요양시설 생활노인의 주관적 안녕감에 관한 연구 = A study on the Subjective Well-Being of Elderly Nursing Home Residents

다국어 초록 (Multilingual Abstract)

The population of people aged 65 years and older in South Korea is increasing rapidly. While many older people are in good health, the large portion of older adults suffer from complex medical conditions or functional problems that can lead them to depend on others. In July 2008, Korean government introduced a system of Long-term Care Insurance to provide in-home services(e.g., home-visit care) and long-term care services(e.g., nursing homes) for vulnerable older people who are dependent on others. As a result, older adults moving to long-term care services are rising dramatically.
As living standards in South Korea have improved remarkably over the past several decades, nursing homes have become more popular among the older people who seek comfortable lifestyle and convenient healthcare services that meet their physical and psychosocial needs. However, studies regarding happiness and subjective well-being of older people in nursing homes in South Korea are limited.
This study, based on a model of Moos & Lemke(1996), designed a conceptual model to investigate factors that impact subjective well-being of elderly in nursing homes and analyzed variables and path in a conceptual model. The conceptual model in this study is composed of personal factors(e.g., perceived health status , involvement in decision-making process)
environment factors(e.g., staff care, room, facility, food, social interaction, and resident involvement) and psychological coping resource(e.g., mastery) which are the major factors that influence the subjective well-being of elderly nursing home residents.
Potential participants without cognitive impairment and communication difficulty were recruited from fifteen nursing homes in Daegu, Kyung-Pook province and Kyung-Nam province in South Korea. The participants were interviewed individually by a researcher and research assistants using structured questionnaires. The final participants(N=163) consisted of 32 males and 131 females. SPSS 15.0 and AMOS 7.0 were used to analyze the data.
The major results of this study are the followings.
The study showed that the perceived health status of nursing home residents directly affected mastery (β=.779 p<.001) while involvement in decision-making process lead positive influence (β=.143 p=.057). However, resident satisfaction did not affect mastery. Second, the study showed that the perceived health status of nursing home residents did not have significant relationship to the subjective well-being. Similarly, the involve- ment in decision-making process had little impact to the subjective well-being. On the other hand, resident satisfaction had statistically significant relationship to the subjective well-being(β=.641, p<.001). Mastery lead positive influence to the subjective well-being(β=.553, p=.015). Finally, some paths proven to be statistically insignificant in the conceptual model were eliminated, and ultimately the model was remodified as final model. The final model was used to investigate any differences between gender and duration of living in nursing home (less or more than 1 year) by multiple group analysis. It showed a congeneric model which has little differences by the gender and the duration of living in nursing homes.
In summary, the study showed that the perceived health status of a nursing home resident and involvement in decision-making process gave the influence to a mastery and the mastery and resident satisfaction were also the factors to affect to the subjective well-being of nursing home residents
These findings have important implications for healthcare providers in nursing homes as well as policy makers.
First, the study suggests that it is necessary to provide systematic health care and environment that emphasize on the independent life and self-decision. The autonomy of nursing home residents should be respected so that mastery will increase. Second, to increase the subjective well-being of the nursing home resident, the health care program should provide individualized care. Pre-admission program should be established to increase involvement in decision-making process. Finally, to increase the emotional well-being of nursing home residents, not only positive-oriented treatment program, but also staffs training program for psychosocial care should be utilized. In order to increase the resident satisfaction, it is necessary for healthcare providers to focus on user oriented operation of the nursing homes, which demonstrates supplier-oriented operation.
Due to random sampling from limited areas instead of sampling from nationwide, this study is limited. Moreover, other variables including nursing home sizes and programs that could possibly affect subjective well-being were not considered in this study.

목차 (Table of Contents)

• 제1장 서론 1
• 제1절 문제 제기 1
• 제2절 연구 목적 및 연구 문제 4
• 제3절 논문의 구성 5
• 제2장 이론적 배경 6
• 제1절 주관적 안녕감 6
• 제2절 이론적 모델 17
• 제3절 주요 변수의 설정과 변수간의 관계 21
• 제3장 연구 방법 37
• 제1절 연구 모형 및 연구 가설 37
• 제2절 조사 대상 및 자료 수집 방법 39
• 제3절 변수 정의 및 측정 도구 43
• 제4절 척도의 신뢰도 48
• 제5절 자료 분석 방법 49
• 제4장 분석 결과 53
• 제1절 일반적 특성 53
• 제2절 주관적 안녕감에 관한 모델 분석 57
• 제5장 논의 및 제언 79
• 제1절 연구 결과 요약 79
• 제2절 논의 81
• 제3절 제언 85
• 제4절 연구 의의와 한계 89
• 참고문헌 93
• Abstract 105
• 부록 109