일반노인과 재가급여 장기요양 노인의 간호 요구도 조사연구

Abstract

ABSTRACT A Study on Nursing Needs for General Senior Citizens and Home-Staying Long-Term Care Senior Citizens ？ Moon, jung wook Advisor: Prof. Moon, Kyung Rye M.D., Ph.D. Department of Alternative Medicine, Graduate School of Health Science Chosun University

This study is conducted to see how much care is required for home-staying service recipients among general senior citizens and home-staying long-term care senior citizens in an effort to lay a foundation for providing proper intervention to maintain and improve the health of home-staying long-term care senior citizens and, further, ameliorate the quality of life for them.

Collecting data from general senior citizens was done by visiting senior citizen welfare halls, senior citizen colleges and senior citizen centers from Oct. 24 - Nov. 15, 2008. Data from home-staying service recipients were collected by visiting their homes. Questionnaires were used to record one-to-one interview with senior citizens. For survey purposes, 200 general senior citizens and home-staying long-term care recipients residing in Suh-gu and Gwangsan-gu, Gwangju City were selected at random.

In this study, highly reliable measuring tools used for diseases in general senior citizens and home-staying service recipients were employed. General characteristics of data collected to identify overall nursing needs were analyzed by real numbers, percentiles, averages and standard deviations; differences in nursing needs in line with the general characteristics were analyzed by the t-test and ANOVA; and the correlations among nursing needs were analyzed by Pearson Correlation Coefficients.

The results of the analyses are as follows:

1. In terms of general traits regarding survey subjects, female senior citizens accounted for 62.5%; 61.7% of them were still married; and 56.3% of home-staying care patients had dead spouses. In terms of disposable allowance, 45.8% of general senior citizens had more than 200,000 won per month in their pockets and 47.6% of home-staying care senior citizens had less than 100,000 won per month for free use. Their income came from pensions/savings (55.0%) or from family members (45.0%).

While 88.3% of general senior citizens were living in their own homes, 50.0% of home-staying care senior citizens were residing in their own homes. In terms of family types, 48.3% of general senior citizens were living with their spouses and 36.3% of home-staying care senior citizens were living alone.

2. With respect to perceived states of health, 34.2% of general senior citizens said, "so, so", while 70.0% of home-staying care senior citizens said that they had bad health. When it comes to health hampering their everyday life, 54.2% of general senior citizens said they felt a little uncomfortable and 53.8% of home-staying care senior citizens said their states of health were quite obstructive. Compared with peers, 40.8% of general senior citizens said, "the same" and 75.0% of home-staying care senior citizens said their states of health were worse. In terms of their concerns about their health, 54.2% of general senior citizens said, "often worrisome" and 75.0% of home-staying care senior citizens said, "always worrisome". 60.8% of general senior citizens had 1-2 diseases and 75.0% of home-staying care senior citizens had more than 3 diseases. The diseases they suffer from were high blood pressure (50.8%), arthritis (39.2%), back pain (20.0%), diabetes (15.8%) and digestive tract disorders (12.5%) for general senior citizens. In the case of home-staying care senior citizens, they were arthritis (78.8%), high blood pressure (48.8%), diabetes (42.5%), back pain (38.8%) and digestive tract disorders (36.3%). In addition, 50.8% of general senior citizens and 72.5% of home-staying care senior citizens were exposed to malnutrition.

In terms of daily activities, self-esteem, depression and satisfaction with life, both groups had low levels, but home-staying care senior citizens had much lower level.

3. The overall nursing needs of the study subjects were found to be 1.92 on average: for general senior citizens, 1.55 and for home-staying care senior citizens, 2.48. All the 9 fields showed significant differences.

In terms of field-by-field nursing needs, disease-related education and consultation were most required. Exercise and movement, and personal hygiene were equally needed. General senior citizens needed cares of breathing, food and water intake, temperature maintenance, bowel movement, medication and wound treatment, while home-staying care senior citizens required services of temperature maintenance, food and water intake, breathing, medication, wound treatment and bowel movement. Other lesser needs varied according to the illnesses each subject had.

In terms of nursing needs by general traits, only sex and residence type were significant. Male home-staying care senior citizens required the highest nursing needs and female general senior citizens had higher nursing needs in general senior citizens. Home-staying care senior citizens who did not have their own homes had the highest needs while general senior citizens with their own homes needed more care.

In terms of age, home-staying care senior citizens with 65-69 years of age had the highest nursing needs. In terms of marital status, divorced/separated senior citizens require the highest level of care. Home-staying care senior citizens whose income came from pensions/savings and who said their children were wealthy required the highest nursing needs. Senior citizens living alone asked for the least care level. Home-staying care senior citizens who lived with spouses required higher level of care, which is quite different from general senior citizens.

The study results above indicate that the senior citizens need disease-related education or knowledge, exercise and movement and personal hygiene rather than wound care or medication. Home-staying care senior citizens required higher level of care in all the survey fields. The care to be provided for them should focus on supportive intervention like health maintenance and improvement rather than on physical illnesses. Furthermore, systematic and built-in intervention and tools need to be developed to provide effective care services for home-staying long-term care senior citizens.

Key Words: general senior citizens, home-staying long-term care senior citizens, nursing need