• 대한간호학회지
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• 제42권2호
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• pp.236-247
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• 2012

Purpose: Purposes of this study were: evaluation of family burden of caring for elders who receive long term care services, and examination of differences in burden before and after the introduction of long term care service in Korea. Methods: Data were collected by questionnaires from 416 caregivers of elders who were registered with the Long Term Care Insurance Corporation in six cities. Data were collected in September, 2010 and analyzed using descriptive statistics, paired t-test, and ANOVA with the Scheffe test, and stepwise multiple regression. Results: Family burden decreased significantly after longterm care service was initiated. Subjective burden decreased from 2.93 to 2.69 (t=11.78, $p$<.001), and objective burden, from 3.40 to 3.10 (t=12.73, $p$<.001). Stepwise multiple regression analysis revealed that factors affecting subjective burden were family relations (F=13.60, $p$=.003), age (F=5.47, $p$=.019), job (F=6.98, $p$=.008), and education (F=4.59, $p$=.032), and that factors affecting objective burden were living together (F=17.66, $p$<.001), job (F=13.34, $p$=.003), monthly income (F=6.61, $p$=.010), and type of service (F=6.62, $p$=.010). Conclusion: The results of this first study to investigate caregiver burden after the Korean Long-term Care Insurance System was begun provide positive information for the development of strategies to decrease family burden in long term care.

• 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.

• 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.

• 지역사회간호학회지
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• 제19권2호
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• pp.260-269
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• 2008

Purpose: The purpose of this study was to identify differences in health status and the utilization of long-term care service between urban and rural aged residents in Korea. Methods: Through convenience sampling, 1,405 elders (829 from urban areas and 576 from rural areas) were selected during March 1 to May 31 in 2004. All the subjects agreed to participate and filled out the survey questionnaire after signing the consent form. The instruments utilized in this study were the impairment of physio-sensory function, ADL IADL, cognitive function, and psycho-social function scale. This instrument was developed by modifying the scab developed by Gurland & Wilder (1984). Data was analyzed using the SPSS Win program. Results: There were significant differences in economic status, duration of living and type of medical insurance between rural and urban elderly(p<.05). Physio-sensory functions (t=4.53. p<.001), ADL (t=3.61. p<.001), IADL (t=2.45, p=.014), cognitive functions (t=-2.63. p=.024) and psycho-social functions (t=3.69. p<.001) were significantly different between the two groups. The utilization of long-term care facility in the urban elderly was significantly higher than that in the rural elderly ($x^2=10.14$, p<.001). Conclusion: Considering these findings. the need for long-term care should be assessed by residence characteristics. Because of different utilization of long term care facility according to the elderly's needs, long-term care services should be considered the residence characteristics.

• 보건행정학회지
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• 제32권2호
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• 가정간호학회지
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• 제27권1호
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• pp.64-81
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• 2020

Purpose: The purpose of this study was to identify manpower acquisition strategies of nurse and nurse aide in long-term care Method: The study was proceed using following three stages: to explore workforce status and labor environment with database analysis, literature reviews, to explore the best practices, practical experiences with expert interviews, with focus group interview, to identify problems and present acquisition strategies Results: Acquisition strategies were increasing of pay, improvement of working condition, development of practical educational program, diversification of entry paths, establishing clear roles for nursing staffs, diversification of training program. Conclusion: We found that the acquisition strategies of nurse and nurse aide can be as an useful methods to increase manpower in long-term care for higher quality of services and care.

• 한국융합학회논문지
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• 제9권4호
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• pp.341-349
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• 2018

본 연구는 장기요양 재가서비스 이용 노인의 만성통증이 삶의 질에 미치는 영향에서 우울의 매개효과를 검증하는데 목적을 두었다. 이를 위해 장기요양 재가서비스를 이용하고 있는 노인 204을 대상으로 조사를 실시하였다. 본 연구의 주요 분석결과는 변수간의 상관관계에서 만성통증과 우울은 정적관계, 만성통증과 삶의 질과의 관계에서는 부적 상관관계로 분석되었다. 또한, 만성통증과 우울이 삶의 질에 미치는 영향에 있어서 우울은 완전한 매개효과를 보이는 것으로 검증되었다. 이 결과를 통해 장기요양 재가서비스를 이용하는 노인의 다양한 융합적인 정신건강서비스를 위한 프로그램 개발 필요성에 대해 논의하였다.

• 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.

• 보건행정학회지
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• 제30권1호
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• pp.92-99
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• 2020

Background: The purpose of this study is to analyze the effect of the income support allowance policy for the care workers on wage level. Methods: The analysis data was constructed using database (DB) of long-term care institution, DB of long-term care personnel status, and DB of health insurance qualification and contribution possessed by National Health Insurance Services. We analyzed the wage status of care workers 2009 to 2016 through basic analysis. We used the difference-in-difference analysis method for the workers who worked in the same institution from 2012 to 2013, The effects of the income allowance policy on wage increase were analyzed. Results: As a result of the net effect of the income support allowance policy, the monthly average wage of the care worker increased by 25,676 won and the hourly wage increased by 478 won. As a result of the analysis, it can be confirmed that the income support allowance policy has achieved some of the goals of raising the wage level of the care workers, and the effect of raising wages for other occupations in the long-term care business can be confirmed. Conclusion: The low wage problem of long-term care workers such as care workers is not the only problem in Korea. In other countries, there are various wage support policies for employees. In particular, it is necessary to refer to the improvement in the treatment of care workers in Japan and wage pass-through in the United States. In addition to wages, there is a need to promote policies to provide employment motivation through efforts to improve their social status and improve their job status and career development for employees in long-term care facilities.

• 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.