• 가정∙방문간호학회지
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• 제9권2호
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• pp.114-128
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• 2002

In order to provide information for the establishment and maintenance of a rehabilitation day care center for stroke patients. this study is to assess needs for the rehabilitation day care center of the stroke patients and to identify the factors influencing the needs for the center. The data were collected face-to-face interview with 223 stroke patients. using a structured questionnaire. from September 24. 2001 to November 20. 2001. Major findings are as follows. 1. Most of the participants($94.6\%$) needed rehabilitation day care center for stroke patients. $95.5\%$ of participants were willing to use the rehabilitation day care center. 2. Also the score of the needs for the center's health services was $2.84\pm60$ out of 4.00. In regards to the sub-contents. while the physical exercise therapy showed the highest mark($3.54\pm71$) in the needs. the following marks showed physical therapy($3.48\pm79$), training for the memory. thinking and judgment($3.30\pm93$). training for ADL($3.09\pm99$). health education program($3.04\pm93$). In the meantime. the expected effects from the use of the center are $2.89\pm61$ out of 4 and its sub-contents showed that the center would promote their physical and mental well-being($3.30\pm74$) and the center would be more effective than in home care($3.12\pm70$). 3. Meanwhile. the desired frequency of use in the future and distance had significant interrelation with their families living together(p<.05). In addition those who paid to use it differentiated significantly according to their ages and the types of insurance they had(p<.05). 4. The needs in degrees of speech disorder therapy and hobbies & amusements. the patients with other disease had significantly higher degrees than those patients without it (p<.05). Also in regard to the need degrees for physical therapy. healthy education programs and individual counseling including their families. the degrees of the patients with speech disorders were significantly lower than those of the patients without the disorder (p<.05). On the other hand. the patients with speech disorders were significantly higher than those patients without it in the need degree of the speech disorder therapy (p=.000). And the needs in degree concerning about speech disorder therapy. physical exercise therapy. training for ADL. medicinal substances therapy and family education were negatively correlated with the ADL (r=-.236$\sim$.305, (p<.005). 5. Finally. the expected effect of using the rehabilitation day care center showed significant differences statistically according to whether or not they had other disease (p<.05). In conclusion. the study showed the stroke patients were willing to use the center and had a high requirements for it and they especially had relatively high need degrees for the physical exercise therapy. physical therapy. training for memory. thinking and judgment. and healthy education program. And significant factors for the use of the center were their ages. types of insurance. family cohabitation. complications and speech disorders. ADL and so forth. Accordingly. the rehabilitation day care center needs to be established for the stroke patients and the center should develop rehabilitation care programs. which are individual and special programs customized for each patient's characteristics and health conditions.

• 디지털융복합연구
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• 제18권2호
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• pp.351-360
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• 2020

이 연구는 노인케어종사자를 대상으로 한 노인케어 전문 온라인 교육프로그램을 개발하기 위해 실시하였다. 연구자료는 2019년 11월28일부터 12월 15일까지 K사이버대학교에 재학 중인 노인케어종사자를 대상으로 실시하였다. 자료분석은 카이제곱검정, ANOVA를 사용하였고 사후분석으로는 scheffe method를 사용하였다. 연구결과 노인케어 전문교육 요구도는 요양보호사가 간호조무사보다 유의하게 높았다. 노인케어 온라인 교육요구도 사회복지사가 간호조무사보다 유의하게 높았다. 수행도에서 '노인에 대한 이해와 상담'과 '노인 놀이프로그램 실제'는 사회복지사, 요양보호사, 간호조무사순 이었고, 실습 교육 요구도에서 '치매와 호스피스 및 웰다잉교육'는 사회복지사가 높은 요구도를 보였다. 결론적으로 노인전문케어 필요성 및 노인케어 온라인 교육의 요구도에 따른 각 군별 맞춤형 전문화된 온라인 교육을 위한 콘텐츠 개발이 필요하며 추후 효과를 검증하는 중재 연구가 필요하다고 생각된다.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.260-269
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• 2018

