장기요양기관에서 보완대체요법 적용을 위한 방법론적 고찰 - 장기요양보험 관리주체의 관점에서

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A Methodological Study for the Application of Complementary and Alternative Therapy at Long-Term Care Facilities
-Focusing on a Long-Term Care Insurance Manager's Perspective-

Kim, Myung-soo
Advisor : Prof. Moon, Kyung-Rye, Ph.D.
Department of Alternative Medicine,
Graduate School of Health Science
Chosun University

With a rapid increase of the senior citizens' population in Korea, the number of seniors citizens who are having difficulties due to elderly diseases is increasing, too. In addition, weakening health of senior citizens not only increases dependability in everyday life and limits social roles of senior citizens, but also leads to problems such as financial burden of a family or financial health insurance problems. Therefore, there is a desperate need today more than ever for diverse studies and interests in appropriate medical services and care for senior citizens who are experiencing difficulties in everyday life.
In order to actively counteract to the senior citizens' problem, the government started a senior citizens' long-term recuperation insurance system on July 1, 2007. However, the insurance provides senior citizens who cannot do things alone in daily life with services to support physical activities or housework, and the reality is that there is still a lack of a system that provides a comprehensive service for daily health management for senior citizens who have complex demands for treatment and insurance. The system does provide a link between long-term facilities and medical facilities, but this is normally for extreme diseases, and the only care there is for chronic and degrading diseases are drugs. In such a reality, alternative supplementation treatments to surgeries and chemical drug use of senior citizen patients, such as treatment methods that are a combination and balance of physical, mental, spiritual, social and environment fields, that see the patient as a whole human being and strengthens the patient's immunity and natural treating ability, is the most appropriate solution for daily health management of senior citizen patients.
In order to apply senior citizens' welfare services to daily life, first, they must be easy to apply regardless of time or place, second, they must supplement disadvantages and side effects of modern day technology and be appropriate for senior citizens who have low immunity, and third, they must be able to control and combine imbalance between the mind, emotions and body.
Specific alternative supplementation treatments that can be executed in everyday life are image treatment, bath treatment, scent treatment and music treatment, and previous studies show through documentary analysis that these treatments are effective on emotional stability and reduction of depression, relieving stress, overcoming fatigue, relieving pain, improving awareness functions of dementia patients, and reducing violent or problematic actions.
This study aimed to find a method to activate application of alternative supplementation treatments at long-term facilities from a manager's perspective, which is the perspective of the National Health Insurance Corporation, and theoretically it used a social welfare application approach method and support approach method as a frame and used case management functions and active service quality methods of long-term recuperation insurance. Through these tools, client's health condition and improvement of independency in daily life were reflected in evaluation of long-term facilities, and a graded incentive system was introduced in the facility salary, and conditions to carry out alternative supplementation treatments were provided through promotion of the Long-term Recuperation Insurance Association, to find a way to activate application of alternative supplementation treatments at long-term facilities.
Alternative Title
A Methodological Study for the Application of Complementary and Alternative Therapy at Long-Term Care Facilities -Focusing on a Long-Term Care Insurance Manager's Perspective
Alternative Author(s)
보건대학원 대체의학과
보건대학원 대체의학과
Awarded Date
Table Of Contents
목 차

Ⅰ. 서론 1
A. 연구의 배경 및 필요성 1
B. 연구의 목적 3
C. 연구 범위와 방법 3
D. 연구의 제한점 4
Ⅱ. 이론적 배경 5
A. 장기요양보험 제도 5
1. 노인장기요양보험의 개념 5
2. 장기요양보험 적용대상 6
3. 급여종류 6
4. 장기요양기관 7
5. 장기요양요원 7
6. 장기요양보험의 관리운영기관 8
B. 보완대체요법 8
1. 보완대체요법의 정의 9
2. 보완대체요법의 특징 9
3. 보완대체요법의 분류 11
4. 보완대체요법의 현황 12
5. 보완대체요법의 법적 지위 13
6. 보완대체요법의 인식 및 이용실태에 대한 선행연구 고찰 17
Ⅲ. 장기요양기관에서 적용 가능한 보완대체요법 19
A. 노인의료복지서비스 증진을 위한 보완대체요법 19
B. 심신요법 20
1. 심신요법의 개념 20
2. 심신요법의 종류 20
3. 심상요법과 관련한 선행연구 고찰 26
C. 목욕요법 26
1. 목욕의 생리적 변화 26
2. 목욕요법의 효과 28
3. 목욕요법의 종류 29
4. 목욕요법의 선행연구 고찰 31
D. 향기요법 31
1. 향기요법의 원리와 효과 32
2. 아로마 오일의 사용방법 32
3. 향기요법 선행연구 고찰 33
E. 음악치료 35
1. 음악치료의 개념 35
2. 음악치료의 원리 36
3. 음악치료의 효과 37
4. 음악치료에 대한 선행연구 고찰 39
Ⅳ. 보완대체요법 적용을 위한 접근방법 41
A. 보완대체요법 적용을 위한 사회복지실천 접근방법의 틀 41
1. 직접적(미시적) 접근방법 41
2. 간접적(거시적) 접근방법 41
3. 지원적 접근방법 41
B. 장기요양보험에서의 사례관리 42
1. 사례관리의 개념적 정의 42
2. 사례관리의 목적 43
3. 장기요양보험에서의 사례관리자의 역할 43
C. 장기요양기관에서 보완대체요법 적용을 위한 방법론 44
1. 도입 44
2. 사정 45
3. 서비스 계획 45
4. 서비스와 연결 45
5. 점검 46
6. 평가 47
Ⅴ. 고찰 및 제언 49
A. 고찰 49
B. 제언 50
1. 적극적인 서비스 질 관리 51
2. 장기요양 인력에 대한 보완대체요법 교육 52
3. 방문재활 서비스 제도 도입 53
4. 장기요양 인력에 대한 처우 개선 53
참고문헌 55
김명수. (2008). 장기요양기관에서 보완대체요법 적용을 위한 방법론적 고찰 - 장기요양보험 관리주체의 관점에서.
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