• 한국산학기술학회논문지
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• 제14권1호
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• pp.247-256
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• 2013

본 논문은 방문요양서비스를 이용하고 있는 대상자 중심의 서비스 평가를 바탕으로 중요도와 성과도 분석을 통해 관리전략을 제시하였다. 연구대상은 강원도 S시에 소재한 3개소의 재가장기요양기관에서 서비스를 받고 있는 대상자로 하였으며, 자료 분석은 SPSS 12.0을 이용하여 기초통계, 신뢰도분석, 요인분석을 실시하였다. 분석결과 방문요양서비스 중요도는 총5점 만점에 4.55점으로 나타났고, 성과도는 4.26점으로 나타났다. 집중개선영역은 '신속한 서비스 제공'과 '안심하고 서비스 제공'으로 나타났고, 유형성의 4개 속성, 신뢰 확신성의 4개 속성, 대응 공감성의 1개 속성은 개선고려 영역으로 나타났으며, 신뢰 확신성의 3개 속성, 대응 공감성의 5개 속성은 강점유지영역으로 나타났다. 결론적으로 방문요양서비스 질을 높이기 위해서는 우선적으로 집중개선영역의 성과향상이 필요하며, 서비스 제공자의 지속적인 교육과 훈련을 통한 전문성의 확보와 규칙적인 대상자 중심의 서비스 평가를 통한 관리가 필요할 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제22권5호
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• pp.469-477
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• 2001

본 논문은 가정에 있는 만성질환자, 퇴원한 환자 및 자신의 건강을 염려하는 정상인 등을 대상으로 매일 측정한 심전도. 혈압. 혈중 산소 포화농도 등과 같은 생리변수와 건강 설문에 대한 응답을 분석하여 건강상태를 지속적으로 파악하고, 비정상적인 상태가 발견될 경우에는 의사가 정확히 확인하여 필요한 조치를 조언하는 재택건강관리서비스에 대해서 기술하고 있다 재택건강관리서비스를 위해서 가입자는 재택건강관리단말기와 인터넷에 연결된 PC를 가정에 구비하여야 한다. 관제센터는 의사와 가입자의 기본정보와 가입자의 건강정보를 저장하기 위한 데이터베이스 시스템, 생체신호와 건강설문을 분석하여 현재상태의 비정상여부를 판단하는 건강상태자동평가시스템, 가입자와 의사들이 웹 브라우저를 사용하여 원하는 건강정보를 데이터베이스에서 검색, 조회하고. 그 내용을 수정. 편집하여 저장할 수 있는 웹 기반 건강정보관리시스템이 필요하다. 또한, 공중전화망 및 무선통신망을 이용한 음성 및 문자 전송과 인터넷을 이용한 전자우편에 의해 의사의 소견을 가입자에게 전달하는 통합 메시징 시스템 (UMS). 종합검진센터에서 의사가 검사결과와 문진 결과를 입력하기 위한 정보입력 PC. 병원에서 의사가 가입자의 정보를 조회하거나 정밀진단결과를 입력하기 위한 인터넷 PC 등이 설치되어야 한다. 일반에게 이러한 서비스를 널리 보급하기 위해서는, 생리변수들의 무구속 및 무자각 측정기술과 지능적인 건강평가 알고리즘의 개발에 대한 연구가 계속 수행되어야 할 것이다.

• 한국보건간호학회지
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• 제14권2호
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• pp.246-259
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• 2000

The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

• 한국콘텐츠학회논문지
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• 제12권4호
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• pp.282-291
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• 2012

본 연구는 요양보호사의 직무만족이 서비스 질에 미치는 영향을 분석하여 요양보호사의 직무만족 향상과 보다 나은 질적 서비스를 제공하기 위한 자료로 활용하는데 그 목적이 있다. 부산시 소재 6개구 소재 16개 기관에서 근무하는 요양보호사에게서 회수된 설문지 250부 중 216부를 SPSS 12.0 을 이용하여 설문문항의 신뢰도 검증, 상관관계 분석, 회귀분석을 실시하였다. 요양보호사 직무만족 요인이 서비스 질에 미치는 영향을 알아보기 위해 회귀분석을 실시한 결과, 요양보호사의 업무자체 만족도가 높을수록, 직업안전성에 대한 만족도가 높을수록 서비스 질에 긍정적인 영향을 미치고, 요양보호사의 업무부담, 직무환경에 관한 만족은 서비스 질에 유의미한 영향을 미치지 않는 것으로 나타났다. 요양보호사의 업무자체만족도 수준과 직업안정 관련 구조 개선을 충족시킬 수 있는 여건들이 조성된다면 보다 양질의 요양보호 서비스 제공을 기대할 수 있다는 것을 보여주는 것이다.

