농촌지역 노인전문요양시설 치매노인의 생활행위에 관한 연구

양금석 한국농촌건축학회 2008 농촌건축 : 한국농촌건축학회논문집 Vol.10 No.27

The purpose of this study is to clarify the actual condition of the daily living activities of the elderly with dementia in skilled nursing facilities. The thorough investigation and observation works were made from the view points of daily living behaviors and behavioral places of the recuperating elderly with dementia. This article discusses about the basic characteristics of the elderly and the actual condition of the daily living activities of the elderly with dementia in 2 skilled nursing facilities. The results of this study are summarized as follows; There is no wide difference between skilled nursing facilities on the characteristic of living behaviors of the elderly with dementia. Daily living activities and the use of spaces are largely influenced by the daily program and the operation policy of each skilled nursing facilities in addition to human relationship of the elderly with dementia. Common spaces such as day room, dining room plays an important role for their daily living activities, because that most of the elderly with dementia stay long during daytime. Layout of each private room and common space seems very crucial point in designing these facilities, in order to enable demented people to live their lives more independently. The purpose of this study is to clarify the actual condition of the daily living activities of the elderly with dementia in skilled nursing facilities. The thorough investigation and observation works were made from the view points of daily living behaviors and behavioral places of the recuperating elderly with dementia. This article discusses about the basic characteristics of the elderly and the actual condition of the daily living activities of the elderly with dementia in 2 skilled nursing facilities. The results of this study are summarized as follows; There is no wide difference between skilled nursing facilities on the characteristic of living behaviors of the elderly with dementia. Daily living activities and the use of spaces are largely influenced by the daily program and the operation policy of each skilled nursing facilities in addition to human relationship of the elderly with dementia. Common spaces such as day room, dining room plays an important role for their daily living activities, because that most of the elderly with dementia stay long during daytime. Layout of each private room and common space seems very crucial point in designing these facilities, in order to enable demented people to live their lives more independently.

간호학생의 노인요양시설에서의 노인간호실습 경험

김정아(Kim, Jeongah) 질적연구학회 2016 질적연구 Vol.17 No.1

Purpose: The purpose of this study is to examine the nursing student experiences of gerontological nursing practicum at elderly care facilities. Methods: The participants of this study were 74 nursing students in their sophomore year of college. Reflective journals were collected from all participants after practicing 45 hours of gerontological nursing practicum at elderly care facilities. Data were analyzed using the qualitative thematic analysis method suggested by Braun and Clarke. Results: Four common themes were observed from the collected significant statements: Experience of 1) difficulties and internal conflicts, 2) empathy and understanding, 3) expanded recognition, and 4) reflection and growth. Conclusion: The above findings provides an understanding of the nursing student experiences of gerontological nursing practicum at elderly care facilities. This result may be helpful for improving the nursing practical curriculum for gerontological practice.

장기요양시설 규모별 간호서비스 요구 및 제공현황 비교

이정석,황라일,박세영,한은정 경희대학교 동서간호학연구소 2020 동서간호학연구지 Vol.26 No.1

Purpose: The aim of this study was to provide information on the extent and variations of elderly residents’ nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse’s aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers’ perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities. 목적 : 전국 노인장기요양 입소 시설을 대상으로 시설 규모별 간호처치 요구 및 간호서비스 제공 현황, 그리고 간호책임자의 의료 및 간호서비스 제공에 대한 인식도를 비교함으로써 향후 입소 노인 대상 연속적이고 통합적인 간호서비스 제공 모델을 개발하기 위한 기초자료를 제공하는데 목적이 있다. 연구방법 : 전국에 분포한 노인장기요양 입소 시설을 유형별, 소재지역별, 정원규모별로 비례층화표본추출한 2017 년 8 월 16 일부터 9 월 30 일까지 설문조사한 총 1,041 개 기관을 대상으로 분석하였다. 연구결과: 30인 이상 노인요양시설은 노인요양공동생활가정에 비해 간호사 배치율, 의료연계율 및 전문적 간호 서비스의 요구를 수행할 가능성이 더 높은 것으로 나타났다. 또한 간호책임자는 입소 시설 규모가 작을수록 간호인력 부족, 의료 및 간호처치 요구에 대처하는데 더 큰 어려움을 겪고 있었으며, 모든 입소 시설에서 응급 대처에 필요햔 간호사 배치가 필요하다고 인식하는 것으로 나타났다. 결론 : 본 연구에서는 노인요양공동생활가정의 간호처치 및 의료적 요구를 충족시킬 방안의 마련과 함께 입소 시설 내 간호 인력 수준을 높이고 의료 연계 및 서비스의 접근성을 향상시키기 위한 제도적 방안 모색이 필수적임을 확인하였다.

