• 한국콘텐츠학회논문지
• /
• 제17권6호
• /
• pp.339-350
• /
• 2017

본 연구는 2014년 12월 현재 노인장기요양기관이 국민건강보험에 신고한 임금자료 DB 즉, 공공데이터를 활용하여 요양보호사의 근로실태와 임금수준을 분석하였다. 2014년 말까지 요양보호사 자격증을 취득한 1,231.357명 중 본 연구는 확인이 가능한 1,221,085명을 대상으로 자료를 구축하였다. 이들 중 91.3%는 여성, 41.0%가 50~59세였다. 전체 자격취득자 중 요양보호사로 근무하는 인력은 약 14.8% 수준에 불과하였다. 취업 중인 요양보호사의 약 73.2%가 현 직장 근무연수가 3년 이내이며, 이들의 임금은 입소시설의 경우 월 129.2만원(처우개선비 포함 139.1만원), 재가기관의 경우 시간당 6,421원(처우개선비 포함 7,046원)이었다. 이와 같은 분석을 통해 본 연구는 요양보호사의 근로실태와 임금을 보다 구체적이며, 시계열적으로 파악하기 위해서는 입소시설과 재가기관을 구분한 분석뿐만 아니라, 처우개선비 효과에 대한 분석이 필요하다는 것을 제시하였다.

• 대한간호학회지
• /
• 제26권4호
• /
• pp.768-781
• /
• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• 한국엔터테인먼트산업학회논문지
• /
• 제15권8호
• /
• pp.423-432
• /
• 2021

본 연구에서는 노인의 라이프케어 및 삶의 질향상을 위해 도입되어 시행되고 있는 통합돌봄사업의 미래 가치성 확대와 방향성 제시를 위하여 현황과 문제점들을 알아보고 이를 통해 다음과 같은 연구적 결론을 제시하였다. 첫째, 서비스 수혜 노인의 욕구분석은 조사자 중심이 아닌 환자 중심으로 구성하며, 특히 의료진의 진료방문을 통한 의학적관리 부분이 강화되어야 하며, 성별과 연령, 장애유형과 개인적 욕구취향에 따른 특화된 서비스 항목 부분이 점진적으로 강화되어야 할 것이다. 둘째, 서비스 항목에 대한 만족도 및 중복성 그리고 효과성 등을 분석하여 예산을 절감하며 수요자 중심의 서비스 항목구성과 신규 서비스 필요 항목 적용 등을 고려해 나간다. 셋째, 통합 스케줄관리시스템 도입을 통하여 서비스 제공 직역단체와 수혜자 간의 사전예약 및 방문 스케줄 관리의 전문화가 필요하다. 넷째, 재원 문제해결을 위한 노력으로, 보건의료 재정과 장기요양보험제도 그리고 사회복지재정사업 등과 합리적 재원공유 제도마련이 필요하며, 서비스 관련 산업분야와의 재원의 연계나 순환, 지방 공공의대 출신 인력투입 방안을 고려할 수 있다. 이상의 제안을 통해 통합돌봄사업은 보편적 노인 케어시스템으로의 완성과 미래 가치를 지닐 수 있게 될 것이다.

