• 제목/요약/키워드: family health

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노인장기요양보험 시설서비스 본인부담금에 대한 가족수발자의 경제적 부담감 영향요인 (Factors Related to Family Caregiver Financial Burden of Out-Of Pocket Expenses for the Nursing home service under Long-term Care Insurance System)

  • 한은정;이정석;권진희
    • 보건행정학회지
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    • 제22권3호
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    • pp.383-402
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    • 2012
  • The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

  • Jongudomkarn, D;Singhawara, P;Macduff, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4401-4408
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    • 2015
  • Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.

가족발달단계에 따른 간호요구영역에 관한 연구 (Study of The Area of Nursing Need by the Family Developmental Stage)

  • 최부옥
    • 대한간호학회지
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    • 제7권2호
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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마을단위 보건요원의 활동이 사업 성과에 미치는 영향 -강화지역사회 보건시범사업지역에서- (The Influence of Family Health Workers' Activities on Health Program Performance -Evaluative Research in the The Kang Wha Community Health Demonstration Project-)

  • 서경
    • Journal of Preventive Medicine and Public Health
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    • 제11권1호
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    • pp.24-30
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    • 1978
  • This study was designed to analyse effects of Family Health Workers' activities on the performance of a child immunization program as part of the evaluative research in the community health demonstration project in Kang Wha. Frequent shortcomings of evaluative research are problems in setting evaluative indices, difficulties in interpreting influences of socioeconomic changes due to lack of control and failure of demonstrating association between activity input and program performance. Specific objectives of this study was to improve the frequent shortcoming of evaluative research by isolating the effects of Family Health Workers' activities on the performance of the program through controlling other variables which also influenced the program performance. The target population consisted of 1240 children who were born between Jan. 1971 and Dec. 1975 in Sunwon Myun, and Naega Myun in Kwang Wha Gun, Kyonggi Province. The data were collected in part through 20 Family Health Workers who interviewed the mothers of these children in their villages during Nov. 1977. Part of the data were obtained by summarizing Family Health Workers daily activity records. All data were grouped for each birth cohort according to the 20 villages. Dependent variable of the model is the measle immuinization rate of each village and the independent variables are characteristics of baby, mother, household, travel time to the health subcenter, to Kang Wha Town, and the mean member of visits to the household by Family Health Workers as well as their other related activities and the year of birth of children according to village. The model was analysed by stepwise multiple regression technique. The summarized results show that overall $R^2$ were 39.3% and mean number of Family Health Worker household visits, mean age of mother and mean economic status were significant variables in explaining the immunization rate. Therefore Family Health Workers' activities are one of the significant variables in influencing the increased immunization rate of children in villages of the project area.

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지역사회 정신보건서비스 제공 전$\cdot$후 정신장애인의 의료비용, 삶의 질, 가족 부담감 비교연구 (Comparative Research of the Medical Cost, The Quality of Life, The Family burden of the Mentally III before and after the Community Mental Health Service)

  • 노인영
    • 한국보건간호학회지
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    • 제15권1호
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    • pp.56-72
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    • 2001
  • Community mental health management system emphasizing on the rehabilitation and the return to the community has been established and carried out for many years. The study has been demanded to prove that the decreasing rate of the recurrence of the mentally ill resulted to lower their medical costs, to enrich the quality of life, and to reduce the psychological burden of their family. This study tried to prove that the mental health services to the mentally ill which were registered in community mental health center of A city have an influence on the medical cost, the quality of their lives. the family burden. The subject group of this study were 39 home-based mentally ill patients and their 37 family members, totally 76 people registered in mental health center of A city and participated in its program. This research had been measured twice, the first before the intervention and the second after at least a year. The measuring tools in the research were the medical cost measurment tools developed by the researcher, the quality of life index by Yoo ja, Noh(1988) and the family burden by Montgonery(1985). The methods were modified and supplemented in this study. This research made use of SPSS Win 10.0. The results of this study are the same as followings. 1) There were the significant difference in the medical cost before and after the mental health service delivery. 2) The quality of lives of the mentally ill, after the mental health services delivered were significantly higher than before. 3) The family burden were significantly reduced after the delivery of community mental health services. Community mental health services brought out efficient results to the social return and rehabilitation. And these results means that the mentally ill changed highly the quality of life and their burden of family and medical cost were reduced. So the public organization and the private society should help positively the mentally ill and their family through mental health policy and social service agency to live healthy lives and to be valuable member of society.

