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목차
I. 서론 10
1. 연구 필요성 및 목적 10
2. 연구문제 13
3. 변수의 조작적 정의 13
1) 서비스 평가 13
2) 환경지원 중요도 13
3) 유니트 케어 도입 의도 14
4. 연구 범위와 흐름도 14
II. 이론적 배경 16
1. 노인요양시설의 개념 및 관련 제도 16
1) 노인요양시설의 개념 16
2) 노인요양시설 관련 제도 19
2. 노인요양시설의 거주환경 24
1) 노인요양시설의 거주환경 분류 24
2) 노인요양시설의 거주환경 특성 25
3. 노인요양시설 거주노인의 환경 지원 29
1) 노인요양시설 거주노인의 이해 29
2) 노인요양시설의 환경지원 중요성 32
3) 환경지원 특성 33
4. 유니트 케어 시설 환경 38
1) 유니트 케어 의미와 특성 38
2) 유니트 케어 공간구성 40
3) 유니트 케어의 제도화와 시설 규정 44
4) 유니트 케어 효과 47
5. 노인요양시설 관련 선행연구 48
1) 노인요양시설의 서비스와 환경지원에 관한 연구 48
2) 노인요양시설의 서비스와 유니트 케어 도입에 관한 연구 49
3) 노인요양시설의 환경지원과 유니트 케어 도입에 관한 연구 50
III. 연구 방법 52
1. 연구 대상 및 자료수집 방법 52
2. 연구 모형 및 연구 가설 52
1) 연구모형 52
2) 연구가설 53
3. 측정도구 55
1) 노인요양시설 시설환경 실태 55
2) 노인요양시설 서비스 평가 56
3) 환경 지원 중요도 58
4) 유니트 케어 도입 의도 61
4. 자료 분석 64
IV. 연구결과 65
1. 조사대상자의 일반적 특성 65
2. 노인요양시설 시설환경 실태 분석 66
1) 노인요양시설 현황 66
2) 노인요양시설 생활환경 실태 70
3) 노인요양시설 개선방향에 대한 의견 74
2. 유니트 케어 도입 의도에 관한 연구모형 79
1) 측정 도구의 타당성 검증 81
2) 확인적 요인분석 90
3) 구조모형의 검증 92
V. 결론 98
1. 요약 및 논의 98
1) 노인요양시설의 시설환경 실태 98
2) 서비스 평가가 환경지원중요도와 유니트 케어 도입 의도에 미치는 영향 99
2. 제언 101
1) 실천적 측면 101
2) 정책적 측면 102
3. 향후 연구를 위한 과제 103
참고문헌 104
Abstract 112
부록 116
〈그림 1-1〉 연구의 흐름도 15
〈그림 2-1〉 유니트 케어 시설에 대한 생활단위와 개호단위 형태 41
〈그림 2-2〉 유니트 케어 시설의 공간구성 형태 41
〈그림 3-1〉 연구모형 53
〈그림 3-2〉 유니트 케어 특성 측정변수 항목 선정 방법 61
〈그림 4-1〉 구조모형의 경로계수 도식 93
〈그림 4-2〉 매개효과 검증을 위한 모형별 수식도 96
Elderly long-term care facilities in our country only focusing on the quantitative expansion and effective management for increasing number of elderly man, the service is rather standardized than diverse service according to individual characteristic, so the quality of service is insufficient. Due to this, the poor living environment of elderly long-term care facilities are being concerned, and the demand for diversification of elderly long-term care facilities and improvement of service quality are expected to be spread out. At this point as a head of care facilities, the Unit Care facilities environment centered on living environment meet the needs of individual property of elderly are receiving great attention. So the Unit care is needed to be introduced on the Elderly long-term care facilities and in the aspects of how operating method of facility can be changed depend on management philosophy of the Head of facility ,the study was targeted toward them.
The purpose of this study is to find out actual condition of the facility environment in elderly long-term care facilities, and analyze the influence of assessment serviced in director managing the elderly long-term facilities on importance of environmental support and intentional introduction of unit care.
For this study, the survey conducted from November-December 2011 282 facilities in Daegu and Gyeongbuk operated in accordance with the provisions of the Welfare and aged Acts were targeted and the survey conducted from November-December 2011 on those facilities was used to analysis. Analysis of the data was analyzed in frequency and percentage, to find out surveyed population and social characteristics and each variable on general matters. Also to determine the current status of elderly long-term care facilities recognized by the chief of facilities, the means and standard deviation were calculated. In order to analyze the impact on unit care introduction intention, the structural equation modeling analysis was performed. For the measurement items of the questionnaire, the exploratory factor analysis through the Varimax orthogonal rotation was carried out. For the intentional consistency between measurement items, the Cronbach α factors were calculated.
Based on study result, now suggest the practical and political aspects for introduction of the elderly long-term care facilities.
First, suggesting present major challenges in practical term, since it has shown that the elderly long-term care facilities’ support for privacy and independence of residents is insufficient, the facility environmental plan for maintain privacy is needed though the small residental environmental plan. It is important to find out elder long-term care facilities residents’ need and characteristic and provide individual care, however the facility environment and caring labor force environment is not supporting these demands. So the physical supporting environment for providing small caring unit is need to be planed. The common bathroom has to be built near the dwelling room and common space, also it is desirable to equip nurse’s room near the dwelling room. A plan for support environment, which can help independent life of residents and maintain continuous interaction is necessary.
Second, suggesting major challenges in political term, most of the dwelling room in elderly long-term is shared with many people and the area is very small, it is hard to equip personal goods in the room. The standard of legislation and policy for extending and enlarging elderly long-term care facilities are necessary. In the case of small life unit style recuperation facilities, the shortage of labor force in caring expected to be happen. For the moving to individual care, a institutional standard in raising the payment and employee placement base is need to be prepared in order to solve the labor force shortage in elderly long-term care facilities. Because it has shown that, to make small individual facility environment in elderly long-term care facilities, the perception of importance in environmental support considering characteristic elder residents in facility is necessary. So targeting elderly long-term care facilities’installation the education and training program that can understand residents in diversified perspective is needed.
Conclusion based on the result presented above, the current facility environment of elderly long-term care facilities, financial, managing system etc. is not well equipped, so the adopting unit care in practice is on hard way. In order to adopt unit care facility environment, it is necessary to establish infrastructures like facilities and labor power, determine regulation for new facility style and make political standard for facility, labor power and operation. So that the small life unit style elderly long-term care facility can be adopted to our society.*표시는 필수 입력사항입니다.
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