• 한국콘텐츠학회논문지
• /
• 제22권3호
• /
• pp.547-559
• /
• 2022

본 연구는 정신재활시설을 이용하고 있는 정신장애인 가족의 돌봄 경험은 어떠한지 탐색하기 위한 질적 연구이다. 분석결과, 정신장애인 가족의 삶은 6개의 주제에서 12개의 하위주제로 나타났다. 발병하기 이전의 삶의 모습은 전기난로처럼 따뜻하고 편안한 일상생활, 가족간 갈등으로 새장의 앵무새처럼 답답하고 힘든생활로 나타났다. 증상이 나타나기 시작한 당사자를 바라보는 느낌은 앞이 잘 보이지 않는 두려움과 막막함, 삶을 꽃 피우기 전 질병에 갇힌 자녀에 대한 죄책감이었고, 강제 입원, 그리고 나의 느낌은 찢어지는 마음에 어찌할 바를 모름, 불투명한 회복과 미래의 삶에 대한 걱정으로 생각이 혼란해짐으로 나타났다. 질병이 장기간 지속되고 입·퇴원이 반복되면서 느낀 경험은 주변에 가족의 정신병이 알려질까 두려움, 반복되는 재발과 증상 악화에 대처하기 위해 안간힘을 씀으로 도출되었다. 정신재활시설을 이용하면서 변화된 삶은 편안한 쉼터에서 마음의 위로를 받음, 미래에 대한 희망이 보이고 웃을 수 있는 여유가 생김으로 나타났고, 앞으로 기대하는 삶, 그리고 희망은 작은 변화를 보며 감사함을 느낌, 회복을 위한 따뜻한 울타리가 되길 다짐함으로 도출되었다.

• 농촌의학ㆍ지역보건
• /
• 제34권1호
• /
• pp.24-33
• /
• 2009

2008년 9월 경상북도 영천시 소재 Y 지적장애인 특수학교에서 설사 유행이 신고되었고, 일부 환자의 검체에서 Shigella sonnei가 검출되었다. 이에 Y 학교와 초발 환자 신00이 기거하고 있던 경산시 소재 D 재활원에서 발생한 세균성이질에 관한 역학조사를 실시하였다. Y 학교와 D 재활원은 지적장애인을 위한 학교 및 생활시설로서 모두 직영급식을 하고 있다. 지적장애가 있는 학생과 원생들을 상대로 설문조사는 시행하지 않았고 교사와 직원들을 상대로 면담을 실시하였다. Y 학교와 D 재활원에서 직장 도말 검사를 각각 298건, 361건 실시하고 환경 검체 검사를 각각 60건, 20건을 실시하였다. 학교와 재활원의 환경조사를 실시하였고 음용수와 조리용수, 생활용수의 공급원을 파악하였다. 환자는 격리 치료하고 추가 환자 발생을 일일 능동 모니터링하였다. 환례는 2008년 9월 18일부터 9월 26일까지 Y 학교와 D 재활원의 구성원 중에서 설사(하루 2회 이상의 묽은 변)가 있는 경우 혹은 직장도말 배양검사 결과 Shigella sonnei 양성인 경우로 정의하였다. 환례 정의에 따라 조사 대상 659명 중 환례는 8명으로 1.2%의 발생률을 보였고 이들은 모두 Y 학교 학생이었다. 직장도말 배양검사 결과 Shigella sonnei가 5명의 학생에서 검출되었고, 이들 중 3명에서는 설사 증상이 있었으며 나머지 2명은 무증상이었다. 환례 8명 모두 단체숙식을 하고 있었는데 이들 중 2명은 Y 학교 기숙사 기린방에서 생활하였고, 4명은 D 재활원 온유방, 나머지 2명은 D 재활원의 까치방과 자비방에서 각각 생활하였다. Y 학교와 D 재활원의 환경조사 결과 특이사항이 없었으며, 공통적으로 음용수와 조리 용수는 상수도에서 공급받고 화장실의 생활용수는 하수도에서 공급받고 있었다. D 재활원의 지하수 1건에서 대장균군이 양성이면서 일반세균이 20,000 CFU/mL으로 나왔다. Pulsed-Field Gel Electrophoresis 검사에서 5건 모두 동일한 DNA 절편 양식을 보였다. D 재활원과 Y 학교에서 발생한 세균성이질은 동일한 균주에 의한 유행으로 판단한다. D 재활원의 온유방에서 현성 또는 불현성 감염자인 교사나 자원봉사자와의 직 간접 접촉을 통해 최초로 1명 이상의 원생에게 전파시켰을 가능성이 있다. 그 후 환례들과 직 간접 접촉에 의하여 D 재활원의 온유방 내, 다른 방과 Y 학교 학생에게 전파되었을 가능성이 있다고 추정한다. 단체 시설의 교사와 자원봉사자에 대하여 손씻기의 중요성이 더 강조되어야 하고 전염이 가능한 증상이나 질병이 있을 때에는 접촉이나 봉사 활동을 자제해야 할 것이다.

