• 한국치위생학회지
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• 제22권1호
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• pp.63-72
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• 2022

Objectives: This study was conducted to prepare basic data to propose the necessity and utilization of oral welfare products in the welfare services of the long-term care insurance system, focusing on facility workers working in elderly facilities. Methods: The analysis was conducted on 144 workers working at some local elderly facilities. The questionnaire was constructed by classifying the use of oral welfare tools into 6 questions and the necessity and demand for oral welfare devices into 13 questions. Frequency analysis and technical analysis were performed for data analysis, and one-way ANOVA was performed for differences in the necessity and demand for oral welfare equipment. The statistical significance level was p<0.05. Results: As a result of examining the awareness of the necessity and demand for oral welfare equipment among workers in elderly facilities, the awareness of the necessity of including oral welfare equipment in the items of welfare equipment in the current long-term care insurance system was high at 4.15 points. As a result of analyzing the correlation between awareness of care products and the need and demand for oral welfare equipment, it was confirmed that there was a statistically significant positive correlation (p<0.01). Conclusions: In the long-term care insurance system for the elderly, oral welfare products need to be considered for welfare equipment services. The provision of oral welfare products within the long-term care insurance system for the elderly can provide opportunities and services to select various self-care tools. In addition, it is expected that it will be possible to promote changes in the long-term care insurance system for the elderly and to improve the system in a variety of positive ways.

• 지역사회간호학회지
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• 제31권1호
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• pp.1-12
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• 2020

Purpose: The purpose of this study was to identify the factors influencing organizational commitment of staffs according to the size of long-term care facility. Methods: A cross-sectional descriptive study was designed. Data collection was conducted for a total of 315 employees in long-term care facilities located in Seoul, Gyeonggi, Gangwon, Gyeongbuk, and Chungnam. Data were collected from July 2018 to October 2018 using questionnaires which included emotional labor, job satisfaction, organizational commitment, and general characteristics. In order to confirm the differences in the size of the facility, the facilities with less than 30 beds, those with 30-99 beds, and those with more than 100 beds were analyzed. Data were analyzed using descriptive statistics, t-test, ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, Pearson's correlation analysis, and multiple regression. Results: The job satisfaction and organizational commitment were significantly different according to the size of long-term care facility. Organizational commitment was influenced by 'external job satisfaction' in less than 30 beds, was influenced by 'external job satisfaction, and attentiveness to required display rules of emotional labor' in 30~99 beds, and then was influenced by 'type of job, and internal job satisfaction' in more than 100 beds. The predict variables accounted for 23.0%, 41.0%, and 34.0% of organizational commitment respectively. Conclusion: These findings show that tailored interventions should be provided depending on the size of facility in order to increase organizational commitment. In addition, organizational commitment programs should be developed by considering strategies to reduce the emotional labor and to increase job satisfaction.

• 한국컴퓨터정보학회논문지
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• 제24권5호
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• pp.121-130
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• 2019

The purpose of this study was to explore the level of the moral distress for nurses working in long-term care hospitals or nursing homes, and identify factors that influence the moral distress. Data were collected through self-reported questionnaires including the Korean version of Moral Distress Scale-Revised (KMDS-R), Jefferson Empathy Scale for Health professionals (K-JSE-HP), Moral Sensitivity Questionnaire (K-MSQ), and the Hospital Ethical Climate Survey (HECS). A total of 194 nurses from 11 long-term care hospitals or 27 nursing homes completed the structured questionnaires. Data were analyzed using IBM SPSS Statistics version 25. As results, the mean score for moral distress was $73.81{\pm}51.29$ in this study. The moral distress of nurses working at nursing homes was higher than that of nurses working in long-term care hospitals. Among the sub-factors of moral distress, the 'futile care' was the highest score and the 'limit to claim the ethical issue' was the lowest. The main factor affecting moral distress among nurses in this study was the ethical climate of organization. In this paper, we propose that in order to effectively reduce the moral distress of nurses working in a long-term care hospital or a nursing home, it is more impactful to address structural issues related to the caregiver workplace than to adjust individual factors.

• 보건행정학회지
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• 제27권2호
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• pp.139-148
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• 2017

Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.282-291
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• 2004

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

• 간호행정학회지
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• 제12권2호
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• pp.189-195
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• 2006

Purpose: This study was to identify nursing interventions which were perceived highly in the importance and performance of nursing interventions by nurses in long-term care facilities for elderly. Method: Data was collected from nurses working in long-term care facilities for elderly over 2 years who participated in continuous education by Korea Association of Senior Citizens Welfare Institution. Data was analyzed using mean and paired t-test to compare difference between the importance and performance of each nursing intervention. Results: Among 264 nursing intervention, 49 nursing interventions were considered highly important and performed very often by nurses. Especially, 11 nursing interventions had significant difference between the importance and the performance, which meant that nurses perceived them as the most important and they were not implemented often as much as that by nurses. Conclusion: The results of this study revealed that what kinds of the nursing interventions were perceived highly important and performed very often by nurses in long-term care facilities for elderly. These nursing interventions can be utilized in the development of standardized nursing intervention classification to be used for the long-term care facilities for elderly.

