• 아태비즈니스연구
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• 제11권4호
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• pp.49-63
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• 2020

Purpose - This study aims to assess six aspects of resident satisfaction (satisfaction with room, home, social interaction, meals service, staff care, and resident involvement) and to identify the most influential aspect of satisfaction upon word-of-mouth (WOM) intention in a continuing care retirement community (CCRC). Design/methodology/approach - A total of 293 paper survey questionnaires with a cover letter and postage paid envelopes were mailed to the CCRC residents. To test reliability and validity of the multidimensional resident satisfaction, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used. Then, the structural equation modeling technique (SEM) was applied to test causal relationship between resident satisfaction and WOM intention. Multiple regression was used to identify the most influential aspect of resident satisfaction on WOM intention in the CCRC. Findings - The results of EFA and CFA on the 157 responses received out of the total 293 surveys indicated that six dimensions of resident satisfaction were statistically distinct. Among the six dimensions, satisfaction with resident involvement, social interaction, and staff care significantly influenced their WOM intention. Furthermore, the most influential aspect of satisfaction upon WOM intention was resident involvement. Research implications or Originality - This study empirically tested the six dimensions of CCRC resident satisfaction, and identified resident involvement as the most influential factor upon WOM intention in a CCRC where WOM intentions plays a crucial role during the selection process of prospective residents.

• 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.

• 가정간호학회지
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• 제4권
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• pp.5-22
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• 1997

The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

• 한국전자통신학회논문지
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• 제18권4호
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• pp.677-686
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• 2023

본 논문에서는 사용자의 외출 목적을 인지하고 외출 시 도움을 줄 수 있는 유용한 정보를 전달하는 스마트 홈 외출 케어 시스템의 설계 및 구현에 대해 연구한다. ESP8266을 이용하여 기상청의 RSS 서비스 데이터를 실시간으로 전송할 수 있고, Arduino MEGA를 이용하여 데이터를 분석 후 사용자에게 기상정보를 제공할 수 있는 시스템을 구현한다. 앱인벤터를 활용하여 필요한 물품을 잊지 않고 챙길 수 있으며 원하는 날씨와 목적에 맞게 설정을 변경 가능하다. 마이크 위치는 외부에 배치하여 인지도를 12% 높였으며, 압력센서의 감도는 최대 210 kΩ으로 설정했다. 문 사이에 장애물이 있을 경우 자동으로 문이 열린다. 서랍 천장에 초음파 센서를 배치해 0.5cm~10cm 범위 내 물체를 인식해 물체 유무를 확인하고 카메라를 설치해 보안 강화 시스템을 연구헸다.

• 한국응급구조학회지
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• 제12권3호
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• 호스피스학술지
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• 제1권1호
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• 한국농촌건축학회논문집
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• 제10권4호
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• pp.9-16
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• 2008

The purpose of this study is to compare and seize the type of the path of flow for nurses and living assistant, of the path of flow for evacuation and walking practice by analysis plan for the care facilities in the out-of-home service. It supposed many problem for living in the care facilities for the aged get down activity, especially their relates with difficulty in walking. And services of nurses and living assistant get mixed properties by that problem for the aged with difficulty in walking. It classified into T type, L type, H type, ${\Box}$ type, - type all the path of flow for nurses and living assistant on the longest from nursing station to each bedroom, the path of flow for evacuation from each room to exit, the path of flow for walking practice on the corridor and lobby. The three path of flow are influenced by an inner court, especially passable court is the important primary factor in the communication between the aged, a course and time required of flow.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 디지털융복합연구
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• 제17권11호
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• pp.29-37
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• 2019

노인들은 건강상태가 다소 좋지 않더라도 지역사회에 지속적으로 거주하기 원한다. 그러나 노인의 건강 및 기능상태에 맞는 통합적인 돌봄지원 시스템의 부재로 생활시설을 선택하는 경우가 증가하고 있다. 본 연구는 2017년 노인실태조사를 활용하여 장기요양인정을 신청한 노인들을 대상으로 욕구에 맞는 서비스를 이용하고 있는지를 탐색적으로 논의하고자 한다. 분석결과 첫째, 장기요양인정을 통해 등급을 받은 노인 중에서 경증 노인은 방문요양 등 재가서비스를 주로 이용하고 있었다. 그러나 경증 노인 중에서 일부는 요양시설에 입소하고 있어서 기능 상태에 맞지 않는 서비스를 이용하고 있었다. 둘째, 방문요양서비스가 주야간보호서비스에 비해 월등히 이용이 높아서 노인 상태에 맞는 복합적인 재가서비스가 이루어지지 못하고 있었다. 셋째, 등급 외 노인의 경우 등급인정 노인에 비하여 일상생활 수행을 위한 도움을 충분히 받지 못하고 있었으며, 경로당이나 노인복지관 등 지역사회복지서비스 이용도 낮았다. 따라서 장기요양인정자의 경우 건강 및 기능상태가 경증 임에도 지역사회에 계속 거주하지 못하고 시설에 입소하는 경우가 발생하고 있고, 등급 외 노인의 경우 필요한 지역사회 돌봄 서비스를 적절이 이용하지 못해서 장기요양인정자로 상태가 악화될 가능성이 높은 것으로 판단된다.

• 한국사회복지학
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• 제60권1호
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• pp.187-209
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• 2008

본 연구자들은 재가노인의 사례관리 과정에서 가장 핵심적인 요소가 되는 욕구 중심의 통합적 사정을 위한 28개의 욕구가 포함된 사정도구를 개발하였으며, 그 후속 연구로 개발된 욕구사정도구를 활용해 전국 노인복지관 협회 산하 120개 기관의 재가 노인 676명의 사정 데이터를 수집하고 데이터마이닝의 의사결정 나무분석 기법을 활용하여 욕구에 적합한 사회복지 서비스를 제공하기 위한 욕구추출 알고리즘을 개발하였다. 본 연구를 통해 재가노인의 욕구 28개에 대한 욕구추출 알고리즘은 <표3>에 요약하였다. 욕구 8번 "외출 시 도움을 원한다."의 의사결정모형을 예로 들면, 호소 23번을 주요 변인으로 외부이동 도움을 요청할 경우 80.3%와 요청하지 않을 경우 11.4%로 구분되었다. 이용자가 외부 이동에 대한 호소가 있고, 수발자가 있는 경우 87.9%로 욕구가 증가하였지만, 수발자가 없는 이용자의 경우 47.4%로 감소하였다. 노인이 외부이동 지원에 대한 요청과 수발자가 있으며, 청소하기의 완전도움이 필요한 경우, 외부이동 도움에 대한 욕구는 94.2%로 나타났다. 그러나 이용자가 외부이동의 도움을 요청하지 않더라도, ADL의 목욕하기에 완전도움으로 응답한 경우 외출도움의 욕구는 11.4%에서 80.0%로 급격히 증가하는 것을 확인할 수 있다. 그러나 ADL 목욕하기의 기능이 부분도움 또는 완전자립의 경우 외출도움이 필요하다고 분류될 가능성은 7.7%로 낮게 나타났다. 위와 같은 의사결정모형은 최대 나무 깊이는 5수준을 정지규칙으로 하여, 부모마디와 자식마디의 사례 수를 각각 50과 25로 지정하였다. 이를 통해 "외출 시 도움을 원한다"라는 욕구의 경우 182.13%의 효과적인 의사결정을 하고 있다. 본 연구의 결과로 제시한 알고리즘은 재가노인의 욕구를 추출함에 있어서 체계적이고 과학적인 기초자료로 활용될 수 있다.