본문 바로가기
KERD
논문KCI 등재

활동보조서비스 이용자의 선택과 성과 간의 관계

A Study of Relationship between the User's choice and Outcomes in the Personal Assistance Service

1

조회

0

다운로드

7

인용

0

참고문헌

키워드

초록

본 연구의 목적은 활동보조서비스에서의 이용자의 선택과 서비스 주요 성과 간의 관계를 검증함으로써 활동보조서비스의 성과를 높이기 위한 정책적․실천적 개입 방안을 제시하는 것이다. 활동보조서비스 이용 중증장애인 133명에 대하여 이용자 선택과 서비스만족도, 자기효능감, 사회참여 간의 관계를 알아보기 위해 PLS(Partial Least Square) 분석을 실시하였다. 그 결과, 서비스기관을 스스로 결정하고 자신의 의사를 서비스계획에 많이 반영한 경우일수록 서비스만족도가 높았다. 한편 서비스만족도는 자기효능감변화를 완전매개로 하여 사회참여변화에 영향을 미치는 것으로 나타났다. 위와 같은 연구결과는 활동보조서비스 이용에 주도적으로 참여한 장애인이 서비스에 대한 만족도가 높고, 심리적으로 긍정적인 변화를 경험한 장애인이 사회참여도 활발하게 하게 된다는 것을 보여준다. 따라서 활동보조서비스의 만족도를 높이기 위해서는 중증장애인의 선택권과 참여가 보장되어야 하며, 사회참여 성과를 촉진하기 위해서는 자기효능감 강화 등 심리적 임파워먼트에 대한 고려가 필요하다는 것을 제시해주고 있다.

Abstract

Purpose. The purpose of this study is to investigate the relationship between user's choice and outcomes in PAS. Method. We used secondary data collected via a survey of Personal Assistance Service (PAS) users by the Ministry for Health, Welfare and Family Affairs, Republic of Korea(2007). PLS (Partial Least Square) analysis was conducted to examine the relationship between the level of choice(formative variable) on PAS, service satisfaction(reflective variable), change in self-efficacy(reflective variable), and self perceived change in social participation(reflective variable), since they used services. Control variables were age, sex, income, service time per visit. We used SmartPls 2 which is a software application for the design of structural equation models on a graphical user interface. Result. The participants who had greater choice and control in their service reported more satisfaction with PAS. There was a positive association between service satisfaction and self-efficacy. Interestingly self-efficacy variable fully mediated the relationship between satisfaction and social participation. Conclusions. We should adopt an approach to raise service satisfaction to enhance PAS outcomes for severely disabled people. Not only assistants but also family, service providers need to recognize the right of choice and self determination that could be addressed in PAS program. Also policy makers should build up precondition for choice. Psychological empowerment should be considered as factors to facilitate social participation in PAS.

참고문헌 (83)

