요양보호사의 임파워먼트에 미치는 영향 요인 연구 = A Study of Factors that Influence Empowering of Care Givers: In Long-term Care for the Elderly

국문 초록 (Abstract)

본 연구는 요양보호사들이 서비스를 제공함에 있어 필수 조건인 자신의 욕구에 부합된 자원을 동원하는 능력 즉 임파워먼트 수준에 대해 알아보고. 요양보호사들의 임파워먼트에 영향을 미치는 요인 들을 규명하여 보고자 이 연구를 시행하였다.
이 연구를 위하여 재가시설 및 입소시설에 근무하고 있는 요양보호사 250명을 대상으로 설문조사를 통하여 다음의 결과를 얻었다.
학력이 높을수록, 입소시설의 요양보호사가, 하루 평균 5-9명에 대상자를 담당하는 요양보호사가, 그리고 하루 평균 10시간 이상 근무하는 요양보호사가 다른 요양보호사들보다 임파워먼트 수준이 높았다. 전문적 능력, 자기효능감, 피드백 과 변혁적 리더십이 요양보호사의 임파워먼트에 유의미한 정(+)적인영향을 주는 것으로 나타났으며 역할갈등은 부(-)적인 영향을 미치는 것으로 나타났다. 요양보호사의 인구사회학적 특성에 따른 개인 심리적 요인, 업무요인, 조직요인 등의 평균점수 비교 결과 업무요인이 개인 심리적 요인이나 조직요인들의 점수보다 낮게 나타났다. 이에 본 연구자는 이상의 결과를 토대로 다음과 같이 제언한다.
첫째, 요양보호사의 학력, 전문적 능력의 문제를 해결하기 위해서는 요양보호사 양성 교육의 질을 높여야 한다.
둘째, 국가시험제도들을 통하여 일정한 수준이상의 요양보호사들을 배출함으로 요양보호사에 대한 인식제고와 전문 인력으로서의 자부심을 고취시킬 수 있어야겠다.
셋째, 요양보호사들의 처우개선이다.
넷째, 보수교육이나 재교육 등을 통한 지속적인 교육이 필요하다.
다섯째, 역할 모호를 줄이기 위해 구체적인 업무지침, 작업매뉴얼들이 작성되고 비치되어 업무수행에 도움을 주어야 하겠다.
여섯째, 요양보호사들에 대한 지도감독과 서비스의 질적 관리를 위한 수퍼바이져 제도의 확립이 필요하다.
일곱째, 케어 매니지먼트제도를 통한 요양보호 대상자와 서비스제공 인력과 지역사회 복지자원과의 연계 등을 통한 서비스 질의 향상이다.

다국어 초록 (Multilingual Abstract)

