• 제목/요약/키워드: physical and mental health care

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장애인의 상용치료원 보유가 환자 중심 의사소통에 미치는 영향 (The Effect of Having a Usual Source of Care on Patient-Centered Communication among Persons with Disabilities)

  • 전보영;이민영;안은미
    • 보건행정학회지
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    • 제31권4호
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    • pp.518-530
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    • 2021
  • Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.

요양시설 노인의 사회적지지, 신체적 및 정신적 건강수준이 삶의 질에 미치는 영향에 대한 공분산구조분석 (Covariance Structure Analysis of the Influence of Social Support, Physical and Mental Health Status on Quality of Life among the Elderly at Care Facilities)

  • 임영아;조영채
    • 한국산학기술학회논문지
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    • 제18권8호
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    • pp.210-220
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    • 2017
  • 본 연구는 요양시설 노인의 사회적지지(MOS-SSS), 신체적(ADL, IADL) 및 정신적(CES-D, MMSE-K) 건강수준이 삶의 질(WHOQOL-BREF)에 미치는 영향을 파악 하고자 시도하였다. 조사대상은 D광역시에 소재하고 있는 15개소의 요양시설에 입소하고 있는 65세 이상 노인 524명을 대상으로 하였다. 자료 수집은 2015년 11월부터 2016년 1월까지의 기간 동안에 조사원이 조사대상 요양시설을 직접 방문하여 면접 조사하였다. 연구결과, 삶의 질 평균 점수는 사회적지지 총점이 낮은 군일수록, ADL 및 IADL이 정상범위노인 군보다 기능장애노인 군에서, CES-D가 정상상태 군보다 우울상태 군에서, MMSE-K가 정상상태 군보다 인지기능장애 군에서 유의하게 낮았다. 조사대상자의 삶의 질은 사회적지지, 일상생활수행능력, 도구적 일상생활수행능력 및 인지기능장애와 유의한 양의 상관관계를 나타낸 반면, 우울과는 유의한 음의 상관관계를 나타내었다. 공분산 구조분석 결과, 신체적 기능은 정신적 기능이나 사회적지지 보다 삶의 질에 더 큰 영향을 미쳤으며, 신체적 기능, 정신적 기능 및 사회적지지가 낮을수록 삶의 질을 저하시키는 효과가 있는 것으로 나타났다. 따라서 요양시설 노인의 삶의 질을 증진시키기 위해서는 신체적 기능의 향상을 위한 구체적인 방안을 모색할 필요가 있다고 생각된다.

치매나 알츠하이머 환자를 위한 주간보호시설의 프로그램에 관한 미국사례 연구 (Programs of Activities and Services of the Adult Day Care Center for the Elderly with Alzheimer's Disease and Dementia in the U.S.A)

  • 곽인숙
    • 대한가정학회지
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    • 제40권10호
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    • pp.123-139
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    • 2002
  • The purpose of this study was to understand the adult day care center as a place for the elders and adults and to develop an initial understanding of the services and activity programs for adult day care for the cognitively-impaired in the U.S.A. The data were collected from 12 Adult Day Care Centers(ADC) from 2001 to 2002 by personal interview and the documents about the programs. ADC programs provided primarily social, recreational, and health activities and services in a group setting. Centers offered participants to socialize, enjoy peer support, and receive health and social services in a stimulating and supportive environment that promotes better physical and mental health. For this purpose those centers offered not only professional health care, occupational.speech.physical therapies but also socio-recreation and therapeutic-recreation services.

신체·정신복합질환자의 민간의료보험 가입 여부가 의료이용에 미치는 영향: 한국의료패널 데이터 2018년 자료 활용 (The Effects of Private Health Insurance on Healthcare Utilization of People with Physical and Mental Illness: According to 2018 Korea Health Panel Survey Data)

  • 나리영;윤석준
    • 보건행정학회지
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    • 제33권3호
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    • pp.264-272
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    • 2023
  • Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

노인의 스트레스 인지가 전반적인 건강상태 및 구강건강상태에 미치는 영향 (Effect of perceived stress on general health and oral health status in elderly: results from the Korea national health and nutrition examination survey 2014)