  1. 김경미, "장애인의 활동보조서비스 이용 이후 삶의 변화에 대한 연구: 신체적, 심리적, 사회관계적 측면을 중심으로", 한국사회복지학, 57(4), pp.253~274 (2005), 한국사회복지학회
  2. 보건복지부, "2008년도 장애인 활동보조지원사업 안내", ~ (2009)
  3. 이익섭, "활동보조서비스 성과 및 영향요인에 관한 연구", 한국사회복지학, 59(1), pp.117~143 (2007), 한국사회복지학회
  4. 고미현, "인터넷 커뮤니티에서 사용자 참여가 밀착도와 지속적 이용의도에 미치는 영향", Asia Pacific Journal of Information Systems, 18(2), pp.41~72 (2008), 한국경영정보학회
  5. 양희택, "장애인 활동보조서비스(PAS) 유형에 따른 활동보조서비스 이용자 만족도 비교", 임상사회사업연구, 4(3), pp.111~132 (2007)
  6. 이광원, "자립생활 프로그램 참여 기간이 중증지체장애인의 자기효능감과 내외통제성에 미치는 영향 연구", 석사, pp.2004
  7. 이웅규, "정보기술 사용에서의 전유가 내재적", 외재적 동기 및 사용용이성에 미치는 영향 : 블로그 사용자들을 중심으로, 2008, pp.33(1), 131~148[DOI]
  8. 정무권, "특허취득 및 디자인등록 공시에 따른 기업가치의 변화와 매출력 및 원가력의 매개효과", 경영학연구, 37(6), pp.1347~1373 (2008), 한국경영학회
  9. 정윤경, "남편의 정서적 폭력과 아내의 우울과의 관계 : 가정폭력 교정 치료프로그램 이수자의 아내를 대상으로 분석", 박사, pp.2009
  10. 진종훈, "기업의 문화마케팅이 기업이미지제고를 통해 구매의도에 미치는 영향-서울, 충청 지역 대학생 중심으로-", 한국콘텐츠학회 논문지, 8(4), pp.147~154 (2008), 한국콘텐츠학회
  11. 홍세희, "구조방정식모형 : 고급방법", 고급연구방법론 워크샵시리즈4 (2008)
  12. 황덕란, "온라인 쇼핑몰에서 소비자의 쇼핑 동기와 감정이 쇼핑 행동에 미치는 영향 : 구매경험자와 잠재구매자간의 차이 분석", 경영연구, 22(2), pp.347~375 (2007), 한국산업경영학회
  13. Askheim, O., "Personal Assistance in Sweden and Norway: From Difference to Convergence?"", Scandinavian Journal of Disability Research, 10(3), pp.179~190 (2008)
  14. Bandura. A., "Self-efficacy : the exercise of control" (1997), W.H. Freeman and Co.
  15. Beatty, P. W., "Personal assistance for people with physical disabilities: Consumer-direction and satisfaction with services", Archives of Physical Medicine and Rehabilitation, 79(6), pp.674~677 (1998)
  16. Beaulaurier, R. L., "Social work practice with people with disabilities in the era of disability rights", Social Work in Health Care, 32(4), pp.67~91 (2001)
  17. Benjamin, A. E., "Comparing consumer-directed and agency models for providing supportive services at home", Health Services Research, 35, pp.351~366 (2000)
  18. Bent, N., Jones, "Factors determining participation in young adults with a physical disability: A pilot study", Clinical Rehabilitation, 15(5), pp.552~561 (2001)
  19. Bolton, B., "Development of a measure of intrapersonal empowerment", Rehabilitation Psychology, 43, pp.131~142 (1998)
  20. Breda. J., "Cash and Care: Policy Challenges in the Welfare State", pp.235~248 (2006), The Policy Press
  21. Brown, B., "Self-efficacy beliefs and career development", ERIC Digest, (205) (1999)
  22. Chase, B. W., "Life satisfaction among persons with spinal cord injuries", Journal of Rehabilitation, 66(3), pp.14~20 (2000)
  23. Chin, W. W., "Issues and opinion on structural equation modeling", MIS Quarterly: Management Information Systems, 22(1), pp.7~16 (1998)
  24. Clark, H., "It Pays Dividends: Direct Payments and Older People" (2004), Policy Press
  25. Clark, M. J., "A longitudinal comparison of consumer-directed and agency-directed personal assistance service programmes among persons with physical disabilities", Disability and Rehabilitation, 30(9), pp.689~695 (2008)
  26. Conger, J.A., "The empowerment process: Integrating theory and practice", Academy of Management Review, 13, pp.471~482 (1988)
  27. Dejong, G., "The independent living model of personal assistance in national long-term care policy", Generations, 8, pp.89~95 (1992)
  28. Dempsey, I., "Toward a clarification of empowerment as an outcome of disability service provision", International Journal of Disability, Development and Education, 44(4), pp.287~303 (1997)
  29. Dijkers, M. P. J. M., "Measures of social outcomes in disability research", Archives of Physical Medicine and Rehabilitation, 81, pp.S63~S80 (2000)
  30. Doty, P., "Consumer-Directed Models of Personal Care: Lessons from Medicaid", Milbank Quarterly, 74(3), pp.377~409 (1996)
  31. Dumont, C., "Toward an explanatory model of social participation for adults with traumatic brain injury", Journal of Head Trauma Rehabilitation, 19(6), pp.431~443 (2004)
  32. Dumont, C., "Perceived self-efficacy as a factor associated with social participation of adults having sustained a traumatic brain injury", Canadian Journal of Occupational Therapy, 72(4), pp.222~233 (2005)
