• Korean Journal of Social Welfare Studies
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• v.42 no.4
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• pp.35-59
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• 2011

As the long term care insurance for the elderly has been established for 3 years it was noticed that the success of the policy is depending on the care workers. This study is to analyze and evaluate what are the characteristics and factors influencing their job satisfaction. The questionnaire survey was conducted over 291 care workers who are employed at 61nursing home for the elderlyin Jeollanamdo. The survey result is as following. Firstly, 93.5% of workers were female, 78% of them were over 40-50 years old, and 68.7% of them werelower than a high school graduate as their academic background. Secondly, 63.2% were contract-based or temporary employees, 53.3% had a work-related education less than 5 times for the past year, and 79.7% had an annual salary lower than KRW 20 million. Thirdly, the overall job satisfaction was 3.19 on the Likert scale of 5. Also, the job satisfaction was higher for the care workers working and getting paid by home than by company, for full-time workers than temporary workers. In addition, it was found that the more workers have work-related education and the higher their annual salary is, the higher their job satisfaction is. The study evaluated the factor influencing on their job satisfaction and suggested the way to improve it based on the survey analysis.

• Health Policy and Management
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• v.32 no.2
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• pp.190-204
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• 2022

Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults. Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender. Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men. Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.

• 한국노년학
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• v.38 no.4
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• pp.1035-1055
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• 2018

The purpose of this study is to investigate the relationship between public care and family care. Public care for older adults began in 2008 with the implementation of the Long-Term Care insurance in South Korea. Although the expansion of public care has the purpose of reducing the care burden for the family, it is not easy to say whether the developments of public care system reduce the amount of family care for older family members. Theoretically, public care and family care are expected to have various relationships depending on the degree of the role and function(substitution, hierarchical compensatory, task specific, supplementation, complementarity). And literatures have showed inconsistent results depending on the country, data, and methods. In this study, we analyzed the relationship between two care types focusing on home care services for older persons. Analyses were based on data from the second(2008) to sixth(2016) waves of Korean Longitudinal Study of Ageing(KLoSA). To investigate elderly care dynamics in the households, we pooled the data for four changes between two periods(2008-2010, 2010-2012, 2012-2014, and 2014-2016). This study used an analytic sample of 262 older adults, who are aged 55 over and experienced public care at least one point of time. We used Fixed-Effects(FE) model to analyze the differences within the same individuals under the condition that time-invariant unobserved factors are controlled. This study distinguished the cases of entry into public care and other cases of exiting public care. The results showed that older people who are dependent on public care are less dependent on family care than before. In both entry and exit groups, negative relations were maintained, but in the entering stage of public care, the degree of negative relations was relatively small, whereas in the stage of maintaining or departing from public care, relatively negative relations were strong. At the beginning periods, even though public care increased, family care did not decrease significantly. On the other hand, at the time of ending public care and relying on family care, family care increased significantly. The results of this study show that the relationship between public care and family care is close to hierarchical compensatory model and varies according to the stage of caring transition. Also, it was found that the cases of transition from public care to family care have the biggest burden of elderly care than other groups.

• The Journal of Korean Medicine
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• v.37 no.3
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• pp.112-122
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• 2016

Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.

• Journal of Oriental Neuropsychiatry
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• v.24 no.3
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• pp.211-228
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• 2013

Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.

• 한국노년학
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• v.41 no.2
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• pp.217-240
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• 2021

The purpose of this study is to examine the effect of care workers' employment characteristics and perception of facility directors' transformational leadership on quality of service through a hierarchical linear model. For this aim, survey data were collected amongst 240 older adults and 200 care workers who are affiliated within 45 long-term care facilities in Seoul, and analyzed using SPSS 26.0 and HLM 8.0. As a result, one's perception of transformational leadership had a positive effect, whereas, among employment characteristics, employment type and working hours had negative effects on quality of service. Regular workers with fewer working hours and higher awareness of transformational leadership toward the director provided higher quality of service. But wage, total experience and tenure didn't meaningfully affect it. Therefore, the following suggestions were presented. First, it is necessary to reorganize incentive, salary systems and budgets, changing the status of temporary workers' hourly wage system into that of regular workers' monthly one in order to strengthen employment security with acknowledging fundamental professional values through reinforcement of expertise. Reinforcement of long-term care's publicness and establishment of base facilities are also suggested. Second, maintaining appropriate hours of work and rest including annual leave under the Labor Standards Act is needed. Also, increasing the salary of and decreasing working hours for night shift workers are required. Third, education and intervention for inspiring transformational leadership of directors and strengthening qualification standards of them are required.

• 한국노년학
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• v.39 no.3
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• pp.531-548
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• 2019

The purpose of this study is to provide basic data in order to improve service quality based on empirical analyses about a relationship among positive psychological capitals, service quality, and job satisfaction of professional care workers under the Long-Term Care Insurance in South Korea. In this study, total 430 numbers of the workers who were currently working in nursing homes for the elderly at the cities of Ansan, Anyang, Bucheon, and Kwangmyeong in Gyeonggi Province, South Korea, participated in self-report questionnaires. Only 393 questionnaires were used for the final analyses after excluding the ones that neither were not returned nor didn't completed it all. These are major results. First, positive psychological capitals affect positively on service quality. Second, job satisfaction works as a mediating effect in the process of positive psychological capitals affect on service quality. Based on above results, it is possible to suggest it as down below. First, it is required to have policies that will be helpful for both positive psychological capitals and capacity building through human resource management in systematic approaches. Second, it is also required to acknowledge that having positive psychological capitals is effective to improve both their job satisfaction and service quality. Therefore, it is necessary to change environmental circumstances in relevant institutions where this acknowledgement will be applied.

• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.254-263
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• 2015

Objectives: The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. Method: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use. Results: Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility. Conclusion: The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

• Research in Community and Public Health Nursing
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• v.22 no.3
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• pp.302-314
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• 2011

Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ${\alpha}$. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long.term care insurance grade as a gold standard. Results: The Cronbach's ${\alpha}$ was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

• The Journal of Korean society of community based occupational therapy
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• v.1 no.2
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• pp.45-59
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• 2011

Objective : he aim of this study is to describe on the definition of the welfare state and scope of the social welfare and to analyze the development of the social welfare policy for the disabled in South Korea. Methods : We described on the definition of the welfare state and scope of the social welfare and analyzed the social welfare policy and welfare policy for the disabled among Korean Government through literature review. Finally, We also analyzed the welfare policy for the disabled in the Roh Moo-hyun Administration. Results : Welfare policy or welfare policy for the disabled was developed as economic growth from 'selective welfare' to 'universal welfare'. Scope of the social welfare was expanded from 'minimum guarantee' of the Lee seong-man administration to 'participatory welfare' of the Roh moo-hyun administration and that was similar to the welfare policy of administration for the disabled. Conclusion : We suggest that occupational therapist based community should find unmet health need and provide home-based rehabilitation services to the disabled and the elderly.