• 제목/요약/키워드: Level of care

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노인장기요양보험 이용현황과 제도확대방향의 모색 (Observations on Long-Term Care Insurance Utilization and Implication for its Expansion)

  • 윤희숙
    • 보건행정학회지
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    • 제20권3호
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    • pp.104-122
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    • 2010
  • Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

여성의 피부건강행위에 대한 인식도와 실천도의 상관관계분석 (Correlation of Practice and Cognition for Women's Skin Care Behavior)

  • 최은영;오현주;백승화
    • 대한예방한의학회지
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    • 제4권2호
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    • pp.273-284
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    • 2000
  • The objective of this study consists on clarifying what factors are influenced upon skin care behavior using fender's Health Promotion Model, widely used to anticipate practices of health care behavior for women with keen interest in skin care and then manifesting their correlations from July 1 to August 22, 1998, on 159 women interested in skin care. A subvariable included practice of skin care behavior and independent variables include general characteristics, health fitness, the level of agreement with the advantages of the perceived skin care behavior, the level of cognition of the necessity for skin care behavior The data collected processed with ANOVA and multiple regression analysis to clarify what factors among other independent variables have the most powerful effects upon skin care. The resultant findings were revealed, as follows : 1. In health care behavior among skin care behavior,'full ingestion of water' represented the highest value by 3.45 points, 2. The testees of this study had for the most part a higher level of cognition for the necessity for skin care behavior than for practice of skin care behavior. The more points they have for cognition of the necessity for skin care behavior, the more points they present for practice of skin care behavior. 3. From the perspective of the relationship between sociometic factors on the testees and their skin care behavior, the higher level married women were on (p<0.05) and the more points they have for economic status, the higher points were reflected . 4. The correlations between the testees' recognition or perception factors and points for practice of skin health state showed the higher points than the group who thought that they did not know their own skin health state (p<0.05). The higher the points of skin care fitness (p<0.0001), the higher the points of self-awareness (p<0.0001) 5. The factors that had the most powerful influence upon cognition and practice of women's skin care behavior were found, with statistical significance, to be adjustable factors such as age, smoking, drinking habit, economic status, etc. and points of cognition of the necessity for skin care behavior.

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혈액투석 환자의 자기관리 수행도와 이에 영향을 미치는 요인 (Self-Care and Associating Factors in Hemodialysis Patients)

  • 전진호;강혜경
    • 보건교육건강증진학회지
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    • 제16권1호
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    • pp.149-166
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    • 1999
  • Self-care and the performance of their own role might be important for the prevention of complications and improvement of quality of life in hemodialysis patients with chronic renal failure(CRF). To improve well-being and quality of life for the patients, the author estimated the level of self-care and associating factors through a questionnaire. The information was composed of the knowledge for hemodialysis and renal disease, the level of self-care, health belief, supports from the family, disease-related stresses, personal characteristics, medical history, relationships with medical personnel, etc. The data was gathered from 126 hemodialysis patients who were undergoing hemodialysis in one university hospital and five hospitals in Kyungsangnam-Do area from December 1997 to January 1998, and was analyzed by PC SAS program(version 6.12) with the level of significance($\alpha$=0.05). The mean age of subjects was 47.0$\pm$13.5years with no significant difference in gender distribution. The mean duration of hemodialysis was 39.0 months, and their frequencies of hemodialysis were more than three times per week(77.0%). Only 21.4% had the specific education on hemodialysis and CRF. In the level which was expressed as the score out of 100, the mean of knowledge was 90.7$\pm$9.1 and the mean of self-care was 73.9$\pm$12.7, that means, they only partially carried their knowledge into practice. They showed a significant correlation between knowledge and health belief($\gamma$=0.282); self-care and health belief($\gamma$=0.357), family supports and knowledge($\gamma$=0.221), self-care($\gamma$=0.402), health belief($\gamma$=0.431); and health belief and stress($\gamma$=-0.361). Age, religion, marrital status, education, and relationships with medical personnel showed positive correlations, and smoking showed negative correlation with self-care. In the multiple regression with the level of self-care as dependent variable, and each of the characeristics as independent variables, supports from the family($\beta$=6.615=0.158), the experience of disease specific education($\beta$=4.959), relationships with medical personnel($\beta$=6.615), current smoking($\beta$=-6.986), and current drinking ($\beta$=-7.095) were detected as significant factors. The value of R-square was 34%. In summary, to promote the level self-care and to improve the well beings and Quality of life for the hemodialysis patients, it would be emphasized that they terminate smoking and drinking, and it would be recommended that the education programs and supports from the family be strengthened. And, because there was a considerable difference between the level of knowledge and self-care, it would also be emphasized to propose the education programs which focused on execution. In addition to that, there is a need to improve relationships between the patients and medical personnel through positive changes in the attitudes of the medical personnel.