중증장애노인을 위한 의료복지시설의 공간구성에 관한 연구

이을규,양관목,김성룡,이경락 대한건축학회 2023 대한건축학회논문집 Vol.39 No.3

The aging rate of Korea is currently 15.7% in 2020 and is expected to exceed 34.4% in 2040. The use of welfare services for the elderlyshows a tendency to shift from facility services to home healthcare services. Prior to 2008, nursing facilities were divided into paid carefacilities, actual cost care facilities, and free care facilities. However, with the introduction of the long-term care insurance system for theelderly in 2008, it seems that facilities for the elderly and health and medical policies have been operated in a more comprehensive manner. But there is a part where more functional differentiation needs to be made in welfare facilities for the elderly. In this way, proper medicaltreatment is provided and excessive services are not implemented, so insurance premiums are claimed properly, and thus long-term careinsurance for the elderly and medical insurance finances are strengthened. Ultimately, it will reduce the burden of medical expenses for theelderly and increase the quality of services. Currently, the legal boundary between nursing homes for the elderly, elderly hospitals, andgeneral hospitals is ambiguous, and it is difficult for the elderly to select appropriate facilities. The facilities to be investigated in this studyare facilities that can be used by the elderly with severe disabilities at level 2 or higher for long-term care in Korea and abroad. Throughthis study, we found the following facts. The current spatial composition of the medical welfare facilities for the elderly is still insufficientto practically realize the principle of respect for human beings, the principle of home protection, and the principle of professional protectiondevelopment, which are the ideologies of welfare facilities for the elderly. It is being built to the extent that it barely meets the legalstandard of 23.6㎡ of gross floor area per resident and the legal standard of bedroom area per resident of elderly care facilities. As a result,Currently, the medical welfare facilities are insufficient to secure the private life area of the elderly, and it is difficult to secure sufficientspace for privacy in accordance with the principle of respect for human beings. 본 연구는 중증장애노인을 위한 의료복지시설을 대상으로 하고, 입소 노인 1인당 시설 연면적과 침실 면적이 어느 정도 비율로 공간구성이 되고 있는지 분석하고, 건축적인 공간구성이 노인의료복지시설의 이념인 인간 존중의 원리, 가정보호 중심의 원리, 전문적 보호 전개의 원리를 실질적으로 실천할 수 있는 휴식 공간과 교류공간 등의 지원실 공간구성이 잘 되어 있는지 분석한다. 또한 침실 단위평면 계획이 어떻게 구성되어 있는지 분석한다. 그럼으로써 본 연구가 노인요양병원과 노인요양시설의 건립목적에 맞는 향후 노인시설계획 및 설계에 있어서 기초자료로 이용될 수 있도록 한다. 국내의 조사대상 시설은 장기요양등급 2등급 이상의 중증 장애를 가지고 있는 노인들이 입소 가능한 시설로서, 노인의료복지시설 전문가로부터 추천받은 전국의 노인요양병원 14개 시설과, 노인요양시설 8개 시설을 조사 대상시설로 선정하여, 건축도면분석과 함께 운영자에게 인터뷰조사를 실시했다. 국외의 조사대상 시설은 일본의 노인요양시설을 대상으로, 국내의 장기요양등급 2등급 이상에 해당하는 요개호 3~5등급의 중증의 장애를 가지고 있는 노인들이 입소 가능한 시설 5개를 선정하여 분석하였다. 결론으로 국내의 조사대상 시설은 일부 시설을 제외하고는 대체로 노인요양시설의 입소자 1인당 연면적 법적기준과 입소자 1인당 법적 침실 면적 기준을 만족하고 있다. 그러나, 일부 시설은 노인요양병원으로 허가받아서 입소 노인 1인당 연면적이 노인의료요양시설의 기준(연면적 23.6㎡/1인 이상)보다 낮게 나타나고 있으며, 입소 노인 1인당 침실면적도 노인의료요양시설의 기준(6.6㎡/1인 이상)보다 낮은 면적을 보이고 있다. 이는 노인의료요양시설과 같이 장기간 입원 생활을 하여야 하는 노인들에게는 노인요양병원이 전체적으로 매우 열악한 환경에서 일상생활을 강요받게 된다. 그러므로 노인요양병원의 침실면적과 총연면적 법적기준을 노인요양시설의 법적기준으로 통일할 필요가 있다. 일본의 조사대상 시설과 비교하였을 때, 일본의 1인당 시설 연면적은 평균 45.4㎡로 국내 허가 기준의 2배 정도넓게 나타났으며, 1인당 침실 면적도 15.5㎡로 나타났다. 이렇듯 국내시설의 1인당 연면적이 좁다는 것은 휴식 공간과 소그룹 활동 공간 등의 지원 공간이 좁다는 것을 알 수 있는데, 침실공간이 좁다는 것은 자기의 애착 물건 보관이나 사진 장식, 소파 등 자기만의 영역에서 시간을 보내는 기회가 상대적으로 줄어든다. 즉 이것은 이러한 공간에서 행해지는 노인들의 휴식과 교제활동, 그리고 개인적인 공간에서의 행동 횟수가 상대적으로 줄어든다는 것을 의미한다.

