• 제목/요약/키워드: long-term care center

검색결과 322건 처리시간 0.033초

Propensity score matching analysis on inpatient period differences of hemorrhagic stroke survivors depending on medical insurance coverage

  • Kim, Sang-Mi;Kim, Young;Lee, Seong-A
    • Physical Therapy Rehabilitation Science
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    • 제8권2호
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    • pp.67-73
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    • 2019
  • Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.

방문요양 요양보호사의 소진 경험에 관한 연구 (A study on the Burnout Experience of in Home Care workers)

  • 황순애;김진경;임해영
    • 한국콘텐츠학회논문지
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    • 제22권10호
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    • pp.330-348
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    • 2022
  • 본 연구의 목적은 방문요양 요양보호사의 소진 경험에 관한 질적 사례연구 수행을 통해 이들의 소진 예방 및 극복을 위한 유용한 이론적, 실천적 시사점을 도출하는데 있다. 이를 위해 방문요양 요양보호사들이 65세 이상 장기요양급여 서비스 대상 노인 및 그 가족보호자와, 파견하는 재가노인복지센터와의 관계경험 안에서 어떠한 맥락을 경험하였는지를 분석하였다. 분석 결과, 도출된 상위범주는 총 12개로, '의심받는 존재로 전락한 나', '추락한 자존감', '더 하고 싶지 않은 방문요양보호사 활동', '억압된 존재', '폭력적 상황에 노출', '가치절하된 돌봄 노동자', '전문 직종으로 인정받기 어려운 일', '일의 경계선이 명확하지 않는 노동', '노인가족에 대한 실망', '개선되기 쉽지 않는 사회적 인식과 노력', '파견기관의 열악한 처우', '파견기관에 대한 불신'으로 나타나고 있다. 위와 같은 연구결과 및 논의점을 바탕으로, 방문요양보호사의 소진을 예방하거나 감소하기 위한 제언방안을 제시하였다.

VR을 활용한 인지재활 프로그램 개발 (Development of Cognitive Program Using VR)

  • 한정원;강지원;윤정빈
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2022년도 추계학술대회
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    • pp.509-510
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    • 2022
  • 현재 경증치매를 갖고 있는 노인은 노인장기요양보험법에 의해 치매안심센터나 지역의 주간보호센터에서 인지프로그램을 제공받을 수 있지만, 지역의 독거노인은 치매 고위험군이면서 장기요양제도의 혜택은 받지 못하고 있는 상황이다. 독거노인의 비율은 점차로 높아져 가고 있지만 자립생활을 위한 일상생활능력향상 프로그램이나 치매예방을 위한 인지프로그램의 제공은 상당히 미미한 상황이다. 본 논문에서는 지역의 독거노인을 대상으로 ICT나 VR을 활용한 인지프로그램 개발의 필요성과 활용성을 조사, 분석하였다. 독거노인들은 새로운 기술에 대한 호감이 높았고, 기술활용에 대한 두려움과 호기심을 가지고 있었다. 다만, 새로운 기구나 기술을 접목할 때의 인간 관계와 유대감이 매우 필요함을 알 수 있었다.

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한국의 선도병원으로서의 위상 재구축에 관한 연구 - 서울대학교 병원 마스터 플랜 사례 - (A study on the reshaping the prospect of a leading hospital in Korea - a case study : Seoul National University Hospital Master Plan -)

  • Lee, Jung Man;Kim, Kevin
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제8권2호
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    • pp.61-66
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    • 2002
  • 서울대학병원의 마스터플랜 재구성에 대한 프로젝트로서 기존의 환경에 대한 조사와 분석 그리고 외국사례와의 비교를 통해 앞으로 서울대학병원이 나아가야 할 목표 및 방향을 단기(1-2년), 중기(2-5년), 장기(10년 이상)계획으로 나누어 각 단계별 항목들을 분석, 구체화하였다. 단계계획에서는 응급실의 확장과 어린이 병원증축에 대한 내용을 제시하였고, 중기계획에서는 외래진료센타(ambulatory care center)에 대한 공간구성을 통하여 기존 마스터플랜이 나아가야 할 방향을 제시하였다. 장기계획에서는 어린이 병원의 이전, 캠퍼스 기능구획을 연구, 교육, 병원으로의 분류, 공급시설의 개선과정을 제시하였다. 이 연구를 통하여, 한국의 병원시장에 대한 경향을 다음과 같이 분석할 수 있었다. 1) 증축공간이 부족한 도심에 밀집한 한국병원의 경우, 리노베이션을 통한 마스터플랜은 다양한 시설물을 개선, 관리, 통합할 수 있는 방법이다. 2) 편리성, 환자의 프라이버시, 전문성, 방문자 오락시설, 통합적인 치료환경의 구축이다. 3) 예방 의약품의 증가, 건강센타, 건강중심의 프로그램, 확장된 진료시설 등 건강유지분야의 개발이다. 마스터 플랜은 계속 진행되는 과정의 일부분이며, 변화하는 조건 속에서 적용되어, 수정되어져야 할 것이다.

