• 제목/요약/키워드: 노인간호학

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Exploratory Study of Person Centered Care Practice in Korean Long-term Care Facilities using DCM(Dementia Care Mapping) as a tool (DCM(Dementia Care Mapping)을 활용한 한국 요양시설에서의 사람중심케어 실천의 탐색적 연구)

  • Kim, Dongseon
    • 한국노년학
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    • v.41 no.2
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    • pp.197-215
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    • 2021
  • This study aims to evaluate Person Centered Care practice and characteristics of care services in Korean long-term care facilities using Dementia Care Mapping as a tool. DCM, systematic observational evaluation tool for measuring dementia patients' QOL, was transformed into self-report rating scale. The process of transforming DCM into a scale of 34 items involves operationalization of DCM concepts and it's adaptation into Korean long-term care practices. Review by research team of Bradford university was added to maintain DCM concept and meaning in this scale. The scale with Cronbach alpha of .88 was surveyed on 343 care workers. Survey result shows PCC value practiced by them is 3.77(of 5 likert scale) and values on each categories of PCC reveal the characteristics of care in Korean facilities; attachment(4.02), comfort(3.95), inclusion(3.89), identity(3.67) and occupation(3.41). Dementia care in Korean facilities focuses on recipients'safety, comfort but lacks individualistic care and the meaningful and fulfilling occupation for patients. Looking at the organizational and individual factors influencing DCM values, the small facilities showed higher PCC values and there are no significant difference in PCC values between public and private facilities. Managers and care workers with career of 1~2 years showed higher PCC values compared to other career ranks and lengthes. This study suggests care practice should be centered on personhood of patients in long-term care facilities, for which introduction of unit care and education of PCC for service providers including support personnel are needed. DCM and Korean DCM scale developed in this study are suggested for the PCC-based assessment on care quality.

Influence of Community Contextual Characteristics on Community Differences of Mental Health (지역사회 상황적 특성이 지역사회 간 정신건강 차이에 미치는 영향)

  • Kim, Jae-Hee
    • Journal of the Korean Applied Science and Technology
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    • v.35 no.4
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    • pp.1285-1294
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    • 2018
  • The purpose of this paper was to identify the relationship between the characteristics of community mental health, and to identify if mediatable contextual property acts as factor influencing community mental health. Data of 229 municipal population groups were collected from KNSO and The 6th Community Health Plan. The data were analyzed using ANOVA, Spearman correlation, and multiple regression analysis. The perceived stress showed significant difference depending on health budget, mental health budget, number of mental health personnel, and was negatively correlated with proportion of the elderly, employment rate, percentage of NBLS recipients, health budget, and number of mental health personnel. The depressive mood differed depending on the number mental health personnel, and was negatively correlated with percentage of NBLS recipients and number of mental health personnel. Mental health budget and number of mental health personnel were respectively influencing factor of perceived stress and depressive mood. Following the above result, in order to reduce the gap between the mental health of communities, the researcher suggests that mental health budget as well as overall health budget and the number of mental health personnel be enforced.

A Correlation Study on Spiritual Wellbeing, Hope and Perceived Health Status of the Elderly (노인의 영적안녕, 희망 및 지각된 건강상태에 관한 연구)