노인 요양원에서 근무자의 구강건강 인식상태조사 연구

전양현(Yanghyun Chun),김태석(Taeseok Kim) 대한치과의사협회 2024 대한치과의사협회지 Vol.62 No.4

Proportion of the elderly is steadily increasing, and accordingly, number of elderly care facilities for elderly support is also rising up. However, number of nursing caregivers for welfare services is not following the increasing tendency of elderly care facilities. In this study, we surveyed the oral care work fatigue and satisfaction of the nursing caregivers in elderly care facilities, and what the nursing caregivers think to improve quality of welfare services. Also, we analyzed the factors that have relation with self-care ability of the elderly patients in elderly care facilities to help patients care of nursing caregivers. The above can be summarized as results and proposals as follows. 1. Most of the nursing caregivers were engaged in oral healthcare. Satisfaction of oral healthcare work tended to be high, but fatigue of work and need to improve oral healthcare procedure were also high. 2. To make improvement, nursing caregivers argued that regular oral checkup by dental specialists in the facility is needed, followed by regular education of oral health care to nursing caregivers. This was contrary to the opinions of administrators, who rated regular education of oral health management to administrators as the most important one. 3. Nursing caregivers in elderly care facilities were actively performing oral healthcare, but they felt fatigue of work and argued needs to improve working environment. To achieve this, muti-disciplinary approach should be considered, including improvement of oral healthcare speciality, systemic improvement to ease the healthcare burden on nursing caregivers, and to bridge the gap of opinion between nursing caregivers and administrators in elderly care facilities.