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도시 가족계획요원의 직무수행에 영향을 미치는 요인에 관한 연구 -서울특별시 동단위 가족계획카드관리요원을 중심으로- (A Study on the Factors which Influenced the Performance of Urban Family Planning Health Personnels' Function - Around the FP health personnels in the Seoul metropolitan city-)

  • 이명숙;문형화
    • 한국보건간호학회지
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    • 제3권2호
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    • pp.143-156
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    • 1989
  • This study was done in order to analyze the factors which influenced the performance level of urban family planning health personnels' task. Interview survey was done during the period May, 1989. Interviewee were 130 family planning health personnels among total of 140 family planning health personnels in Seoul metropolitan city area. The internal consistency reliability was tested by Cronbach’s Alpha and the construct validity of the survey tool was tested by Factor analysis. Multiple stepwise regression analysis was used to identify major factors influenced to perform family planning health personnels' task. The results of this study were summarized as follows: 1. The internal consistency reliability was high and very significant (Cronbach's Alphs=0.8445, p<0.0000). 2. The construct validity was high and very significant. This analysis was contained 5 factors; registering and keeping of eligible woman records, health educating for FP & MCH, referral for vasectomy and tubal ligation and loop, supplying contraceptive appliances, sending moved-out eligible woman records. 3. Among a total of 15 contents of their functions recording of daily report and monthly report (76.2%), classifying and keeping of records(66.2%), registering of eligible woman records(60.85ti), distribution of leaflets and pamplets(54.6%), counselling & supervision about family planning(53.8%) were actively performed. Sending moved-out eligible woman records(60.8%), health education for community people(49.2%), referring contraceptors' side-effects were poorly performed. 4. The factors which influenced the performance level of urban family planning health personnels' function were age, marital status, educational level, certification, number of residents, number of eligible women, job car-eer, work responsibility, job satisfaction knowledge, position, cooperation of community people, cooperation of Dong Office, cooperation of Health Center. These 14 variables were able to explain job function from 21.4% of follow-up care of contraceptor to 9.1% of classifying & keeping of eligible woman records.

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청소년의 가족기능 및 구강건강 관심도가 구강건강영향지수(OHIP)에 미치는 영향 (The Effect of family function and oral health concern on the oral health impact profile(OHIP) in the adolescents)

  • 이경희;이혜순
    • 한국치위생학회지
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    • 제15권4호
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    • pp.583-591
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    • 2015
  • Objectives: The purpose of the study was to investigate the effect of family function and oral health concern on the oral health impact profile (OHIP) in the adolescents. Methods: A self-reported questionnaire was completed by 368 middle school students in Gyeongnam from June 9 to 20, 2014. Except incomplete answers, 337 data were analyzed by frequency analysis, chi-square test, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis using SPSS 20.0 program. The questionnaire consisted of eight questions of the general characteristics of the subjects, seventeen questions of family function, eleven questions of oral health concern, fourteen questions of oral health impact profile (OHIP)-14. Results: OHIP-14 was higher and it showed better oral health-related quality of life in lower grade, liberal parents' rearing attitude, and satisfaction with parent-child relationship. The family function and oral concern were significantly correlated with the OHIP-14. The influencing factors on the oral health-related quality of life are the family function of communication, oral concern of self oral care and food, and general characteristics. Conclusions: The oral health-related quality of life in the adolescents was affected by family function and oral health concern. It is very important and necessary to develop and apply the oral health promotion program including the family function in the adolescents.

