• 제목/요약/키워드: care giver

검색결과 123건 처리시간 0.023초

노인돌보미바우처 정책집행분석 -선택과 경쟁은 실현되는가?- (A Policy Implementation Analysis on the Care Voucher for the Aged -Focusing on Choice and Competition-)

  • 양난주
    • 한국사회복지학
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    • 제61권3호
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    • pp.77-101
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    • 2009
  • 본 연구는 노인돌보미바우처 정책집행분석 사례연구로 일선 집행현장에서 바우처 논리인 소비자 선택과 제공자 경쟁이 실현되는지, 어떤 양상으로 실현되는지 분석하였다. 서울시 ${\bigcirc}{\bigcirc}$ 구를 조사지역으로 선정하여 4개 제공기관과 돌보미, 일선공무원, 이용자를 대상으로 일선집행과정을, 그리고 보건복지가족부, 사회서비스관리센터 등의 정책관련자들을 대상으로 정책설계와 운영을 조사하였다. 총 39명에 대한 심층인터뷰와 참여관찰이 수행되었다. 연구 결과, 노인돌보미바우처 집행 일선에서는 정책설계에서 가정한 바우처 이용자의 제공기관 선택과 제공기관의 경쟁은 실현되고 있지 않았다. 일선공무원은 공급자지원방식에서와 마찬가지의 관행으로 이용자명단을 기관에 전달하고 제공기관은 '제공기관회의'를 구성하여 이용자를 나누고 있었다. 하지만, 이용자의 선택은 다양한 차원에서 이루어지고 있었으며 제공기관과 돌보미는 서비스 제공에서 이용자 중심성을 실현하는 방식으로 변화를 보이고 있었다.

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입원환자의 비공식적 의료비용 부담에 관한 연구 (A Study on the Informal Cost Burden of the Patients Admitted to the Hospital)

  • 한미현
    • 간호행정학회지
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    • 제7권1호
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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NIC에 근거한 척수손상환자의 가정간호 중재 프로토콜 개발 (Development of Home Care Nursing Intervention Protocols for Spinal Cord Injury Patients Based on NIC)

  • 문성미;김선희
    • 가정∙방문간호학회지
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    • 제8권1호
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    • pp.25-37
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    • 2001
  • Spinal cord injury patients need rehabilitation after the acute stage. They should be cared for at home to decrease hospitalization. Home care nurses play an important role in making spinal cord injury patients who have physical. and psychosocial problems do their best. For effective care, home care nurses need standardized nursing intervention protocols for spinal cord injury patients, but they are rarely developed. Therefore, this study was conducted to develop home care nursing protocols, based on NIC, that are applicable to spinal cord injury patients at home. Forty home care nursing charts of spinal cord injury patients registered in a home care nursing agency from July 1st, 1994 to August 31st, 1999 in S city were analyzed. Fifteen home care nurses participated in this study as a user validity validation group, The results of this study are as follows. 1. Fifteen nursing diagnoses were classified through the frequency analysis of home care nursing charts and previous literature for 40 spinal cord injury patients: altered urinary elimination, constipation, high risk for impaired skin integrity, chronic pain, impaired skin integrity, impaired social interaction, knowledge deficit, bowel incontinence, high risk for injury, altered role performance, care giver role strain, impaired physical mobility, sexual dysfunction, dysreflexia, and ineffective breathing pattern. 2. Based on validation by experts and user validities, 93 nursing interventions which were above ICV(Index of Content Validity) .80 were chosen. 3. Nursing intervention protocols which showed above ICV .80 were developed.

