• 한국콘텐츠학회논문지
• /
• 제13권4호
• /
• pp.170-186
• /
• 2013

인구가 고령화되면서 전체 인구의료비 가운데 고령인구에 지출되는 의료비의 비중은 증가하여, 건강보험 의료급여 등의 재정을 압박하는 경향은 갈수록 심화될 전망이다. 노인성 질환으로 인해 의료비용 부담이 증가함으로서 사회적 문제로 발전됨에 따라 노인보건의료의 현황을 분석하고, 현행 관련법제도를 살펴보고 문제점을 도출하고자 하였으며, 외국의 노인보건실태와 동향을 토대로 시사점을 도출하여 우리나라에의 법제도적 개선방안을 제시하고자 하였다. 그 결과 현행 노인보건의료보장의 관련법 체계의 문제점, 현행 노인장기요양보험법상의 문제점을 도출하였고, 법적 개선방안으로서는 건강보험의 보장성 강화, 장기 요양보험료 재정의 건전성 확보문제, 노인복지와 장기요양보험제도의 연계와 상호보완 기능을 강화, 치료요양에 대한 노인장기요양보험제도와 노인복지법의 중복성 문제, 등급판정체계의 개선, 재가서비스 지원강화 등 노인의 특수성을 반영하여 의료서비스의 질적 수준의 개선이 필요하다고 보고 노인장기요양법제의 개선과제를 제기하는 등 노인의료서비스의 지원확대 방안을 제시하였다. 노인을 대상으로 하는 중증응급 의료서비스의 질을 제고하기 위해서는 적정 응급의료자원의 확보뿐만 아니라, 그 효율적 운영체계의 마련도 필요하다. 아울러 급증하고 있는 노인의료비에 대응하기 위해서 "노인의 의료확보에 관한 법률"을 제정할 필요성을 제시하였다.

• 대한간호학회지
• /
• 제38권6호
• /
• pp.853-865
• /
• 2008

Purpose: The aim of this study was to develop and to analyze the task of gerontological nurse practitioners (GNPs) in Korea. Methods: The definition of GNP and job description was developed based on developing a curriculum (DACUM) by 7 panels who have experienced in DACUM analysis and gerontological nursing. One hundred sixty nurses who were working at long term care facilities were participated. The questionnaire included frequency, importance, and difficulty of duties, tasks, and task elements. The data were collected in November 2006, analyzed by descriptive statistics. Results: The job description of GNPs in Korea revealed 5 duties, 23 tasks, and 86 task elements. On the all five duties, the highest duty in frequency and in importance was professional nursing care ($3.25{\pm}0.35$, $3.49{\pm}0.29$). But the highest duty in difficulty was research ($3.24{\pm}0.46$). 'Prevent health problem ($3.42{\pm}0.43$, $3.56{\pm}0.33$)', 'Teach other staffs ($2.83{\pm}0.77$, $3.39{\pm}0.43$)', 'Develop the evidence-based standards ($2.43{\pm}0.76$, $3.22{\pm}0.43$)', 'Develop the self ($2.81{\pm}0.65$, $3.26{\pm}0.42$)', and 'Participate the team activities' were the highest score in frequency and in criticality of tasks. 'Provide emotional support to older adults and families ($3.16{\pm}0.41$)', 'Counsel older adults and their families ($3.14{\pm}0.49$)', 'Do clinical research ($3.32{\pm}0.49$)', 'Quality insurance ($3.25{\pm}0.49$)', and 'Build collaborative system ($3.18{\pm}0.47$)' were perceived the most difficult tasks. Conclusion: The political efforts for the legislation of role and task of GNPs were needed.

• 보건의료생명과학 논문지
• /
• 제9권1호
• /
• pp.95-102
• /
• 2021

본 연구는 강원도 영북권역에 소재하는 모든 의료기관을 대상으로 지역주민 중 65세 이상 노인인구의 의료기관 이용도를 2003년부터 2017년까지 입원 질환을 '요양병원을 포함'과 '요양병원을 제외'로 나누어 분석하였다. 그 결과 영북권역 노인인구 입원이용(요양병원 포함)에서 고혈압과 치매, 근골계 질환, 소화기계 질환, 기타 질환 순으로 차지하고 있으며, 노인인구 입원이용(요양병원 제외)의 경우 고혈압을 포함하는 혈액·순환기계 질병, 소화·비뇨기계 질환, 정신질환, 기타 질환 순으로 나타났다. 따라서 노인들의 치료 및 건강관리가 매우 중요하며 이를 위한 공공 의료조직의 확충이 필요하며 이를 위해 지역 내 의료기관, 단체, 대학 등과 거버넌스 구축이 필요하며 이를 바탕으로 강원도 영북지역 노인의 건강한 삶을 유지 할 수 있도록 예방적 차원의 보건사업이 수행되어야 한다.