• The Journal of Korean Physical Therapy
• /
• 제14권4호
• /
• pp.75-86
• /
• 2002

The patients with a central nervous impediment and a sequela caused by a Stroke are continuously increasing, and the burden of family and society for Stroke patients are also increasing. Since Stroke patients are required to receive a long time medical treatment and care. It adds a economical burden as well as a mental and physical burden of patient's family. In addition, it is a primary factor which deepens the disparity of medical resources in social aspect. But the social concern for these patients are very insufficient and are entirely left to the patient's family The mediation of Skilled Nursing Facility for Stroke patients enable to receive more special and proper medical treatment and recuperation service in the middle of time when they return to home from hospital. It also contributes to the settlement of the charge of patient's family and the serious disparity of medical resources. Therefore, this study will summon the social understanding of the necessity of Skilled Nursing Facilities through the above debate.

• 재활간호학회지
• /
• 제4권2호
• /
• pp.240-247
• /
• 2001

The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

• 지역사회간호학회지
• /
• 제14권3호
• /
• pp.397-406
• /
• 2003

The purpose of this study is to provide the basic data in order to improve the quality of charged recuperation facilities which are specialized in the old. after finding out the satisfaction degree for the services which are provided in the current charged recuperation facilities specialized in the old and surveying the services which are demanded by users. As for the research method. the subjects were 88 family members of the users in the five charged recuperation facilities, which are specialized in the old and located in Seoul and Incheon. The survey research was executed from 27th July to 15th September, 2002. Then the collected data were analyzed by using the SPSS 10.0 for windows program. The research results are as follows. Firstly, in the satisfaction degree of the user's family about the daily service showed the highest satisfaction degree for the kind service of the staff to the users. In the satisfaction degree about the specialized service of the user's family, the satisfaction degree was high in bedsore prevention, periodical health care, proper medical treatment, family counsel, and adequate disease management. In the satisfaction degree about the facility and environmental service, the satisfaction degree about the surrounding environment of the facility or safety facility, and the comfort condition was high. In the satisfaction degree about the services related to the local society, it was high in the hospital and medical-related field. Secondly, in the demanded services, the demanding degree for worship, mental and spiritual nursing, hospice, funeral service, family meeting, and support for the special vehicle were not so high, but it was shown that they were generally demanded. Thirdly, it was shown that the provided services had an overall high satisfaction degree. In the service satisfaction degree according to the general characteristics of the user's family, it was recognized that there was a significant difference between the distinction of sex and local society related services. Also, there was a significant difference in the satisfaction degree between age and specialized service. Through the above research results, detailed rehabilitation programs such as linguistic treatment and working treatment should be more and more compensated in order to supplement the insufficient points of the services provided by the charged recuperation facility specialized in the old. Additionally, the correlation with the local society such as education and training for specialized human labor, close cooperation among the facilities, and positive participation in local society events are thought to be reinforced.

• 재활간호학회지
• /
• 제5권2호
• /
• pp.180-192
• /
• 2002

The purpose of this study was to survey basic data for management of elderly day care centers. In this study, occupation, leisure life, and food, clothing and habituation, as well as social relationship, health state and behavior, and general characteristics of subjects were examined to identify the factors affecting their cognition, need and preference of the day care centers. The subjects of this study were 392 elderly, aged 60 years or over, living in Gangnung and neighboring districts. Data were collected by educated interviewers from November 4 through November 22, 2002. The subjects were interviewed face to face, one for one after the interviewee's agreements on the survey. The collected data were analysed with logistic regression analysis by SAS (statistical analysis system). Logistic regression analysis was done to identify affecting factors for cognition, need and preference of the elderly day care centers. The major findings are as follows: 1. The factors affecting cognition for the day care centers were analysed. The subjects with an occupation and a lower satisfaction level of living environment and friendship, who were economically secure enough to manage a sudden accident, showed a higher level of cognition of the day care centers. The subjects with a higher level of mental health state and a lower level of IADL also showed a higher level of cognition. On the general characteristics younger female subjects showed a higher level of cognition. 2. The subjects with a lower level of perceived economic condition who did not own their housing and were not economically safe enough to manage a sudden accident, had showed a higher level of need for the day care centers. It showed that the subjects with a high level of mental health state, a bad eye sight and dental condition, a good perceived health condition, and a lower level of IADL, needed the centers. 3. The subjects who had an occupation, however, not capable of making their own daily expenses, and a low occupation satisfaction level, and who did not own their housing, and were economically poor not enough to manage a sudden accident, showed a higher preference for the day care centers. The subjects with higher levels of friendship satisfaction and perceived health condition, not living with their spouse, and a higher education level, showed a higher preference for the centers. In conclusion, the common factors affecting their cognition, need and preference of the day care centers were occupation, economic security enough to manage accidents, and friendship satisfaction level. Especially, the subjects who had an occupation, however, not economically secure enough to manage accidents, and who did not live in their own housing with a good perceived health condition, showed high levels of need and preference for the day care centers. These results can be used as basic data to develop the efficient elderly day care centers, thus contribute to the elderly welfare in a local community.