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하이데거의 눈으로 '간호'를 바라보기: 실존하는 존재에 대한 성찰 (Looking into the Nursing from the Viewpoint of Heidegger: Reflections on the Existence of Being)

  • 김수미;최희승
    • Perspectives in Nursing Science
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    • 제11권2호
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    • pp.94-100
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    • 2014
  • Purpose: This article is aimed at broadening the perspectives of nursing by applying Heidegger's philosophical reasoning and views to nursing beliefs. Methods: Heidegger's main concepts on a human's way of being were the source for examining the encounter between care-receiver and care-giver in nursing. In addition, the paper illustrates the attitudes that nurses must present to their care-receiver in existential nursing. Results: As nurses and care-receivers experience existential crises due to anxiety about death and fear over uncontrollable situations, they both raise questions about the significance of their existences. By putting their deep reflections on these questions into nursing practice, nurses can exist as "Mitdasein" and be open to a number of possibilities in nursing. Conclusion: Nurses must be open to a number of possibilities in nursing by embracing various experiences of life and individuality without criticism, and pursuing the existing lives of their counterparts as well as their owns. They are able to take this attitude by raising fundamental questions about life and the existence of human beings through ceaseless reflections on their experiences, then implementing the result of these reflections in their lives and nursing practices.

노인요양병원 입원실의 실내디자인 특성에 대한 사용자 평가 - 간호사와 간병인 및 보호자를 대상으로 - (Users' Evaluation of Interior Design Features of Patients Rooms in Geriatric Hospital - From the perspectives of Nurses and Care-Givers -)

  • 오찬옥
    • 한국실내디자인학회논문집
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    • 제23권2호
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    • pp.182-192
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    • 2014
  • Demands for geriatric hospital have increased in an era of rapidly aging population. Most of aged patients tend to stay in institutions for long terms. This means that the patient rooms of geriatric hospital should be given different considerations from those of normal hospital in designing interior features. They should be a homelike places for the aged patients and designed to take care of specific needs of the aged. However, most of geriatric hospitals are designed with little attention to such point. They appear almost same to normal ones. This study attempts to examine how users evaluate patients' rooms. The users are nurses, care-givers and family members of aged patients in six geriatric hospitals in Busan. They rated 12 features of patient rooms from 0 point to 100 points and described reasons why they rated in that way. Also, the walk-through was done for these six hospitals. 12 features are sizes of patient rooms, sizes and fixtures of bathrooms, sizes and locations of windows, bed layout, numbers and types of chairs, sizes and types of closet, lighting, color scheme, finishes of floor and wall, and interior design tone. Followings are findings : The users evaluated patients' rooms relatively positive. However, extra chairs for visitors, closet in patients rooms and storage in bathroom, and sizes of patients rooms and bathrooms were evaluated relatively negative.

보건진료 전담공무원의 다문화대상 보건의료서비스 제공실태와 다문화 인식 조사 (Health Service Delivery and Attitudes toward Multi-cultural Clients of Community Health Practitioners)

  • 김진학;송민선
    • 가정∙방문간호학회지
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    • 제23권1호
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    • pp.5-15
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    • 2016
  • Purpose: This study was conducted to evaluate health service delivery and attitudes, toward multi-cultural clients amongst community health practitioners (CHPs). Methods: A survey was conducted among 242 CHPs from December 10-22, 2015. The collected data were analyzed using chi-square test, t-test, and ANOVA using SPSS 18.0. Results: General awareness of multi-culturalism varied significantly by CHPs age and language ability. Additionally, utilization of services in accordance with the location of community health centers (CHCs) was significantly higher in rural areas than urban areas CHCs in post-partum maternal & neonate care giver service (in maternal child health), management of health educational programs and management of physical exercise (in implementing healthy life style) and networking resources in & outside of CHCs (in management of chronic disease). Conclusion: CHPs deliver health-care services to multi-cultural clients, but have not received sufficient training or education to serve these clients effectively. CHPs who received multi-cultural and foreign language training had more positive experiences with multi-cultural clients. This supports the needs for developing educational programs to enhance multi-cultural understanding amongst CHPs.