  33. Dunst, C. J., "Building and mobilising informal family support networks. in Support for caregiving families: Enabling positive adaptation to disability", pp.121~141 (1989), Paul H. Brookes
  34. Eustis N. N., "Common needs, different solutions? Younger and older home care clients", Generations, 16(1), pp.17~23 (1992)
  35. Foster, L., "Improving the quality of Medicaid personal assistance through consumer direction", Health affairs, pp.162~175 (2003)
  36. Fornell, C., "Two Structural Equation Models : Lisrel and PLS applied to consumer exit-voice theory", Journal of Marketing Research, 19, pp.440~452 (1982)
  37. Freedman, R. I., "The power to choose: Supports for families caring for individuals with developmental disabilities", Health and Social Work, 25(1), pp.59~68 (2000)
  38. Gefen, D., "Structural Equation Modeling and Regression: Guidelines for Research Practice", Communication of the Association for Information Systems, 4, pp.2~72 (2000)
  39. Gilson, S. F., "Personal assistance services and case management", Journal of Case Management, 6(1), pp.13~17 (1997)
  40. Glendinning, C., "Buying Independence: Using Direct Payments to integrate health and social services" (2000), Policy Press
  41. Hagglund, K. J., "A comparison of consumer-directed and agency-directed personal assistance services programmes", Disability and Rehabilitation, 26(9), pp.518~527 (2004)
  42. Hammel, J., "What does participation mean? An insider perspective from people with disabilities", Disability and Rehabilitation, 30(19), pp.1445~1460 (2008)
  43. Hasler, F., "Clarifying the Evidence on Direct Payments into Practice" (2003), National Centre for Independent Living
  44. Hasler, F., "Making Direct Payments Work: Identifying and overcoming barriers to implementation" (2004), Pavilion Publishing
  45. Jarvis, C. B., "A Critical Review of Construct Indicators and Measurement Model Misspecification in Marketing and Consumer Research", Journal of Consumer Research, 30(2), pp.199~218 (2003)
  46. Keigher, S.M., "The limits of consumer directed care as public policy in an aging society", Canadian Journal on Aging, 18(2), pp.182~210 (1999)
  47. Khatutsky, G., "Personal care satisfaction among aged and physically disabled medicaid beneficiaries", Health Care Financing Review, 28(1), pp.69~86 (2006)
  48. Kosciulek, J. F., "Structural analysis of the consumer-directed theory of empowerment", Rehabilitation Counseling Bulletin, 44(4), pp.209~216 (2001)
  49. Kremer, M., "Consumers in charge of care: the Dutch Personal Budget and its impact on the market, professions and the family", European Societies, 8, pp.385~401 (2006)
  50. Larson, L., "Development and validation of the Counseling Self-Estimate Inventor", Journal of Counseling Psychology, 39, pp.105~120 (1992)
  51. Matsuda, S. J., "Barriers and satisfaction associated with personal assistance services: results of consumer and personal assistant focus groups", OTJR: Occupation, Participation & Health, 25(2), pp.66~74 (2005)
  52. Matthias, R. E., "Paying friends, family members, or strangers to be home-based personal assistants: How satisfied are consumers?", Journal of Disability Policy Studies, 18(4), pp.205~218 (2008)
  53. Meyer, M., "'They're taking the place of my hands: Perspectives of people using personal care", Disability and Society, 22(6), pp.595~608 (2007)
  54. Mitchell, J. M., "Satisfaction ratings and problems experienced with paid personal attendant care: Ethnic comparisons", Topics in Geriatric Rehabilitation, 14(4), pp.53~67 (1999)
  55. Morris, J., "Care or empowerment? A disability rights perspective", Social Policy and Administration, 31(1), pp.54~60 (1997)
  56. Morris, J., "Independent living: the role of the disability movement in the development of government policy. in Cash and Care: Policy Challenges in the Welfare State", pp.235~248 (2006), The Policy Press
  57. Nunnally, J.C., "Psychometric Theory" (1978), McGraw-Hill
