Purpose: This case report aimed to provide basic data to improve instrumental activities of daily living and quality of care for elderly with dementia. Methods: A total of ten sessions were organized and operated once a week for 16 elderly with dementia. Data analysis was conducted through observational evaluation of participation, concentration, and satisfaction, and pre and post test for each individual. In-depth interviews were performed at the end of each session. Results: Participants were 16.0% in their 70s, 68.7% in their 80s, and 6.3% in their 90s. Their average instrumental activities daily living (I-ADL) score was 20.12±4.93. Post test scores increased in 78% of the elderly. Participation, concentration, and satisfaction were the highest in the 8th session, which was operated under the theme of ‘A good day to go to the hospital,’ and the lowest participation, concentration, and satisfaction were in the 5th session, which was operated under the theme of ‘A good day to go out.’ Conclusion: In the case of elderly with mild or early dementia, performance of instrumental activities of daily living can be improved through repetitive learning. Thus, there is a need to continuously provide such program as a regular program for elderly people in the early stages of dementia.

Purpose: This case aims to present basic data needed to improve cognitive function and quality of care for aged with dementia. Methods: A total of ten sessions were organized and operated once a week for 12 aged with dementia using the center. Data collection was conducted from July 27 to September 30, 2022. Data analysis was conducted through observational evaluation of participation, satisfaction, and performance of each individual and in-depth interviews at the end of the program. Results: Among the 12 subjects who participated in the quality improvement program, an average of 8.4 subjects in each session showed high levels of participation and satisfaction. On the other hand, the performance level was low, with an average of 6.9 subjects per session. In the in-depth interview, two concepts were confirmed: ‘regrets about the past’ and ‘satisfaction with present life.’ Conclusions: We hope that the results of this case report will be useful in developing a multifaceted cognitive therapy program to improve the cognitive function of aged with dementia in the future.

This study assessed the nutrient consumption of children from lunch at day care centers and kindergartens. A total of 184 lunch plates were selected in two child day care centers and two kindergartens in Seoul. Weights of the menus in planned meals were measured and amount of served and consumed lunches were calculated using a digital photography technique. Nutrients of the planned, served, and consumed lunches were assessed using CAN-Pro 4.0 and the Index of Nutritional Quality (INQ) was calculated for each meal. Compared with the estimated energy requirement for lunch for 3-5 year old children, the planned meals of the child day care centers and kindergartens contributed 42.8% and 98.8% of the daily energy requirements, respectively. At a child day care center, a served meal provided more nutrients than a planned meal since some children requested more servings after eating the served meals. This showed that the planned meal did not meet children’s needs as well as the nutrient requirements. At the other child care center, children were served less than the planned meal by 6.8%, which resulted in serving less energy, calcium, potassium, and vitamin C than the required nutrients for lunch. Kindergarten A served meals with the energy requirement for lunch of 101.8%, but Kindergarten B served a meal with the energy requirement of 83.5%. Since the served portions were too small to meet nutrient requirements of the children, they consumed almost all the food served, and their nutrient consumption was similar to the nutrients served. Even though they consumed all the food served, their nutrient consumption did not meet their nutritional requirements. When assessed by INQ, the quality of the meal was good; children could consume enough nutrients when served proper quantity. Teachers who are responsible for serving meals need to be educated on proper portion sizes and how to encourage children to practice healthy eating. To promote healthy eating among children, parents need to provide children with messages consistent with what they have learned at institutions and to be a good role model in daily dietary life.

본 연구는 현재 시행중인 노인장기요양보험제도 중 주야간보호서비스 수가 책정에 대한 적합한 개선방안의 정책을 제안하는데 목적이 있다. 연구방법은 2019년과 2020년 주야간보호서비스 수가를 4개 주야간보호센터별 청구 모델을 작성하고 비교하여 문제점과 개선방안을 찾고자 했으며 현행 노인장기요양보험 제도 중 주야간보호서비스 수가 책정에 대한 문제점 및 개선방안의 정책제안은 다음과 같다. 문제점은 첫째, 주야간보호서비스 2020년 수가 인상 적절성 문제, 둘째, 주야간보호서비스 시설의 운영 문제, 셋째, 주야간보호 프로그램 서비스 질 문제 그리고 넷째, 재정의 안정적 확보 문제를 이야기 할 수 있다. 이에 대한 대안으로 첫째 적절한 수가인상 체계 마련, 둘째 인건비와 운영비를 분리 지급, 셋째 수가 정액제, 넷째 미이용일수 수가 적용 확대, 다섯째 월 한도액 현실화 도입을 제안하였다.

