• 대한간호학회지
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• 제34권2호
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• pp.372-378
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• 2004

Purpose: The purpose of this study was to measure the functional status of stroke patients cared for in different long-term care settings. Method: We assessed all stroke patients in two home health care agencies, four nursing homes and one geriatric hospital in Korea (n=171) using the Resident Assessment Instrument (RAI), which comprises Activity of Daily Living (ADL), urine incontinence, bowel incontinence, a Cognitive Performance Scale (CPS),and being understood and understanding others. Data was collected by face-to-face surveys with patients. Results: The mean ADL score, urine incontinence score, bowel incontinence score, CPS, and being understood score and understanding others score were lowest for the patients receiving home health care, and highest for the patients in nursing homes. Low scores described poor and high scores good functional status. The results showed significant differences in physical and cognitive function scores between the three groups of patients. Conclusion: This study suggests that there may be large differences between the patients in these three types of long-term care settings. These findings can be used to help develop and implement efficient long-term care programs.

• 사회복지연구
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• 제43권1호
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• pp.203-227
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• 2012

본 연구는 노인요양시설에서 생활하는 노인들이 경험하는 관계적 공격성이 우울감에 미치는 영향을 분석하고 시설적응이 미치는 매개효과를 검증했다. 이를 위해 서울 경기 지역 기초생활수급자 대상 노인전문요양시설 3곳과 노인요양시설 3곳에서 182부의 설문지를 회수해서 분석의 근거로 삼았다. 그리고 SPSS18.0 프로그램을 이용하여 빈도분석 및 상관관계분석 등을, AMOS 7.0 프로그램을 사용해 구조방정식 모형을 분석했다. 그밖에 Sobel test를 이용해 매개효과의 통계적 유의미성을 검증했다. 조사결과를 분석한 결론은 다음과 같다. 첫째, 노인요양시설에서 생활하는 노인들 사이에 나타나는 관계적 공격성과 우울감 사이에는 통계적 상관관계가 없는 것으로 나타났다. 둘째, 노인요양시설 입소노인 간의 관계적 공격성이 우울감 사이에 시설적응의 매개효과가 있다. 즉, 시설에서 관계적 공격성이 높을수록 노인들의 시설적응은 낮아지고, 시설적응이 낮을수록 노인들의 우울감이 커지는 것으로 나타났다. 이러한 결과를 바탕으로 제언을 하면 다음과 같다. 첫째, 노인요양시설에서 노인들 사이의 긍정적인 유대관계를 형성하기 위해서 새로운 입소노인들이 기존 입소노인들과 함께 공감대를 형성할 수 있는 건강프로그램, 종교프로그램 등을 개발하여 공통된 관심사를 통해 상호관계를 증진시키도록 한다. 둘째, 노인들의 시설적응을 돕기 위한 방안으로써, 개인용품을 시설에 반입하는 허용 범위를 넓히는 방법을 생각할 수 있다. 셋째, 노인들 사이에서 나타나는 괴롭힘 같은 부정적 관계가 발생하는 상황을 중재 혹은 예방 및 경감하기 위한 프로그램을 해당 시설에서 적극적으로 개발할 필요가 있다.

• 지역사회간호학회지
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• 제13권4호
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• pp.668-678
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• 2002

Purpose: The number of nursing home residents has been increasing in Korea. Nurses need to know the lived experience of relocation of the elderly to long-term care facilities. However, studies on this issue has not yet been conducted in Korea. Therefore, this study was carried out to understand the experience of institutionalization of the elderly using a phenomenological approach. Method: There were 11 participants who consisted of 5 men and 6 women living in 3 different nursing homes. The data was collected through in-depth interviews and participant observation from June 1999 to October 2001, and analyzed by Colaizzi's phenomenological method. Result: A total of 275 meaningful statements related to the experience of institutionalization by the elderly were obtained. Of the 275 statements, 175 were found as the statements with more general forms. 28 themes were grouped into 8 theme clusters. These theme clusters included' resentment at their sons', irresistible admission', 'humiliation on institutionalization', 'being unbearable to shock', 'grief to unfamiliarity', 'being in agony of outwards', 'regret for self-life' and 'comfort for new residence'. Conclusion: Based on these results. we can understand the lived experience of institutionalization of the Korean elderly. We need to develop a nursing program to help the elderly cope with this crisis, and studies about the familys experience on their parents admission to institutionalized facility warrant further exploration.

