• 지역사회간호학회지
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• 제15권4호
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• 치위생과학회지
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• 제18권3호
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• pp.182-187
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• 2018

As the elderly population increases, they are increasingly affected by oral health problems. Therefore, efforts are being made to improve the oral health of older people, alleviate mental discomfort, and reduce unmet dental needs. This study was conducted to confirm the relationship between the National Health Insurance Elderly Denture Coverage and the unmet dental need for the edentulous elderly, as part of the protection policy. We analyzed the 2011 and 2013 Community Health Survey data of the edentulous elderly, aged 75 years or older, before 2012. In order to more precisely confirm the effects of the denture donation policy on unmet dental care, basic life recipients who were subject to the free elderly prosthetic project were excluded from the analysis. The final analysis included 20,400 subjects. According to our investigation of the factors that affect the unmet dental needs of the elderly, the National Health Insurance Elderly Denture Coverage did not affect unmet dental needs. The statistically significant variables that affected the unmet dental needs of the elderly were education and income levels, which are representative socioeconomic status variables. The lower the level of education, the unhealthier the dental care experience, and income levels showed a similar tendency. The elderly who have a low socioeconomic status are more likely to experience unmet dental needs because they lack the knowledge and socioeconomic ability to pay for dental care. Therefore, the policy for health protection of the entire elderly population should be continuously expanded. In addition, the socioeconomically vulnerable groups may have health problems due to the restriction of medical use, which may lead to quality of life deterioration.

• 인간식물환경학회지
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• 제24권1호
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• pp.107-117
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• 2021

Background and objective: The purpose of this study is to investigate the effect of a forest healing program in terms of depression, neuropsychological and physiological benefits for the elderly. Methods: For this purpose, we developed a forest therapy program for the elderly who are vulnerable to dementia and conducted a total of 11 sessions of forest therapy activities in a forest once a week. We measured the changes in depression, resting-state Electroencephalography(EEG) and heart rate variability (HRV) before and after the program. There were 60 subjects aged over 65 yesrs old. 30 subjects participated in the forest therapy program, and the other were in the control group. The Geriatric Depression Scale was used to measure the level of depression, neuroNicle FX2 (Laxtha, Korea) was used to measure the resting-state EEG, and photoplethymogram (ubpulse T1, Laxtha, Korea) was used to measure the HRV. Results: The results showed that the depression index of the experimental group improved with statistical significance after the program (experiment group = 3.267 decrease of the mean). In the EEG measurement, the alpha-peak frequency at rest (experimental group = 0.227 Hz increase of the mean) was improved (mean increase = 0.23 in the experimental group, p < .05). The high frequency of HRV, which represents the parasympathetic nerve activity of the body's autonomous response, was also significantly improved (mean increase = 0.396 in the experimental group, p < .05). Conclusion: The results suggest that the forest therapy program can reduce the cognitive, psychological and physical risk factors of dementia for the elderly at risk of cognitive decline. Therefore, forest therapy activities may be suitable for the prevention of dementia in the elderly.

• 대한교통학회지
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• 제34권5호
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• pp.409-420
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• 2016

한국은 2026년에 초고령화 사회(super aged society)로 진입될 것으로 예상된다. 그럼에도 불구하고 보행은 인간의 기본적인 이동권리라는 측면에서 교통약자의 대부분을 차지하는 고령자의 안전하고 편리한 이동권리 확보는 가장 기초적인 복지로 중요하지만 간과되기 싶다. 이러한 측면에서 본 논문에서는 교통시설물을 설계시 활용을 위한 고령자의 보행특성을 분석하여 제시하였다. 운동 역학적인 보행변수들을 일반인과 비교한 결과, 모든 변수들이 일반인에 비하여 약 75% 수준으로 분석되었다. 고령자는 일반인에 비하여 보행속도가 느리고, 어깨의 움직임이 적은 대신 발목의 움직임이 많으며, 발을 낮게 들며, 지면반발력이 크게 작용되는 등의 보행변수별 보행특성이 조사되었다. 또한 고령자 집단은 집단 안에서도 보행변수별로 서로 차이가 크며, 이를 walking Balance Muscles Factor별로 2개 혹은 3개로 집단화가 가능함을 군집분석을 통하여 알아보았다. 이와 같은 고령자 보행특성은 보도, 경사 및 단차 등의 교통시설물 설계에 활용될 수 있을 것이다.