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EWDCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, B6, B12, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, B6, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

In this study, we measured the concentration of Particulate Matter(PM10), Formaldehyde(HCHO), and Total Bacteria Count (TBC) at two facilities: day care centers, and postnatal care centers located in the cities of Gyeonggi, Gangwon, Jeolla and Gyeongsang from January 1, 2012 to December 31, 2015. PM10 concentration was similar to the day care centers and postnatal care centers. HCHO concentration was the highest in the postnatal care centers. TBC concentration was the highest in the day care centers. Comparing the different cities, PM10 concentration was the highest in Gyeonggi, HCHO concentration was the highest in Gyeonggi, and TBC concentration was the highest in Gyeonggi. As a result of HCHO's risk assessment, it was found that adults exceeded the carcinogenicity tolerance of 10−6 specified by the US EPA. This study is expected to be helpful in preventing damage to health from the contaminated indoor air at sensitive facilities, and can be used as basic data for indoor air quality management.

본 연구의 목적은 어린이집 원장의 여성 리더십과 조직문화, 보육 교직원의 직무만족도와의 관계를 실증 분석하는 것이며, 이를 통해 바람직한 여성리더십의 형성으로 어린이집의 보육의 질을 높임으로써 궁극적으로 우리 사회가 직면하고 있는 저출산의 정책적 대안을 수립하고자 하였다. 연구를 위해 경기 구리 지역의 어린이집 교사를 대상으로 회수한 324부의 설문지를 활용하여 분석을 실시하였다. 연구결과, 어린이집의 원장의 어성리더십, 조직문화와 직무만족도는 유의한 상관관계를 가지고 있으며 여성리더십은 다른 두 요인에 정(+)의 인과관계를 가 지는 것으로 나타났다. 주목할 연구결과는 세 가지 요인을 포함할 경우에는 여 성리더십은 조직문화를 매개변수로 하여 직무만족도에 영향을 미치는 것으로 분석되었다. 그리고 직무만족도 가운데 ‘집단적 문화’요인이 직무만족도에 가장 높은 인과관계를 가지는 반면, ‘위계적 문화는 유의한 관계가 나타나지 않았다.

본 연구는 노인주간보호시설(day care center)의 서비스 품질이 이용자의 재이용 의사에 미치는 영향 과, 이용자 만족도의 매개효과를 규명하고자 한다. 이를 위해 서울권 노인주간보호시설 이용자 200명을 대상으로 설문조사하였고, 그 중 유의미한 설문지 183부를 회수하여 분석하였다. 노인주간보호시설 서 비스 품질을 독립변수로, 이용자 만족도를 매개변수로, 이용자의 재이용 의사를 종속변수로 설정하여 빈도분석, 상관분석, 매개영향분석 및 다중회귀분석을 실시하였다. 연구결과 서비스 수준은 재이용에 영 향을 미치지 않았고, 과정품질이 재이용에 가장 높은 영향을 미치는 것으로 나타났다. 또한, 과정품질 다음으로 결과품질이 재이용에 큰 영향을 미치는 것으로 나타났다. 이 같은 연구결과에 비춰봤을 때 노 인주간보호시설의 서비스를 발전시키기 위해선 (1) 종사자들에 대한 교육･훈련 및 처우개선, (2) 관련 법 제의 정비와 개선이 필요할 것으로 보인다.

본 연구의 대상은 서울지역과 경기도지역에 소재한 가정어린이집에 근무하는 보육교사 319 명이다. CCTV 설치에 대한 보육교사의 인식을 알아본 결과, CCTV 설치 의무화 이후 CCTV가 100% 설치되어 있었으며, 문제행동 수정용을 위해 영아에게 CCTV 설치가 필요하다고 인식 하였고 CCTV를 활용에 관한 보육교사의 인식을 알아본 결과, 안전사고 예방과 문제발생시 확인하는 ‘안심보육’의 용도가 가장 높았으며 전반적으로 아동학대 예방에 효과가 있는 것으로 조사되었다. CCTV의 교육적 활용은 ‘영아의 자유놀이 관찰 및 분석’이 가장 높았으며 CCTV 설치로 인해 가장 혜택 받는다고 생각하는 집단은 ‘부모와 영아’로 나타났다. CCTV의 설치로 ‘보육시설과 교사에 대한 부모의 인식’이 긍정적으로 바뀌었으며 반면 ‘교사와 아동의 사생활 침해’라는 부정적 인식이 나타났다. 마지막으로 CCTV 설치 후에 느끼는 변화 차이를 살펴본 결과, CCTV를 설치한 후 교사들은 변화를 인식 하지 못하고 있었으며 CCTV 설치 필요성에 관계없이 전반적인 반응은 영아를 대하거나 말할 때, 행동할 때 제약을 받는 다고 인식하였다.