  • 최은실;조한아
    • 한국치위생학회지
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    • 제17권5호
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    • pp.899-910
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    • 2017
  • Objectives: This study was conducted to identify the rates of perceived stress of elderly people over 65 years old and to confirm the influence of stress on general health and oral health status. Methods: Using data from the National Health and Nutrition Survey for 2014, 1,472 people over 65 years of age were selected as final subjects. Stress was used as an independent variable and dependent variables were included physical health (perceived health status), mental health (depression), and oral health (perceived oral health status). The following confounding variables were adjusted for the current study: demographic characteristics (gender, age, education level, house income) and health - related characteristics (drinking, smoking, exercise, frequency of tooth brushing, using oral care product, dental exam, comorbidity, restrict activity). Complex sampling analysis was applied and logistic regression was performed to determine the effects of stress on physical health, mental health and oral health status. Odds ratio (OR) and 95% confidence interval (95% Confidence Interval, 95% CI) were calculated. Results: Logistic regression indicated that stress was significantly associated with low physical health (OR=2.18, 95%CI: 1.49-3.20), low mental health (OR=8.68, 95%CI: 4.98-15.11), low oral health (OR=1.53, 95%CI: 1.06-2.21) after adjusting for confounding variables. Conclusions: The perceived stress of the elderly was found to be related to the general health and oral health status. Therefore, it is necessary to evaluate stress as a predictor of health risk for the health promotion of the elderly on multidisciplinary assessment and continuous evaluation. In addition, health support policies should be provided to achieve good health status for elderly.

유료 노인 낮보호 시설 모형개발에 관한 연구 (A Study on the Fee-Based Model Development of Day Care Centers for the Elderly)

  • 정신숙;정연강
    • 지역사회간호학회지
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    • 제10권1호
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    • pp.5-18
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    • 1999
  • The aim of this study is the development of a fee - based model day care center for the elderly by inquiring into the current condition of facilities in America and in Korea, and in surveying the opinion of domestic elderly about day care facilities. A field trip to U.S. day care services was held between July 5 and July 15 in 1997, and an on-the-spot study for domestic facilities took place during March in 1998. Our research reveals that the overall supply of day care facilities can not meet future demand in terms of quality and quantity. Therefore a model must be created for day care centers of a that consists of a director from a professional group. an adequate environment, and a standardized in order to offer a qualified public health service linked to the home and community in Korea. The director of a day care center is a critical variable in determining the quality of service. Professional skills related to the needs of the elderly and the person's quality of service should be considered in appointing director for the center. This study belleves that a professional nurse should be the director of a day care center. The operating environment of a day care facility should be made up of considerable space comparable to the number of residents, should be in a comfortable and safe location, and should have equipment that provides a qualified, safe service to the elderly. Our model is designed for 20 persons and allocates 4 Peng per person. This model is comprised of a reading room. a craft room, a health room, a room for physical therapy, a dining room, a staff office, and a multi -purpose room connected to other rooms. Day care service should be a comprehensive service program meeting the multidimensional needs of the elderly. A comprehensive service program needs a team of various professionals made up of the elderly family, participants, nurses, social workers, physical therapists, nutritionists, and medical doctors. The program will also include health care service, physical therapy, speech therapy. diet, occupational therapy, transportation service, health and an education program, etc. In conclusion, a model of a day care center is developed with the following components: a professional director and an environment and program, that considers the physical, mental, and social characteristics of the elderly. A model should also motivate self-reliance self-fulfillment in the elderly in order to fulfill their health needs and to prevent isolation from society and mental depression. Furthermore, This facility will be a beneficial factor in reducing a family's burden on caring for the elderly that includes unnecessary hospital expenses. The following is a suggestion based on results this study: A service program should be developed to fit the conditions of the elderly in Korea by specifically analyzing the needs of the elderly.

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신생아집중치료실 간호수가 산정을 위한 간호행위별 상대가치 산정 (Resource-Based Relative Value for Estimation of Nursing Behavior in Neonatal Intensive Care Units)

  • 문선영
    • Child Health Nursing Research
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    • 제12권1호
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    • pp.15-24
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    • 2006
  • Purpose: This study was done to define nursing behavior in neonatal intensive care units so as to estimate resource-based relative value-. Method: Participating in this study were 292 nurses in neonatal intensive care units. The study surveyed physical and mental labor, stress and time involved in nursing work. Tool used in this study was a nursing labor per relative value tool. For analyzes, the relative value of each nursing behavior was calculated, where the mean value of the three components, labor intensity and component-by-component explanatory power were in percentage terms. Results: 1. Nursing behaviors in neonatal intensive care unit were classified and defined at three levels: 5 main domains, 17 mid-domains, and 42 small domains. 2. The per component explanatory power of intensity involved in nursing labor showed physical effort to be 32.45%, mental 32.86%, and stress 34.69%. 3. The reliability of nursing labor factors was very strong, Cronbach's alpha value of 0.96. Conclusion: In this research, which is a first in defining nursing behavior in neonatal intensive care units, individual nursing behavior were broken down using resource-based relative value for nursing cost, and each nursing behavior was successfully translated to a numerical value.