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기관지확장증 환자에서 폐 비결핵성 마이코박테리아증의 유병률 (Prevalence of NTM Pulmonary Infection in the Patients with Bronchiectasis)

  • 이정연;송재우;홍상범;오연목;임채만;이상도;고윤석;김우성;김동순;김원동;심태선
    • Tuberculosis and Respiratory Diseases
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    • 제57권4호
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    • pp.311-319
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    • 2004
  • 연구배경 : 기관지 확장증(BE)이 NTM 폐질환의 선행 요건임은 잘 알려져 왔으나 최근 결절이 동반된 BE의 경우 NTM 폐질환의 결과일 가능성이 제시되어 흉부 CT상 BE 소견이 있는 환자들을 대상으로 NTM폐질환의 유병률을 살펴보고자 하였다. 방 법 : 2002년 1년간 서울아산병원에서 흉부 CT를 시행하여 BE소견이 있는 1244명 중 항산균검사를 1회 이상 시행한 866명을 대상으로 하였고(BE군), BE소견이 없고 객담항산균 검사를 1회 이상 시행한 292명을 대조군으로 하였다. BE군은 흉부 CT소견상 주로 우중엽, 설상엽 및 하엽에 양측성으로 분포하는 BE군(1군), 상엽의 공동 및 석회화 등 전통적으로 폐결핵 치료후의 병변으로 알려진 소견을 동반한 BE군(2군), 기타 BE군(3군)으로 구분하였고, 1군은 다발성 소결절 동반 유무에 따라 1-결절군 및 1-비결절군으로 구분하였다. 각 군에서 객담 항산균 도말, 배양, 및 동정결과와 임상상 및 방사선학적 소견을 비교 분석하였다. 결 과 : 1-결절군은 다른 모든 군과 비교하여 유의하게 NTM 동정률이 높았다(24.2%, p<0.05). ATS 기준에 따른 NTM 폐질환 예도 1-결절군(5/62, 8.1%)에서 대조군, 2군, 3군에 비하여 유의하게 높았다(p<0.05). 균주 별로는 MAC이 11예(55%), M. abscessus 5예(25%)로 가장 많았다. 결 론 : 주로 우중엽, 좌 설상엽 및 하엽의 양측성의 BE와 동반된 소결절들의 소견은 NTM 폐 감염의 가능성을 시사하는 소견이다. 그러나 이러한 소견을 가진 많은 환자에서는 NTM이 동정 되지 않아 이들이 임상 전단계 (subclinical stage)의 NTM증인지 아니면 별개의 다른 질환군 인지 확인되지 않았다. 추후 장기간의 추적관찰 및 조직검사를 통한 규명이 필요하리라 사료된다.

치매노인의 거주형태 및 서비스유형에 따른 간호관리의 효과분석 (A Study on the Effectiveness of Care of Patients with Alzheimer s Disease According to Residence Arrangement and Types of Services)

  • 홍여신;박현애;조남옥
    • 대한간호학회지
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    • 제26권4호
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    • pp.768-781
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    • 1996
  • The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

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여대생을 위한 단기복합 체중조절프로그램 효과판정 (Evaluation of Short Term Weight Control Program for Female College Students)

  • 강연하;이경옥;하은희;김주영;김화영
    • Journal of Nutrition and Health
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    • 제37권6호
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    • pp.493-501
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    • 2004
  • The purpose of this study was to evaluate weight control program provided by university health care center for female college students. The program was 8-week long and composed of diet, exercise, and behavioral modification. Evaluation was made on the completion of 8-week program and a follow-up survey was done at 3-24 months after the end of program by telephone or bye-mail. Total of 76 women completed the 8-week program and 51 for follow-up survey. On the completion of 8-week program, significant decreases in body weight, BMI, body fat (kg), % body fat, and WHR were resulted, however, no change in muscle mass was found. Even the subjects without weight change showed significant reduction in body fat (kg) and % body fat. Total food intake was decreased resulting in reduced intakes of most nutrients. Meal distribution of energy was changed; %energy from snack decreased from 22% to 14%, and proportion for breakfast increased. Blood values of hemoglobin, hematocrit, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride were within normal range, and no changes were observed by this program. The follow-up survey revealed that 88.3% of the subjects continued to lose weight after completion of the program, while only 7.8% gained weight. And 78.4% of the subjects considered the program effective. In conclusion, the weight reducing regime with education is effective for long lasting weight control and health conscious behavior for female college student. Since the subjects reduced the size of meal, instead of cutting only calories down, food selection to meet all the nutrient requirements except energy should be emphasized.