여성들의 생애주기별 건강증진행위와 관련요인에 관한 연구 - 일개 통합시를 중심으로 - (A Study about Promoting Health Lifestyles and Relating Variables on the Life-cycle of women)

  • 이은희;소애영;최상순
    • 대한간호학회지
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    • 제29권3호
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    • pp.700-710
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    • 1999
  • Promoting women's health lifestyles are important due to their connection to family health. The purpose of this study was to analyse women's health lifestyles(HPL) and their effects on women's life-cycle, so in order to develop a program in a women's health care center. The subjects included were 1080 women over 18 years old living in Wonju city, and were selected by stratified and purposive sampling. The data were collected through a questionnaire and interview. The Cronbach $\alpha$, %, mean, ANOVA, Pearson's correlation, and regression in SPSS PC Win. package was used to analyze the data. The sample was sepernted into three groups premarital group 20.2%(premarital women between 18 and 40 years old), delivery and children rearing group 49.9%(marital women between 18 and 40 years old), over middle agedelderly group 29.9%(women over 41 years old). Significant difference were found in the HPL according to group. Also, relating variables, such as self-efficacy, family functions, health locus of control and gender role perception that were considered relating variables to HPL significantly differed among the three groups. HPL significantly correlated with self-efficacy, family functions, HLOC and gender role perception in all participants and at all groups. The regression analysis of HPL was interpreted 40.6% with relating variables, self-efficacy, health attention, family functions, and internal locus of control, health perception, power other locus of control and chance locus of control in all participant. Self-efficacy, family functions, health attention were considered important variables in premarital group, self-efficacy, family functions, internal locus of control, health attention, health perception and power of control were important in delivery-rearing group. Self-efficacy, health attention, internal locus of control, family functions and health perception were important in middle aged-elderly group. As a result, we found the differences HPL scores and relating variables according to life-cycle groups. Therefore, we should prepare health promoting education programs for women according to women's life cycles. Also we suggest that women's health care centers based on communities was needed for proper management of women's health.

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청소년이 지각하는 자아존중감, 가족기능, 사회적지지가 건강증진행위에 미치는 영향 (The Effect of Self-esteem, Family Functioning, Social Support on Health-Promoting Behavior in Adolescents)

  • 심미경
    • 부모자녀건강학회지
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    • 제8권1호
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    • pp.64-74
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    • 2005
  • Purpose: The purpose of this study was to identify the effects of self-esteem, family functioning, social support on health-promoting behavior and to investigate the factors affecting health-promoting behavior in adolescents. Method: The participants in this study were 181 students of high school located in Seoul and Daejon. The data were collected from November 1 to December 18, 2004. The date were analyzed with descriptive statistics, t-test or ANOVA, Pearson Correlation Coefficient and stepwise multiple regression. Result: Health-promoting behavior in adolescents was significantly different according to sex, grade, their father's school career and economic status. There was a Significant correlation between health-promoting behavior, self-esteem, family functioning and social support. Social support was a predictor of health-promoting behavior and accounted for 32% of the variance. Family functioning and self-esteem were also predictors of health-promoting behavior and accounted for 12% of the variance. Conclusions: This findings suggest that the program and strategies that increase health-promoting behavior by promoting self-esteem, family functioning and social support should be developed in adolescents.

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치매환자 가족부양자의 불안 및 우울 관련 요인: 2015년 지역사회 건강조사를 바탕으로 (Factors Related to Anxiety and Depression of the Family Caregivers' with Dementia Patients: based on 2015 Community Health Survey)

  • 엄태림;최보영
    • 한국학교ㆍ지역보건교육학회지
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    • 제19권3호
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    • pp.65-77
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    • 2018
  • Background & Objectives: This study aims to investigate the health status of family caregivers with dementia patients and identify the factors related to their anxiety and depression. Methods: Data from 2015 Community Health Survey(n=2,426) was used. A chi-square test was performed to investigate the health status of family caregivers, and a multiple logistic regression analysis was used to identify the factors associated with anxiety and depression. Results: Odds ratio(OR) of anxiety and depression was 1.29 times higher in female, 2.49 times higher in over 70 years versus under 39 years. ORs were lower 34.0%, 26.0%, 26.0% in the working group, the physical activity group, the alcohol drinking group respectively. ORs of anxiety and depression were 4.54 times, 1.57 times higher in the stress group, the chronic disease group respectively. And ORs were 61.0%, 28.0% lower respectively when social networks and social activities was present. Conclusions: The rate of experiencing anxiety and depression was high in family caregivers with dementia patients. It is necessary to provide diverse programs to reduce the burden of family support, anxiety and depression of family caregivers.