문화간호를 위한 한국인의 민간 돌봄에 대한 연구 : 출생을 중심으로 (Study on Folk Caring in Korea for Cultural Nursing)

  • 고성희;조명옥;최영희;강신표
    • 대한간호학회지
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    • 제20권3호
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    • pp.430-458
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    • 1990
  • Care is a central concept of nursing. Nursing would not exist without caring. Care and quality of life are closely related. Human behavior is a manifestation of culture. We can say that caring and nursing care are expression of culture. The nurse must understand the relationship of culture with care for ensure quality nursing care. But knowledge of cultural factors in nursing is not well developed. Time and in - depth study are needed to find meaningful relationships between culture and care. Nurses recognized the importance of culturally appropriate nursing There are two care systems in culturally based nursing. The folk care system and the professional nursing care system. The folk care system existed long before the professional nursing care system was introduced into this culture. If the discrepancy between these two care systems is great, the client may receive inappropriate nursing care. Culture and subcaltures are diverse and dynamic in nature. Nurses need to know the caring behaviors, patterns, and their meaning in their own culture. In Korea we have taken some first step to study cultural nursing phenomena. It is not our intent necessarily to return to the past and develop a nationalistic of nursing, but to identify the core of traditional caring and relate that to professional nursing care. Our Assumptions are as follows : 1) Care is essential for human growth, well being and survial. 2) 7here are diverse and universal forma, expressions, patterns, and processes of human care that exist transcul - turally. 3) The behaviors and functions of caring differ according to the social structure of each culture. 4) Cultures have folk and professional care values, beliefs, and practices. To promote the quality of nursing care we must understand the folk care value, beliefs, and practices. We undertook this study to understand caring in our traditional culture. The Goals of this study were as follows : 1) To identify patterns in caring behavior, 2) To identify the structural components of caring, and 3) To understand the meaning and some principles of caring. We faised several questions in this study. Who is the care-giver? Who is the care-receipient? Was the woman the major care -giver at any time? What are the patterns in caring behavior? What art the priciples underlying the caring process? We used an interdisciplinary team approach, composed of representatives from nursing and anthropology, to contribute in -depth understanding of caring through a socicaltural perspeetive. A Field study was conducted in Ro-Bong, a small agricultural kinship village. The subjects were nine women and one man aged be or more years of age. Data were collected from january 15 to 21, 1990 through opem-ended in-depth interviews and observations. The interview focused on caring behaviors sorrounding birth, aging, death and child rearing. We analysed these data for meaning, pattern and priciples of caring. In this report we describe caring behaviors surrounding childbirth. The care-givers were primarily mothers- in -low, other women in the family older than the mother - to- be, older neighbor woman, husbands, and mothers of the mother-to- be. The care receivers were the mother-to-be the baby, and the immediate family as a component of kinship. Emerging caring behavior included praying, helping proscribing, giving moral advice(Deug - Dam), showing concern, instructing, protecting, making preparations, showing consideration, touching, trusting, encouraging, giving emotional comfort, being with, worrying about, being patient, preventing problems, showing by an example, looking after bringing up, taking care of postnatal health, streng thening the health condition, entering into another's feelings(empathizing), and sharing food, joy and sorrow The emerging caring component were affection, touching, nurtuing, teaching, praying, comforting, encouraging, sharing. empathizing, self - discipline, protecting, preparing, helping and compassion. Emerging principles of. caring were solidarity, heir- archzeal relationships, sex - role distinction. Caring during birth expresses the valve of life and reflects the valued traditional beliefs that human birth is given by god and a unique unifying family event reaching back to include the ancestors and foreward to later generations. In addition, We found positive and rational foundations for traditionl caring behaviors surrounding birth, these should not be stigmatized as inational or superstitious. The nurse appropriately adopts the rational and positive nature of traditional caring behaviors to promote the quality of nursing care.

