노인의 복합문제 해결을 위한 서비스 연계 방안 : 소득·학대·우울·자살문제를 중심으로 = A Study on Service Linkage as the Solution for Overlapping Problem of the aged : Focused on income·abuse?depression·suicide problems

다국어 초록 (Multilingual Abstract)

Income, abuse, depression, and suicide problems have been regarded as critical problems that affects quality of life in elderly. Income and abuse are related to survival problems, and depression and suicide are significant public health problems. Effective solutions to those problems is urgently need. However, a bigger problem is that older people have multiplicative problem. We need to show more concern for those older.
The purpose of this thesis is to explore degree of overlapping among income․abuse․depression․suicide problems, and to find linkage alternatives of such problem. So, we analyzed path among four older problems and moderating effect of national income security or prevention older abuse and society activity participation in the path between older problems.
A total of 300 questionnaires were sent out for the survey. Data were collected from 286 elder peoples over age 65 inhabited public rental housing, elder who lives alone, elder of self-reliance protection program or national basic livelihood security, home care elders. These samples may include the most severe cases of income, abuse, depression, and suicide. And thus may not be representative of the general population. Analyses used SPSS Version 8.02 and AMOS Version 7 for Windows. Structural equation modeling was used to analyze path and moderating effects.
The major findings of this study appeared as follows.
First, in korea the older problems are very serious. Approximately 87.7% of the participants reported having income problem, 83.5% reported depression, 16.1% reported abuse, and 23.9% reported suicide ideation.
Second, two hundred seven(72.3%)of participants were identified as the older with overlapping problem. Man, 70's, elementary school graduate and elder who lives alone had higher overlapping problem than other group. The older have overlapping problem of nine types, such as Income·abuse, income·depression, income·suicide, depression·suicide, income·abuse· depression, income·abuse·suicide, income·depression·suicide, abuse· depression·suicide, income·abuse·depression·suicide. And we should provide those in need with nine service linkage.
Third, there are pathways among four older problems. Results of the path analysis illustrated that there is a statistically significant meaning. Income problems had direct and indirect effect on other three problems-abuse, depression, and suicide-. Abuse had direct and indirect effect on depression and suicide problems. Depression had direct effect on suicide problem.
Fourth, we found moderating effects of basic old age pension in paths of income-abuse and income-depression, of self-reliance protection program in paths of income-depression and income-suicide, of the recognition of Korea Elder Protection Agencies in path of abuse-depression, and of the recognition of older abuse reporting call in paths of abuse-depression and abuse-suicide. But society activity participation didn't have moderating effects in path of depression-suicide.
From the results of the analyses, we make a proposal on implications for the development of service linkage as the solution for overlapping problem of the older.

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구의 필요성과 목적 1
• 2. 연구방법 5
• 3. 연구범위 및 한계 6
• Ⅱ. 이론적 배경 8
• 1. 노인과 노인문제 8
• 1) 노인의 정의와 특성 8
• 2) 노인문제의 개념 8
• 3) 노인문제의 원인 9
• 4) 노인문제의 특성 9
• 2. 복합적 노인문제와 인과성 10
• 1) 소득․학대․우울․자살문제 10
• 2) 노인문제의 관련성과 인과성 28
• 3) 노인문제의 복합성 31
• 3. 노인문제에 대한 기존의 대응 실태 및 한계 35
• 1) 개별 노인문제에 대한 대응실태 35
• 2) 복합노인문제에 대한 서비스연계 실태 44
• 3) 노인문제에 대한 기존 대응의 한계 46
• 4. 노인의 복합적 문제 해결을 위한 서비스 연계 49
• 1) 연계의 필요성 49
• 2) 연계의 개념 50
• 3) 연계의 특성 51
• 4) 서비스 연계 방법 52
• Ⅲ. 조사방법 57
• 1. 연구모형 57
• 2. 조사대상 및 자료수집방법 58
• 3. 변수 및 측정도구 60
• 1) 노인문제 변수 60
• 2) 조절변수 70
• 4. 자료분석방법 72
• Ⅳ. 조사결과 분석 및 논의 74
• 1. 조사결과 분석 74
• 1) 조사대상자 특성 및 노인문제의 차이 74
• 2) 확인적 요인분석 80
• 3) 항목별 분석 86
• 4) 노인문제의 심각성과 복합성 93
• 5) 상관성 분석 96
• 6) 소득문제, 노인학대, 우울, 자살 간의 경로분석 98
• 7) 소득문제, 노인학대, 우울, 자살 간 경로에서 조절효과분석 101
• 8) 분석결과의 요약 109
• 2. 논의 112
• 1) 노인문제의 심각성 및 위기 노인 특성에 대한 인지 112
• 2) 복합적 노인문제의 확인 113
• 3) 노인문제 간 경로의 확인 114
• 4) 조절효과의 확인 115
• 5) 복합문제 해결을 위한 연계의 필요성 확인 115
• Ⅴ. 복합적 노인문제 해결을 위한 서비스 연계 방안 119
• 1. 서비스 연계 방안 마련의 조건 119
• 1) 서비스 연계를 위한 법적 기반 마련 119
• 2) 서비스연계정보시스템의 구축 122
• 3) 사례대상자 발굴 강화 및 대상자 관리의 체계화 125
• 4) 유관기관 조사 및 네트워크화 126
• 2. 서비스 연계 방안 127
• 1) 복합문제 해결을 위한 종합적 서비스 연계 방안 127
• 2) 복합문제 유형별 서비스 연계 방안 132
• 3) 서비스 연계의 업무진행 과정 147
• 4) 서비스 연계 방안 실현의 제약요인과 대응방법 152
• Ⅵ. 결론 및 제언 158
• 참고문헌 162
• 설문지 172
• Abstract 178