• 지적과 국토정보
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• 제48권1호
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• pp.169-186
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• 2018

급속한 고령화 사회에서 노인인구가 갖는 사회적 영향력은 더욱 가속화될 것이다. 본 연구에서는 인공지능 방법론 중 머신러닝, 인공신경망, 국토정보 분석을 통해 노인복지 취약지구를 추출하는 방법론을 정립하는데 목적을 두었다. 분석방향 정립을 위해 65세 이상 노인, 공무원, 노인복지 시설물 담당자와 인터뷰 후 방향을 설정하였다. 경기도 용인시를 대상으로 500 m 공간단위 벡터 기반 격자에 15분 이내 지리적 거리 수용력, 노인복지 향유도, 공시지가, 이동통신 기반 노인활동을 지표로 설정하였다. 10단계 군집형성 후 모의학습 결과 RBF 커널 알고리즘을 활용한 머신러닝 서포트 벡터머신에서 83.2%의 예측정확도가 나타났다. 그리고 역전파 알고리즘을 활용한 인공신경망에서 높은 상관성 결과(0.63)가 나타났다. 변수간 공간적 자기상관성을 분석하기 위해 지리적 가중회귀분석을 수행했다. 분석결과 결정계수가 70.1%로 모형으로 나타나 설명력이 우수한 것으로 나타났다. 변수의 공간적 이상값 여부와 분포패턴을 검토하기 위해 국지적인 공간적 자기상관성 지수인 Moran's I 계수와 Getis-Ord Gi 계수를 분석하였다. 분석결과 용인시 신도시인 수지 기흥구에서 노인복지 취약지구가 발생하는 특성을 보였다. 본 연구의 인공지능 모의방법과 국토정보 분석의 연계는 최근 정부의 지역여건을 고려한 노인복지 불균형을 해결하는데 활용될 수 있을 것이다.

• 대한기관윤리심의기구협의회지
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• 제5권1호
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• pp.21-32
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• 2023

Purspose: The purpose of this study is to examine the meaning and definition of vulnerable subjects in clinical trials in light of domestic and international regulations and guidelines, to analyze the contents of standard operation procedures (SOPs) among advanced general hospitals in Korea that conduct clinical trials, and to examine deliberation procedures for operation plans. Methods: The study examined how vulnerable research subjects were defined and described in related regulations and the classification of vulnerable research subjects presented in the IRB/HRPP SOPs of 18 clinical trial institutions, including 11 AAHRPP-accreditated general hospitals in Korea, as well as the operation of the IRB deliberation. Results: Among all domestic and international regulations and guidelines, only the The Council for International Organization of Medical Sciences (CIOMS) guidelines explain why vulnerability is related to judgments on the severity of physical, psychological, and social harm, why individuals are vulnerable, and for what reasons. However, the classification of vulnerable subjects by institutions differed from the classification by the International Conference on Harmonization-Good Clinical Practice (ICH-GCP). A total of the 16 institutions classified children and minors as vulnerable research subjects. 14 institutions classified subjects who cannot consent freely were classified as vulnerable subjects. 15 institutions classified sujects who can be affected by the organizational hierarchy were classified as vulnerable subjects. Subjects in emergency situations were regarded as vulnerable research subjects in 8 of institutions, while people in wards, patients with incurable diseases, and the economically poor including the unemployed were categorized as vulnerable research subjects in 7, 4, and 4 of institutions, respectively. Additionally, some research subjects were not classified as vulnerable by ICH-GCP but were classified as vulnerable by domestic institutions 15 of the institutions classified pregnant women and fetuses as vulnerable, 11 classified the elderly as vulnerable, and 6 classified foreigners as vulnerable. Conclution: The regulations and institutional SOPs classify subjects differently, which may affect subject protection. There is a need to improve IRBs' classifications of vulnerable research subjects. It is also necessary to establish the standards according to the differences in deliberation processes. Further, it is recommended to maintain a consistent review of validity, assessment of risk/benefit, and a review using checklists and spokeperson. The review of IRB is to be carried out in a manner that respects human dignity by taking into account the physical, psychological, and social conditions of the subjects.

