주야간보호서비스 이용 치매노인 주돌봄자의 부양경험 : 자녀동거가구와 노인부부가구를 중심으로

송기자 경희대학교 공공대학원 2016 국내석사

본 연구의 목적은 주야간보호서비스 이용 치매노인 주돌봄자의 부양경험을 자녀동거가구와 노인부부가구를 중심으로 심층 파악하여 기술함으로써 이용자별 맞춤서비스 제공에 대한 필요성을 부각시키고, 주돌봄자의 부양부담을 경감할 수 있는 방안을 마련하기 위함이다. 연구 목적을 위해 실제 상황에 대해 구체적으로 알아볼 수 있는 질적 사례연구를 연구방법으로 선택하였고, 치매노인을 직접 돌보는 주돌봄자를 연구참여자로 선정하여 심층면접을 통해 자료를 수집하였다. 연구참여자들의 심층면접 진술 내용을 분석하여 총188개의 의미 있는 진술을 도출하였고, 도출된 구나, 문장들을 의미단위로 함축하여 자녀동거가구 35개, 노인부부가구 40개의 하위범주와 공통의 핵심 이슈 9개를 범주로 정하였다. 9개 범주는 치매의 발병, 부양의 어려움, 가족의 지지형태, 주야간보호서비스의 접근, 주야간보호서비스 이용 후의 변화, 주야간보호서비스 만족 요인, 주야간보호서비스 추가욕구, 요양시설 이용에 대한 견해, 정부의 치매관리 정책에 대한 인식이다. 연구 결과에서 주돌봄자들은 치매노인이 주야간보호서비스를 이용하면서 낮 동안 시간적 여유를 갖게 되어 경제활동, 사회활동, 여가활동을 마음 편하게 할 수 있게 되었다고 한다. 하지만 주야간보호서비스를 이용하지 않는 야간이나 주말에는 집에서 누군가 돌봐야하기 때문에 부양부담에서 자유로울 수 없다고 했다. 특히 다른 가족의 지지가 부족한 노인 배우자가 치매노인을 돌보는 경우 더 큰 어려움을 호소했다. 제도 9년차를 맞이한 노인장기요양보험은 주야간보호를 비롯한 장기요양서비스의 공급을 민간에서 운영하는 기관에 크게 의존하고 있다. 따라서 환경이 열악한 민간기관의 경우 시설과 인력기준에 대한 정책적 지원, 제도의 개선 및 보완을 통해 이용자들에게 제공되는 서비스 질을 향상 시켜야 한다. 본 연구는 주야간보호서비스의 발전 방향을 모색하기 위해 영국, 미국, 일본의 주야간보호 서비스 현황과 시사점을 찾아보았고, ‘단기보호제도 확대 적용’, ‘시설 및 인력 기준 재정비’, ‘욕구별 맞춤형 프로그램 개발 필요’, ‘인식 개선을 위한 적극적인 홍보’를 개선과제로 제시하였다. 고령화 사회를 살아가는 우리는 대부분 직·간접적으로 치매노인 부양에 대한 책임과 부담을 안고 있다. 주야간보호서비스는 향후 재가서비스를 지향하는 정책적 추세와 맞물려 치매노인 돌봄에 주도적인 역할을 할 것이다. 따라서 정부의 치매관리종합계획이 치매노인에게는 맞춤형 프로그램을 제공하여 잔존기능을 지속시키고, 치매노인을 돌보는 주돌봄자에게는 실질적인 도움들을 지원할 수 있는 정책이 되기를 기대한다. This study aimed at examining in detail the caring experiences of primary caregiver of elderly households with adult children and elderly couple households, thereby emphasizing the necessity for providing a customized service for each user and presenting a way to reduce primary caregivers’burden of looking after the elderly with dementia using day and night care services. To this end, a qualitative case study, which enables a detailed examination into an actual case, was selected as a research method. Primary caregivers who looked after the elderly with dementia were selected as research participants in this study. The research participants were subjected to in-depth interviews to collect data. From the analysis of what the participants said during the interviews, a total of 188 meaningful statements were drawn. The drawn phrases or sentences were made into meaning units, producing 35 sub-categories for elderly households with adult person, 40 sub-categories for elderly couple households and nine categories involving common key issues. The nine categories include the development of dementia, the difficulty of caring, the form of support from family, approaching the day and night care services, changes made after the using day and night care services, satisfaction factors of the day and night care services, additional desire regarding the day and night care service, views on using care facilities, and perception on the government's policy to manage dementia. According to the results of this study, primary caregiver was able to do economic activities, social activities and leisure activities without concern for the elderly during the elderly began to use the day and night care services. However, they were not free from the burden of looking after the elderly as one of the family members had to take care of the elderly during the night and weekends when the day and night care services were not provided. Particularly, when an elderly person looked after the spouse with dementia with little support from other family members, the elderly person had far more difficulty. The long-term care insurance for the elderly, which has operated for nine years, has largely depended on private institutions to provide long-term care service including the day and night care. Therefore, private institutions with poor conditions have improved the quality of services for users through policy support for facilities and manpower standard and the improvement and complementation of the systems. In order to seek the direction for the development of the day and night care services, the present conditions of the day and night care services in the United Kingdom, the United States, and Japan were examined, and suggestions were gained from such examination. This study proposed the following four things to be improved. First, extension of the short-term care system. Second, strengthening facility and manpower standard. Third, necessity for the development of a customized program for each desire. Fourth, an aggressive promotion for the improvement of perception. Most of people in the aging society have the direct or indirect responsibility of looking after the elderly with dementia. In the future, the day and night care services will play a leading role in taking care of elderly people with dementia in combination with the policy trend that seeks in-home services. Therefore, it is hoped that the government's comprehensive plan to manage dementia will provide a customized program for elderly people with dementia, helping them to maintain the remaining functions, and give practical help to primary caregiver looking after the elderly with dementia.

