• 한국노년학
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• 제37권3호
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• pp.549-565
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• 2017

노인장기요양제도의 최일선에서 서비스를 제공하는 요양보호사의 자질을 향상시키는 것은 궁극적으로 요양서비스의 질 향상에 기여한다. 이 연구는 요양보호사의 자질 향상을 위한 직무교육의 바람직한 방향을 찾기 위해 다양한 전문가와 이해당사자의 의견을 수렴하고 합의하고자 수행되었다. 연구 방법은 요양보호사와 교육운영주체 및 행정주체로 구성된 초점집단 인터뷰를 통해, 현 요양보호사 직무교육, 치매전문교육 체제 및 운영의 문제점을 도출하고 문제 인식을 공유함으로써, 현실적이고 실효성 있는 교육 개선방안을 도출하였다. 인터뷰 내용 분석 결과, 의견을 크게 '직무교육', '치매전문교육', '교육운영체제', '인력관리' 4개의 대범주로 분류하여 각 범주별 합의된 의견과 개별 의견을 제시하였다. 현장 중심의 교육내용에 대한 요구가 높았고, 실무 경험이 풍부한 강사진의 필요성을 제기하였다. 교육 기회가 확대되어야 하고, 그러기 위해서는 근무 여건 개선이 전제되어야 한다는 의견이 있었다. 교육운영체제 측면에서는 교육 주체와 교육 운영의 법적 근거가 필요하며, 정부, 요양기관 및 협회 간 역할 정립이 우선 되어야한다는 주장이 있었다. 현장 인력관리 측면에서 인력 수급 및 처우 개선 문제가 시급하다는 호소가 많았고, 처우문제는 곧 직무교육 참여에의 동기부여에 직접적인 영향을 주고 있었다.

• 한국임상약학회지
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• 제32권4호
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• pp.321-327
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• 2022

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists' medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. 'Continued use or regular daily use of hypnotics' was the most highly detected item (9 cases) followed by 'multiple prescriptions within each class of hypnotics/sedatives' (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

• 가정과삶의질연구
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• 제19권4호
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• pp.49-68
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• 2001

The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.61-69
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• 2021

Purpose: Senior long-term care facilities are vulnerable to a cluster infection because of frequent physical contact, large group dining, communal living, and room sharing. This study aims to provide architectural improvement plans for a quarantine system in the facilities. Methods: Actual quarantine action data, guidelines from governments and institutes, in-depth interviews with facility staff are analyzed. Results: To prevent a cluster infection in the senior facilities, it is necessary to provide an architectural plan focusing on increasing the number of single rooms and isolation rooms, providing isolation rooms for staff, separation of a soiled room from a clean room, planing an entry vestibule and a visitor's room. Implications: It is important to analyze the existing condition of facilities that had been going through cohort isolation and provide the architectural solution to strengthen infection control.

• 노인간호학회지
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• 제20권3호
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• pp.193-203
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• 2018

Purpose: This study was done to develop a predictive model for quality of life of elderly residents in long-term care facilities (LTCF). The study was based on Brofenbrenner's ecological system theory and a literature review. Methods: Data were collected using a convenience sample of 205 elderly residents in 2 nursing homes located in D city and 1 nursing home located in K province. The exogenous variables were individual factors, family support, and facility environmental factors. The endogenous variables were self-esteem, accommodation adaptation and quality of life of elderly residents in LTCF. Collected data were analyzed through structural equation modeling using AMOS 20.0. Results: Eleven of the twelve hypotheses were supported, but the hypothesis that facility environment factors effect self-esteem was not supported. Quality of life of elderly residents in LTCF was explained first by facility environmental factors, followed by self-esteem, individual factors, accommodation adaptation, and family support with an explanatory power of 83.0%. Conclusion: To improve the quality of life of elderly residents in LTCF, the service and environment preparation provided by facilities is important, and it is necessary to provide emotional counseling to improve the self-esteem of these elders.