본 연구의 목적은 장기요양시설에 거주하는 치매 노인의 욕구를 대상자와 간호제공자의 관점에서 각각 평가함으로써 치매 노인의 실제적인 욕구를 반영한 중재를 제공하기 위함이다. 본 연구에는 3개의 노인전문병원에서 총 145명의 치매 노인과 62명의 간호사들이 참여하였다. 치매 노인의 충족된 욕구 및 미충족된 욕구는 Camberwell Assessment of Need for the Elderly(CANE) 도구를 이용하여 평가하였다. 치매 노인 대상자의 인지기능, 정신행동상태, 일상생활수행능력(ADL), 도구적 일상생활수행능력(IADL)을 측정하여 총 욕구의 개수와의 상관관계를 파악하였고, 다중회귀분석 방법을 이용하여 욕구에 미치는 영향요인을 파악하였다. 연구결과, 치매 노인이 평가한 평균 욕구의 개수는 11.94개였으며, 평균 미충족 욕구의 개수는 2.91개였다. 반면 간호사들이 평가한 치매 노인의 평균 욕구의 개수는 14.71개였으며, 이중 미충족 욕구는 평균 1.94개였다. 가장 많은 수의 치매 노인들이 미충족 욕구로 인식한 영역은 낮 시간 활동 영역이었다(42.2%, n=61). 반면 간호사들의 경우 24.1%(n=14)만이 이 영역에 대한 욕구가 미충족 되었다고 평가하여 두 집단 사이에 차이가 있음을 나타내었다. 치매 노인의 총 욕구의 수에 유의하게 영향을 미치는 요인은 IADL과 ADL 수준이었다. 따라서 장기요양시설의 간호제공자들은 치매 노인의 충족 및 미충족 욕구 평가시 대상자의 관점을 반영하여 이를 바탕으로 간호의 우선순위를 설정해야 하며, 대상자들의 일상생활 수행에 충분한 도움을 주어야 하겠다. 향후 지역사회 치매 환자 및 보호자를 대상으로 치매 환자의 욕구 평가 연구가 필요하다.

• 한국콘텐츠학회논문지
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• 제17권11호
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• pp.435-445
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• 2017

본 연구는 단순 의료이용의 차이를 확인하거나 제한적인 의료필요와 의료이용지표를 활용하여 의료이용의 형평성을 연구한 선행연구의 한계를 극복하기 위하여 수행되었다. 구체적으로 의료필요지표로 활동제한여부, 만성질환이환여부와 수, 주관적 건강상태를 활용하였고 의료이용지표로 외래와 입원, 응급이용횟수와 진료비를 활용하였다. 아울러 의료필요를 고려한 의료이용의 형평성을 분석하기 위하여 집중지수와 집중곡선, Le Grand계수를 활용하였다. 주요 분석결과, 첫째 단순한 의료이용 집중정도로 볼 때 저소득층의 의료이용량이 고소득층에 비해서 많은 것이다. 특히, 저소득층 입원이용이 외래나 응급이용에 비해서 크게 많았다. 둘째, 저소득층에게 의료필요가 집중된 것으로 나타났다. 즉, 저소득층의 건강상태가 좋지 않은 것이다. 셋째, 의료필요를 고려한 의료이용의 형평성을 확인하기 위하여 Le Grand계수를 산출하였다. 의료필요를 고려하더라도 고소득층의 의료이용량이 많았다. 즉, 단순한 양적인 의료이용은 저소득층의 이용이 많았지만, 의료필요를 고려한 의료이용횟수는 고소득층이 많은 것이다. 또한, 전체진료비는 활동제한여부와 만성질환수를 고려했을 때는 고소득층의 의료이용이 많았으며 주관적 건강상태와 만성질환이환여부를 고려하였을 때는 저소득층의 의료이용이 많았다. 따라서 대체로 저소득층이 건강상태에 비해 의료이용을 충분히 하지 못하는 것을 알 수 있었다. 한편, 저소득층의 주관적 건강상태와 만성질환이환여부 관련 의료필요에 비해 의료비지출이 많았는데 이는 저소득층이 스스로의 건강상태와 만성질환이환에 대한 인식을 소극적으로 함으로써 의료필요가 과소평가된 것이 원인으로 사료된다.

• 한국치위생학회지
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• 제20권5호
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• pp.571-580
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• 2020

Objectives: This study aimed to investigate the factors associated with unmet dental needs among adults with activity limitations. Methods: Data were obtained from the seventh Korean National Health and Nutrition Examination Survey (KNHANES). The final sample consisted of 945 adults aged 20 years or older with limited activity. Logistic regression analysis was used to examine the influence of predisposing, enabling, and need factors on unmet dental needs. Results: The proportion of adults with unmet dental needs during the last year was 52.2% in the middle-aged group and 45.5% in the older adult group. Higher household income was associated with fewer unmet dental needs in both groups. In the older adult group, married people were less likely to have unmet dental needs. In the middle-aged group, adults who perceived their oral health as poor were more likely to have unmet dental needs. Conclusions: All three factors (predisposing, enabling, and need) were found to be associated with unmet dental needs among adults with activity limitations. Special efforts should be made to improve access to dental care services for middle-aged adults with activity limitations.

• 한국의료질향상학회지
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• 제25권1호
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• pp.29-42
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• 2019

Purpose: The aim of the present study was to identify the relationship between educational needs and the caregiving burden of primary caregivers with stroke patient. Methods: This cross-sectional and descriptive study was conducted in 2016 with 115 primary caregivers for stroke patients at a university hospital. The caregiving burden and educational needs were investigated using structured questionnaires via interviews. Data were analyzed with descriptive statistics, the t-test or ANOVA, and Pearson's correlation analysis using IBM SPSS Statistics version 23.0. Results: The scores of caregiving burden and educational needs of primary caregiver with stroke patient were $77.65{\pm}1.66$ and $123.33{\pm}2.37$, respectively. The caregiving burden was associated with health status in primary caregivers' general characteristics. The caregiving burden and educational needs of primary caregivers have a significant correlation (r = .44, p <.001). Conclusions: Educational needs of primary caregivers with stroke patient are associated with their caregiving burden. Therefore, it is necessary to develop a primary caregiver centered intervention program considering educational needs to improve their caregiving burden. Also, to promote quality of nursing, there is the need to increase the educating competency of nurse and nursing professionalism of clinical nurse using various educational training program.