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대구광역시 노인복지시설 유형별 수요추정 (A Study on the Forecast of Bed Demand ofr Institutional Long-term Care in Taegu, Korea)

  • 김명희
    • 대한간호학회지
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    • 제30권2호
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    • pp.437-451
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    • 2000
  • The purpose of this study was to estimate the forecast of bed demand for institutional long-term care for the elderly persons in Taegu Metropolitan City. The study subject was the total 1,877 elderly persons over age 65 living in Taegu. Among them 1,441 elderly persons were sampled from community and 436 were from the elderly admitted 5 general hospitals. Data collection was carried out by interview from 25 August to 25 December 1997. The measuring instrument of this study was the modified tool of CARE, MAI, PCTC, and ADL which were examined for validity and reliability. In order to forecast bed demand of Nursing Home, this study revised prediction techniques suggested by Robin. The results were as follows : 1. OLDi of Taegu City were 122,202 by the year 1998 and number of Low-Income Elderly Persons were 3,210. 2. The Level I : Senior Citizen Home $ADEMi=\frac{AQi * ASTAYi}{365 * AOCUi}$. AQi = OLDi * LADLi * NASi * ALONi * LIADLi * AUTILi. Predicted number of bed demand for Home Based. Elderly Persons were 4,210 and Low-Income Elderly Persons were 1,081 and Total Elderly Persons were 5,291 by the year 1998, 6,343 by the year 2000 and 8,351 by the 2005. 3. The Level II : Nursing Home $BDEMi=\frac{(BQ1i+BQ2i) * BSTAYi}{365 * BOCUi}$. BQ1i = OLDi * HADLi * ALONi * HIADLi BQ2i = OLDi * HADLi * FAMi * OBEDi Predicted number of demand for Total Elderly Persons were 668 by the year 1998, 802 by the year 2000 and 1,055 by the 2005. 4. The Level III : Nursing Home $CDEMi=\frac{COLDi * HDISi * CUTILi * CSTAYi}{365 * COCUi}+OQi/10$ Predicted number of demand for Total Elderly Persons were 1,899 by the year 1998, 2,311 by the year 2000 and 3,003 by the 2005. 5. Predicted number of bed demand of long-term care facilities in the year 1998 according to Levels were 4.3% among elderly persons in Taegu by Level I, 0.5% by Level II and 1.5% by Level III. Number of elderly persons in current long-term care facilities were 458 in LevelI I,284 in Level II. 6. Deficit number of bed demand of long-term care facilities were 4,833 in Level I, 384 in Level II, 1,899 in Level III for the elderly persons in Taegu Metropolitan City.

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1급 응급구조사의 병원 전 응급환자평가와 응급처치시행에 대한 인식과 실천정도 (The Level of Awareness and Practice in Prehospital Emergency Patient Assessment and Emergency Care of Paramedic in Fire Station)

  • 강용주;최은숙
    • 한국응급구조학회지
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    • 제15권2호
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    • pp.67-84
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    • 2011
  • Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

결장루보유자의 강인성과 자가간호역량과의 관계 (The Relationship Between Hardiness and Self-Care Agency of Persons with a Colostomy)

  • 배은숙
    • 재활간호학회지
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    • 제3권1호
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    • pp.15-26
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    • 2000
  • This study examined the relationship between the level of hardiness and self-care agency of persons with a colostomy. The purpose of the study was to explore the effect of hardiness on self-care agency of persons with a colostomy and to identity factors influencing on. The ultimate goal was to help nurses improve the person's self-care agency and to contribute theoretical base for the planning of supportive nursing interventions to increase the level of self care. The subjects for the study consisted of 43 persons aged above eighteen below seventy had had Miles operation and permanent colostomy. The data were collected from July, 1998 to September 15, 1998. The instruments used for this study were the Health-Related Hardiness (Pollock, 1984) and the Self-carer As Inventory Scale(Genden & Taylor, 1988). The Self-Carer As Inventory translated by So Hyang-sook and was modified by author of this study. The data were analysed by using SAS computerlized program and included number, percentage, t-test, ANOVA and Pearson Correlation Coefficient. The results of the study are summarized as follows. 1. Hardiness was significantly related to Self-care agency(r=-0.531. p=0.0002). That is, the higher the hardiness, the higher the level of Self-care agency. 2. In the relationship between general characteristics and traits of persons with a colostomy and hardiness were significant difference in monthly income (F=2.79, p=0.03), problem in stoma management (F=3.29, p=0.01). 3. In the relationship between general characteristics and traits of persons with a colostomy and Self-care agency were significant difference in monthly income (F=2.93, p=0.03), problem in stoma management(F=2.93, p=0.01). Therefore, in order to increase the level of Self-care agency of ostomate Nurses should be helpful to provide them with hardiness training to strengthen their control, commitment and challenge(subconcepts of hardiness).