현재 시행중인 노인장기요양보험제도 중 주야간보호서비스에 대한 적합한 개선방안의 정책을 제안하는데 목적이 있으며, 현행 노인장기요양보험제도 중 주야간보호서비스에 대한 문제점 및 개선방안의 정책제안은 다음과 같다. 주야간보호서비스 문제점으로는 첫째, 대상자 선정에 있어 등급자별 차등 수가 문제, 둘째, 프로그램 서비스 질 문제, 셋째, 주야간보호 서비스 전달체계 문제 그리고 넷째, 재정의 안정적 확보 문제를 이야기 할 수 있다. 이에 대한 대안으로 첫째, 인건비와 운영비를 분리 지급, 둘째, 수가 정액제, 셋째 미이용일수 수가 적용 확대, 넷째 월 한도액 현실화, 다섯째, 불필요한 행정업무 축소, 여섯째 단독 센터 추가 인센티브 도입을 제안하였다.

The number of children who use day-care centers is increasing. Most indoor air quality (IAQ) management has been based on daily average pollutant concentrations measured once a year. A more comprehensive management of IAQ is needed to protect children’s health from air pollutants in day-care centers. In this study, we investigated the weekly variation of air pollutant concentrations in a nursing room of a day-care center located at the roadside for a week in June of 2014. Average concentrations of CO2, PM10, black carbon, and total surface area of lungdeposited particles during nursing time of the day-care center were 510 ppm, 27.8 μg/m3, 1.87 μg/m3, and 30.6 μm2/cm3, respectively, with a similar diurnal pattern shown on weekdays.

본 연구의 목적은 주․야간보호 종사자 처우와 개선방안에 대하여 본 연구를 통해 논의와 제언을 제시하였다. 인터뷰는 주․야간보호센터 4개소에서 인터뷰를 진행하였으며, 시설장 4명, 실무자 4명에 대해서 동일한 질문을 내용으로 면접 인터뷰를 진행하였다. 4개소의 시설은 사회복지법인 2개소, 개인시설 2개소로 진행하였으며, 4개소 모두 운영방식 및 종사자 처우의 차이점에 대해서 분석하고 확인하였다. 인터뷰 결과로 전체의 주․야간보호 시설을 대변할 수 있는 내용은 아니지만 노인장기요양기관과 사회복지시설이라는 동일성과 전국이 동일한 주․야간보호 급여 이용수가 운영체제라는 점을 고려했을 때, 운영주최의 특성에 따라, 혹은 시설장이나 대표에 따라서 운영방식과 종사자 처우가 상당부분 다른 점을 확인할 수 있었다. 복지관 부설 주․야간보호의 법인 시설의 경우 지자체 보조금 및 법인 지원금으로 재가노인복지시설 인건비 가이드라인을 유지하였으며, 복지관 종사자 처우를 2014년 사회복지관·노인복지관 직원 기본급 권고 기준(사회복지직)과 사회복지이용시설(복지관) 종사자 수당 기준에 준하는 급여를 연봉제로 전환하여 지원하고 있음을 확인하였으며, 그로 인한 종사자 처우 등으로 인한 직무만족이 높음을 확인하였다.또한 높은 직무만족이 클라이언트에게 직접적으로 전하는 서비스 질에 영향을 미치고, 만족도가 상향된다는 것을 종사자 인터뷰와 연구조사 및 결과로 확인하였다. 아울러, 인터뷰와 사전자료를 통하여 종사자 직무만족 수준과 종사자 처우와 개선방안을 제시하였다.

The purpose of this study is to develop an objective instrument to measure ICT utilization ability of day care center teachers and verify its validity and goodness of fit. With the developed scale, the survey was conducted with 297 day care center teachers. As a result, the reliability of all questions was over .6, and the construct validity of the instrument consisting of 20 questions in 4 factors was verified in exploratory factor analysis. As a result of performing confirmatory factor analysis, it was found that GFI=.949, AGFI=.898, and RMR=.029, indicating that the goodness of fit index is sufficient to be used as a measuring model. The scales of ICT utilization ability are composed of 4 factors: Factor 1 is called editing, Factor 2 is program application, Factor 3 is installation and maintenance, and Factor 4 is named communication. With these factors, the measuring device for ICT utilization ability of day care center teachers, which is composed of a total of 20 questions, is confirmed.