교육대학원생의 자기주도성이 자기효능감을 매개로 경력개발역량에 미치는 영향

송기자 광운대학교 대학원 2023 국내석사

본 연구는 교육대학원에서 학습을 경험한 재학생과 졸업생을 대상으로 자기주도성, 자기효능감, 경력개발역량에 대한 인식과 개인배경에 따른 각 주요변인에 대한 인식의 차이를 알아보았다. 교육대학원생의 자기효능감이 경력개발역량에 미치는 요인을 분석하고, 자기주도성과 경력개발역량의 관계에서 자기효능감의 매개효과를 알아보는 것을 목적으로 하였다. 이를 통해서 교육대학원생의 자기주도성과 자기효능감을 증진시키고 경력개발역량을 높일 수 있는 방안을 모색하였다. 첫째, 교육대학원생이 지각하는 자기주도성, 자기효능감, 경력개발역량 인식은 보통수준이다. 둘째, 교육대학원생의 개인배경에 따른 자기주도성, 자기효능감, 경력개발역량의 인식 차이를 분석한 결과, 연령에 따른 각 변인의 인식 차이는 자기주도성의 학습에 대한 애정과 열정, 솔선수범 및 독립성, 자기주도성 총점에서 나타났다. 셋째, 자기효능감에 미치는 요인을 분석한 결과, 자기주도성의 학습기회에 대한 개방성, 솔선수범 및 독립성, 효율적인 학습자라는 자아개념이고, 사회적 효능감은 효율적인 학습자라는 자아개념이고, 자기조절 효능감은 학습에 대한 애정과 열정, 솔선수범 및 독립성, 효율적인 학습자라는 자아개념이 높다. 자기주도성과 경력개발역량의 관계에서 자기효능감의 매개효과를 검증한 결과, 자기주도성은 경력개발역량에 영향을 미치는 직접효과도 있고, 자기효능감이 경력개발역량에 영향을 주는 간접효과도 있는 것으로 나타났다. This study targets current students and graduates who have studied at graduate schools of education and investigates differences between perceptions of self-initiative, self-efficacy, and career development competence and perceptions of each major variable based on personal backgrounds. In addition, the objectives of this study are to analyze the effect of education major graduate students’ self-efficacy on career development competence and to find out the effect of self-efficacy as a medium in the relationship between self-initiative and career development competence. Based on these, it identifies ways to enhance self-initiative and self-efficacy of the education major graduate students and enhance their career development competence. The ultimate purpose is to provide help to these students who strive to improve their career development competence and acquire the expertise required for field work while balancing between work and study to cope with social changes. To achieve these goals, data has been collected through a survey performed on 395 current students and graduates of graduate schools of education combined. Then, the collected data has been analyzed using IBM SPSS Statistics 26.0 program and verified at the significance level of p<.05. The results are as follows. First, the perceptions of self-initiative, self-efficacy, and career development competence by the education major graduate students are at the normal level. Self-initiative comes in order of “love and passion for learning,” “exemplariness and independence,” “openness to learning opportunities,” and “self-identification as an effective learner,” and self-efficacy is in order of “self-control efficacy,” “academic learning efficacy,” and “social efficacy.” Therefore, it is necessary to enhance the levels of self-initiative, self-efficacy, and career development competence. Second, the results of analyzing the perception differences in self-initiative, self-efficacy, and career development competence based on personal backgrounds of the students are as follows. There is no difference in the perception of the major variables for different genders and occupations. The perception differences of each variable for age appear in the sub-factors of self-initiative including love and passion for learning, exemplariness and independence, and the total self-initiative score. In all three factors, “51 to 60 years of age” shows higher results than “40 years of age or younger.” The differences in the recognition of each variable based on whether the students are currently enrolled in school are found in academic learning efficacy and career development competence of self-efficacy. One of the sub-factors of self-efficacy, academic learning efficacy, is higher for “current students” and “graduates” than for “others/students on leave of absence.” As for career development competence, “current