Journal of dental hygiene science (치위생과학회지)

The Korean Society of Dental Hygiene Science (한국치위생과학회)
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Evaluation of Oral Health Promotion Program Connected with Hypertension and Diabetes Management Programs: Use of a Logical Model

일부 보건소 고혈압·당뇨관리교실 연계 구강건강증진 프로그램 운영 및 평가: 논리적 모형을 이용하여

  • Yoo, Sang-Hee (Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University) ;
  • Shin, Bo-Mi (Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University) ;
  • Bae, Soo-Myoung (Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University) ;
  • Shin, Sun-Jung (Department of Dental Hygiene, College of Dentistry and Research Institute of Oral Science, Gangneung-Wonju National University)
  • 유상희 (강릉원주대학교 치과대학 치위생학과 및 구강과학연구소) ;
  • 신보미 (강릉원주대학교 치과대학 치위생학과 및 구강과학연구소) ;
  • 배수명 (강릉원주대학교 치과대학 치위생학과 및 구강과학연구소) ;
  • 신선정 (강릉원주대학교 치과대학 치위생학과 및 구강과학연구소)
  • Received : 2016.07.08
  • Accepted : 2016.07.22
  • Published : 2016.08.31
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Abstract

This study aimed to design and operate a complementary integrated health management program based on the connection between the hypertension and diabetes management programs and the oral health programs at a public health center. It also proposed to suggest the phased evaluation indicators. In this study, 48 adults registered in the hypertension and diabetes management program were selected from the Gangneung public health center. The clinic-specific programs were led by dental hygienists and operated for visitors twice every two weeks. The programs were designed based on the logical model, and indicators for evaluating the structure, process, and outcome were presented and applied to the input, process, output, and outcome. The evaluation indices consisted of quantitative and qualitative indicators, and the planning and operation, goal achievement, and effect of each program were assessed. The process evaluations were assessed by the appropriateness of the managers and the operating fidelity of the programs. Indicators for evaluating the outcomes were gingival bleeding, oral health knowledge, oral health awareness, and the satisfaction of the participant and the manager. The clinic-specific programs resulted in positive changes in the evaluated outcomes. The integrated health management of visitors to the hypertension and diabetes management program is important as the general and oral health has common risk factors. Furthermore, long-term operation and continuous monitoring of oral health programs are necessary to evaluate the common factors in chronic disease management.

본 연구는 강릉시보건소 고혈압 당뇨관리사업과 구강보건사업을 연계한 통합건강증진사업을 기획, 수행하고 단계적 평가지표를 제시하여, 고혈압 당뇨관리교실에 등록한 30세 이상의 성인 중 48명을 대상으로 진료실 개별 구강건강관리 프로그램을 운영하였다. 인력 시설 장비 등의 구조평가와 담당자의 적절성 및 프로그램 운영 충실도 등의 과정평가를 통해 사업의 기획 및 수행상태를 파악할 수 있었으며, 개선방안 모색을 통해 사업의 효율성을 높일 수 있었다. 결과평가 결과로 '구강건강지식'은 8점 만점에 1차 5.52점, 2차 7.42점으로 나타났으며(p<0.001), '구강건강인식'은 20점 만점에 1차 13.31점, 2차는 17.29점으로(p<0.001) 지식과 인식 문항 모두 1차에 비해 2차 점수가 유의한 차이로 높게 나타났다. '치은출혈' 검사 결과 1차 '출혈 있음'이 89.1%, 2차 71.7%로 감소하였으며(p=0.021), 'PHP index' 검사 결과 1차 3.28점, 2차 2.42점으로 유의한 차이가 있었다(p<0.001). 프로그램의 전체적인 만족도는 '매우 만족, 만족'이 98.0%, 재참여 의사 및 권유 의사는 '매우 그렇다, 그렇다'가 각 97.9%, 93.7%로 매우 높게 나타났다. 사업담당자 1:1 면접설문조사를 통한 질적 평가 결과, 프로그램의 '전체적인 구성의 적절성'은 내용이 짜임새있게 구성되어 '매우 적절, 적절'이라고 응답하였으며, '연계 절차의 적절성'은 현황 및 요구도 조사에서 대상자의 위험요인을 적절히 파악하여 연계가 이루어졌으며, 당뇨와 치주질환의 연관성에 따라 사업을 연계하여 운영하는 것이 '적절'하다고 응답하였다. '성과지표의 적절성'으로는 '참여 인원수, 효과성(치은출혈, PHP index, 구강건강지식 및 인식), 만족도 평가'가 성과지표로 '매우 적절, 적절'하다고 응답하였다. 논리적 모형의 사업은 투입-활동-산출-결과에 따라 구조, 과정, 결과 평가지표로 구조화되어 단계적 평가가 이루어지기 때문에 균형적인 평가가 가능하며, 평가지표는 정량적 지표와 정성적 지표로 구성되어 체계적인 사업 평가가 이루어질 것으로 생각된다. 고혈압 당뇨관리교실 내소자의 통합적 건강관리를 위해 본 연구에서 기획된 개별 관리 프로그램과 평가지표의 적용 확대 가능성이 높을 것으로 생각되며, 논리적 모형을 적용한 프로그램의 일반적인 적절성과 평가지표의 타당성을 확인하고, 만성질환 관리 측면에서 공통의 효과를 측정할 수 있도록 지속적인 운영과 모니터링이 필요할 것으로 생각된다.

Keywords

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