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장기 보호 여성노인의 수발에 관한 연구 - 수발특성과 우울을 중심으로 - (Caregiving for the Long-Term Care Elderly Women - Focusing on Caregiving Characteristics and Depression -)

  • 김태현
    • 대한가정학회지
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    • 제41권6호
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    • pp.143-156
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    • 2003
  • The present study was initially designed to figure out the general condition of care giving system for the elderly women who need long term care and the level of their depression according to the conditions of care. And This research is intented to present appropriate policy that could help the establishment of supporting system for the fragile elderly women.1 used the data from <2001 National Study on the Needs for the Long-Term Care Elderly> by Korea Health and Population Institute. The results are as follows: First, Two third of all the respondents had serious problems (2-9 activities limits) in Instrumental Daily Living Ability(DAL). Most respondents reported “low” in satisfaction level related to receiving care, meaning the elderly had negative perception for the care from the family. The elderly expected their children to be as the primary care giver and mostly wanted to live with them in the future. Second, The majority of the long term care elderly women haven't used community service facilities very often and said they are not likely going to use the facilities in the future. Third, The respondents reported high in depression level as to lower satisfaction with their children's support, poorer health condition, more reluctant to use service facilities due to the cost, and fewer friends and neighbors resources around them. Therefore I could say that negative factors for the elderly women's psychological health were having unsatisfactory relationship with intimate people, developing physical illness, being in economic difficulties. That is, receiving less help from close family members, shrinking social network, and experiencing economic hardship would have negative effects on elderly women's psychological health. In the basis of these results, I suggest that in the mean time we shouldn't overlook the importance of the private support when we develop the public elderly support system.

장기요양보험제도에 따른 인력양성의 네트워크 사례연구 - 부산시 영도구 요양보호사 교육운영 사례 - (Case Study on Network of Manpower-training related to Long-term care insurance system - Focus on Education management about Long-term care-giver of Yong Do Gu in Busan city -)

  • 남희은;임창호;류황건;배성권;김상희;김선희;이재희;김향은
    • 보건의료산업학회지
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    • 제2권1호
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    • pp.125-136
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    • 2008
  • Government came to enforce long-term care insurance system in preparation for the rapid aging society. Whether this system is successful or not depends on the professionalism of long-term care-givers who are professional population in charge of care service. Currently in the early stage of enforcement, such problems as a race cutting fee resulted from numerical increase of educational facilities, insolvent operation, degradation of education level resulted from unprofessional instructor, are pointed out. As a mean of manpower-training on long-term care insurance system, this study is to research public-private-university network model of the Academy of Continuing Education attached to Ko Sin University which is the case of Yong Do Gu Busan city. Networking between the vision and development strategy of Yong Do Gu on continuing education city, education system on community manpower-training supported by Ko Sin University, and service field of welfare for the elderly can not only contribute to the professionalism of long-term care-givers but also play an ideal role in manpower-utilization and arrangement of community. Through this networking, high quality of education level and circumstance, using the existing infra, manpower-training and utilization for continuing education of Yong Do Gu can be accomplished. Additionally, the connection with facilities related with welfare for the elderly can contribute to professionalism and accountability of manpower-networking.

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돌봄의 개념분석 (Concept Analysis of Caring)

  • 이병숙
    • 대한간호학회지
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    • 제26권2호
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    • pp.337-344
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    • 1996
  • Caring is being rediscovered as a central and unifying concept of the nursing. Traditionally, nursing profession has emphasized spirit and activities of caring. But there is little efforts to study the caring phenomena scientifically and systematically in nursing, and then the concept of caring is still remained unclear and ambiguous. Changes of social, and health care environment are threatening the philosophy and practice of caring, so it is urgent to identify caring more scientifically and to rediscover the nature of nursing discipline. Knowledge of the caring is essential component for the development of nursing as a science and a profession. The first thing to study a concept is thought to be the analysis of the concept. So in this study, concept analysis of caring was performed to clarify the concept of caring as a basis for the study of caring afterward. The approach used for the concept analysis of caring was the approach presented by Walker and Avant. The defining(or critical) attributes of caring identified in this study were (1) a series of activities for helping others, (2) concern and devotion. (3) interpersonal relationship, and (4) scientific and systematic process. The identified antecedents of caring were (1) awareness of other's needs for help, and (2) moral and cognitive motivation for helping others. The identified consequences of caring were (1) healing, (2) satisfaction, and (3) growth. And the consequences of caring were revealed to both of the care giver and the care receiver. The empirical referents of caring could be the behaviors of interpersonal relationship through scientific and systematic process with concern and devotion for others.

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