을 대상으로 주 2일, 1일 3회 치과위생사가 전문가구강관리를 제공하고 1개월 간격으로 3회에 걸쳐 타액분비량과 타액 내 mutans streptococci 집락 수를 세어 구강건강상태를 비교하였다. 연구결과 타액분비량은 관리 전 5.8 ml에서 1개월 후 6.4 ml, 2개월 후 7.5 ml로 증가하였고, 세균 수는 약 $6{\times}10^8CFU/ml$에서 2개월 후 약 $3{\times}105CFU/ml$로 20배 이상 감소하였다. 전신질환에 따른 구강관리 전후의 세균 수의 변화는 고혈압과 당뇨병이 있는 환자의 세균 수가 유의하게 감소하였다. 충전치아의 수와 고정성보철물의 수가 많을수록 세균 수는 유의하게 감소하였다. 전문가구강관리는 요양병원 장기입원 환자들의 구강내 Streptococcus mutans 수와 밀접한 관련이 있는 것으로 나타났다. 따라서 향후 요양병원 장기입원환자의 특성을 고려한 실질적이고 지속적인 구강관리가 이루어지도록 구강보건프로그램을 개발하는데 필요한 다양한 연구가 실시되어야 한다.

• International Journal of Human Ecology
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• 제2권1호
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• pp.39-55
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• 2001

Concerns about paid-facilities for the elderly with dementia from middle and upper class families have been discussed lately in Korea. Small-scale, home-like group homes for the elderly with dementia were developed in Sweden in the 1980, but they have not been effectively introduced in Korea where they remain a comparatively new concept. The group home, however, would provide a good alternative to Koreans who feel guilty when they have to leave their frail parents in large-scale facilities or hospitals instead of caring for them at home. The aim of this paper is, first, to define the care of the demented elderly who come from upper and middle class families in Korea and, secondly, to discuss the need for group homes to help care for them. A survey was done by questionnaire and was answered by 577 respondents who belonged to middle and upper class families living in Korea in December 2000. Methods of analysis were frequency, mean, and Chi-square. The results of this study were as follows: 1) the traditional notion that the eldest son should be burdened with the primary responsibility for a demented parent has weakened remarkably; 2) a small-scale long-term care facility was considered the most desirable living environment for the demented elderly; 3) the facilities families needed for professional hospitals for victims of dementia, senior citizen centers, large and small-scale long-term care facilities, day-care centers, and short-stay and service housing. The study also revealed that there was low awareness of the group home. The most preferred type of structure for group homes was a single-family detached house, and the most preferred management system was small-scale that could create home-like atmosphere. Additionally the respondents wanted group homes to consist of 6-8 residents with 2-4 persons per room. The results of this study strongly suggest that policy makers should encourage the development of smallscale group homes as an alternative form of housing for the elderly with dementia.

• 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.

• 지역사회간호학회지
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• 제28권4호
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• pp.513-523
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• 2017

Purpose: We evaluated the psychometric properties of a questionnaire on the acceptance of the quality improvement information system (QIIS) among long-term care workers (mostly nurses). Methods: The questionnaire composes of 21 preliminary questions with 5 domains based on the Technology Acceptance Model and related literature reviews. We developed a prototype web-based comprehensive resident assessment system, and collected data from 126 subjects at 75 long-term care facilities and hospitals, who used the system and responded to the questionnaire. A priori factor structure was developed using an exploratory factor analysis and validated by a confirmatory factor analysis; its reliability was also evaluated. Results: A total of 16 items were yielded, and 5 factors were extracted from the explanatory factor analysis: Usage Intention, Perceived Usefulness, Perceived Ease of Use, Social Influence, and Innovative Characteristics. The five-factor structure model had a good fit (Tucker-Lewis index [TLI]=.976; comparative fit index [CFI]=.969; standardized root mean squared residual [SRMR]=.052; root mean square error of approximation [RMSEA]=.048), and the items were internally consistent(Cronbach's ${\alpha}=.91$). Conclusion: The questionnaire was valid and reliable to measure the technology acceptance of QIIS among long-term care workers, using the prototype.

• 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.