A year elapsed since the fifth social insurance, long-term care for the elderly, has been initiated. Fortunately the beneficiaries' responses were satisfactory, however some issues have emerged in regards to the main work force, Yoyangbohosas(first care givers). For care givers to render service, there are two necessary requirements that must be fulfilled: Acquirement of necessary resources and the harmony between those resources and the abilities of care givers . The ability of care givers to efficiently utilize resources accorded to them is called empowerment.
For this, I have explored care givers' level of empowerment. Also, I intend to identify factors that affect care givers' empowerment level, and discuss solutions to problems associated with such factors. In conducting this experiment, I surveyed 250 care givers employed in home care centers and residential home care centers. Using SPSS version 13.0, I've ran the data through statistical correlation analysis and multiple regression analysis to verify and obtain the following data.
As a result, initially, If one looks at the varying empowerment levels of care givers depending on demographics, the more educated, those that are employed in home care centers, those that are responsible for 5-9 subjects, and those with average working hours of ten or higher turned out to have a higher empowerment level.
Second, when looking at individual psychological factors, professional ability and self efficacy influenced empowerment levels.
Third, among working factors, autonomy and feedback had positive influences on empowerment levels, while role conflict had a negative influence.
Fourth, among organizational factors, innovative leadership influenced empowerment.
Fifth, when the average of respective factors have been calculated -demographic, individual psychological, working, and organizational-,individual psychological factors' average was higher than organizational or working factors'.
With these results in consideration, I suggest the following.
First, to solve problems associated with care givers' education level and professional ability, the quality of education for care givers' needs to be improved. With the current education system, it is hard for care givers to engage in their services with utmost confidence. For care givers' professional education, thereneeds to be higher standards for establishing educational institutions, and an enforcement of a regular verification system of such institutions (Gen Hong Lee, 2009) so that a suitable environment can be made.
Second, there needs to be a national testing system that will ensure a general competency of care givers' which will enhance public awareness and also boost care givers' self-efficacy level as a professional resource. Through this, I consider that the problem with education level and professional ability can be somewhat ameliorated.
Third, the treatment of care givers needs to be improved. A certain level of labor cost for care givers needs to be ensured for their morale and to prevent mediocre or even bad service quality. Especially the low labor costs in home care center due to time limits and labor cost limits must be solved.
Fourth, there needs to be a systematized post-education such as supplementary education or re-education for care givers. Especially in home care center, currently there are no supervisors of care givers, and so subjects are often neglected. To solve this, post-education and a supervisor needs to be assigned. Regular post-education in respective institutions, and education through case conferences are necessary, in addition, supplementary education should be implemented annually.
Fifth, to ameliorate role confusion and aid in carrying out work, a detailed procedural manual should be written up and displayed
Sixth, a supervising system for care givers' is necessary. At least in residential care centers, some degree of supervision is available by superiors, but in home care center supervision is simply non-existent. A supervising system that will strictly ensure that care givers are servicing with pristine quality needs to be established as soon as possible.
Seventh, through the care management system a connection should be established among care giver subjects, servicing human resources, and local social welfare resources to enhance service quality. In regards to Elderly long-term insurance system, rather than employing approaches for curing, pre-cautionary and managing approaches should be employed. This Thesis submitted to the faculty of the Graduate School of Hanyoung Theological University in partial fulfilment of the requirement for the degree of Ph.D in December, 2009.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구 목적 3
• 3. 연구 문제 4
• 4. 용어의 정의 4
• Ⅱ. 이론적 배경 6
• 1. 노인장기요양보험제도 6
• 1) 한국 6
• 2) 독일 12
• 3) 일본 16
• 2. 요양보호사 제도 21
• 1) 한국 21
• 2) 독일 23
• 3) 일본 23
• 3. 임파워먼트 24
• 1) 임파워먼트의 필요성 25
• 2) 임파워먼트의 차원 27
• 3) 임파워먼트의 구성요소 31
• 4) 임파워먼트의 영향요인 34
• 4. 임파워먼트 선행연구 고찰 44
• 1) 사회복지사 44
• 2) 간호사 45
• 3) 간호조무사 46
• 4) 장애아 보육교사 47
• 5) 자원봉사자 47
• 6) 가정봉사원 48
• Ⅲ. 연구방법 51
• 1. 연구모형과 가설 51
• 2. 연구대상과 자료수집 52
• 3. 연구도구 53
• 4. 자료분석 61
• Ⅳ. 연구결과 분석 62
• 1. 연구결과 분석 62
• 2. 논의 99
• Ⅴ. 요양보호사의 임파워먼트 영향요인 105
• 1. 인구사회학적 요인 105
• 1) 학력 105
• 2. 개인심리적 요인 105
• 1) 전문적능력 105
• 2) 자기효능감 105
• 3. 업무요인 106
• 1) 자율성 106
• 2) 피드백 106
• 3) 역할모호 107
• 4. 조직요인 107
• 1) 변혁적리더십 107
• Ⅵ. 결론 및 제언 108
• 참고문헌 111
• 부록 124