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뇌졸중 이환 노인의 일상생활수행능력 변화에 미치는 영향: 장기요양 재가 서비스와 시설 서비스를 중심으로

Factors Associated with the Changes in Activities of Daily Living in Older Adults with Stroke: A Comparison of Home Care and Institutional Care

  • 정운숙 (경동대학교 작업치료학과) ;
  • 임은실 (대구보건대학교 간호학과)
  • 투고 : 2016.10.25
  • 심사 : 2016.12.11
  • 발행 : 2016.12.31

초록

Purpose: To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care. Methods: This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC. Results: All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years. Conclusion: The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.

키워드

참고문헌

  1. Statistics Korea. Trend of stroke prevalence. [Internet]. Daejeon: Statistics Korea. 2015 [cited 2016 July 20]. Available from: http://kosis.kr/wnsearch/totalSearch.jsp
  2. Kim MH, Jung YH, Lee DH. Cardiovascular diseases prevention and control campaign, 2015. Public Health Weekly Report. 2015;8(39):925-928.
  3. Kwon YD, Chang HJ, Choi YJ, Yoon SS. Nationwide trends in stroke hospitalization over the past decade. Korean Medical Association. 2012;55(10):1014-1025. http://dx.doi.org/10.5124/jkma.2012.55.10.1014
  4. Kim HS, Kim JM, Yim HS, Hong JS, Ha DS, Kwon JB. Efficient recycling based on research generated through the use of analysis of acute care stroke patients. Goyang: National Health Insurance Service Ilsan Hospital; 2015 December. Report No.: 2015-20-023.
  5. Dewey HM, Thrift AG, Mihalopoulos C, Carter R, Macdonell RA, McNeil JJ, et al. Informal care for stroke survivors: Results from the North East Melbourne Stroke Incidence Study (NE MESIS). Stroke. 2002;33(4):1028-1033. https://doi.org/10.1161/01.STR.0000013067.24300.B0
  6. Kang EJ, Kim DJ, Sun YD, Yoon SS. Development of health care system for the elderly with medical expenditure analysis. Seoul: Korea Institute for Health & Social Affairs; 2006 December. Report No.: 2006-05.
  7. Hyun KR, Lee SM. Effects on the functional status changes of LTC (Long Term Care) services. Journal of the Korean Gerontological Society. 2012;32(2):593-609.
  8. Lee SJ, Kwak CY. Effects of visiting nursing services in longterm care insurance on utilization of health care. Journal of Korean Academy Community Health Nursing. 2016;27(3):272-283. http://dx.doi.org/10.12799/jkachn.2016.27.3.272
  9. National Health Insurance Service. Statistical yearbook of longterm care insurance for the elderly. Seoul: National Health Insurance Service; 2015. 685 p.
  10. Yoon JY, Lee JY. Development of outcome indicators of urinary incontinence for quality evaluation in long term care hospitals. Journal of Korean Academy Nursing. 2010;40(1):110-118. http://dx.doi.org/10.4040/jkan.2010.40.1.110
  11. Mitchell JB. Patient outcomes in alternative long-term care setting. Medical Care. 1978;16(6):439-452. https://doi.org/10.1097/00005650-197806000-00001
  12. Market KD, Popejoy L, Petroski G, Mehr D, Rantz M, Lin WC. Clinical outcomes of aging in place. Nursing Research. 2005;54(3):202-211. https://doi.org/10.1097/00006199-200505000-00008
  13. Braun KI, Rose CL, Finch MD. Patient characteristics and outcomes in institutional and community long-term care. Gerontologist. 1991;31(5):648-656. https://doi.org/10.1093/geront/31.5.648
  14. Lee TW, Cho EH, Yim EH, Lee HS, Ko YK, Kim BN, et al. Activities of daily living in nursing home and home care settings: A retrospective 1-year cohort study. The Journal of Post-Acute and Long-Term Care Medicine. 2015;16(2):114-119. http://dx.doi.org/10.1016/j.jamda.2014.07.013.
  15. Park CJ. Cost-effectiveness analysis of long-term care services: care in institution vs in-home care. Journal of Welfare for the Aged, 50, 145-172.
  16. You HJ, Lee HY, Kim KA, Jo JH, Kim DH. Strengthening longterm care facility services expertise. Seoul: National Health Insurance Service; 2013 November 30. Report No.: 2013-12.
  17. Kown JH, Han EJ, Lee JS. Long-term care services payroll management improvement. Research Report. Seoul: National Health Insurance Corporation; 2009 December. Report No.: 2009-33.