• 한국콘텐츠학회논문지
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• 제17권9호
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• pp.426-436
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• 2017

본 연구는 시설 치매노인을 대상으로 영양불량 상태에 영향을 미치는 요인을 분석하고자 실시하였다. 연구대상은 충남 소재 요양시설 3곳에 거주하는 치매노인 140명으로 자료 수집은 2016년 5월 30일~9월 30일까지 하였고 자료는 설문지를 이용하여 실시하였다. 수집된 자료는 t-test, ANOVA, 상관관계, 회귀분석으로 검정하였다. 대상자의 영양불량 상태는 고 위험군 (84명, 60.0%)이 많았으며, 성별, 장기요양등급, 신체기능, 식사행동 장애 및 인지기능과 관련을 보이는 것으로 나타났다. 다중 회귀 분석결과 영양불량 상태에 유의한 영향변수는 신체기능(${\beta}=0.379$, p=.000) 식사행동 장애(${\beta}=0.264$, p=.001), 인지기능(${\beta}=-0.187$, p=.014)으로서 이들 변수는 영양불량 상태에 대해 35.9%의 설명력을 보였다. 본 연구결과는 시설 치매노인의 영양불량 상태 개선을 위한 프로그램 개발에 기초자료로 활용될 것으로 기대된다.

• 한국식생활문화학회지
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• 제34권4호
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• pp.389-400
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• 2019

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

• 대한영양사협회학술지
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• 제19권4호
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• pp.400-415
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• 2013

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.

• 한국사회복지학
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• 제59권3호
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• pp.175-199
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• 2007

이 연구에서는 부산과 대구 지역의 노인시설에 근무하는 사회복지사, 간호사, 생활지도원 502명을 대상으로, 노인보호 관련 종사자들의 업무특성을 반영하여 고안된 측정도구들을 활용하여 이들의 일반적인 특성과 업무 스트레스, 업무 만족, 치매 및 인간중심 보호와 관련된 인식과 태도를 조사하여 그 결과를 분석하였다. 분석 결과 노인시설 종사자들의 급여수준이 낮고 근무시간이 길며 업무 부담이 과중한 상태인 것으로 나타났다. 치매 및 인간중심 보호와 관련된 종사자들의 인식수준은 높은 편이었으나, 업무 만족 수준이 낮았고 노인에 대한 보호 제공 및 업무환경과 관련된 스트레스가 높게 나타났다. 노인장기요양보험제도 시행을 앞두고 노인에게 사회적 보호를 제공할 전문 인력의 원활한 수급과 전문성 향상, 보호의 질 제고를 위하여 노인시설 종사인력에 대한 처우 개선과 인력 확충, 중장년기 인력 활용, 노인시설 종사인력에 대한 전문적 훈련과 교육 강화, 노인시설에서의 인간중심 보호 방식의 도입과 실천이 필요함을 제시하였다.

• 디지털융복합연구
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• 제18권4호
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• pp.479-487
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• 2020

본 연구의 목적은 노인주간보호시설에 대한 잠재이용자들이 지각하는 이용욕구와 운영 현황을 파악하여 문제점과 발전방향을 제안하는 것이다. 자료수집은 J도에 거주하는 일반인 320명을 대상으로 기관 인식과 이용욕구를 설문지로 조사하였으며, 6개 시설의 기관장 및 종사자에 대한 심층인터뷰, 기관의 운영 현황을 파악하고자 하였다. 분석결과 잠재이용자들은 주간보호시설의 기능 및 구체적인 역할에 대해 많이 인지하고 있지 않았으며, 시설비용 부담은 국가에서 부담하며, 시설을 이용 시 중요한 요인은 시설 및 환경인 것으로 나타났다. 심층인터뷰에서는 지금의 정책이나 제도는 현실과 괴리가 커 종사자들의 지위나 역할 그리고 기관의 운영 상태와 맞지 않는 것으로 나타나, 현장형 시스템의 재정립이 요구되고 있다. 연구결과를 바탕으로 주간보호시설의 발전방향은 국가차원에서 시민들에게 주간보호시설의 인식 개선 및 제고를 위한 적극적인 홍보와 가족지원강화가 필요하다. 둘째, 이용자의 욕구를 반영한 시설과 환경의 개선을 통한 요양서비스의 질을 높여야 한다. 셋째, 종사자의 열악한 고용 여건과 처우를 현실에 맞게 개선해 요양서비스의 질을 높여 나가야 한다.