성인 발달장애인 주간활동서비스와 활동지원서비스가 부모의 돌봄 시간 및 돌봄 부담에 미친 영향

The Effects of Daytime Activity Services and Activity Assistant Services for Adults with Developmental Disabilities on Parental Caregiving Time and Burden in South Korea

본 연구는 발달장애인 주간활동서비스, 활동지원서비스가 부모의 돌봄 시간과 돌봄 부담을 줄이는 데에 긍정적인 역할을 하였는지 확인하고 두 서비스의 발전방안을 논의하는 데 목적이 있다. 이를 위해 2020년 발달장애인 일과 삶 데이터를 사용하여 성향점수 매칭 후 다중회귀분석을 실시하였다. 분석 결과, 주간활동서비스와 활동지원서비스 모두 이용, 주간활동서비스 이용은 특별한 관계를 보이지 않았다. 활동지원서비스를 이용할 경우 돌봄 시간은 감소되었으나, 돌봄 부담은 증가한 것으로 나타났다. 추가 분석 결과, 성인 지적장애인 자녀를 둔 부모의 경우 주간활동서비스와 활동지원서비스를 모두 이용하거나 활동지원서비스를 이용할 때 돌봄 시간이 감소하는 것으로 확인되었다. 이를 통해 현재 서비스 체계의 한계점을 진단하고, 돌봄 시간과 돌봄 부담 경감을 위해 필요한 서비스 개선 방향 및 후속연구 등을 제안하였다.

The Daytime Activity Services (DAS) for adults with developmental disabilities in Korea were introduced in 2019 to secure meaningful daytime activities, and to reduce parental caregiving burden. Activity Assistant Services (AAS) include physical activity support and household activity support, which can affect caregiving time and burden. However, few studies have attempted to identify whether the DAS and AAS leads to the reduction of parents' caregiving time and burden. Therefore, we attempt to find out whether the DAS and AAS play a crucial role for parents. Using the 2020 work and life survey data for developmental disabilities we employed Propensity score matching (Kernel) and multiple regression with propensity score matching. We have two independent variables, DAS, AAS (Participation=1, No participation=0). The dependent variables are caregiving time meausred by average caregiving time per day, and caregiving burden measured 5-Likert scale indicating 5 for very burdensome and 1 for no burdensome. Control variables include parents' health status, age, gender, employment status, education level, child's health status, age, gender, employment status, education level, major disability, activity of daily living (ADL), and instrumental activity of daily living (IADL), challenging behavior, number of people under 18 years of age and grandparents in the household, average monthly household income, etc. Overall, we do not find that parents who received DAS*AAS, DAS have experienced in reducing caregiving time and burden. However, when we divide into parents of adult with intellectual disability and adult with autism, we are able to observed reduction in parental caregiving time, which is statistically significant(DAS*AAS: B=-2.077*, p<.05, AAS: B=-1.267*, p<.05). These results suggest that it is necessary to address the issue of reduced Activity Assistance Service (AAS) hours in case of overlapping use and to secure sufficient personnel within the AAS.