일본의 노인복지시설 생활공간 유형에 관한 연구

김성룡,이을규 한국농촌건축학회 2025 농촌건축 : 한국농촌건축학회논문집 Vol.27 No.2

Korea’s aging rate is currently 20.3%, and it has already entered a super-aged society in December 2024. However, there are areas where more functional differentiation is needed for the welfare facilities for the elderly. As such, the provision of adequate medical services and excessive services are not properly implemented, insurance premiums are charged and the finances of long-term care insurance and medical insurance for the elderly are being strengthened. Ultimately, it will be possible to reduce the burden of medical expenses for the elderly and improve the quality of services. Currently, the types of elderly care facilities are not diverse, so the elderly are unable to choose the appropriate facilities, have mild disabilities, and are forced to live with the elderly with severe diseases, and the symptoms often change suddenly to severe symptoms. Therefore, the purpose of this study is to provide data that can be helpful in the design of elderly care facilities in Korea by considering the architectural characteristics of various elderly care facilities in Japan. In this study, we examine the differences between Japan’s elderly care facilities by type and examine their architectural characteristics. Through this study, the following facts were found. The elderly facilities in Japan started as poor relief facilities and were differentiated into elderly-only facilities used only by the elderly, and the composition of spaces centered on multi-person rooms that somewhat lack privacy has developed into semi-private rooms, and single-person rooms have now developed into general facilities. In the case of multi-person rooms, problems such as privacy problems and decreased autonomy have occurred due to the lack of personal privacy space of residents. Accordingly, recently, a unit-care model has been introduced that enables communal living and social exchange while ensuring individual independence. The average total floor area of facilities per person in the surveyed facilities was about 47.0㎡, which was twice as wide as the domestic permit standard, and the average floor area of the private rooms was 15.5㎡. Through this study, it can be seen that the facility composition of many elderly care facilities currently has relatively diverse spaces to practically practice the principles of human respect, home protection-oriented, and professional protection development, which are the planning ideologies of welfare facilities for the elderly, and in particular, the installation of rest and exchange spaces is secured in various ways regardless of large and small facilities.

