미국 내 아시안 노인들의 가정 및 지역사회 기반 서비스 이용에 영향을 미치는 요인에 관한 연구
Factors affecting use of home and community-based services among the Asian Americans in the U.S.
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연구목적 : 본 연구는 미국 내 아시안 노인들의 가정 및 지역사회 기반 서비스(Home and Community-based services) 이용에 영향을 미치는 요인을 알아보는 목적으로 수행되었다. 연구 방법 : 2004년 National Long-term Care Survey 중 지역 내 거주하고 있는 노인을 대상으로 한 설문조사에 참여한 108명의 아시안 노인들이 연구표본으로 사용되었다. 앤더슨의 행동주의 모델 에 의거하여, 선행요인 (성별, 나이, 교육수준, 및 결혼상태), 촉진요인 (메디케이드와 사보험의 유무), 그리고 욕구요인 (수단적 활동 수행의 어려움과 일상생활 활동 수행의 어려움)들이 독립 변수들로 사용되었다. 연구결과 : 본 연구를 위해 로지스틱회귀분석이 사용되었다. 18명의 노인( 연구표본의 19%)만이 가정 및 지역사회 기반 서비스를 사용해본 경험이 있는 것으로 나타났다. 로지스틱 회귀분석 모델은 통계적으로 유의미했으며, 교육수준과 일상생활활동의 어려움이 지 역 내 기반 서비스 이용여부에 영향을 미치는 것으로 나타났다. 결론 : 다른 인종집단에 비해, 매 우 낮은 공식적 서비스 이용률과 노인보호 부양에 있어, 비공식적인 지지망에 대한 높은 의존 을 보이는, 아시안 노인들이 지역사회에서 보다 건강하게 거주하며, 이들을 돌보는 가족보호부 양자들의 부양 부담을 줄이기 위해서는, 아시안 노인들의 가정 및 지역사회 기반 서비스의 접근 성을 높이기 위한 적극적인 노력이 요구된다.
Abstract
Study Aim: This study identifies factors that affect the use of home and community-based services (HCBS) among the Asian elderly in the United States. Methods: The data for the study was extracted from the Community Survey of 2004 National Long-term Care Survey. 108 Asian elderly in the community were included in this study. Anderson’s Behavioral model, consisting of predisposition (age, gender, education, and marital status), enabling factors (Medicaid coverage and family income) and needs factors [Difficulties of Activities of Daily Living (ADLs) and the Instrumental Activities of Daily Living (IADLs)], provides a conceptual model for this study. Results: A logistic regression was conducted for the study. Only 18 elderly (19%) used any type of HCBS. The logistic regression model was significant (X2 = 29.165, p<.005) and the results showed that education (B= .219, Exp (B) =1.245, p=.028) and the number of ADL difficulties (B= .428, Exp (B) =1.524, p=.014) were significantly related to the use of HCBS. Conclusion: HCBS is believed to adequately meet the needs of Asian older adults who have showed a strong preference for informal care and low use of formal services in literature. Thus, it is required to improve access to HCBS especially for Asian older adults to promote the health of Asian older adults dwelling in community and furthermore reduce caregiving burden of informal caregivers.
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