• 지역사회간호학회지
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• 제29권2호
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• pp.170-183
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• 2018

Purpose: Although innovative interventions using technologies have been introduced in long-term care settings, available evidence is still anecdotal. The purpose of this study is to investigate and synthesize the outcomes of interventions using technologies delivered to nursing home residents. Methods: Published clinical trials were identified through PubMed, CINHAL, Cochrane and PsycINFO databases and manually hand-searching. Eligible studies were articles published between 1997-2016 in English or Korean with a randomized controlled trial or quasi-experimental design in which interventions using technologies were delivered to nursing home residents. Results: A total of 20 studies were selected for this review. Types of interventions using technologies were classified into the electronic documentation technology (n=1), the clinical decision support system (n=1), the safety technology (n=1), the health and wellness technology (n=10), and the social connectedness technology (n=7). Overall resident outcomes indicated that interventions using technologies improved behavioral symptoms and psycho-social outcomes, but mixed results were shown in the aspects of physical function, cognitive function, social relationship and quality of service. Conclusion: This review demonstrates that incorporating technologies into nursing home care have positive effects on residents' psycho-social outcomes and behavioral symptoms. To disseminate the effectiveness of interventions using technologies, further research is needed to determine what mechanisms underlying such relationships exist.

• 한국노년학
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• 제29권2호
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• pp.477-488
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• 2009

본 연구는 노인요양시설에 거주하는 노인의 시설 입소초기(3개월)의 생생한 경험을 토대로 입소노인들이 겪는 어려움을 파악하여, 시설운영자들이 입소노인들의 입소초기 삶의 질과 연관된 요인들을 이해하는 근거자료로 이용될 수 있도록 하고, 입소초기에 입소노인들이 겪는 심리사회적 문제에 효과적으로 개입, 중재할 수 있는 프로그램 개발의 기초자료로 활용될 수 있도록 하기 위해 수행되었다. Patton에 의한 주제분석 방법을 적용한 질적 연구방법을 적용하였고 6명의 입소초기 노인들과의 다면적 심층 면담을 통하여 수집된 자료를 분석한 결과 입소과정 및 입소초기의 경험으로 자발적인 입소결정, 가족의 강권에 따른 입소결정, 자율성의 제한, 개별성의 결여, 입소 전 후의 생활 연계성의 단절, 관계형성의 제한, 미래자아상에 대한 부정적 예견 등의 중심주제가 도출되었다. 시설입소에 대한 노인들의 초기반응에 영향을 주는 근본적인 조건은 독립성과 자율성이었으며 이러한 것들은 입소와 관련된 의사결정 과정 뿐 만 아니라 입소 이후의 적응에도 많은 영향을 주는 것으로 나타났다. 이로부터 노인들에게 입소 후의 생활에서의 자율성을 비롯하여 일상 활동에 대한 선택의 기회를 부여하고, 입소노인의 안전을 위협하지 않는 한 스스로 할 수 있는 일은 직접 수행하게 함으로써 자신의 삶이 독립적이라 생각할 수 있도록 환경을 조성해주는 것이 입소시설에 대한 적응도를 향상시킬 것으로 생각된다. 또한 신체적, 인지적 기능이 비슷한 노인들 간의 활발한 사회적 교류를 통해 새로운 대인관계를 형성하여, 삶의 재편성(reorganization)과 안정화(stabilization)가 일어날 수 있도록 돕는 것이 필요하다고 본다.

• 한국실내디자인학회논문집
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• 제24권3호
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• pp.186-196
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• 2015

This research comprehended the fundamental cause of elderly nursing home residents' negative feelings of loneliness, depression, fear, and loss of self-usefulness as existential issue, since they already went through loss, death of loved ones, geriatric disease and disability. The purpose of this research is to explore how existentialism and existential psychotherapy theory of Irvin D. Yalom can be applied to nursing home environment design, and to suggest design directions. Based on his framework of human's ultimate interest, death, freedom followed by responsibility, isolation, and meaninglessness, interior design suggestions and applicable spaces were presented. Four cases from Australia, Denmark, Japan and Korea were analyzed according to design suggestions to grasp the current situation and to draw further proposition. The conclusions are as follows. (1)Environment should support nursing home residents to resolve existential issues. (2)Death is the least supported issue on all of the cases. Environmental elements that can induce residents to think and discuss on death, hospice program and space for memorial service is necessary. (3)Regarding to freedom, the environment should support resident's disability to maintain independence as much as possible and residents autonomy and decision should be respected. Single/double rooms, motorized bed, free and safe usage of kitchen and garden are necessary. (4)For isolation, Space and time for meditation should be provided. (5)To find meaning of life, environment should support residents in both physical and cognitive aspect so that they can contribute to others. Space for hobby is necessary for continued creativity and self-realization.