• 한국콘텐츠학회논문지
• /
• 제13권5호
• /
• pp.234-242
• /
• 2013

2007년 노인장기요양보험법이 제정되었고 이 법은 질병 및 장애가 있는 노인들에 대한 요양비용을 사회구성원들이 함께 부담하는 체계를 구축하여 노인 및 그 가족구성원의 삶의 질을 향상시키는데 그 목적이 있다. 노인장기요양보험제를 실현하기 위해 요양보호사제도가 마련되었다. 요양보호사란 거동이 불편한 노인을 시설에서 돌보거나 또는 노인이 거주하는 가정을 방문하여 보호활동을 벌이는 사람들을 말한다. 그런데 최근 발표된 국가인권위원회의 조사에 의하면 요양보호사들의 근무환경이 매우 열악한 것으로 드러났다. 저임금, 포괄임금의 남용, 장기간 근로, 인력배치기준 및 휴게시설 미비, 요양보호서비스 이외의 노무제공, 수급자에 의한 성희롱 등의 문제가 있는 것으로 나타난 것이다. 인구의 고령화가 빠른 속도로 진행되고 있고 노인들에 대한 요양보호의 중요성과 요양보호사들의 역할이 증대되고 있는 상황을 고려한다면 이들의 업무환경에 대한 개선이 절실히 필요하다. 이러한 견지에서 이 논문은 국가인권위원회가 발표한 자료를 바탕으로 노동인권의 측면에서 요양보호사들이 겪고 있는 문제점들을 살펴보고 효과적인 개선방안에 대해 논의 해본다. 결국 요양보호사들이 직면한 문제들을, 정부의 철저한 관리 감독과 요양보호사의 처우 개선 그리고 수급자의 인식 개선 등을 통해 바로잡는다면 더 나은 노동환경에서 요양보호사들이 질 높은 서비스를 제공할 수 있을 것으로 기대한다.

• 한국간호교육학회지
• /
• 제3권2호
• /
• pp.163-192
• /
• 1997

As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

• 한국보건간호학회지
• /
• 제25권2호
• /
• pp.289-301
• /
• 2011

Purpose: This study was conducted to investigate the level of health behaviors, perceived health status, emotional and cognitive conditions and depression of the elderly residence in homeless shelters, and to identify related factors on their depression. Method: This was a descriptive study using a questionnaire. Geriatric Depression Scale (GDS-15) was used for examining depression, and other questionnaire were adopted and modified from the customized visiting health care service. Result: The 41 subjects displayed mild depression ($5.34{\pm}3.33$). The majority were non-smokers (73.2%) and non-drinkers (85%), and 81.1% of the subjects did light activities with 74.4 % performing regular exercise more than once per week. Perceived health status was above average in 70.7%, and feeling stress (70.7%), suicidal thoughts (12.2%) and abnomal KDSQ-C (29.3%) were shown in emotional and cognitive conditions. Depression had a significant relationship with regular exercise (t=3.61, p=.001), perceived health status (t=3.47, p=.041) and suicidal thoughts (t=2.85, p=.007). Conclusion: It is necessary to increase shelters for the elderly homeless and construct the system for examining not only their physical health but also their psychological problems, and to ensure long- term care recognizing their unique characteristics and needs, and their increasing number.

• 지역사회간호학회지
• /
• 제13권2호
• /
• pp.280-291
• /
• 2002

Objectives: This study was conducted to evaluate the maternal child health services provided by public health centers in Pyungtaek city. Methods: Data were collected based on multiple sources of official records. A questionnaire survey was obtained from 50 mothers with premature babies, and 89 mothers with full- term babies, in order to compare their demographic factors, and physical, obstetrical, and emotional status. In addition, the investigators collected data on pre and post follow-up care for the remature group to evaluate the effects of home visiting services on them. Moreover, additional data were collected from 135 pregnant women and 315 mothers with infants, to assess their degree of satisfaction for prenatal education course and breast feeding practices. Results: 1) The pregnant women's satisfaction for the prenatal education course, knowledge, and practices on self care were considered to be high. 2) Of the mothers with infants, 62.9% experienced breast feeding, but only 35.9% of them did it for six months. 3) Premature birth rate in the region was 5.6%, and 75.6% of all premature babies received follow-up care. 4) The mothers with premature babies experienced premature rupture of membrane. placenta previa, preeclampsia, and cesarean section more frequently than the mothers with full-term babies. 5) At the pre-intervention data collection point. mothers with premature babies experienced significantly less social support than mothers with full-term babies. In addition, mothers with premature babies reported higher levels of stress and care-giving burdens, and lower level of self esteem, than mothers with full-term babies, although the differences were not statistically significant. 6) In the premature group, stress, care giving burdens, and postpartum depression decreased after the intervention, whereas maternal self esteem, and the husband's support were increased after the intervention. Social support from significant others were somewhat decreased. 7) Satisfaction for the home visiting service in the mothers with premature babies was very high. Conclusion: These results showed a possibility that the recently started maternal child health services provided by the public health centers may be efficient. Although statistically significant differences were not found, the investigators found a potential for changes in a positive direction. Long-term effects of the health services on maternal child health needs should be addressed in future studies.

