노인장기요양보험 복지용구 급여제도 비교

진영란(Young Ran Chin)(陳瑛蘭),김광병(Kwang Byung Kim)(金廣柄) 위기관리 이론과 실천 2013 Crisisonomy Vol.9 No.6

우리나라는 일본과 독일의 제도를 기초로 우리나라의 현황에 맞게 조정하여 노인장기요양보험 복지용구 급여제도를 도입하였다. 제도 도입이후 4년이 지나 안정기에 접어든 현 시점에서 일본과 독일 두 나라의 복지용구급여제도와 우리나라의 제도를 비교분석함으로써 우리나라 복지용구 급여제도의 현주소를 진단하고, 시사점을 도출하고자 하였다. 분석 관점은 복지용구사업소 시설기준, 복지용구관련 인력기준, 복지용구 급여 대상자 및 급여한도액, 복지용구 제공 방법 및 급여 품목, 복지용구 급여수가(판매 ㆍ 대여료) 결정, 대여 복지용구의 세정소독, 급여 제품의 질 관리 등 7가지 영역이었다. 그 결과, 우리나라는 급여 복지용구의 품목과 제품의 단계적 다양화, 복지용구 선정 및 상담서비스 강화, 대여 복지용구의 세정소독 관리강화, 복지용구에 대한 질 관리 및 불의의 사고에 대한 대비, 복지용구산업 활성화 방안 모색 등이 필요한 것으로 나타났다. After long term-care insurance was introduced, about four years had passed. Among these benefits, medical devices benefits referenced the Japan's and German's extremely much before setting the benefits up. These two nation's standards or guidelines of medical devices benefits had focused on seven core points, those are facilities & manpower, subjects & the limit of benefit price, items of medical devices, service delivery types(lending, selling), offering payment, cleaning & disinfection of the devices, and quality management. The purpose of this study is comparing standards or guidelines of medical devices benefits in Korea, Japan and german, which is focused on the seven core points. Therefore, this study find out how the guidelines or standards will be revised for improving the quality of medical devices benefits. Our standards or guidelines had some shortcomings in manpower, monitoring of cleaning & disinfection, quality control of medical device itself, and counselling services. Besides, we need to diversify our medical device products so as to meet subjects demands and to develop quality control methods.

복지용구사업소 운영 현황

진영란(Chin, Young Ran),이효영(Lee, Hyo Young) 한국노년학회 2010 한국노년학 Vol.30 No.3

2008년 7월 노인장기요양보험제도 도입으로 공적 급여가 시작된 장기요양서비스 중 복지용구는 노인의 자립생활 지원 및 가족의 수발부담 경감 효과가 기대되는 중요한 서비스이다. 새로운 제도 도입 후 일 년이 경과한 현 시점에서 소비자에게 직접 복지용구를 제공하고 있는 복지용구사업소의 운영 현황을 파악하고자 전국 복지용구사업소를 대상으로 우편설문조사를 실시하였다. 194개소의 조사 자료를 분석한 결과, 대부분의 복지용구사업소는 관리, 인력, 시설, 서비스 등의 측면에서 보완해야할 여러 가지 문제들이 발견되었다. 복지용구사업소의 월매출액은 평균 797만원에 불과하여 경영상 어려움을 가질 것으로 판단되었다. 또한 배상책임보험은 절반 정도만이 가입되어 있어 사고 시 대비할 수 있는 체계가 갖추어지지 않은 경우가 많았으며, 정규직 인력 평균 2.6명 중 사회복지사 및 물리치료사는 약 20%에 불가하며 전문적 교육을 이수한 경험은 거의 없었다. 뿐만 아니라 세정소독시설을 갖춘 사업소 중 오염청결구역을 구분하는 비율은 44.8%에 불과하여 실제 세정ㆍ소독의 의미가 없는 경우가 많았다. 이에 양질의 복지용구서비스가 이루어지기 위해서는 배상책임보험 가입을 통한 불의의 사고에 대비, 복지용구 관련 인력에 대한 교육, 대여 복지용구의 세정소독 관리 강화 등이 필요할 것으로 판단된다. This study was conducted to understand current management status of welfare medical device centers and to suggest complementary point. Method: We surveyed 194 welfare medical device centers through the mail. The survey was done in three domains, i. e. management of service, assuring the health resources, offering the service. Results & Conclusions: According to the result of our study, several problems, which should be improved in the near future, were suggested. That were improving facilities(especially in sanitization of the devices), operating an education or training program for the personnel, and making up for the current management. It was very important for soft landing of long-term care insurance and improving quality of the elderly's life that 'Ministry of Health and Welfare' and 'National Health Insurance corporation' must support welfare medical device centers for discharging their roles