Daily Amperometric Monitoring of Immunoglobulin E in a Mouse Whole Blood: Model of Ovalbumin Induced Asthma

  • Lee, Ju Kyung;Yoon, Sung-hoon;Kim, Sang Hee
    • 전기화학회지
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    • 제25권1호
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    • pp.13-21
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    • 2022
  • There is an increasing interest in monitoring of specific biomarker for determining progression of a disease or efficacy of a treatment. Conventional method for quantification of specific biomarkers as enzyme linked immunosorbent assay (ELISA) has high material costs, long incubation periods, requires large volume of samples and involves special instruments, which necessitates clinical samples to be sent to a lab. This paper reports on the development of an electrochemical biosensor to measure total immunoglobulin E (IgE), a marker of asthma disease that varies with age, gender, and disease in concentrations from 0.3-1000 ng/mL with consuming 20 µL volume of whole blood sample. The sensor provides rapid, accurate, easy, point-of-care measurement of IgE, also, sequential monitoring of total IgE with ovalbumin (OVA) induced mice is another application of sensor. Taken together, these results provide an alternative way for detection of biomarkers in whole blood with low volumes and long-term ex-vivo assessments for understanding the progression of a disease.

Recognizable Investigation on Home Visiting Physical Therapy of Physical Therapist in Gwangju and Jeonnam

  • Yu, Seong-Hun;Kim, Seung-Rae;Cho, Sung-Hyoun;Seo, Tae-Hwa;Moon, Young-Sung;Kim, Myeong-Hui;Kim, Hyun-Jin
    • 대한물리의학회지
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    • 제11권3호
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    • pp.19-34
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    • 2016
  • PURPOSE: This study seeks to examine the awareness and need of home visiting physical therapy among physical therapist in Gwangju and Jeonnam province. METHODS: Survey was conducted during the continuing education on physical therapist held in Gwangju in 2015 with 297 participants. The survey questionnaire consisted of 12 questions on the characteristics of physical therapists, 8 questions regarding the awareness of home visiting physical therapy, and 7 questions on need. RESULTS: Significant differences were found regarding service period, according to categories of the inconvenience associated with commuting to/from hospitals, long-term treatment for patients, high quality treatment with intensive care, treatment at a time of patients' choosing. The category of hospital fees reduced due to early discharge from the hospital also saw significant differences, depending on respondents' marital status, dependent family, and service period. Providing treatment without causing discomfort to patients in front of others also saw significant differences according to physical therapist career period. Home visiting physical therapy is easier for family members to take care of patients also saw significant differences according to education and physical therapist career period. CONCLUSION: Survey indicates that physical therapist province feel the need for home visiting physical therapy in many respects. However, since as many as half of the surveyed physical therapists have only heard of home visiting physical therapy or are have no awareness of the this form of treatment, it appears that there is a need to raise awareness of home visiting physical therapy among physical therapist and introduce appropriate policies.

일본 자녀양육지원정책의 변화와 보육소의 지역사회 개방(開放) (Changes in Parenting Support Policy and Opening Day Nurseries to Local Communities in Japan)

  • 최미미
    • 비교교육연구
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    • 제27권4호
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    • pp.285-310
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    • 2017
  • 본 연구에서는 일본 자녀양육지원정책의 변화와 더불어 지역사회 내 자녀양육지원 거점으로서 보육소의 기능 및 역할에 대하여 살펴보았다. 이를 통하여 한국 자녀양육지원정책 및 보육시설의 나아갈 방향에 대한 시사점을 제공하는 데 목적이 있다. 본 연구의 분석 자료로 일본 내각부의 소자화사회 대책 백서, 보육소보육지침 등 국가 수준의 문헌들을 중심으로 분석하였다. 분석 결과, 일본 자녀양육 관련 정책은 국내외 자녀양육 환경의 변화 및 사회적 요구를 파악하여 지역사회 구성원 모두를 위한 중장기적이고 포괄적인 정책을 도입함과 동시에 자녀양육에 대한 사회적 인식 개선을 도모하고 있음을 알 수 있었다. 2001년 "아동복지법" 일부 개정에 따른 보육사 자격의 법정화, 2008년 일본 보육소보육지침(보육소 보육 가이드라인)의 고시화에 따라 지역사회 내 자녀양육지원의 일환으로 가정에 근접해 있는 보육소의 역할이 대두되었으며, 지역사회의 공적 자원으로 개방되어 활용됨으로써 보육소의 사회적 책임이 명시되었다. 이를 바탕으로 한국 지역사회 내 자녀양육지원거점 기관으로서 어린이집의 역할 및 기능에 대한 재고가 필요함을 알 수 있었다. 또한 지역사회 내 어린이집 및 부모들과 같은 실제 관계자들에 대한 목소리에 귀를 기울일 것이 요구된다. 나아가 지역사회 내 구성원 간 협력을 통하여 자녀양육에 대한 이해 및 가치를 공유하고, 그와 관련된 정보를 교환할 수 있는 공동의 장(場) 활성화를 도모하여야 한다.