저소득층 가정 부모의 아동안전사고 예방행위 실천에 영향을 미치는 요인

황라일(Hwang, Ra Il),임여진(Im, Yeo Jin) 한국보건간호학회 2013 韓國保健看護學會誌 Vol.27 No.2

Purpose: This study examined the characteristics of in-home injuries of children in low-income families and sought to identify the factors affecting parental in-home injury prevention practices. Methods: A cross-sectional descriptive survey design was applied, using questionnaires on in-home injury characteristics in children, parental in-home injury prevention practices, parental perceptions and knowledge on childhood injuries, and the Parental Stress Index. We queried 169 parents of children less than 5years of age who were enrolled in Nutrition Plus Projects at community health centers. Results: Overall, 92.7% of children had experienced in-home injuries, with sliding crashes and bumping injuries as the most frequent type of injury. The recovery rate with a scar after injury was 26.3%. Parental practices for in-home injury prevention were higher according parental age, educational status, and previous learning experiences regarding in-home safety and injury prevention. The two most significant factors affecting parental in-home injury prevention practices were age and parental perception of childhood injuries as being controllable and preventable. Conclusions: Considering the high risk of in-home childhood injuries in low-income families, safety education and the promotion of injury prevention practices for parents are recommended. The strategy to enhance the parental perception on preventing childhood injuries needs to be addressed.

병원 급식 식대 급여화에 따른 입원 환자의 급식만족도 조사

황라일(Rah Il Hwang),권진희(Jin Hee Kwon) 대한지역사회영양학회 2008 대한지역사회영양학회지 Vol.13 No.3

This study aimed to evaluate the amount of patients` satisfaction with hospital foodservices among those who were benefited from national health insurance during theirhospitalization. A total of 3,094 inpatients from 191 medical institutions were enrolled in this survey. The survey was carried out from July 23 to September 14, 2007 through the face-to-face interview method. All analyses were made using the SPSS software (version 13.0). The mean age of the participants was 53.3 years, 57.0% were women; 34.7% were high-school graduates. Among the respondents, 30.9% stayed in the hospital for 7~14 days long, and 52.0% were hospitalized in multi-patient rooms for six persons. The 87.7% of total population had a general diet, and 9.6% selected the food menu that was notcovered by health insurance. In addition, 38.3% of patients regarded the fee of foodservice as inexpensive. Overall, the satisfaction score with hospital foodservice was 3.63 on a Likert-type scale ranging from 1 (extremely dissatisfied) to 5 (extremely satisfied). However, the limitations were indicated including the lack of providing nutritional information and quality of taste. In conclusion, the quality of hospital foodservice might not deteriorate even after enforcement of national payment of medical insurance. Further efforts are required for the diversification of menus and legislative work for improving quality of food service for a successful hospital foodservice policy.

노인장기요양 방문간호 현황 및 추이

황라일 ( Hwang Rah Il ),박소영 ( Pak So Young ) 경희대학교 동서간호학연구소 2019 동서간호학연구지 Vol.25 No.2

Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.

미취학 자녀를 둔 어머니의 취업여부에 따른 양육스트레스와 관련요인

윤지원 ( Ji Won Yoon ),황라일 ( Rah Il Hwang ),조헌하 ( Hun Ha Cho ) 한국여성건강간호학회 2009 여성건강간호학회지 Vol.15 No.4

업무상 정신질환과 자살 산업재해 신청자 추이 및 특성 분석

김경하 ( Kyung Ha Kim ),황라일 ( Rah Il Hwang ),정성원 ( Sung Won Jung ) 경희대학교 동서의학연구소 2015 동서간호학연구지 Vol.21 No.1

Purpose: This study was conducted to analyze the annual trends and characteristics of work-related mental disorders including suicide among Korean workers. Methods: Employing the Industrial Accident Compensation Insurance (IACI) data collected by the Korea Worker’s Compensation & Welfare Service, we analyzed total work-related mental disorders and suicide cases (n=455) claimed to IACI from 2008 to 2012. We paid a special attention to workers’ socioeconomic status and occupational characteristics. Results: The number of injured workers and industrial accident rate decreased during the study period, whereas the case of work-related mental disorders showed significant increase. Mental disorders cases were more prevalent in workers who were male, aged the 40s, and engaged in finance, as well as with 1-5 years of working duration than their respective counterparts. Increasing trend of suicide cases was statistically significant by the Cochran- Mantel-Haenszel test (p=.002). Conclusion: This study suggests that work-related mental disorder management strategy and system should be established.