  • Sung, Mi-Soon;Kim, Chung-Nam
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.53-69
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    • 1999
  • A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the elderly. 195 respondents who lived at their homes and 148 respondents who lived at the facilities for elders such as nursing homes and elder's rehabilitation centers were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale, Nowotny(1989)'s hope scale and Northern Illinois University's health self rating scale was used. From August 10th to August 25th, 1998, ready made questionnaires were handed out by researcher to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the elders was 42.27($SD{\pm}9.67$) in a possible range of 20-80. The average point of spiritual wellbeing was 2.11($SD{\pm}0.97$) point to 4 point full marks. The mean score of religious wellbeing was 21.37($SD{\pm}7.02$) and that of existential wellbeing was 20.90($SD{\pm}4.63$) in a possible range of 10 - 40. The average point of religious wellbeing was 2.14($SD{\pm}0.70$)points and existential wellbeing was 2.09($SD{\pm}0.46$) points to 4 point full marks. 2. The mean score for hope was 67.16($SD{\pm}12.28$) in a possible range of 29-116. The average point of hope was 2.31($SD{\pm}0.42$) points to 4 point full marks. 3. The mean score for perceived health status was 8.72($SD{\pm}2.49$) in a possible range of 4-14. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.5209, p=0.0001). 5. In testing the hypothesis concerning the relationship between spiritual wellbeing and perceived health status, there was a statistically positive correlation(r=0.1427, p=0.0081). 6. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.2797, p=0.0001). 7. There were significant differences in spiritual wellbeing according to sex, religion, and present occupation. 8. There were significant differences in hope according to residential places, age, religion, educational level, family status, average monthly pocket money. 9. There were significant differences in perceived health status according to residential places, sex, age, educational level, present occupation and family status. From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, spiritual wellbeing and perceived health status, hope and perceived health status. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, elder's perceived health status also can be improved.

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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Elderly people's understanding level of their life style in next generation (차세대 노인의 노후생활 형태 인식에 관한 연구)

  • Kim, Hee-Chung;Chung, Yeong-Kang;Gwun, Young-Mi
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.211-224
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    • 1997
  • The purpose of this study is to find a solution to effectively nurse elderly people in the aging society of next generation by analyzing relationship among the social problem of elderly people in the future society, their preferred life style, and their understanding level of an asylum for the aged. Data for this study were collected by questioning 316 persons(257 visitors at C University hospital and 59 residents in Chun - Ra Nam Do) from December 1996 to March 1997. The results were as follows: The assumption that an individual's preferred life style at old age depends on his /her understanding level of the social problem of elderly people was verified ($X^2=9.75$, p<0.00). The assumption that one's understanding of an asylum for the aged depends on his /her understanding level of the social problem of elderly people was verified ($X^2=4.40$, p<0.05). The assumption that one's understanding of an asylum for the aged depends on his/her pre-ferred life style at old age was verified($X^2=34.51$, p<0.01). Among those who want to live together with children when they get old, the following differences in their conception were noted: Elderly people who has lost his /her wife /husband should marry again(p<0.01). Children should take care of their parents(p<0.01). Children should live with their parents(p<0.01), A desirable living style for an elderly people. An undesirable living style for an elderly people. Among those who want to live alone when they get old, the following differences were observed: It is okay for children to live separately from their parents as long as they provide financial support(p<0.01). Any child, regardless of the distinction of sex or the order of birth among siblings, can take care of his/her parents(p<0.05), It is desirable for an elderly people to live alone (p<0.01). It is undesirable for an elderly people to live in an asylum for the aged(p<0.05). It was verified that those who view an asylum for the aged in a negative way believe that children should take care of their parents. Also, it was verified that those who view an asylum for the aged in a positive way believe that children should provide financial support to their parents even though they do not live together(p<0.01). Regardless of the subjects' opinions on seriousness of the social problem of elderly people, the assumption that any child, regardless of the distinction of sex or the order of birth among siblings, can take care of his/her parents was verified(p<0.01) (p<0.05). Regardless of the subjects' view on asylum for the aged, the assumption that it is undesirable place for an elderly people to live was verified (p<0.01). The assumption that one's understanding of an asylum for the aged depends on the distinction of sex among general characteristics such as sex, age, educational background, occupation, and religion was verified(t=-2.82, p<0.01). The assumption that an individual's preferred life style at old age depends on the distinction of sex among general characteristics such as sex, age, educational background, occupation, and religion was verified(t=l.68, p<0.l).

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The Correlation Among Health Status, Burden and Quality of Life of the Adult Stroke Patient's Family and the Elderly Stroke Patient's Family (노인층과 청·장년층 뇌졸중 환자가족의 건강상태·부담감 및 삶의 질과의 관계)

  • Kim, Kwuy-Bun;Lee, Kyung-Ho
    • Korean Journal of Adult Nursing
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    • v.13 no.2
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    • pp.262-276
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    • 2001
  • The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.

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