만성질환노인을 위한 의료사회복지실천 모형 개발 = Model development for social work in health care for the aged chronic patients

다국어 초록 (Multilingual Abstract)

The aim of this study is to develop, from the ecological point of view, a comprehensive and continuous practical model of medical social work, with the intention of helping aged chronic patients with their rehabilitation and reducting the care-giving burden of their family.
For the research the aged chronic patients, their family members and medical social workers were surveyed. Based on this survey, the comprehesive needs of the aged chronic patients, the assessment and characteristics of their needs, and the hardships of their families were analyzed. The various factors influential in the practice of social work in health care, such as the functions and roles of the medical socail workers and the process of their intervention were also analyzed.
The summary of this analysis is as follows:
1. The needs of aged chronic patients range over the solution of disease-related problems, social-welfare programs and other things including discharge. These needs are affected by many factors such as the type of the disease the age of the patient, the kind of insurance, and the difference of supporting family.
2. As the family plays a very importnat part in the decision of the hospitalization and discharge of the patient it is necessary that with the client system the family should be regarded as the main supporting system.
3. The survey reveals that the treatment of the aged chronic patients is deeply connected with the community resources, making it necessary for the medical institution to actively take advantage of them.
4. It is also shown that in the final phase of the patients the discharge from hospital is primarily decided by the doctors, and the consulting service at the discharge centers on the patients' prognosis, the evaluation of the patients' economic situation, and the ways of helping them.
Therefore the practical model for medical social work developed to satisfy the needs of the aged chronic patients and intended to help the family in difficulty has the following characteristics:
1. As the aged chronic patients are needed to be taken care of continuously rather than medical intervention, this model, based on the ecological point of view, lays a great emphasis on a comprehensive assessment, paying attention to the importance of the role of the family and to the resources of the community.
2. Besides an approach to a client system, this model is a supporting system for the family of the patients, the family of the patients is a resource system as well as a client system.
3. This is a practical model which needs the professional intervention of medical social workers who are supposed to assess the needs of the aged chronic patients and their family.
4. This is a practical social work model emphasizing the continuity and sustain ability of the service, which is caused by the repetition of hospitalization and discharge.
5. This is a kind of community-related model needing an active social intervention of the medical social worker.
6. This is a model demanding to plan discharge at the terminal phase and in most cases at the! patients' death, when the discharge is decided by the patients' family and the doctor.
In short, the practical model for medical social work in dealing with the aged chronic patients is a model composed of the functions and roles of the medical social workers, their intervention skill in the process of social work practice, and the interaction of various factors. This study is thought to have developed a new practical model for the treatment of the aged chronic patients.

목차 (Table of Contents)

• 목차
• Ⅰ. 서론 = 1
• 1. 연구의 배경 및 연구목적 = 1
• 2. 연구방법 = 6
• 3. 연구의 범위 및 한계 = 7
• 4. 용어의 정의 = 11
• Ⅱ. 이론적 배경 = 14
• 1. 만성질환노인과 생태학적 관점 = 14
• 2. 만성질환노인의 가족적 특성 = 26
• 3. 만성질환노인을 위한 지원체계 = 35
• 4. 만성질환노인과 의료사회복지실천 = 53
• 5. 선행연구 동향 = 73
• Ⅲ. 조사설계 = 84
• 1. 조사대상 및 조사방법 = 84
• 2. 조사도구의 구성과 내용 = 85
• 3. 신뢰도 분석 = 89
• 4. 자료 분석 방법 = 92
• Ⅳ. 조사결과의 분석 및 논의 = 93
• 1. 조사대상자의 일반적 특성 = 93
• 2. 만성질환노인 및 가족의 욕구 = 97
• 3. 의료사회복지사의 직무 및 역할에 관한 분석 = 110
• 4. 만성질환노인 및 가족을 위한 의료사회복지실천 과정 = 121
• 5. 조사결과에 대한 논의 = 136
• Ⅴ. 만성질환노인을 위한 의료사회복지실천 모형 개발 = 148
• 1. 만성질환노인을 위한 의료사회복지실천 모형 개발의 기본 전제와 특성 = 148
• 2. 만성질환노인을 위한 의료사회복지실천 모형의 구성요소 = 153
• 3. 만성질환노인을 위한 의료사회복지실천의 진행 과정 = 160
• 4. 만성질환노인을 위한 의료사회복지 실천 모형 = 169
• Ⅵ. 결론 및 제언 = 172
• 참고 문헌 = 176
• 부록1 설문지(의료사회복지사용) = 193
• 부록2 설문지(만성질환노인용) = 207
• Abstract = 215