Day-care center is one of living micro-environments for children. In urban area, day-care centers may be influencedby air pollutants emitted from the vehicle exhaust. In this work, diurnal variation of major pollutants and effectof outdoor air on indoor air quality were investigated using real-time instruments for a day-care center locatednear the heavy road. 48-h continuous monitoring at both indoor and outdoor were made in summer. The day-care center equipped with ceiling system air-conditioners was operated from 7:30 a.m. to 19:30 p.m. Indoor CO₂concentration responded greatly to the human activity. Indoor NO₂ concentration shows a big difference betweendaytime and nighttime, implying that outdoor NO₂ may penetrate into the indoor through opening of doors orwindows during the daytime. Indoor to outdoor concentration ratio of submicron particle surface area is <1 dueto the penetration of outdoor ultrafine particles.

As the country's elderly people who are 65 years or older recently exceeded 10% of the total population with development of medical technology and improvement of living standards, Korea has turned into an aging society. Especially in Gyeonggi-do, as of late December 2012, elderly people who were 65 years or older were 1,135,242 persons, taking up 18.98% of the region's population and registering the largest number of elderly people in the nation's cities or provinces. Due to such a sharp rise in elderly population, support for the elderly is increasing the burden on families and communities. The study aims to take as its subjects elderly people staying at authorized elderly welfare facilities, who are weak in mind and body and have difficulty in daily life with disabilities, or adult day care facilities that take care of elderly people during the day or at night, examine the concept of adult day care facilities and instances in foreign countries, and study the status of the adult day care facilities located in Gyeonggi-do, their services, and safety by figuring out space arrangement based on program implementation. Spacial arrangement in program operation should satisfy fuction and purpose from the manager and user's perspective, and a desirable program operation should provide separate spaces for the elderly with Alzheimer's and those without Alzheimer's. Compared to residential care facilities, adult day care facilities incur less financial burden and, compared to other authorized services, have many right functions that can upgrade the quality of users and satisfy their desires. Major countries like Japan, the UK, and Sweden recognize the right functions of day and night care services and aggressively support and utilize adult day care facilities. For adult day care facilities, quality services should be developed and use and choices should be enhanced as regards services. Development of special programs for the elderly with dementia and stroke, instead of simple protective functions of a program, must be actively promoted, while manpower training is required for program operation, conveniences, and safety. By developing and providing space arrangement models that focus on efficiency, convenience, and safety of program operation, adult day care operation can be revitalized, while quality of elderly care may be enhanced and welfare budget can be saved.

본 연구는 노인 주간보호프로그램에 참여하는 노인들의 경험을 이해하고 활동 참여의 과정을 설명하는 것 을 목적으로 하였다. 연구방법 : 본 연구는 노인 주간보호 참여자들의 경험과 그 과정에 대한 깊은 이해를 얻기 위해 질적 연구방법의 하나인 근거이론 접근법을 이용하였다. 참여자에 대한 심층면담, 참여관찰, 그리고 운영일지 등을 통해 자료를 수집하였고, 이를 지속적 비교법을 통해 분석하였다. 결과 : 지역사회에서 장애를 가진 노인들은 일상적인 활동의 결여와 대인관계의 고립으로 인하여 지속적인 건강 의 악화를 경험하였다. 노인 주간보호는 참여자에게 일상적 활동과 사회적 관계 형성의 기회를 제공하였고 이 러한 경험은 새롭게 일상을 재구성하는 과정으로 설명되었다. 결론 : 주간보호에서 활동참여를 통한 일상의 재구성은 일과와 대인관계의 변화와 관련되었다. 노인 주간보호는 활동참여의 기회를 제공한다는 점에서 건강과 활동참여의 연관성을 주목해온 작업치료사들이 보다 관심을 가 져야할 임상영역이다.

The indoor level of phthalates in children-facilities was assessed in this study. The samples of house dust were collected at various children's facilities (40 day-care houses, 42 child-care centers, 44 kindergartens, and 42 indoor playgrounds) in summer (Jul~Sep, 2007) and winter (Jan~Feb, 2008) periods, and analyzed by GC-MS. The DEHP was detected in almost every sample (detection rate : 99%) and the detection rate of DnBP and BBzP was more than 80%. The average concentrations of DEHP, DEP, DnBP, and BBzP in house dust were 388 ㎍/g dust, 37㎍/g dust, 108㎍/g dust and 349㎍/g dust, respectively. The relationship between construction period and DEHP level was statistically significant. But, other factors such as flooring material, construction period and water leakage were not statistically significant relationship with phthalates levels. The Phthalate levels were similar or more higher than other the European country.