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중소 병원 간호사의 환자안전문화에 대한 인식과 안전간호활동 수행 정도 (Perception of Patient Safety Culture and Safety Care Activity among Nurses in Small-Medium Sized General Hospitals)

  • 이나주;김정희
    • 간호행정학회지
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    • 제17권4호
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    • pp.462-473
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    • 2011
  • Purpose: This study was done to identify the factors affecting the perception of patient-safety-culture and the level of safety-care-activity among nurses in small-medium sized general hospitals. Method: Data were collected during April and May 2011, from 241 nurses of five hospitals. A hospital survey questionnaire on patient-safety-culture and safety-care-activity was used. Collected data were analyzed using descriptive statistics, Pearson correlation, t-test, ANOVA, Scheffe test and multiple-regression. Results: There were significant differences in the level of perception of patient-safety-culture according to the nurses' age, type of hospital, position, work department, and knowing whether there was a Patient-Safety committee in their hospitals. Nurses with higher perceived level of the patient-safety-culture performed more safety-care-activities. Factors influencing on the safety-care-activities were general patient safety, having had safety-education, patient-to-nurse ratio, employment status, and the level of reporting medical errors. These factors explained 22.9% of the safety-care-activity. Conclusions: The study findings suggest that in order to improve the nurses' perceived level of patient-safety-culture and safety-care-activity, the hospitals need to establish patient-safety committees and communication systems, and openness to reporting medical errors are needed. Better work conditions to ensure appropriate work time, regulate patient-to-nurse ratio, and nursing education standards and criteria, are also required.

노인의 주관적 구강건강수준 관련 요인 (Factors Related to Subjective Oral Health Level of the Elderly)

  • 정수진
    • 융합정보논문지
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    • 제11권6호
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    • pp.171-180
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    • 2021
  • 본 연구는 노인들의 구강관리행태, 구강건강관리 자기효능감, 사회적지지가 주관적 구강건강수준에 미치는 영향을 알아보기 위해 실시하였다. 자료조사는 2019년 9월 17일부터 2019년 11월 22일까지 대전광역시와 충청남도 일부지역에 거주하는 노인들을 대상으로 하였으며, 수집된 자료는 𝑥2-test, Pearson 상관분석, 로지스틱 회귀분석으로 분석하였다. 조사결과 주관적 구강건강수준은 틀니를 사용하고 있지 않은 경우 3.242배, 일일 칫솔질 횟수가 3회 이상인 경우 2.339배 증가하였으며, 구강건강관리 자기효능감과 사회적 지지가 각각 1.755배, 1.192배 증가함에 따라 주관적 구강건강수준도 증가하였다. 이상의 결과를 토대로 노인들의 주관적 구강건강수준의 증진을 위해서는 틀니관리방법과 칫솔질교습 등의 구강보건교육의 기회를 확대하고, 구강건강관리 자기효능감과 사회적 지지를 강화시킬 수 있는 정책 마련이 필요하다.

당뇨병 환자의 발반사요법 교육프로그램 후 발관리지식, 자가간호행위, 생리적지표의 변화 및 관련요인분석 (A Study on the Related Factors and the Change after Foot-reflexo-massage Education Program for Diabetic Patients)

  • 이영희
    • 성인간호학회지
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    • 제16권2호
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    • pp.222-232
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    • 2004
  • Purpose: The purpose of this study was to identify the change in foot care knowledge, self care behavior, and physiologic indexes after foot reflexomassage education program, and the related factors. Method: Data were collected from 20 patients who were visited out patients clinic. The change and difference were analyzed with non-parametric statistics. Result: There were significant differences in foot care knowledge(P=.001), self care behavior(P=.000), dosalis pedis blood flow volume (P=.011), skin temperature of foot(P=.001), dorsalis pedis pulse(P=.000), capillary filling time of foot (P=.000) between pre and post. The level of changes of foot care knowledge was significant differences according to admission experience (P=.049), and negative related to systolic blood pressure(P=.028). The level of changes of self care behavior was related to age(P=.049), that of dosalis pedis blood flow was significant difference according to smoking(P=.042), that of skin temperatureof foot(P=.002) and dosalis pedis pulse(P=.038) were significant difference according to weight. The level of changes of capillary filling time of foot was related to diagnosis period(P=.014). Conclusion: Foot-Reflexo-Massage education program is an effective nursing intervention to promote foot care in diabetic patients. And the related factors can be recommended for the management of diabetic patients.

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요양병원의 간호인력 확보수준과 구강간호 실시여부가 노인 환자의 폐렴발생에 미치는 영향 (Impact of Nurse Staffing Level and Oral Care on Hospital Acquired Pneumonia in Long-term Care Hospitals)

  • 채정미;송현종;강근석;이지윤
    • 간호행정학회지
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    • 제21권2호
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    • pp.174-183
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    • 2015
  • Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.