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

• 한국치위생학회지
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• 제16권3호
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• pp.373-381
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• 2016

Objectives: The purpose of the study is to investigate the awareness toward use and service contents of long term care for the elderly. Methods: A self-reported questionnaire was completed by 296 adults from August 13 to October 20, 2014. The questionnaire consisted of general characteristics of the subjects, awareness toward long term care insurance for the elderly, awareness toward long term oral health care services, use of long term care service and use intention for the long term care insurance. Data were analyzed by SPSS 18.0 program. Results: Those who were aware of the long term care insurance accounted for 55.4 percent. Approximately 50 percent of the respondents recognized long term care service items, home visit care, home visit bathing, and home visit nursing. Most of the respondents had information of long term care services by way of mass media and direct contact. Only 13.4 percent of the respondents were aware of the oral health service in the long term care insurance. The subjects were aware of denture cleaning, oral cleaning and oral health education out of oral health service in order; and oral health services that needed to be offered were denture cleaning, oral health education and professional toothbrushing. They reported that dental hygienists were the most important manpower that offered the efficient oral health care services. They answered that professional manpower and financial support are required for oral health services. The positive thinking to long term care insurance accounted for 89.2 percent and 91.3 percent had use intention for oral health services. Conclusions: Many elderly people have mastication or dysphagic problems due to systemic diseases. Therefore, it is necessary to announce the long term care insurance and long term care services for the elderly people.

• 가정간호학회지
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• 제6권
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• pp.46-58
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• 1999

The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

• 대한간호학회지
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• 제30권6호
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• 호스피스학술지
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• 제2권1호
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• pp.41-57
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• 2002

This study was done to examine spiritual well-being of hospice care service volunteers for the purpose of providing them with programs promoting coping skills in response to the wholistic needs of patient effectively, also providing data for professional or nonprofessional hospice training program. Subjects were 123 volunteers serving in 6 hospice centers in Jeonbuk province at present. Data collection were done from 16 Oct. 2000 to 17 Nov. 2000. questionnairs were consisted of activities of hospice care service volunteer and spiritual well-being. The study results were as follows 1.Mean of activities of hospice care service volunteers were 2.433, those activities were divided into 5 categories such as spiritual, activities of volunteer for themselves, psychosocial, physical area and bereavement. The highest mean score was spiritual area 2.578, activities of volunteers for themselves 2.525, psychosocial area 2.456, physical area was 2.359 and the lowest mean score was bereavement area 2.130. 2.Spiritual well-being of hospice care service volunteers was 5.25, the highest mean. In subcategories of spiritual well-being, religious spiritual well-being was higher than existential spiritual well-being, mean score for each one was 5.41, 5.10. 3.Statistically significant relations among demographic characteristics such as gender(t=2.72, P=.008), status of marriage(t=6.067, P=.003), occupation(F=3.795, P=.025), frequency of visiting for volunteered hospice care(F=3.833, P=.024) were noted. 4.Statistically significant demographic characteristics of hospice service volunteers was religion(t=-4.38, p=0.000), status of marriage(F=3.505, p=0.033), frequency of visiting for volunteered hospice care(F=3.107, p=0.048), level of satisfaction from hospice care volunteer service(F=3.610, p=0.030), hospice service volunteers doing more home visiting(5-9times/month) had higher status of spiritual well being than volunteer with less home visiting(1-4times/month) 5.A significant relationship between activities of hospice service volunteers and status of spiritual well-being was noted(r=.236, p=.004), activities of hospice service volunteers was related to both subcategories of spiritual well-being such as religious well-being(r=.210, p=.010) and existential well-being(r=.208, p=.011). From the results of the study It is noted that status of spiritual well-being for hospice volunteers influences on service activities. It means spiritual well-being should be considered as a essential character for hospice service volunteers, it also means that managing and maintaining of status of spiritual well-being for hospice service volunteers is important. On the base of the study recommendation are made as follows: 1.Considering status of spiritual well-being for hospice care service volunteers is needed to promote hospice care activities. 2.It is necessary to develope spiritual well-being programs for hospice care service volunteers and further study for effect validation of them is needed. 3.Further study to sort out effecting variables for hospice care service volunteer activities is needed. 4.It will be desirable to have spiritual well-being information included in the hospice education program.

• 가정간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.