• 농촌의학ㆍ지역보건
• /
• 제27권1호
• /
• pp.51-64
• /
• 2002

전라남도의 무작위 추출된 10개 시 군과 광주광역시 5개 구의 방문보건사업 담당직원 200명 중 우편설문조사에 응답한 144명을 연구대상으로 하여 방문보건 사업과 관련된 교육훈련경험 여부와 만족도, 응답자의 주관적 판단에 의한 방문보건서비스 관리 지식 정도 그리고 향후 방문보건사업에 필요한 교육훈련에 대한 요구도에 대해 조사하여 향후 방문보건요원의 교육훈련의 기초자료를 제공하고자 하였다. 본 연구의 주요 결과는 다음과 같다. 1. 조사대상자 중 3년 동안 한가지 이상의 중앙교육 훈련 경험자는 43명(29.9%), 광역자치단체의 교육훈련 경험자는 57명(39.6%), 그리고 지방자치단체의 교육훈련 경험자는 53명(36.8%) 등으로 나타났다. 교육과정에 대한 만족도를 점수화 한 결과 중앙 교육($2.38{\pm}0.57$)이 광역자치단체 교육($2.18{\pm}0.57$)과 기초자치단체 교육($2.13{\pm}0.54$)보다 높았다. 2. 조사대상자의 방문보건서비스 관리 지식 정도는 환자 및 질병관리 영역 중 투약 및 검사, 상처 및 욕창 관리, 환자 개인위생, 고혈압환자 관리, 당뇨환자 관리, 관절염환자 관리 그리고 전염성질환자 관리, 고위험 가족 및 가정환경 관리 영역 중 환경위생 관리, 안전 및 사고 관리 그리고 감염관리, 건강증진관리 영역이 5점 만점에 평균 3점 이상이었으며, 재활 및 요양 영역은 전반적으로 평균 3점 이하의 점수를 보였다. 3. 조사대상자의 방문보건서비스 관리 지식 정도는 간호사 자격증을 소지하고 있는 경우 높았으며, 중앙 교육 중 노인보건, 재활 등 실무영역과 정신보건전문간호사, 광역자치단체 교육 중 보건진료원보수교육, 정신 보건교육, 그리고 기초자치단체 교육의 건강증진영역, 노인보건, 재활 등 실무영역, 정신보건영역과 급성질환 관리영역에 대한 교육훈련 경험이 있는 경우 높았다. 4. 조사대상자의 교육내용에 대한 요구도는 노인건강 관리과정이 가장 높았고, 최근 업무가 새롭게 추진되고 있는 노인보건, 호스피스, 치매노인관리, 재활, 건강증진 등이 높은 것으로 조사되었으며, 방문보건사업 업무별로는 방문보건사업전반이 가장 높았고 방문보건사업에서 실제 서비스를 제공하는 분야가 교육의 요구도가 높은 것으로 나타났다. 또한 교육방법으로는 공무원 집단교육(47.0%)을, 교육전담 주체는 광역자치단체 (30.4%)를, 교육방식은 실습(57.7%)을, 교육횟수는 년 2-3회(44.5%)를, 교육기간은 3-5일(41.0%)을 선호하는 것으로 나타났다. 향후 지역사회 주민에게 효과적인 방문보건서비스를 제공하기 위해서는 방문보건사업에 대한 지식 정도를 높일 수 있는 교육훈련의 기회를 확대하고 방문보건요원의 교육요구도에 근거하여 교육훈련을 개선해야 할 것이다.