• 가정과삶의질연구
• /
• 제19권4호
• /
• pp.49-68
• /
• 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.

• 한국콘텐츠학회논문지
• /
• 제13권4호
• /
• pp.170-186
• /
• 2013

인구가 고령화되면서 전체 인구의료비 가운데 고령인구에 지출되는 의료비의 비중은 증가하여, 건강보험 의료급여 등의 재정을 압박하는 경향은 갈수록 심화될 전망이다. 노인성 질환으로 인해 의료비용 부담이 증가함으로서 사회적 문제로 발전됨에 따라 노인보건의료의 현황을 분석하고, 현행 관련법제도를 살펴보고 문제점을 도출하고자 하였으며, 외국의 노인보건실태와 동향을 토대로 시사점을 도출하여 우리나라에의 법제도적 개선방안을 제시하고자 하였다. 그 결과 현행 노인보건의료보장의 관련법 체계의 문제점, 현행 노인장기요양보험법상의 문제점을 도출하였고, 법적 개선방안으로서는 건강보험의 보장성 강화, 장기 요양보험료 재정의 건전성 확보문제, 노인복지와 장기요양보험제도의 연계와 상호보완 기능을 강화, 치료요양에 대한 노인장기요양보험제도와 노인복지법의 중복성 문제, 등급판정체계의 개선, 재가서비스 지원강화 등 노인의 특수성을 반영하여 의료서비스의 질적 수준의 개선이 필요하다고 보고 노인장기요양법제의 개선과제를 제기하는 등 노인의료서비스의 지원확대 방안을 제시하였다. 노인을 대상으로 하는 중증응급 의료서비스의 질을 제고하기 위해서는 적정 응급의료자원의 확보뿐만 아니라, 그 효율적 운영체계의 마련도 필요하다. 아울러 급증하고 있는 노인의료비에 대응하기 위해서 "노인의 의료확보에 관한 법률"을 제정할 필요성을 제시하였다.

• 한국콘텐츠학회논문지
• /
• 제17권5호
• /
• pp.366-375
• /
• 2017

본 연구는 의료급여환자와 가족 3인, 요양병원에 4년 이상 근무한 경험이 있는 종사자 5인에 대한 심층면접조사를 통하여 도덕적해이가 우려되고 있는 의료급여환자의 요양병원 이용과정과 입원, 의료서비스, 퇴원과 전원 등에 대하여 분석하였다. 주요 분석결과와 함의는 다음과 같다. 첫째, 요양병원 입원은 의료급여환자의 선택보다는 의료기관간의 연계와 유치를 위한 경쟁적 홍보에 의해서 이루어지고 있었다. 둘째, 의료급여환자의 요양병원 장기입원의 원인은 본인부담이 적어서 도덕적 해이를 유발할 수도 있었지만 거주지 부재, 간병인 부재 등 퇴원 후 사회적인 보호수단이 없는 것도 주요 원인이었다. 셋째, 대다수 의료급여환자들이 치료가 필요한 상태이지만, 건강보험환자에 비해 필요성이 높지 않음에도 입원을 유지하는 경우가 있었다. 넷째, 요양병원의 의료서비스는 재활서비스가 주를 이루고 있으며, 간호인력과 간병인의 역할이 중요하였다. 다섯째, 의료급여환자들은 요양병원 의료비를 수급비와 가족지원 등으로 부담하고 있지만, 일부 환자들은 병원에서 간병비나 본인부담을 면제 혹은 감면받고 있었다. 여섯째, 공공기관과 사회복지기관은 요양병원에 환자를 의뢰한 이후 지속적인 관리를 하지 않고 있으며, 퇴원 후 지역사회서비스 연계가 필요한 것으로 나타났다.