• 대한간호학회지
• /
• 제49권1호
• /
• pp.26-35
• /
• 2019

Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

• 한국콘텐츠학회논문지
• /
• 제21권3호
• /
• pp.114-120
• /
• 2021

인간의 주거 영역에 있어서 가구는 필수적인 요소이며 특히 다양하고 유연한 배치와 공간의 성격을 명확하게 구분하고 디자인의 통일성 추구에 적합한 시스템가구의 필요성은 점차 확대되어 가고 있다. 우리나라의 고령인구는 현재 15%를 상회하고 있으며 2050년에는 약 40% 가까이 될것으로 전망되고 있다. 증가하고 있는 노인세대는 정보의 공유와 건강관리, 자녀로부터의 독립을 추구하는 등의 기존과는 다른 행동적 양식을 보여주고 있다. 독립적인 일상 생활의 유지를 위해 안정적 주거환경은 필수가 되었으나 인지능력 및 신체적 능력의 저하로 인해 가구로 인한 안전사고가 증가한다는 연구결과로 볼 때 이에 맞는 가구의 필요성이 증가하였다. 따라서 고령인의 생물학적 변화와 특성을 파악하고 시스템가구의 개념정의, 범위 및 한계를 연구하였다. 또한 가전시장의 변화와 가전시장의 트렌드를 파악하여 고령세대가 요구하는 시스템가구의 디자인 방향성을 제시하였다.

• 대한간호학회지
• /
• 제30권3호
• /
• pp.776-790
• /
• 2000

Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups：33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

• 한국치위생학회지
• /
• 제12권4호
• /
• pp.839-848
• /
• 2012

Objectives : Oral care is important for workers and Korean adults to improve the quality of life and perform economic activities. This study was conducted to prepare the basic data to establish the management system for adult oral health by looking into characteristics by ages and the genders questingly. Methods : Oral health examination was conducted on workers in 2009 in the city of Gwangju and Chonnam province. This analysis was extracted using SPSS(SPSS 12.0 for windows, SPSS Inc, Chicago, USA). Results : Among the study respondents, 39.5% workers and 47.7% Korean adults answered their subjective oral health is not good, but there was no statistically significant difference between them(p< $0.001^{***}$). 39.9% workers and 2 0.6% Korean adults were smokers, and they showed a statistically significance in the ages and genders (p< $0.001^{***}$). 91.2 %workers and 49.8% Korean adults brushed their teeth before going to bed, and they showed a statistically significance in the ages and genders(p< $0.001^{***}$). In terms of the gender, male workers and Korean female adults showed high frequency of use, and both workers and Korean adults aged 18-24 showed high frequency with regard to the age. Regarding the use of oral care items, 36.0% workers and 16.9% Korean adults used them, and a statistical significance was shown in both the gender and age(p< $0.001^{***}$). In terms of the gender, female workers and Korean female adults showed high frequency of use and in terms of the age, 45-54 age bracket workers and 30-34age bracket Korean adults used the items frequently. 28.0% workers and 30.7% Korean adults answered that their mastication among oral functions is uncomfortable, and 8.8% workers and 6.5% Korean adults responded that it is hard to pronounce. They were statistically significant in the gender and age(p< $0.001^{***}$). Workers and Korean female adults expressed their mastication discomfort and men expressed that they have a difficulty in pronouncing. In terms of the age, the 54-64 age bracket workers and Korean adults express their inconvenience of mastication and pronunciation. Conclusions : According to the above findings, it needs to build the economical and efficient adult oral health care system in order to enhance both workers and Korean adults' oral health.