노인장기요양기관에 근무하는 간호사의 근무실태 및 직무만족도 영향 요인

이정석(Lee, JungSuk),황라일(Hwang, RahIl),임민경(Lim, MinKyung) 한국보건간호학회 2015 韓國保健看護學會誌 Vol.29 No.3

Purpose: Th study is to explore the working conditions and factors related to job satisfaction of nurses in long-term care facilities for the elderly. Methods: A total of 127 nurses working long-term care facilities, from June to November 2014, completed questionnaires. Face to face interviews were conducted. The questionnaire consists of a total of 32 questions, including 5 questions related to general characteristics, 15 questions related to working conditions, and 12 questions related to job satisfaction(likert scale of 1 to 5). Results: The majority of nurses were employed in institutional care facilities, in urban area, and in privately owned facilities. On average, employed nurses worked 170.7 hours per month. Only 40.9% of them got more than two million won for their monthly salary. They were satisfied with the nature and worth of their work and the workplace relationship, but not with their wages and promotion opportunity 40.2% of nurses reported satisfaction with job. In multiple logistic regression analysis, age was a statistically significant influencing factor on general job satisfaction. Conclusion: The findings suggest that policies must be to improve nurses’ working conditions, for wages, and to support them with education and training for skills development.

노인장기요양 재가서비스 이용자의 시설 입소 영향 요인

한은정(Han, EunJeong),황라일(Hwang, RahIl),이정석(Lee, JungSuk) 한국보건간호학회 2016 韓國保健看護學會誌 Vol.30 No.3

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of ‘2009 Satisfaction survey of Korean long-term care system’. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

장기요양 인정자의 사망 전 의료 및 요양서비스 이용 양상 분석

한은정(Eun-jeong Han),황라일(RahIl Hwang),이정석(Jung-suk Lee) 한국사회정책학회 2018 한국사회정책 Vol.25 No.1

본 연구는 노인장기요양보험 인정자 중에서 사망한 자의 임종 관련 의료비를 분석함으로써, 향후 임종 관련 의료비의 효율적 관리방안과 양질의 임종관리 제공방안을 모색하는데 목적이 있다. 본 연구에서 활용한 자료는 건강보험 및 노인장기요양보험 급여이용자료, 통계청 사망원인 통계자료이며, 2008년 7월 1일부터 2012년 12월 31일까지 장기요양 인정등급을 받고 같은 기간 내 사망한 자 총 271,474명을 최종 분석대상자로 하였다. 연구결과 대상자는 여성(60.6%), 75세 이상(74.7%)이 다수를 차지했고, 대부분이 2개 이상의 질환을 보유하고 있었으며, 특히 고혈압(44.3%), 치매(42.3%), 뇌졸중(29.9%) 등 비율이 높았다. 사망원인은 순환기계질환(29.8%), 암(15.3%), 선천성 기형, 변형 및 염색체 이상(14.7%) 등의 순이었고, 사망장소로는 의료기관(64.4%), 자택(22.0%), 사회복지시설(9.2%) 순이었다. 대상자의 등급인정 이후 사망까지 소요시간은 평균 516.2일이었고, 대상자 중 99.3%는 사망 전 1년간 건강보험 또는 장기요양보험 급여를 이용하였다. 특히, 1인당 평균 총 급여비는 사망한 달에 가까워질수록 규모가 커져, 사망 전 12개월 보다 사망 전 1개월에 3배 이상 높아졌다. 또한, 사망 전 1개월간 대상자의 31.8%는 연명치료 범위에 해당하는 치료를 받은 것으로 나타났다. 향후 장기요양 인정자의 임종 관련 불필요한 의료이용 감소 및 효율적 의료관리를 위해 건강보험과 장기요양보험 급여의 통합적 임종관리 전달체계 확립과 호스피스 등 임종케어의 적극적 도입을 제안한다. Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

인지지원등급자의 주야간보호서비스 이용 현황에 관한 연구

권진희 ( Jin Hee Kwon ),황라일 ( Rah Il Hwang ),장혜민 ( Hye Min Jang ) 한국보건정보통계학회(구 한국보건통계학회) 2021 보건정보통계학회지 Vol.46 No.2