• 보건행정학회지
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• 제29권4호
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• pp.496-501
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• 2019

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities' care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is "government and local government" and "corporation," the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

• 대한영양사협회학술지
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• 제17권3호
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• pp.243-258
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• 2011

The purpose of this study was to investigate the effects of an oral health care education program for care providers on the nutritional status of the elderly in a long-term care facility. This study was conducted at a long-term care facility located in K metropolitan city using a nonequivalent control group non-synchronized design. Fifty-four nursing home residents aged 65 years or older were assigned either to the intervention group (n=27) or the control group (n=24). The intervention group received oral health care from the care providers' intervention group, who provided oral health care for 6 weeks after 6 weeks of oral health care education. Data were collected from the control group and intervention group at the baseline 6 and 12 weeks after oral care education and were analyzed using SPSS windows 16.0. The halitosis was lower in the intervention group than the control group at 12 weeks (P<0.01). Body mass index of the intervention group at 12 weeks was higher than that at 6 weeks. Iron intake of the intervention group at 12 weeks was lower than that at baseline. At baseline, the intakes of riboflavin, folate, and potassium were lower than 75% of dietary reference intakes. In conclusion, an oral care education program for care providers was effective in improving the oral hygiene of nursing home residents, and dietary plans are needed to improve the nutritional status of them.

• 한국콘텐츠학회논문지
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• 제20권10호
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• pp.308-325
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• 2020

본 연구의 목적은 장기요양시설의 노인보호를 위한 시설안전 실태를 파악하고, 이를 바탕으로 한국의 장기요양시설 시설안전 정책의 방향을 도출하고자 하는 것이다. 이러한 연구목적을 위해 주요국의 장기요양시설 시설안전 대응정책에 대해서 검토하고, 한국의 요양시설 안전실태를 파악하였다. 분석에서는 수도권 지역(서울, 경기, 인천) 중심으로 장기요양시설의 시설안전 실태를 분석하였다. 분석결과는 다음과 같다. 첫째, 기관의 안전관리 비교결과이다. 관련 규정 및 법률 비교결과에서 장기요양시설은 사회복지시설, 어린이집, 병원 등에 비해 안전관리가 취약한 것으로 나타났다. 둘째, 입지조건 분석결과이다. 수도권 장기요양시설이 건물의 6층 이상에 위치한 시설이 많았고, 개인시설이 법인, 지자체 시설에 비해 입지조건이 취약하다는 것을 확인하였다. 셋째, 기관의 구조/설비 결과이다. 전체적으로 배연창(화재안전창문), 배연설비, 연기 질식대비 방연마스크, 방화담요 등의 배치상태가 미흡하였다. 또, 법적 필수 설치설비가 미비한 곳도 있었고, 개인시설이 지자체, 법인 시설에 비해 시설 구조/설비구조에서 대체로 미비하였다. 넷째, 안전관리 분석에서 대응매뉴얼, 화재대비훈련 등에서 개인설립 시설이 지자체설립 시설에 비해 미흡하다는 것을 확인하였다. 이상 이러한 연구결과를 토대로 본 연구는 노인장기요양보험 장기요양시설에서 입소노인의 안전한 삶을 살 수 있는 시설환경을 위한 사회복지적 함의를 제시하였다.

• 의료법학
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• 제19권2호
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• pp.173-207
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• 2018

일본은 고령화가 빠르게 진전되어 이미 총 인구 중 65세 이상 인구가 차지하는 비율이 20% 이상인 초고령사회에 해당한다. 일본의 판례는 요양시설에 입소한 고령자가 사상을 당한 다수의 사안에서 요양시설의 손해배상책임을 인정하였다. 구체적인 사안들은 ①전도 또는 전락, ②배회 또는 무단외출, ③질식, ④욕창 및 ⑤이용자 간 사고의 5가지 유형으로 나눌 수 있다. 판례는 대부분의 사안에서 채무불이행책임을 중심으로 검토하였으며, 과실 또는 안전배려의무 위반을 인정하였다. 과실 또는 의무위반은 시설의 관리자 또는 직원이 입소자를 주시하고 주의를 기울일 의무를 위반한 경우 뿐 아니라, 경우에 따라서는 인적·물적 체제를 정비하지 못한 것 자체만으로도 인정된다. 특히 일본에서는 신속한 권리 구제를 위하여 손해배상에 관한 특약 조항이 있는 경우 원고는 사고 및 손해의 발생을 주장·입증하면 충분하고, 피고로서는 불가항력에 의한 사고임을 주장·입증하지 않는 한 손해배상책임을 부담한다고 하여 입증책임의 전환을 인정한다. 그런데 요양시설의 손해배상책임은 시설에서 대상자의 입소를 허락하고 서비스이용계약을 체결하는 것을 주저할 만큼 과중한 것이어서는 안 될 것이다. 이러한 점에서 일본 재판소가 상대적으로 과실상계와 소인감액을 널리 인정한 논리는 충분히 음미할 필요성이 있다. 개호사고 소송에서 법원의 판단은 구체적인 사실관계에 근거한 사례판단이지만, 개호사업자와 이용자에 대한 관계를 살펴보는 것은 향후 우리나라에서 개호사고 소송의 심리·판단 뿐 아니라 요양자의 일탈 및 사고 등을 인식할 수 있는 체제를 구축하기 위한인적·물적 체제를 구축하는 기준을 제시하는 법안을 입안함에 있어서도 시사점을 제공할 수 있을 것이다.