• 대한교통학회지
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• 제33권3호
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• pp.276-283
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• 2015

각 도시에서는 급증하는 자동차로 인해 보행자의 영역은 줄어들고 있고 보행자를 위한 도로시설의 개선은 향상되지 못하고 있어 보행자는 위험한 교통환경에 노출되고 있다. 이러한 열악한 보행환경은 비교통약자에게도 위험하지만 교통약자에게는 더욱 치명적인 위험요소가 될 수 있다. 본 연구에서는 교통약자의 교통안전을 향상시키고 보행환경을 개선하기 위해 교통약자 유형별로 도로시설 이용특성을 분석하였다. 본 연구의 방법은 교통약자를 대상으로 기존 도로의 보행시설을 이용할 때 느낀 정량적, 정성적 사항에 대한 설문조사를 실시하고 이를 바탕으로 정량적, 정성적 요소를 모두 고려한 의사결정방법인 계층 분석적 의사결정방법(AHP)을 이용한 연구를 수행하였다. 제3계층 분석결과 고령자나 장애인의 경우 일부 유사한 특성을 나타내고 있었으며 차량진출입, 도로의 기울기나 포장불량이 높은 순위의 불편요소로 나타났다. 영유아동반자의 경우 승강기가 없는 육교와 지하도가 1순위로 나타나 고령자, 장애인과 다소 차이가 있는 것으로 분석되었다.

• 대한간호학회지
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• 제40권4호
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• pp.589-598
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• 2010

Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

• 한국병원경영학회지
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• 제17권3호
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• pp.23-36
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• 2012

Objectives : The coverage of Korean National Health Insurance is limited to basic level. Korean government encourages private health insurance for covering medical securities. So, many studies examined the determinants of purchasing private health insurance. However, 11% of Korean population is older than 65 in 2011. Considering the elderly is important to establish a health policy. The aim of this study is to examine factors determining the purchase of private health insurance among middle-aged and elderly Korean adults. Methods : We used the second Korean Longitudinal Study of Ageing (KLoSA), selected 8,688 sample of the aged 47 or older for the analysis. KLoSA collected information on demographic characteristics, income, health- related factors. KLoSA data include in the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Logistic regression was used to examine the relationship between the determinants of purchasing private health insurance and the factors which include age, gender, education, residential district, marital status, smoking, drinking, physical exercise, economic activity status, national health insurance type, income, the number of chronic disease, and the number of outpatient, inpatient, oriental hospital visit, dental clinic visit for two years. Results : People who were older, did not live in a city, had higher IADL, currently drunk alcohol, did exercise regularly and had chronic diseases more than three were inclined not to purchase private health insurance. Females, the married, well-educated, past & currently smokers, the employed, high income earners, national health insurers, metropolitan citizens and someone who got high MMSE were more likely to purchase private health insurance. The more people experienced outpatients, inpatients, dental clinics and Chinese medicine clinics, the more private health insurance was purchased. The elderly people over 75 had more private health insurance than the aged 65-74. The strongest factors for private health insurance is gender, and economic status such as income. Conclusion : In this study, we found healthy-high income people were more likely to purchase private health insurance. In contrast, unhealthy-low income and older people did not. The economic factors were strongly related with private health insurance in aged over 75. These mean inequality exists in the using private health insurance. Therefore, the government should consider vulnerable social group before expanding private health insurance.

• 생명과학회지
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• 제34권3호
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• pp.208-213
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• 2024

본 연구는 노인의 우울증 예방 및 치료를 위해 신체활동과 운동이 어떠한 효과가 있는지를 확인하는 것이다. 전 세계적으로 우울증은 지속적으로 증가하는 추세이며 특히 가속화되어 가는 고령화 사회에서 노인의 우울증은 더욱 심각한 문제라고 볼 수 있다. 노인의 우울증은 젊은 층에 비해 예후가 좋지 않으며 노화로 인한 신체적 질병의 증가와 신체적 장애에 의한 자존감 저하로 더욱 취약하다고 할 수 있다. 그러나 노인들의 우울증 관리, 노쇠로 인한 우울증 등의 문제에도 불구하고 지금까지 예방 및 치료에 관한 연구는 미미하다고 판단된다. 따라서 본 연구는 중요한 매개 변인인 수면장애와 우울증, 우울증에 대한 운동과 해마의 연관성, 우울증 관리를 위한 신체활동 및 운동의 과학적 효과를 분석하였다. 추후 노인의 우울증 개선과 자살예방에 관한 다양한 연구들이 수행되어져야 할 것으로 여겨진다.