간호대학생의 문제음주와 음주갈망, 충동성, 전공만족도의 관계

진영란(Youngran Chin),권미형(Mihyoung Kwon) 학습자중심교과교육학회 2022 학습자중심교과교육연구 Vol.22 No.8

목적 본 연구에서는 간호대학생의 문제음주와 전공만족도, 음주갈망, 충동성의 관계를 분석하였다. 방법 이를 위하여 연구목적을 이해하고 참여에 동의한 간호학과 학생 183명을 대상으로 구조화된 설문지를 이용하여 편의표집하였다. 자료는 SPSS 22.0 프로그램을 이용하여 t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, Logistic regression을 실시하여 분석하였다. 결과 대상자의 전공만족도는 평균 58.97±11.31점(Range:18.00~85.00), 음주갈망은 평균 7.11±6.59점(Range:0.00~39.00), 충동성은 평균 64.70±8.27점(Range:42.00~86.00), 문제음주는 평균 9.07±7.53점(Range:0.00~37.00)이었다. 연구 대상자 전체가 음주경험이 있었고, 그 중 48.6%가 문제음주가 있는 것으로 나타났다. 대상자의 전공만족도는 음주갈망, 충동성, 문제음주와 유의한 음의 상관관계가 있는 것으로 나타났다. 음주갈망은 충동성, 문제음주와 유의한 양의 상관관계가 있는 것으로 나타났다. 충동성은 문제음주와 유의한 양의 상관관계가 있는 것으로 나타났다. 문제음주군과 일반음주군을 비교한 결과 간호학과 입학동기, 수업만족도, 음주빈도, 1회 음주량에 유의한 차이가 있었다. 대상자의 문제음주 여부에 영향을 미치는 요인은 음주갈망이었고, 일반음주군에 비해 문제음주군의 음주갈망이 2.043배 높은 것으로 확인되었다. 결론 미래의 보건의료인력으로서 성장해야 할 간호대학생의 문제음주를 조기에 개입하여 예방하기 위하여 전공만족도와 수업만족도가 낮은 학생, 음주빈도가 높고 1회 음주량이 많은 학생을 대상으로 음주갈망과 충동성을 낮추기 위한 노력이 필요할 것으로 사료된다. Objectives The purpose of this study is to understand the relationship between major satisfaction, alcohol craving, impulsiveness, and problem drinking of nursing college students. Methods The study subjects were 183 people who understood the purpose of the study and agreed to participate in the study for nursing students, and data were collected using structured questionnaires. The data were analyzed by performing t-test, ANOVA, Scheffé test, Pearson s correlation coefficient, and logical regression using the SPSS 22.0 program. Results As a result of the study, the average major satisfaction of the subjects was 58.97±11.31(Range:18.00~85.00), the average alcohol craving was 7.11±6.59(Range:0.00~39.00), the average impulse was 64.70±8.27(Range: 42.00~86.00), and the average drinking problem was 9.07±7.53(Range:0.00~37.00) points. It was found that all of the study subjects had drinking experience, and 48.6% of the subjects had problem drinking. It was found that the subject s major satisfaction had a significant negative correlation with alcohol craving, impulsiveness, and problem drinking. Alcohol craving was found to have a significant positive correlation with impulsiveness and problem drinking. Impulsiveness was found to have a significant positive correlation with problem drinking. As a result of comparing the group without problem drinking and the group with problem drinking, there was a significant difference in admission motivation, class satisfaction, frequency of drinking, and amount of one-time drinking. The factor influencing the subject s problem drinking status was alcohol craving, and it was confirmed that the subject with problem drinking was 2.043 times higher than the subject without problem drinking. Conclusions In order to intervene and prevent problem drinking in nursing college students early, efforts should be made to lower the craving and impulsiveness for drinking for students with low major satisfaction and class satisfaction, and students with high drinking frequency and high one-time drinking.