students (A)” and “graduates (A)” have higher results than “others/ students on leave of absence (B).” Third, the results of the regression analysis on the factors affecting self-efficacy are as follows. Academic learning efficacy is higher as the age of the respondent is younger. Openness to learning opportunities, exemplariness and independence, and self-identification as an effective learner are self-concepts of self-initiative, while social efficacy is a self-concept of being an effective learner. Self-control efficacy shows strong self-concepts of love and passion for learning, exemplariness and independence, and self-identification as an effective learner. Fourth, the results of the hierarchical regression analysis on the factors affecting career development competence are as follows. If you look at the research results of Model 1 analyzed by using personal background as an independent variable and Model 2 analyzed by using self-initiative, personal background, and self-efficacy as independent variables, the self-concepts of love and passion for learning and self-identification as an effective learner have an impact on career development competence in Model 1. For Model 2, it is built by adding self-efficacy to Model 1 and shows a significant change in R2. In this model, the self-concepts of love and passion for learning and self-identification as an effective learner under self-initiative and social efficacy and self-control efficacy under self-efficacy have an impact on career development competence. The self-concepts that have the strongest influence on career development competence are love and passion for learning and self-identification as an effective learner under self-initiative and social efficacy and self-control efficacy under self-efficacy. Fifth, the results of verifying the effect of self-efficacy as a medium in the relationship between self-initiative and career development competence show that self-initiative has a direct effect on career development competence while self-efficacy has an indirect effect on career development competence. Based on the results of this study, the following conclusions have been drawn to improve self-initiative and self-efficacy of the education major graduate students and to increase their career development competence. First, a learning operation system integrated with work should be improved to advance learning effects and adapt to jobs or work environments to increase self-initiative, self-efficacy, and career development competence. To continue to improve each individual's career development competence, the more concrete and proactive the student’s competence is, the higher the level of his or her perception change will be. Second, self-efficacy should be increased based on the consideration of the personal background of the education major graduate students. It is necessary to establish an integrated life-long work and learning system for the education major graduate students, who work and study at the same time to acquire career development competence. Third, the education major graduate students should identify measures to increase their career development competence in preparation for adapting to the changing social environment. Self-efficacy should be enhanced by utilizing opportunities such as seminars, discussions, and presentations that encourage professional differentiation and active participation in learning. After all, increased self-efficacy leads to increased personal competence. Therefore, when self-initiative to proactively solve issues is preceded, the improvement of career development competence will become effective.