  58. Nosek, M. A., "Life satisfaction of people with physical disabilities: Relationship to personal assistance, disability status, and handicap", Rehabilitation Psychology, 40(3), pp.191~202 (1995)
  59. Orsega-Smith, E. M., "The role of social support and self-efficacy in shaping the leisure time physical activity of older adults", Journal of Leisure Research, 39(4), pp.705~727 (2007)
  60. Parsons, R., "Empowerment: Purpose and practice principle in social work", Social Work with Groups, 14(2), pp.7~21 (1991)
  61. Perenboom, R., "Measuring participation according to the International Classification of Functioning, Disability and Health (ICF)", Disability & Rehabilitation, 25(11), pp.577~587 (2003)
  62. Pinsonnault, E., "Validation study of a social functioning scale: The social-SMAF (social-Functional Autonomy Measurement System)", Archives of Gerontology and Geriatrics, 48(1), pp.40~44 (2009)
  63. Poole, T., "Direct Payments and Older People" (2006), King's Fund
  64. Priestley, M., "Direct payments and disabled people in the UK: supply, demand and devolution", British Journal of Social Work, 37(7), pp.1189~1204 (2007)
  65. Prince, J. M., "Self-managed versus agency-provided personal assistance care for individuals with high level tetraplegia", Archives of Physical Medicine and Rehabilitation, 76(10), pp.919~923 (1995)
  66. Rappaport, J., "Terms of empowerment", exemplars of prevention: Toward a theory for community psychology, 1987, pp.15, 121~148
  67. Ross, J. M., "Quality of personal assistance" (2009), University of Gothenburg
  68. Schwartz, R., "Self-efficacy and health behaviors. in Predicting Health Behaviour", pp.163~196 (1999), University Press
  69. Simon, B.L., "Rethinking empowerment", Journal of Progressive Human Services, 1(1), pp.27~39 (1990)
  70. Simon-Rusinowitz, L., "Implementation issues for consumer-directed programs: Comparing views of policy experts, consumers, and representatives", Journal of Aging and Social Policy, 14(3), pp.95~118 (2002)
  71. Strauser, D., "Applications of self-efficacy theory in rehabilitation counseling", Journal of Rehabilitation, 61, pp.7~13 (1995)
  72. Teo, H. H., "Predicting Intention to Adopt Interorganizational Linkages: An Institutional Perspective", MIS Quarterly, 7(1), pp.1~31 (2003)
  73. The World Health Organization(WHO), "International Classification of Functioning, Disability and Health", ~ (2001)
  74. Tilly, J., "Consumer-directed home and community services programs in eight states: policy issues for older people and government", Journal of Aging and Social Policy, 12(4), pp.1~26 (2001)
  75. Ungerson, C., "Whose empowerment and independence? A cross-national perspective on 'cash for care' schemes", Ageing and Society, 24(2), pp.189~212 (2004)
  76. Ungerson. C., "Conclusion: dilemmas, contradictions and change. in Cash-for-care in Developed Welfare States", pp.187~206 (2007), Palgrave Macmillian
  77. Van Brakel, W. H., "The Participation Scale: Measuring a key concept in public health", Disability and Rehabilitation, 28(4), pp.193~203 (2006)
  78. Wiener, J. M., "Are consumer-directed home care beneficiaries satisfied? Evidence from Washington State", Gerontologist, 47(6), pp.763~774 (2007)
  79. Witcher, S., "Direct Payments: The impact on choice and control for disabled people" (2000), Scottish Executive Central Research Unit.
  80. Wood, R., "Impacts of concepts of ability on self regulatory mechanisms of complex decision-making", Journal of Personality and Social Psychology, 56, pp.795~817 (1989)
  81. Yoshida, K., "The emergence of self-managed attendant services in Ontario: direct funding pilot project - an independent living model for Canadians requiring attendant services", Research in the Sociology of Health Care., 22, pp.177~204 (2004)
  82. Zimmerman, M.A., "Further explorations in empowerment theory: An empirical analysis of psychological empowerment", American Journal of Community Psychology, 20, pp.707~726 (1992)

관련 논문AI추천

이 간행물의 다른 논문 (10건)