• 한국식품영양학회지
• /
• 제22권1호
• /
• pp.141-149
• /
• 2009

본 연구의 분석결과, 컨조인트 도출모형의 적합성은 Pearson's R은 0.420, Kendall's tau는 0.402(<0.05)로 나타나 도출된 모형은 적합한 것으로 판정되었다. 급식서비스 속성에 대한 중요도는 영양사와의 상담이 51.2%로 가장 높았으며, 배식원의 서비스가 48.7%, 음식의 조리법이 0.1% 순으로 조사되었다. 급식서비스 각 속성의 효용성을 세부적으로 살펴보면 음식 의 경우 '부드러운 조리법 음식의 효용성'이 0.001로서 '일반적인 다양한 음식' -0.001보다 선호되고 있었다. 다음 배식원의 경우 '친절한 배식원의 서비스'가 0.086으로서 '신속한 배식원의 서비스' -0.086보다 선호되는 것을 보여주고 있다. 마지막으로 영양사 상담은 '주 1회'가 -0.138로서 '주2회' -0.2 6보다 선호되는 것을 나타내고 있다. 즉, '부드러운 조리법의 음식/친절한 배식원의 서비스/주 1회 영양사 상담'이 노인의료전문 병원의 환자들로부터 가장 선호되는 급식 서비스 프로파일로 나타나고 있다. 결론적으로 응답자들이 급식서비스를 선택할 때 가장 중요시 하는 속성은 영양사와의 상담(51.2%) 이었으며, 다음으로 배식원의 서비스(48.7%)이었다. 반면 음식의 조리법에 대한 중요도는 0.1%로서 음식의 조리법 자체는 급식서비스를 선택/선호하는 데에 거의 영향을 미치지 않으며, 그보다는 영양사의 상담과 배식원의 배달 서비스가 더욱 중요한 요인으로 파악되었다. 결과적으로 가상의 급식서비스 선호도 모델로써 제시된 8개의 모델에서 일반적인 조리방법, 친절한 말과 미소를 건네는 배식원의 서비스, 주 1회 담당 영양사와의 상담을 제시한 3번 모형이 가장 선호되는 것으로 조사되었다. 노인의료전문 병원 급식서비스의 중요 요소를 파악한 후 가상적인 급식소에 대한 상대적 중요도를 파악을 위한 컨조인트 분석을 실시하였다. 컨조인트 분석은 특정 제품이 가지고 있는 각각의 속성에 고객이 부여하는 효용을 추정함으로써, 고객이 선택할 제품을 예측하기 위한 기법으로 서로 다른 제품 속성에 대한 고객의 중요한 관점을 제시해 준다$^{26)}$. 즉 병원 급식에서 환자들은 정보를 얻고 가능한 대안들을 알고 난 후, 선택 속성의 패턴을 정의하여 이것을 급식소의 결정에 이용할 수 있게 된다. 노인의료전문 병원에서 급식서비스는 치료의 한 분야로써 그 중요성이 증가되고 있으며, 병원에 입원한 환자들을 위한 급식 서비스는 진료외적인 서비스의 한 요소로써 노인급식서비스의 향상을 위한 노력과 품질관리의 중요성이 부각되고 있다. 그러므로 본 연구에서 도출된 노인급식서비스 가상 모델은 노인의료전문 병원에서 행하여지는 급식서비스의 최적화 품질관리를 위하여 이용될 수 있을 뿐만 아니라 만족도 제고를 위하여 사용될 수 있을 것으로 사료된다.

• 한국임상약학회지
• /
• 제28권3호
• /
• pp.167-173
• /
• 2018

Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.

• 한국실내디자인학회논문집
• /
• 제19권2호
• /
• pp.225-233
• /
• 2010

At this point in time South Korea is rapidly metastasizing to a aging society. A major cause of aging can be summarized as increased life expectancy, decrease of nuclear family and birthrate, and South Korea's progress is faster than any other country. From the 1970s, western society has changed social welfare to deinstitutionalization and community care because of problems about economic reason and facilities protection, so the type of elderly social service has also changed from the facility welfare service which is accommodated old people in certain facility to community welfare service which provides various welfare services with living together. Public facilities for low income group which are supported by government are lower, 6.6%, than the United States or Japan, 50%. They are divided into private manage facilities and subscription elderly facilities. These subscription elderly residential facilities show poor administration because of focusing on development and market analysis for investment returns. Therefore, in order to vitalize the elderly welfare residential facilities in Korea, we need plans about systematic services facilities for welfare and phased medical treatments. Therefore, the purpose of this study is that (1) the types and functions of residents for community elderly residential facilities in elderly welfare policies of U.S., and supported policies are researched as a transcendental model, (2) data about operating system with the principles of the market is analyzed, and (3) basic data about welfare facility plan for community residential elderly people is provided.