• Journal of Korean Biological Nursing Science
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• 제3권1호
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• pp.11-28
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• 2001

This study was to identify the levels of perceived stress, immunity cells, physical health and depression, and their relationships among those variables in the elderly who institutionalized comparing home residents. The result of this study can be used as basic data when applying nursing interventions to increase quality of life in the elderly. The questionnaires to estimate stress, health status and depression were collected through direct interview from July to August in 1999 and immunity cells were measured by venous blood specimen collected from 9 to 10 A.M. during the same period. The collected data were analysed using SAS program. The results were as follows. The score of perceived stress of all subjects was 38.49 and perceived stress score of institutionalized elderly(42.62) was significantly higher than that in home resident elderly(34.52). All immune cells tested in this study such as total T cell, helper T cell, suppressor T cell, T4/T8 ration, total B cell, and NK cell, were all under the standard criteria of cells distributions. Most elderly who institutionalized and reside home replied that their health status was not good. However their physical health activity was mostly good even though institutionalized elderly had more disability than home residents. The highest rate was 67.3% as disability due to arthritis. The score of depression in all subjects was 8.2 that indicated having depressive symptom. There was no difference in the depression level between institutionalized elderly and home resided elderly. There was a significant correlationship between physical health and depression, however, the rest of varibles did not show any significant relationships. In summary, the immune cells in the elderly who replied perceiving low level stress, was under normal range. Their health status was perceived as 'not good' but physical health activity was perceived as 'good'. The relationships of stress, immunity, physical health and depression were partially significant but not had evidence as enough as theoretically the suggested relationship. We suggest that further studies using large sample size and more diverse variables should be performed.

• Journal of Computing Science and Engineering
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• 제2권2호
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• pp.180-199
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• 2008

Technology has had a tremendous impact on our daily lives. Recently, technology and its impact on aging has become an expanding field of inquiry. A major reason for this interest is that the use of technology can help older people who experience deteriorating health to live independently. In this paper we give a brief review of the in-home monitoring technologies for the elderly. In the pilot study, we analyze the possibility of employing the data generated by a continuous, unobtrusive nursing home monitoring system for predicting elevated(abnormal)pulse pressure(PP) in elderly(PP=systolic blood pressure-diastolic blood pressure). Our sensor data capture external information(behavioral) about the resident that is subsequently reflected in the predicted PP. By continuously predicting the possibility of elevated pulse pressure we may alert the nursing staff when some predefined threshold is exceeded. This approach may provide additional blood pressure monitoring for the elderly persons susceptible to blood pressure variations during the time between two nursing visits. We conducted a retrospective pilot study on two residents of the TigerPlace aging in place facility with age over 70, that had blood pressure measured between 100 and 300 times during a period of two years. The pilot study suggested that abnormal pulse pressure can be reasonably well estimated (an area under ROC curve of about 0.75) using apartment bed and motion sensors.

• 대한간호학회지
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• 제46권6호
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• pp.836-847
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• 2016

Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

• 근관절건강학회지
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• 제25권2호
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• pp.135-147
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• 2018

Purpose: The purpose of this study was to develop evidence-based guidelines for infection control in nursing homes in Korea (ENIK). Methods: Three steps were planned for the development which were developing a draft and testing the content validity. First, the draft was based on evidence and developed through focus group interviews with nurses in nursing homes, a comprehensive review of international guidelines and literature, and systematic reviews of interventions for infection control and outbreaks in long-term care facilities. Clinical applicability was established through reviews of nursing records and job assignments in one nursing home. The final step consisted of experts evaluating the content validity. The ENIK was revised to fit Korean nursing homes. Results: The ENIK consisted of recommendations in 9 compositions and a one-page practical algorithm. The principles of infection control were presented by statements and specific strategies were recommended in resident care programs. The infection control practical algorithm was organized into 3 steps: screening at admission, prevention, and control at the early stage. The practice to control infection was composed of a 5-step process. Conclusion: The ENIK will contribute to improving the competency of infection control practice because it provides standardized practice and is tailored to Korean nursing homes.