Objectives: The purpose of this study is to provide basic data for developing services suitable for the characteristics of cognitive assistance graders by monitoring the use of day care centers. Methods: In this study, frequency analysis and paired t-test were conducted using a survey conducted before and after the use of the services. Results: ‘Cognitive training’ and ‘Art therapy’ were the most frequent cognitive activity programs implemented, but they did not operate specialized programs for each dementia severity. In addition, day care centers presented difficulties such as a lack of manuals for operating cognitive activity programs. The rate of satisfaction with the service use of cognitive-assistance graders and willingness to continue using the service was high. It was found that they additionally hoped for mobility support necessary for going out and health care services by nurses. After using day care centers, there was little change in cognitive function, depression, and health-related quality of life of cognitive assistance graders. Conclusions: In order to develop a program suitable for the characteristics of cognitive assistance graders, it is necessary to develop a manual and provide professional training for workers in day care centers.

장기요양 급여이용행태별 가족부양자 부양특성 비교

한은정(EunJeong Han),황라일(RahIl Hwang),박세영(SeYoung Park),이정석(JungSuk Lee) 한국사회정책학회 2019 한국사회정책 Vol.26 No.3

장기요양 노인과 가족의 삶의 질을 보호하기 위해서는 노인을 돌보는 가족의 부양현황과 부양부담에 정책적 관심을 기울일 필요가 있다. 본 연구는 장기요양 급여이용 행태별로 가족부양자의 부양 현황과 부양부담을 조사하고 급여이용행태별 부양특성의 차이를 비교하기 위해 시도하였다. 본 연구의 자료는 건강보험정책연구원의 ‘2016 장기요양 등급인정자의 급여이용 행태별 부양실태조사’를 통해 수집되었다. 본 조사는 2016년 6월 ~ 7월 2개월간 총 2,603명의 가족부양자를 대상으로 부양 현황 및 우울, 건강행태, 스트레스, 부양부담감 등에 대해 훈련된 면접원의 일대일면접방식으로 이루어졌다. 재가급여 이용 그룹, 시설급여 이용 그룹, 가족수발 그룹(미이용), 요양병원 이용 그룹(미이용) 4개 그룹으로 구분하여 급여이용 행태별 부양현황 및 부양부담 등을 분석하였다. 본 연구결과 급여 이용행태에 관계없이 응답자의 과반수 이상은 다른 가족구성원으로부터 도움을 받고 있었으나, 재가인 경우 다른 가족으로부터 도움을 받고 있는 비율이 가장 낮은 것으로 나타났다. 가족수발 및 요양병원 이용 그룹에서는 비용에 대한 부담을 높게 인식하고 있었다. 재가와 가족수발 그룹의 경우 시설 및 요양병원 그룹과 비교할 때, 가족부양자의 식사, 운동, 수면, 휴식 등 건강행태가 모두 열악한 수준이었고, 건강상태 악화 경험 비율이 높고, 주관적 건강수준 역시 낮게 나타났다. 더구나 가족부양자의 스트레스, 부양부담, 우울 또한 더 높은 수준이었고, 가족수발 그룹에서는 스트레스 경험 시 ‘그냥 참음’ 비율도 높게 나타났다. 본 연구를 통해 장기요양 급여이용행태별로 가족부양자의 인구사회학적 특성, 부양 현황 및 부양부담 특성에 차이가 있음을 확인하였다. 장기요양 가족부양자 지원 정책 개발 시, 급여이용행태별 가족부양자의 부양특성의 차이를 고려한 접근이 필요하겠다. This study aims to investigate and compare differences in caregiving burdens among family members with the disabled elderly according to the utilization of long-term care. We obtained the data from the project ‘2016 Survey on Family Caregivers’ Burden with Long-term Care Beneficiaries’, studied by the Institute for National Health Insurance. This survey was conducted from June 13 to July 17 2016, and the questionnaires included items of family caregivers’ characteristics and caregiving burdens. Total 2,603 family caregivers completed questionnaires. They were classified into 4 groups according to their utilization of long-term care(home care, institutional care, family care, and long-term care hospital services). As a result, more than half of respondents received help from other families. The group of home care reported relatively smaller help from other families. The groups of family care and long-term care hospital services reported statistically significant higher economic burden. The groups of home care and family care suffered from lack of healthy behaviors such as diet, exercise, and sleeping rest, and their subjective health level were low. And they also reported the higher levels of caregiving stress, depression, and caregiving burden, compared with the groups of institutional care and long-term care hospital services. Our findings suggest that it is needed to consider differences in caregiving burdens among family members by the type of benefits to develop family caregiver support programs.