노인요양시설 입소자의 장기요양등급 개선과 서비스 질 관련요인

진영란,최경원 보건의료산업학회 2014 보건의료산업학회지 Vol.8 No.1

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.

요양보호사 교육기관 교육서비스 질 평가 도구개발

진영란,이효영 보건의료산업학회 2013 보건의료산업학회지 Vol.7 No.4

The purpose of this study is to identify the important factors of education service quality and to develop the evaluation instrument in learning facilities for care workers. This study was processed as four steps. First, the important factors were confirmed through literature reviews and the expert board discussions. Second, the evaluation instrument was developed and validity & reliability of the instrument were checked by factor analysis and Cronbach's α. Lastly, the instrument was rechecked by the expert board in language usages and importance of the items. The results indicated that the important quality factors were divided with infrastructure and service process. Especially, the process contained providing appropriate education information & counseling, providing appropriate contract & paying fees, keeping specified service principles and so on. The study instrument was developed with 28 items. This instrument will be helpful to improve the education service quality. Besides, the staffs must continuously try to improve and manage their education services using the results of this kind of evaluation instrument.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

진영란,김춘미,박일수,한송이 한국지역사회간호학회 2020 지역사회간호학회지 Vol.31 No.S

Purpose: The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. Methods: This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. Results: The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation. Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). Conclusion: In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.

도시 규모 별 청소년의 건강생활 실천 차이와 관련 요인

진영란,양선이 한국농촌간호학회 2023 한국농촌간호학회지 Vol.18 No.1

Purpose: This study is to compare adolescents' health behaviors by city size and to propose regionally tailored health promotion. Methods: We analyzed the data from the 17th Youth Health Risk Behavior Online Survey, national widly performed in 2021. Multi-sample descriptive and linear regression analysis was performed by city size. Results: The frequency of fruit consumption in the last week was 2.88 in the rural area, which is lower than 2.98 and 3.05 in other cities (F=10.98, p<.001). The number of high-intensity physical activity days in the last week (7 days) was 2.90 days in the rural area, higher than 2.74 and 2.73 days in other cities (F=3.36, p=.038). The number of days smoking cigarettes in the last 30 days was 3.23 days in the rural area, higher than 3.08 and 3.02 days in other cities (F=3.41, p=.035). BMI was 22.01 in the rural area, which was higher than 21.57 and 21.61 in other cities (F=4.19, p=.015). Conclusion: School health offices in the rural area districts need to operate to manage lack of fruit intake, smoking, and weight management programs in association with local healthcare institutions.

