• The Journal of Korean Physical Therapy
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• 제20권2호
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• pp.43-48
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• 2008

Purpose: The purpose of this study is to investigate the importance of grade decision and role of physical therapist which follows enforcement of elderly long-term residential care insurance system. Methods: One of the data from grade decision meeting in Bukgu, Busan on 2007 which was 88 case of attached finding of doctor was compared with findings of visited investigator. Result: Eighty-four investigation subjects had 186 diseases that included stroke and arthritis, requiring the need for physical therapeutic approaches. In addition, the results of the door-to-door research project in the northern district of Busan showed that there was no match out of 88 subjects who submitted the viewpoint of the doctor. Such a result was produced as the doctors did not diagnose the patient directly, but rather the diagnoses were obtained from guardians and a door-to-door researcher who had a poor understanding of geriatric motion and function. Conclusion: To enforce long-term care successfully, a re-investigation should be performed for the welfare of the aged.

• 지역사회간호학회지
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• 제21권2호
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• pp.263-272
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• 2010

Purpose: This study was to identify health needs of the elderly at nursing homes by long-term care grade. Methods: The health needs of 116 elders at two nursing homes in Seoul were measured with resident assessment protocols (RAPs), activities of daily living (ADL), and cognitive performance scale (CPS), and pain and depression were measured by resident assessment instrument (RAI). Results: With regard to RAPs, 11 out of 18 items had different distribution in the 3 groups significantly. The 1st-grade elders had a higher percentage of 9 items than the 2nd- and 3rd-grade ones but the 3rd-grade ones had the highest health needs related with activity. The 2nd-grade elders had similar health needs to the 1st-grade ones. In terms of functional level, the 1st-grade elders had the highest percentage of CPS and ADL but the 3rd-grade ones had the highest score of pain and depression out of the 3 groups. The standardized assessment instrument to identify specific health needs by the 3 groups should be developed. Therefore, care plans to meet health needs of the 3 groups will be made. Conclusion: It is suggested that nursing care is required to the elderly of the 1st- and 2nd-grade and safe activity and environment to the 3rd-graded ones.

• 보건행정학회지
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• 제20권1호
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• pp.19-36
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• 2010

Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even in the same grade. We analyzed time study data for 2003, 2005, 2006 which conducted by the Korea Institute for Health and Social Affairs. To look at differences in the volumes of utilized resources, we identified characteristics of beneficiaries that influence utilized resource volumes and categorized services provided by facilities into the rehabilitation treatment category, the problematic behavior category, and the physical malfunction category. Then, we examined each service in consideration of service difficulty levels and wage weights. The result of examination showed that differences in utilized resource volumes exist in all three grades depending on the characteristics of beneficiaries. Especially, in the first grade with a high level of seriousness, utilized resource volumes were different for those three service categories and the problematic behaviour category considered dementia was found to consume the largest volume of resources. Moreover, there was the inversion phenomenon of utilized resources volumes between the grades. This result indicates that utilized resource volumes are different even in the same grade depending on the characteristics of beneficiaries and it is required to consider case-mix for reflection of the volumes of utilized resources depending on the characteristics of beneficiaries.

• 한국융합학회논문지
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• 제5권3호
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• pp.7-16
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• 2014

본 연구는 노인 장기 요양 보험 등급자의 간호요구도와 주 수발자의 부양부담에 영향을 미치는 요인들을 파악하여 노인 장기 요양 보험 등급자를 위한 효율적인 간호중재를 개발하고 주 수발자의 부양부담감을 경감시키는 데 목적이 있다. J시에 거주하고 있는 노인장기요양보험 등급판정 받은자와 함께 거주하며 돌봄을 제공하는 주 수발자 152명을 대상으로 수집된 자료는 SPSS 17.0로 기술통계, t-test, ANOVA, 상관관계분석, 다중회귀분석을 실시하였으며 연구의 결과는 다음과 같다. 노인 장기 요양 보험 등급자의 간호요구도 중 심리사회적요구도가 가장 높았으며, 노인 장기 요양 보험 등급자의 일반적 특성 중 장기요양보험 수급유형과 장기요양 등급에 따라서는 신체적 간호요구와 심리적 간호요구도가 유의하게 나타났다. 주 수발자의 부양부담감 중 신체적 부양부담감이 가장 높았고, 노인 장기 요양 보험 등급자과의 관계가 배우자인 경우와 수입이 적고, 여자인 경우 부양부담감이 높은 것으로 나타났다. 부양부담감에 영향을 미치는 요인 중에서는 1일 간병시간이 가장 큰 영향을 미치는 요인임을 알 수 있었고, 특히 보험급여유형이 일반에 비해 기초생활수급자가, 주 수발자의 성별이 남자에 비해 여자가 부양부담감이 높았으며, 돌봄 제공자의 수가 많을수록 부양부담감은 감소하는 것으로 나타났다.