• Perspectives in Nursing Science
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• 제18권1호
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• pp.10-15
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• 2021

Purpose: The purpose of this study is to evaluate the current status of discharge education and nursing needs of children after musculoskeletal surgery. Methods: The literature from research databases was reviewed and analyzed (using PubMed, RISS review, KISS, and Dbpia). Results: Children who have undergone musculoskeletal surgery face physical challenges due to the effects of splints and immobilization, and experience pain for a long time. Therefore, home care after discharge is of paramount importance in these cases. The discharge education needs of each patient vary with regard to the topic and period. Discharge education should be systematic and consistent, with an emphasis on understanding the needs of the patients and parents. Conclusion: While there are studies on the nursing needs of adult musculoskeletal surgery patients at discharge, studies on discharge nursing needs in children who have undergone musculoskeletal surgery are still insufficient. It is necessary to specifically identify the educational needs of parents of children undergoing musculoskeletal surgery. Interventions that improve the voluntary participation of patients and parents in active self-care need to be developed.

• Journal of Hospice and Palliative Care
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• 제21권2호
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• pp.41-50
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• 2018

영성은 인간의 본질적인 부분으로 말기 환자와 가족의 실제적인 영적요구 충족을 위한 영적돌봄은 HPC에서 가장 중요한 영역이다. 말기환자와 가족의 실제적인 영적요구에 부응하는 돌봄모형을 확인하기 위해 최근 보건의료계에서 가장 많이 사용하는 국 내외 database를 검색하여 분석한 결과, 영성은 전인적 존재인 인간의 본질적인 부분으로, 삶의 위기상황에 더욱 충족되어야 할 존재론적 특성으로서, 말기 환자의 영성평가는 HPCT이 기본적으로 갖추어야 할 역량임이 확인되었다. HPC에 evidence based theory로 활용 가능한 총 10개의 모델이 제시되었다. 세 개의 모델들은 영적돌봄 결과에 초점을 둔 모델로서, spiritual health, QOL, and coping을 중요한 outcome으로 보는 모델들이었다. 영적돌봄수행에 초점을 둔 모델은 7개였으며, HPCT의 다학제간 협력을 통한 돌봄과정을 나타낸 'Wholeperson Care Model', 인간의 보편적인 실존적 요구충족이 보완된 'An Existential Functioning Model', 대상자의 문화적, 그 외 다양성을 고려하는 'An Open Pluralism View', HPCT와 말기환자와의 관계중심모델인 'A spiritual-relational view' and 'The Framework of Systemic Organization', 영적돌봄과정의 전체적 역동을 설명하는 'The principal components model' and 'The Actioning Spirituality and Spiritual care in Education and Training model'이 있다. 이러한 모델을 토대로 HPC에서 가장 최선의 영적돌봄 모델 구축을 위한 지속적인 임상연구 노력이 계속될 필요가 있겠다.

• 부모자녀건강학회지
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• 제5권1호
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• pp.38-49
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• 2002

The purpose of this study was to investigate the needs of a mother when getting the information from the child care web sites. The subjects of this study were collected through on-line and off-line and constituted of 157 mothers who had neonates and infancy. All the mothers could use the internet. On-line subjects were 135 mothers who were the members of "Child Rearing" circle of internet portal site, Daum (www.daum.net) and off-line subjects were 22 mothers who visited the pediatric outpatient department. The instrument had 15 items about needs for information of the child care web sites. 12 items were multiple choice-questions and 3 items were open questions. In data analysis, SPSSWIN 10.0 program was utilized for descriptive statistics. The results were as follows. 1. The most useful web content that mothers represented was food and nutrition(24.4%) and the other rated as following order; growth and development(21.1%), supports among parents(16.8%). 2. The most great web problem that mothers represented was depth of content(43 people) and the other rated as following order; objectivity, specialty and reliability of content(29 people), no problems (23 people), too much advertisements(17 people), obligation on member(4 people). 3. Mothers represented the highest information needs about play and education(65 people) and the other rated as following order; nutrition(44 people), managements of common health problems(39 people), experiences of other parents(10 people), child caring methods (38 people), exchanges of things(7 people). 4. Mothers represented the highest consultation needs about common health problem (62 people) and the other rated as following order; growth and activity(60 people), play and education(30 people), nutrition(22 people), child caring methods(9 people).

• 보건행정학회지
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• 제23권1호
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• pp.90-100
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• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.