노인요양시설 입소 노인의 거주만족도 조사를 통한 효율적인 운영방안

김주연(KIM JU-YEON) 한국교정복지학회 2011 교정복지연구 Vol.- No.21

전통적인 사회에서의 노인은 장기적인 요양을 목적으로 가족의 보호를 받으며, 생활하지만 오늘날의 현실은 산업화, 도시화에 따라 핵가족화로 인한 가족의 구조적ㆍ기능적 변화, 여성의 사회참여, 개인중심의 가치관과 의식구조의 변화 등 노인부양 및 보호에 관한 인식 방법이 과거와는 많은 차이를 보이고 있다 또한 전통적인 효의 개념으로 득병한 노부모를 모신다는 것은 여러 가지로 어려워 시설에 입소시켜 전문적인 보살핌을 원하는 추세이다. 첫째, 거주만족도의 신뢰도를 살펴보면 거주만족도 전체 신뢰도 계수는 0.76이며 각 세부 영역의 신뢰도는 모두 0.77 이상으로 매우 높게 나타났다. 본 연구의 거주 만족도 전체 평균이 2.88로(거주만족도의 척도는 아주 나쁨의 1점에서 아주 좋음의 5점으로 만족도가 높을수록 평균이 높은 것을 의미한다) 나타났으며, 하위 영역 중 시설 운영면과 관련 문항에서 평균이 3.20으로 가장 높게 나타났고, 운영 프로그램 면에서 2.76으로 가장 낮게 나타났다 둘째, 노인요양시설 운영의 효율성의 신뢰도 계수는 0.8341로 높게 나타났으며, 하위 영역의 신뢰도 계수도 0.83을 모두 높게 나타나 시설운영 효율성의 신뢰성은 높다고 볼 수 있다. 셋째, 시설(공간)환경에서 운영 실태는 어르신들의 보호 수준은 전반적으로 사회, 경제발전에 비추어 상당히 뒤떨어진 실정이다. 노인들의 욕구와 특성에 맞는 시설의 환경개선이 시급한 과제이며, 안양시의 시설 수용능력을 제고 할 수 있도록 노인요양시설 보급을 늘려야할 것이다. 넷째, 시설운영 면에서 운영 실태는 종사자의 근무여건 및 자원봉사자의 활용 정도나, 종사자 규모나 근무여건, 인원 배치수준, 업무량 등에서 매우 불만족하고 있는 것으로 나타났다. 이들 종사자에게도 현실에 맞는 급여나 복지혜택이 주어져야 하며 시설에 대한 재정문제와 행정지원도 시설의 서비스 제공과 구분하여 노인복지시설의 만족도 조사를 실시하였으나 재정적으로도 매우 열악하며 운영 재원 확보를 위한 민간단체의 후원수준도 매우 낮으며 또한 정부에 의한 재정 지원도 매우 부족한 실정이어서 이 또한 개선해야 할 시급한 문제로 대두 된다. 다섯째, 프로그램 활용 면에서 운영 실태는 어르신들이 요구하는 프로그램은 종사자와 어르신 모두 높은 비율로 응답한 재활치료와 야유회, 레크리에이션 취미클럽 활동 등으로 나타나고 있으나, 노인요양시설에서 활용되고 있는 프로그램들은 건강프로그램, 취미생활 프로그램, 친목도모프로그램, 교육프로그램 등이 운영되고 있어 제공되는 프로그램들이 어르신들이 요구하는 프로그램 내용과 상당한 차이가 있고, 제공된 프로그램들도 단순 빈약한 것으로 조사 되었다. 여섯째, 거주만족도와 시설운영의 효율성 간의 상관관계를 분석하기위하여 각 만족도의 설명요인들 간의 상관계수를 분석하였다. 시설운영의 효율성의 설명요인인 시설운영과 거주만족도의 설명요인인 시설(공간)환경 간에는 강한 정의 상관이 있는 것으로 나타났으며, 이들 간에 고도의 유의성이 인정되었다(r=0.8777, p<0.0001). 또한 시설운영 효율성의 설명요인인 ‘운영프로그램’과 거주만족도의 설명요인인 ‘시설운영면’ 간에 역시 강한 정의 상관이 나타났으며, 이들 간에 높은 유의성이 인정되었다(r=0.7305, p<0.0001). 그리고 시설운영 효율성의 설명요인 ‘운영프로그램’과 거주만족도의 설명요인인 ‘프로그램면’간에는 약한 정의 상관이 99% 유의수준에서 그 유의성이 있는 것으로 나타났다. Recently, due to the increase of welfare facilities and expansion of the range of welfare services, it is the true that these situations bring about the total amount of welfare. However, the quality of the welfare system is insufficient compared with the increasing the number of the facilities. This study aims to provide an suggestion to improve the efficiency of the nursing home. For this purpose, the residential satisfaction level of the elderly and the reality of facility system were surveyed and the correlation between them is examined. For this study, residential satisfaction and the reality of welfare system were analyzed after consulting the elderly directly and surveying the questionnaires in nursing home, Anyang-city from February 2, 2009 to February 27, 2009. Through the analysis of residential satisfaction and the reality of the facility system, the results are as follows: First, the elderly living in the nursing facility shows their residential satisfaction with 2.88 (Likert scale) on the average of the total in high level of reliability coefficient(0.77). Second, the reliability on the efficiency of the facility system is high with 0.8341 in reliability coefficient. However, the efficiency of the facility system is insufficient. Third, the result of the facility system reality (1) On facility environments, the protection level of the elderly is considerably low compared to the development of society and economy. (2) On facility systems, working condition, the degree of volunteer utilization, the size of facilitators, the disposion of men, and work load are not sufficient to satisfy the elderly. (3) On program utilizations, facilitators and the elderly responses highly on rehap and field trip, recreation, club activity. The programs in the nursing home, however, are usually about health, hobby, friendship and education which is concordably far from the elderly's requests. Forth, the correlation between the examination of facility system reality and the efficiency of facility system is significant by 99% in significance level (r=0.87777, p<0.0001). This means that the efficiency of the facility system and the elderly's residential satisfaction are correspondent. According to this survey, improvements are assumed as follows. (1) The requests of the elderly should be actualized according to society and economic development and supply of the nursing home for the shortage in Anyang city. should be increased upon due consideration that the facilitation capacity. Additionally, for this, government investments should be considered. (2) In order to improve working condition and recruit professional workers, suitable payment and welfare should be required to the facilitators. (3) The lack of financial and administrative support, supporter's civil organization and governmental financial supports are the significant problems to be solved. (4) On programs, coming out of the unchanged program management, various and high quality program development is one of the important tasks. (5) On systematical aspects, considering an aging society, current welfare law for the aged and effective duty performance of government is required and financial supports are should be actualized for people who are not afford to enter the nursing home.