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정신 및 건강요인이 장기요양 노인의 기능적 독립성에 미치는 영향 (The Effect of Functional Independence in Long Term Care Elderly People on the Mental and Health factor)

  • 신홍철;강정일;이경화
    • 대한물리치료과학회지
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    • 제15권1호
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    • pp.47-56
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    • 2008
  • The purpose of this study was to seek for a performance level of functional independence of the long term care elderly people. This study questionnaires 160 elders with 80 in a large city and 80 in small-to-medium sized city in order to find out the functional independence of elderly people. The results of this study were as follows. 1. Functional independence level following health factor; The comparison of degrees of functional independence level between two groups showed significant difference in sanitation, drinking and smoking, eating habit, chronic disease, physical activities, and regular physical examination(P<.05). But the comparison between two groups was not showed significant difference in present treatment, regular exercise. 2. Functional independence level following Psychological factor; The comparison of degrees of functional independence level between two groups showed significant difference in health evaluation(P<.05). But the comparison between two groups was not showed significant difference in quality of life. In conclusion it is needed that stable housing, much physical activities, and diversified family members should be realized and stable livelihood security recipients to maintain and improve health of the aged and to be socially satisfied.

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노인간병가족의 부담요인 및 부담완화를 위한 사회복지서비스와 실천방법의 효과에 관한 연구 (Factors of Caregiving Burden and the Effectiveness of Social Welfare Services for the Family Caregivers of the Impaired Older Persons)

  • 이인정
    • 한국사회복지학
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    • 제46권
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    • pp.319-348
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    • 2001
  • The primary purpose of this study is to examine the buffering effect of social welfare services on the relationship between the level of older persons' impairment and burden experienced by the family caregivers. It also assessed the level of caregiving burden as well as the effect of both older person's impairment and the characteristics of the caregivers on burden. The survey data collected from 150 community residing family caregivers was used for analyses. Findings are as follows. First, the caregivers are more burdened in the deterioration of mental health, scarce time for oneself, and the suffering of social life than in other areas of burden. Second, the more severe the physical and the mental impairment of the elder, the more burden the caregivers experience. The caregivers' characteristics such as the worse mental health, the lower level of attachment to the elder, the longer caregiving hours are also related to the higher level of caregiving burden. Third, the caregivers' use of adult day care and respite care services buffer the relationship between the level of impairment of older persons and the caregiving burden. However, social work counselling, visiting nurse, homemaker services do not have such buffering effects. Among informal support, instrumental support buffers the relationship between the elder's physical impairment and burden, while emotional support buffers the relationship between the elder's mental impairment and burden. According to the results, implication for social welfare services and practice methods for the family caregivers was discussed.

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일 지역에 거주하는 암환자의 삶의 질, 정신건강 및 주관적 건강상태 조사 (Survey on Quality of Life, Mental Health and Subjective Health Status of Community Dwelling Cancer Patients)

  • 이보영;조희숙;권명숙
    • 한국보건간호학회지
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    • 제24권1호
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    • pp.49-60
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    • 2010
  • Purpose: This study investigated the quality of life, mental health and subjective health status of community dwelling cancer patients. Methods: Subjects were 212 out-patients with cancer at Kangwon University Hospital. The study was conducted from July 10 to August 14, 2008. Quality of life as determined by the Euro Quality of life-5 Dimensions (EQ-5D) was measured using Korea Centers for Disease Control and Prevention(KCDC). Mental health and subjective health status were measured using KCDC. Results: EQ-5D determined degrees of difficulty were 25.5%(mobility), 25.2%(anxiety or depression), 23.6%(pain or discomfort), 20.3%(activities of daily living), and 13.7%(self care). An analysis of the association between several factors and mental health showed that the statistically significant factors were age, gender, medical coverage, and private insurance. An analysis of the association between several factors and subjective health status showed that the statistically significant factor was occupation. Conclusion: Cancer patients suffer from significant psychological distress. Programs that address mental and physical health would be beneficial.