  18. Lee TW, Yim EH, Cho EH, Chung JN. Cognitive function, behavioral problems, and physical function in long-term care insurance beneficiaries with dementia in south Korea: Comparison of home care and institutional care services. Journal of the American Geriatrics Society. 2014;62(8):1467-1475. http://dx.doi.org/10.1111/jgs.1294
  19. Lee KG, Cho EH. Activities of daily living and rehabilitation needs for older adults with a stroke: A comparison of home care and nursing home care. Japan Journal of Nursing Science. 2016;7:1-9. http://dx.doi.org/10.1111/jjns.12139
  20. Kane RL, Chen Q, Finch M, Blewett L, Burns R, Moskowitz M. Functional outcomes of posthospital care for stroke and hip fracture patients under medicare. Journal of American Geriatric Society. 1998;46(12):1525-1533. https://doi.org/10.1111/j.1532-5415.1998.tb01537.x
  21. Kane RL, Chem Q, Blewett LA, Sangl J. Do rehabilitative nursing homes improve the outcomes of care? Journal of American Geriatric Society. 1996;44(5):545-554. https://doi.org/10.1111/j.1532-5415.1996.tb01440.x
  22. Mun BM, Lee YS, Lee BH. The relationship between the patient's health beliefs and the implementation of functional movement rehabilitation and ability to perform ADL in stroke patients. Journal of the Korea Academia-Industrial Cooperation Society. 2012;13(7):3057-3064. http://dx.doi.org/10.5762/KAIS.2012.13.7.3057
  23. Hwang HJ, Lee KY, Kim SH. Physical and emotional status of nursing home residents: long-term care of older people via Incheon nursing home network study. Journal of Korean Geriatric Society. 2010;14(3):139-146. http://dx.doi.org/10.4235/jkgs.2010.14.3.139
  24. Boyd M, Broad JB, Kerse N, Foster S, von Randow M, Lay-Yee R, et al. Twenty-year trends in dependency in residential aged care in Auckland, New Zealand: A descriptive study. Journal of American Medical Directors Association. 2011;12(7):535-540. http://dx.doi.org/10.1016/j.jamda.2011.01.014
  25. Hwang EH, Jung DY, Kim MJ, Kim KH, Shin SJ. Comparison of frequency and difficulty of care helper jobs in long term care facilities and client homes. Journal of Korean Public Health Nursing. 2012;26(1):101-112. http://dx.doi.org/10.5932/JKPHN.2012.26.1.101
  26. Jette DU, Warren RL, Wirtalla C. Rehabilitation on skilled using facilities: Effect of nursing staff level and therapy intensity on outcome. American Journal of Physical Medicine Rehabilitation. 2004;83(9):704-712. https://doi.org/10.1097/01.PHM.0000137312.06545.D0
  27. Lee JS, Han EJ, Lee HY, Lee JS. The report on incentives institution improvement measurements for improving the quality of long-term care services. Seoul: National Health Insurance Service; 2012 November 30. Report No.: 2012-17.
  28. Lee MK, Kim EK. Relationship between resource utilization and long-term care classification level for residents in nursing homes. Journal of Korean Academy Nursing. 2010;40(6):903-912. http://dx.doi.org/10.4040/jkan.2010.40.6.903
  29. Yang YA, An SJ, Park YH, Park BR, Heo J, Park JS, et al. A study of visiting rehabilitation service and implementation method. The Journal of Korea Association Occupational Therapy Policy for Aged Industry. 2011;3(1):59-70.
  30. Lee SG, Kwak CY. The effects of visiting nursing services in long-term care insurance. Journal of Korean Academy Community Health Nursing. 2016;27(3):272-283. http://doi.org/10.12799/jkachn.2016.27.3.272

피인용 문헌

  1. 국내 방문간호 연구동향 분석 연구 vol.9, pp.11, 2016, https://doi.org/10.22156/cs4smb.2019.9.11.071
  2. 재가장기요양기관 방문간호사의 간호 경험 vol.19, pp.11, 2016, https://doi.org/10.5392/jkca.2019.19.11.603
  3. Profile of Long-Term Care Recipients Receiving Home and Community-Based Services and the Factors That Influence Utilization in Taiwan vol.17, pp.8, 2016, https://doi.org/10.3390/ijerph17082649
  4. Examination of the Educational Needs of Home Visit Nurses: A Cross-Sectional Descriptive Study vol.18, pp.5, 2016, https://doi.org/10.3390/ijerph18052319