노인요양시설의 산림복지서비스 인프라 및 제공 실태
An Analysis of Infrastructure and Provision of Forest Welfare Service in Nursing Homes for the Elderly
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우리나라 노인요양시설의 산림복지서비스 인프라 및 서비스 실태, 관련 인식을 조사하여 산림복지서비스 활성화 방안을 제시한 횡단적 조사연구이다. 전국 노인요양시설을 대상으로 2016년 8월한 달간 우편설문조사를 통해 수집한 123개 기관의 설문지를 분석하였고, 응답자는 대부분 원장 혹은 사무국장이었다(75.0%). 복합건물의 일부 층을 사용 중인 노인요양시설(16.3%)은 시설 내에 산림복지서비스 인프라를 갖추기 힘들 것으로 사료되고, 인근에 숲이 없는 경우(약 30%)와 숲이 있더라도 휠체어나 경사로가 없는 경우가 많아 이용에 제약이많았다. 노인요양시설 운영자들도 산림복지서비스가 노인에게 긍정적인 효과가 있다고 인식하지만, 장기요양보험 급여의 필수항목은 아니고, 비용과 노력이 많이 소요되면서도 낙상, 이식증 등 사고위험이 있어 수행하지는 못하고 있었다. 국민건강보험공단이 노인요양시설을 평가할 때, 숲등산림치유적 요소를 갖추었는지를 평가할 필요가 있다. 시설 내 정원에 화장실 접근성을 높이고, 시설 인근 숲에 휠체어 진입이 가능한 통로와 리프트 이동로, 안전손잡이를 설치하는 등 산림복지서비스가 가능한 환경으로 조성할 필요가 있다. 또한, 정부는 노인요양시설 산림복지서비스 가이드라인을 개발·보급하여 시설 내외부에서 간편하게 따라할 수 있도록 지원할 필요가 있다. 이러한 노력을 통해 생의 마지막 단계에 있는 노인요양시설 입소노인에게 신체적 정신적 편안함과 적절한 인지자극을 줄수있을 것이다.
Abstract
This is a cross-sectional study that suggests ways to activate forest welfare services (FWS) by investigating the infrastructure, service status, and perception on FWS in Korea. In August 2016, a structured e-mail survey was conducted in nation widely. The respondents were mostly directors and general secretary (75.0%). The considerable number (16.3%) of nursing homes (NH) use some floors of the complex buildings that would be difficult to have FWS infrastructure and about 30% of those without forests near the facilities. The directors of NH recognize that FWS has positive effects on the elderly. However, FWS is not an requisite of the longterm care insurance benefit, and so costly and effort-intensive that FWS has not been activated so far. In order to activate FWS in NHs, it is necessary to develop and disseminate the guidelines on FWS that anyone can easily followed. In addition, when the National Health Insurance Corporation evaluates NHs, they should evaluate not only whether there is a wandering or walking space, but also whether it has forest healing factors such as forests. It is also necessary to create a barrier-free environment both inside and outside of NHs, increasing accessibility to the toilet in gardens, paving a passage for wheelchairs and lifts in forests near NHs. Through these efforts, it is expected that FWS will be activated to provide physical, mental rest and comfort, appropriate cognitive stimulation to the NH residents at the end of life.
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