간호학생의 지역사회간호학 이론교과목 이수 경험

진영란,송연이,김영미 인문사회 21 2017 인문사회 21 Vol.8 No.6

We explored the experiences of nursing students during their learning community health nursing. The focus group interview (FGI) between 11 nursing students in sophomore, junior and senior year were conducted and audio-taped. The central phenomenon is “the growth by oneself in ambiguity.” The causal condition that affects the central phenomenon is abstract and unfamiliar contents of the subject, competition among students, and the motivation of their own learning. Supportive factors among the mediating conditions include teamwork, diverse teaching methods, support of professors, various teaching method, appropriate learning goals, worry about your own professional plan. Unsupportive factors were the boring textbooks, lecture-oriented class, and the professors’ excessive expectations and unclear tasks. The action/interaction strategy focuses on adhere the professor’s guidance, participating in the community volunteer program, concentrating on changing their own changes. The affirmative outcomes refers to understanding on community health nursing and community health nurse, improving their self-learning abilities, improving their positiveness, improving their self-confidence, participating in community activities, determining occupational areas. The negative category was the abandonment, and/or indifference of the study of community health nursing subjects. The professor needs to consider and reflect the learning experiences of nursing students into the curriculum. 본 연구는 간호학생의 지역사회간호학 학습 경험을 탐구하여 보다 효과적인 교수 방법을 제안하기 위함이다. 간호학과 2~4학년 학생 11명을 이론적 포화에 도달할 때까지 초점집단인터뷰(FGI)하여 녹취하였다. 근거이론방법에 따라 방법론적 정확성을 준수하여 분석하였다. 중심현상은 ‘모호함 속에서 스스로 성장하기’였고, 중심현상에영향을 미치는 인과적 조건은 교과 내용의 추상성, 생소함, 맥락적 조건은 직업을 찾고자하는 마음, 동료 간 경쟁, 학생 자신의 학습 동기화 정도였다. 중재적 조건 중 지지적인요인은 동료 간 팀워크, 다양한 교수 방법, 교수의 지지, 다양한 교수학습 매체, 적당한학습목표, 자신의 전문직 계획에 대한 고민 등이었고, 비관적 요인은 지루한 교과서, 강의법에 의존한 수업방식, 교수의 과잉 기대, 불명확한 과제 등이 확인되었다. 작용/상호작용전략은 교수의 지도를 엄격히 준수함, 다양한 공부법 시도, 지역사회 자원봉사 참여, 자신의 변화에 집중함이었고, 결과의 긍정적 범주는 지역사회간호와 지역사회간호사를 이해함, 자가학습능력 향상, 적극성 향상, 자신감 향상, 지역사회 활동에 참여 의도, 직업영역을 정함 등이었고, 부정적 범주는 지역사회간호학 교과목 공부를 포기함, 무관심이었다. 교수는 간호 학생들의 학습 경험을 교육과정에 반영할 필요가 있다.

요양병원 환자분류군별 전반적 건강수준 및 육체적 수발부담 차이

진영란,이효영 보건의료산업학회 2018 보건의료산업학회지 Vol.12 No.1

Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.

한국 청소년의 성별 성관계 조기 시작과 관련 요인

진영란 ( Youngran Chin ),소은선 ( Eunsun So ) 사단법인 아시아문화학술원 2019 인문사회 21 Vol.10 No.2

이 연구는 성관계 시작 연령이 점차 낮아지고 있는 한국 청소년의 성관계 시작 연령이 성별에 따라 차이가 있는지 파악하기 위해 시행되었다. 본 연구는 총 74,186명의 한국청소년 건강행위 조사 자료로 Cox 비례위험 회귀분석을 하였다. 남학생과 여학생 둘 다에서 성관계 조기시작과 유의한 관련성을 나타내는 변인은 가구의 사회경제적 상태, 첫 사정/초경의 나이, 학업성적이었다. 성별로 남학생에서만 유의한 변인은 아버지의 교육수준, 주관적인 신체상, 스트레스 수준이었다. 여학생에만 유의한 변인들은 어머니의 교육수준, 낮은 행복감이었다. 남학생의 성관계시작 연령을 늦추기 위해서는 몽정이 시작되기 전에 스트레스 관리와 아버지와의 의사소통을 늘리는 프로그램을 운영할 필요가 있다. 여학생의 성관계시작 연령을 늦추기 위해서는 초경이 시작되기 전에 행복감을 증진하는 프로그램과 어머니와의 의사소통을 확대하는 프로그램을 운영할 필요가 있다. This study is to investigate the factors associated with the earlier initiation of sexual intercourse by sex in Korean adolescents. We analyzed the Korea Youth Risk Behavior Web-Based Survey data of a total of 74,186 adolescents using Cox proportional hazards regression. The factors that are associated with the early initiation of sexual intercourse in both sexes include the socioeconomic status of household, age of the first nocturnal emission or menarche, and academic grades. The factors only in the male students included father’s education level, subjective body image, and higher stress level. The factors only in female students were mother’s education level, and lower level of happiness. Sex education and interventions to delay initial sexual intercourse are needed to encourage conversations between adolescent males and their fathers, to help adolescent males manage stress around the first nocturnal emissions. For adolescent females, some interventions to encourage conversations with mothers and to increase the happiness in those with early first menses are needed.