장기요양보호노인 가족부양자의 부양부담에 영향을 미치는 요인: 거주지역간 변이 = Rural-Urban Differences in Factors Affecting Caregivers' Burden of Impaired Elders in Korea

국문 초록 (Abstract)

본 연구의 목적은 장기요양보호노인과 가족부양자를 대상으로 부양부담의 정도와 영향요인에 있어서 거주지역간(농촌지역과 도시지역) 변이가 있는지 분석하는 것이다. 분석결과, 부양부담의 모든 항목(신체적 부담, 정서적 부담, 사회적 부담, 재정적 부담)에서 도시부양자가 농촌부양자보다 더 부정적인 경험을 하는 것으로 나타났다. 또한 부양자의 제 특성과 장기요양보호노인의 일상생활수행불능 갯수에 있어서도 농촌지역과 도시지역 간 유의미한 차이가 있었다.
부양자의 부담에 영향을 주는 요인들을 규명한 결과 부양자의 성, 월수발비용, 일상생활수행불능 총갯수는 거주지역과 관계없이 부담에 유의미한 영향요인으로 나타났다. 거주지역 별로 차별화된 영향을 주는 고유한 변인으로는 농촌지역모델에서는 부양기간, 부양자의 주관적 건강상태, 노인의 주관적 건강상태였고, 도시지역모델에서는 노인의 우울도 점수합계였다.
장기요양보호노인을 수발하는 부양자의 부양부담의 정도와 영향요인이 농촌지역과 도시지역에 따라 차이가 있다는 본 연구의 분석결과는 장기요양보호정책 입안 시 각 거주지역이 가지는 고유한 특성이 최대한 반영되어야 함을 시사한다.

다국어 초록 (Multilingual Abstract)

The objectives of this research are to explore rural-urban differences in the characteristics of non-institutionalized impaired elderly and their co-residing primary caregivers in Korea. Data for the analysis are from the public-use data files developed the 2001 National Long-Term Care Survey database. The analysis sample consists of 1,011 care recipients and their primary caregivers. The results show that there is a significant variability in health status of care recipients by area of residence. Compared to their urban counterparts, those impaired elders residing in rural areas reported a lower the ADL scale, meaning that they were better situated in terms of functional ability. This study also finds that there are significant rural-urban differences in the characteristics of caregivers and caregiving burden. Rural caregivers had substantially lower total burden score, implying that they felt less burdened in caring for care recipients.
Regardless of ares of residence, factors influencing caregivers' burden are: caregiver's gender, monthly caregiving expenses, ADL score. caregivers' self-rated health status, care recipients' self-rated health status, caregiving duration are statistically significant only for the rural model; care recipients' depression score only for the urban model. These findings suggest that it is vital for planner and providers to take the rural-urban differences in the characteristics of the impaired elderly and their primary caregivers into account when designing and formulating community-based long-term care service programs.

참고문헌 (Reference)

1 정경희, "장기요양보호대상 노인의 수발실태 및 복지욕구: 2001년도 전국 노인장기요양보호서비스 욕구조사"

2 윤현숙, "장기요양보호노인 가족수발자의 수발부담에 영향을 미치는 요인 -배우자와 자녀 비교-" 한국노년학회 27 (27): 195-211, 2007

3 "인구통계"

4 "노인 장기요양보호대상 욕구실태조사 및 정책방안"

5 Kim, E. Y, "Who Wants to Enter a Long-Term Care Facility ina Rapidily Aging Non-Western Society? Attitudes of Older Koreans Toward Long-Term Care Facilities." 52 : 2114-2119, 2004

6 Laditka, J. N., "The Health Trade-Off of Rural Residence for Impaired Older Adults: Longer Life, More Impairment" 23 (23): 124-32, 2007

7 Nofz,M.P, "Social Services for Older Rural Americans: Some Policy Concerns" 26 : 85-91, 1986

8 Larson, S. L, "Rural-Urban Differences in Usual Source of Care and Ambulatory Service Use: Analyses of National Data Using Urban Influence Codes" 41 (41): III65-III74, 2003

9 Bien, B., "Rural and Urban Caregivers for Older Adults in Poland: Perceptions of Positive and Negative Impact of Caregiving" 65 (65): 203-229, 2007

10 Crosato, K. E, "Rural Women Caregivers in Canada" 6 (6): 520-, 2006

11 Swindlehurst, H. F., "Rural Proofing for Health: A Commentary" 5 (5): 411-, 2005

12 Coburn,A.F, "Rural Long-Term Care: What Do We Need to Know to Improve Policy and Program?" 18 : 256-69, 2002

13 Lee, H. S., "Relationship of Empathy to Appraisal, Depression, Life Satisfaction, and Physical Health in Informal Caregivers of Older Adults" 24 (24): 44-56, 2001

14 Arai, Y., "Patterns of Outcomes of Caregiving for the Impaired Elderly: A Longitudinal Study in Rural Japan" 6 (6): 39-46, 2002

15 Shulz, R., "Patient Suffering and Caregiver Compassion: New Opportunities for Research, Practice, and Policy" 47 (47): 4-13, 2007

16 Cravens, D. D., "Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project" 21 (21): 322-8, 2005

17 Bedard, M., "Health Impact on Caregivers of Providing Informal Care to a Cognitively Impaired Older Adult: Rural Versus Urban Settings" 9 (9): 15-23,

18 Goldstein, N. E., "Factors Associated With Caregiver Burden Among Caregivers of Terminally Ill Patients With Cancer" 20 (20): 38-43, 2004

19 Dwyer, J. W, "Differences in Characteristics of the Caregiving Network by Area of Residence: Implications for Primary Caregiver Stress and Burden" 39 : 27-37, 1990

20 Butler, S.S., "Depression and Caregiver Burden Among Rural Elder Caregivers" 46 (46): 47-63,

21 Marotz-Baden, R, "Coping Strategies: A Rural-Urban Comparison" 35 : 281-288, 1986

22 Morycz,R.K, "Caregiving strain and the desire to institutionalize family members with Alzheimers disease: Possible predictors and model development" 7 (7): 329-361, 1985

23 Stone, R., "Caregivers of the Frail Elderly" 27 : 616-626, 1987

24 Wolff, J. L, "Caregivers of Frail Elders: Updating a National Profile" 46 (46): 344-356, 2006

25 Lee, Meeae, "Caregiver characteristics and experiences: their effects on the probability of nursing home admission"

26 Amirkhanyan, A. A, "Caregiver Stress and Noncaregiver Stress: Exploring the Pathways of Psychiatric Morbidity" 43 : 817-27, 2003

27 Coward, R. T, "An Introduction to Aging in Rural Environments"

28 "2008년 7월 31일 보도자료"

29 정경희, "1998년도 전국 노인생활실태 및 복지욕구조사"