노인요양시설에서 활용되는 간호중재의 중요도와 수행도 분석

박현태,김영애,황혜영 대한간호학회 간호행정학회 2006 간호행정학회지 Vol.12 No.2

Purpose: This study was to identify nursing interventions which were perceived highly in the importance and performance of nursing interventions by nurses in long-term care facilities for elderly. Method: Data was collected from nurses working in long-term care facilities for elderly over 2 years who participated in continuous education by Korea Association of Senior Citizens Welfare Institution. Data was analyzed using mean and paired t-test to compare difference between the importance and performance of each nursing intervention. Results: Among 264 nursing intervention, 49 nursing interventions were considered highly important and performed very often by nurses. Especially, 11 nursing interventions had significant difference between the importance and the performance, which meant that nurses perceived them as the most important and they were not implemented often as much as that by nurses. Conclusion: The results of this study revealed that what kinds of the nursing interventions were perceived highly important and performed very often by nurses in long-term care facilities for elderly. These nursing interventions can be utilized in the development of standardized nursing intervention classification to be used for the long-term care facilities for elderly.

A Study of the Housing Needs of the aged and Elderly Residential Facilities in an Urban Area

임우석 서울대학교행정대학원 2007 The Korean Journal of Policy Studies Vol.21 No.2

The purpose of this study is to find out the demand for residence ofcitizens on the paid elderly residential facilities that has been heightened for itsuse in recent days with the focus on the paid nursing home facilities and the paidelderly treatment facilities. The subject for the survey was 200 adults of 35 yearsor older who reside in Seoul, and for the final analysis, a total of 169 copies ofvalid samples was used. The following is the major result of the study. For thereason of post-retirement entry into the nursing home facilities, the mostresponses came from the fact that they could live with the similar age people asneighborhood or friend. Appropriate residential area would be preferred for 7-12pyeong (1 pyeong=3.3058m2) for single use, and 12-15 pyeong for couples, andfor the appropriate security deposit and monthly living expense at the time ofentering into the facilities, the highest response was for 50 million won and500,000 won for the paid nursing home facilities, and 10-20 million won and600,000 won for the paid elderly treatment facilities. The most important criteriafor using the facilities was in the sequence of entry costs, facilities and others,and the consideration on the facility operator would be in the sequence of facili-ty operation capability and social reliability. And, for the annexation (coestab-lishment) of paid nursing home facilities and elderly treatment facilities, theopinion as desirable was shown high (73.9%).

농촌지역 노인요양시설의 평면 특성에 관한 고찰

양금석 한국농촌건축학회 2016 농촌건축 : 한국농촌건축학회논문집 Vol.18 No.1

The purpose of this study is to clarify the actual conditions of the floor area of skilled nursing facilities in rural area. The thorough investigation and observation works were made from the viewpoints of floor area of the skilled nursing facilities. This article discusses about the basic condition and the floor area for daily living activities of the elderly in 3 skilled nursing facilities in west gyeongnam province. As the result, There is a wide gap between floor area ratio of skilled nursing facilities. The characteristics of the private establishment skilled nursing facilities in the west gyeongnam province were figured out through the analysis of spatial composition in skilled nursing facilities for the elderly. The skilled nursing facilities in west gyeongnam mainly focus on the living environment orientated toward the bedroom. The difficulty is to encourage the communication between the skilled nursing facility patients because the facilities are composed of small semi-public zone.