• 한국사회복지학
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• 제65권3호
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• pp.155-182
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• 2013

본 연구는 장기요양보호대상노인의 시설생활 적응과정은 어떠한지, 어떻게 경험하고, 어떠한 행태적 특징을 보이는지를 살펴보는데 그 목적이 있다. 노인요양시설에서 생활하는 노인 15명을 대상으로 심층면담을 한 내용을 Strauss 와 Corbin(1998)이 제시한 근거이론을 활용하여 분석하였다. 분석결과, 15개의 범주와 42개의 하위범주 그리고 170개의 개념이 추출되었다. 장기요양보호대상노인의 시설적응 과정에서 경험하는 중심현상은 '내버려짐'으로 나타났다. 이에 대한 인과적조건, 맥락적조건, 중재적조건, 작용/상호작용 전략과 결과를 통합한 핵심범주는 '받아들임'으로 구체화되었으며, 그 유형에 따라 운명-체념형, 현실-수용형, 자발적-선택형으로 구분되는 것으로 확인 하였다. 연구 결과를 바탕으로 노인을 둘러싸고 있는 상호작용요인으로써 시설환경과 종사자, 시설 내 다른 노인과의 대인관계, 가족의 지지가 강화되도록 실천적 대안을 제시하였다.

• 기본간호학회지
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• 제17권1호
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• pp.26-34
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• 2010

Purpose: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. Method: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. Results: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. Conclusion: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

• 치위생과학회지
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• 제15권5호
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• pp.569-576
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• 2015

본 연구는 요양보호사의 구강관리교육 프로그램에 필요한 근거를 마련하기 위해 전국 장기요양시설에 근무하는 요양보호사를 대상으로 구강관리교육 실태와 관련 지식, 태도 및 행동을 설문조사하여 다음과 같은 결과를 얻었다. 연구대상자의 27.9%가 구강관리에 관한 교육을 수혜한 경험이 있다고 하였고, 배운 내용으로는 틀니관리와 이 닦기 방법이 90%로 가장 많았다. 그리고 연구대상자들의 구강관리에 대한 지식수준을 확인한 결과, 노인이 복용하는 약물의 부작용, 오연성 폐렴과 치태의 연관성, 잇몸질환, 틀니세척 방법, 와상노인의 구강위생관리에 대한 지식이 부족함을 알 수 있었다. 입소노인의 구강관리의 책임자로서 연구대상자들의 태도수준은 총 10개의 조사 문항 중 8개 문항에서 3점 이상(5점 만점)의 높은 동의수준을 보였으며, 노인의 구강관리를 제공하기 어려운 이유로 구강관리 방법에 대한 어려움(46.4%), 지식의 부족(27.1%) 순으로 응답하였고, 치과의사와 치과위생사가 업무수행에 도움자로서 매우 필요하다(57.3%, 52.9%)고 생각하였다. 이러한 결과를 통해 연구대상자들은 요양시설 입소노인에게 구강관리를 제공하기 위한 태도는 높았지만, 이와 관련한 교육이 부족하며 구강관리업무를 수행하는 데 있어 전문가의 도움이 필요하다는 것을 확인하였다.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권11호
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• pp.1015-1026
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• 2019

본 연구에서는 노인장기요양시설 평가지표개발과 관련된 선행연구의 평가현장 적용성 및 실효성이 미흡하다는 문제의식하에, 노인장기요양기관(시설급여) 평가의 품질향상을 위한 평가지표를 개발하는 데 연구의 목적이 있었다. 이를 위해 2018년도 노인장기요양기관(시설급여) 평가지표에 대한 분석적 고찰, 일본의 노인특별요양홈 평가지표에 대한 분석, 한국의 노인장기요양시설 종사자와 일본의 노인특별요양홈 종사자를 대상으로 한 평가지표 및 평가체계에 관한 FGI를 실시하였다. 연구결과를 토대로 하여 이용자가 양질의 서비스를 제공 받을 수 있도록 지원하는 측면에서 평가지표를 개발하였다. 노인의 특성, 즉 유지 및 호전되기 어려운 노인성 질환의 특성과 기관운영의 방향 및 투명성, 그리고 종말기 케어의 필요성 등을 반영하였다. 기관운영, 환경 및 안전, 수급자 권리보장, 급여제공과정, 급여제공결과를 포괄하는 43개의 평가지표를 제시하였다. 또한, 중복되고, 불필요한 평가과정을 개선하여 평가의 과정 효율성을 증가시킬 수 있는 4단계 다층평가시스템을 제안하였다.