• Journal of the Korean Data and Information Science Society
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• 제26권3호
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• pp.715-727
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• 2015

본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.

• 보건의료산업학회지
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• 제10권2호
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• pp.155-166
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• 2016

Objectives : This study confirmed the limitation of long-term care insurance by analyzing media contents. Methods : Articles and reviews were searched with the article searching system (KINDS) from July 2008 to December, 2015. Results : Among the 155 articles examined, 61.1% highlighted the faults of suppliers, and 25.2% indicated the responsibility of the insurer. As for their purpose, 56.8% reported on accidents, and 32.3% provided information. Furthermore, 74.2% reported on negative contents and only 25.8% on neutral contents. The negative contents consisted of requesting false insurance benefits, amending the range and price indicating the very low salaries of the care givers, limitations on the care grade assessment, and problems related with assistive devices. The majority of neutral articles is for providing information. Conclusions : There were many problems starting from the early stage of the insurance. We must pay attention to these problems. Moreover, we should try to handle and prevent these problems with supportive responses from authorities.

• 한국융합학회논문지
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• 제10권6호
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• pp.401-409
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• 2019

본 연구는 졸업 학년 간호대학생의 노인장기요양 분야 취업의도에 영향을 미치는 요인을 조사하기 위하여 시도하였다. 연구분석은 SPSS program을 이용하여 t-test, ANOVA, 다중회귀분석을 실시하였다. 연구결과 졸업 학년 간호대학생의 노인장기요양기관 취업의도는 평균 2.8점이었고, 간호대학생의 노인장기요양 분야 취업의도는 노인과 살았던 경험유무, 노인문제에 대한 관심의 정도, 가족 중에 노인장기요양보험 혜택을 받은 경우, 장기요양보험제도의 관심의 정도에 따라 차이가 있었다. 노인장기요양기관 취업의도에 영향을 미치는 요인은 평소 노인문제에 대한 관심과 가족 중 노인장기요양보험 수혜 여부로 분석되었다. 따라서 향후 간호대학생의 노인장기요양 분야 취업을 유도하기 위해서는 노인과의 상호작용 및 접촉을 통해 노인문제에 대한 관심을 증대시키는 한편 노인장기요양제도에 대한 관심을 높일 수 있는 다양한 교과 및 비교과 융합 프로그램의 운영이 요구된다.

• 한국농촌간호학회지
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• 제16권2호
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• pp.60-68
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• 2021

Purpose: This case report was attempted to present the process of the end of life nursing care provided by the visiting nurse. Methods: The subject was a person who was decided the long-term care Grade 1 and received a visiting nursing service, and the service was terminated on the death, and then was selected as a case with the consent of his family. The data were collected through long-term care benefit provision records and interviews with the visiting nurse. The nursing process was presented by applying the Omaha System. Results: The subject had digestion-hydration problems and respiration problems in the physiological domain, and the problems of role change, caretaking/parenting, spirituality, and grief in the psychosocial domain were identified. Depending on the problem, the end of life nursing care was provided to the subject and family members through activities on physical symptoms/signs, dietary management, end-life care, and coping skills. Conclusion: We expect that if the visiting nurse provides anticipatory guidance on the death process, the subject will be able to prepare for death comfortably with the family at home instead of vague fear of death.

• Communications for Statistical Applications and Methods
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• 제28권4호
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• pp.393-410
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• 2021

The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

• 한국농촌간호학회지
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• 제15권2호
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• pp.66-73
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• 2020

Purpose: This study was done to report nursing case for ADL improvement of elders who have CVA(Cerebrovascular Accident) sequelae. Methods: The client had registered in the C visiting nursing center after being decided a long-term care Grade 2. Data were collected through consultation logs for recipients, Activities of Daily Living (ADL) records, fall risk assessment (Huhn) sheets, decubitus ulcer risk assessment (Braden Scale) sheets, cognition assessment (K-MMSE) sheets, long-term care benefit provision records, and interviews with visiting nurse. Data were collected and analyzed according to the Omaha System problem classification. The intervention scheme and the problem rating scale for performance were applied to present the case for home-visit nursing. Results: The client registered in August, 2018, was provided home-visit nursing care once a week as of September 2020. ADL, cognitive levels and decubitus ulcer risks were found to have improved. Conclusion: This case report presents the value of classifying nursing problems and checking nursing intervention provided to patients with problems of ADL. The presentation of home-visit nursing cases applying a standardized nursing problem classification scheme for clients with various problems showed that a high quality level of care is guaranteed and evidence-based nursing can be provided by visiting nurses.