• 지역사회간호학회지
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• 제15권4호
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• pp.539-550
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• 2004

Purpose: The purpose of this study was to evaluate the achievements of the project, and also to find out its strengths and weaknesses. Method: This evaluative study employed system theory and analytic techniques by using criteria which were relevance, appropriateness, adequacy, progress, effectiveness and satisfaction for input, process, output, and outcome of program. Study subjects were participants in the home health care program implemented in G public health center in Inchon metropolitan city in 2003. Results: Input factors including recruitment personnel, and support organization development were not adequately met for the program. However. the goal and objectives of the project were really appropriate for the community needs as well as government's policy. For the Process evaluation, home health care record form and computer data base had not progressed as scheduled, but overall program activities were finished on time. However, cooperation between organizations in the health center during service activity were not supportive. Managerial ability of program charged personnel about coordination and integration of team members was not affirmative. Output and outcome evaluation showed that people improved self care ability were 221 (17.5%). and 71 (5.62%) of subjects were moved into category of possible self-care. Client's satisfaction for this project showed a high degree. Conclusions: Based on the above results support organization and staff personnel for this program should be developed. Also, a community network of resources should be established and case management services should be focused continuously in community based home health care.

• 지역사회간호학회지
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• 제16권3호
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• pp.308-319
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• 2005

Purpose: This study investigated knowledge and attitude of home visitors in public health centers toward wife abuse and the actual status of how they were detecting wife abuse and providing interventions. Method: Data were collected using questionnaires from October 2003 to December 2004. The subjects were 403 home visitors at Public Health Centers around Korea. The data were analyzed using SPSS program. Results: The correction rate of knowledge related to wife abuse was 51.9%. The mean score of attitude toward wife abuse was 3.09 (SD=.40) out of 4. showing that their attitude is right. There was a significant difference in attitude according to age (F=3.27, p=.008). One hundred twenty six visitors (31.3%) detected wife abuses and each visitor confirmed 2.3 cases on the average. Forty eight respondents (38.1%) answered that they had provided interventions. Conclusion: This result implies that health visitors have difficulties in detecting wife abuse, and even for identified cases, the rate of providing interventions was low. It was because health visitors' educational experience in wife abuse is insufficient and they do not regard this work as their duty. These findings suggest the necessity for developing nursing in-service programs teaching health visitors their duties and knowledge related to wife abuse.

• 한국보건간호학회지
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• 제29권3호
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• pp.528-539
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• 2015

Purpose: The aim of this study is to provide baseline data on the housing environment of a vulnerable population. Methods: This study provides a descriptive survey on the housing environment of a vulnerable population of a city in Gyeong-gi province. A total of 9,061 households were selected as research participants. Data were collected through face-to-face interviews by visiting nurses from February 2014 to March 2014. Results: Interviewees answered "poor" on items including cold drafts, illumination, daylight penetration, inflow of polluted air, house odor, stairs safety, noise, mold, pests, and ventilation. The score for housing environment problems showed a significant group difference due to gender, age, economic status, family type, type of housing, and type of ownership. Conclusion: These results indicate that the vulnerable population is exposed to a poor housing environment. Thus, there is an urgent need to improve the housing environment for the vulnerable population. Based on this study, linking a visiting health care service program and housing environment improvement projects from relevant administrative agencies might be recommended in order to effectively improve the housing environment.

• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.15-41
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• 2001

연구는 전라북도지역의 보건기관 공무원을 대상으로 지역담당제 실시에 관한 인식과 태도에 대한 기초자료를 얻기 위한 목적으로 시도하였다. 보건기관 근무 공무원들은 지역담당제에 대한 이해도가 매우 높았으며, 지역담당제 실시에 있어 그 실시의 필요성을 높게 인식하고 있으나, 그 실시시기는 단계적 실시의 주장이 높았으며, 제공서비스로는 방문간호와 만성질환관리에 높은 의견을 보였다. 건강증진사업에 국한할 시 건강교실이, 노인보건사업에 국한할 시 방문간호와 거동불편자, 독거노인 등이 높게 나타났으며, 지역담당제 구축을 위한 선결과제로는 재원확보, 인력 및 조직이 재정비가 가장 시급한 것으로 인식하고 있다. 제도개선사항으로는 근무여건 개선이 우선이었고, 지역담당제 구축을 위한 정보체계 확립이 부족하다고 인식하고 있으며, 팀별 지역담당제를 통한 보건사업 전달체계 확립을 위해 적정 전문인력의 배치를 가장 높게 들었다. 지역담당제 실시에 관한 이점으로 대상자에 대한 관리가 잘될 수 있고, 전문성 향상으로 환자에 대한 간호의 질이 향상될 것으로 인식하고 있다. 지역보건사업에서의 지역사회 주민의 요구증대 및 다양화에 따른 대응이 부족하며, 보건소의 사업의 내용개발에 있어서 충분히 개발되고 있지 못하다고 인식하고 있다. 그리고 새로운 보건사업의 확장에 있어서 가장 큰 문제로서 획일적(형식적)사업을 들고 있다. 이러한 연구결과 등을 토대로 하여 지역담당제 정착을 위한 검토방안과 추진전략에 대하여 아래와 같이 제언하고자 한다. 첫째, 지역담당제 실시는 단계적으로 담당지역을 선정하여 실시하고, 지역적 특성을 고려한 사업의 추진이 있어야하며, 현행의 보건사업 업무중에서 이들 사업이 지역담당중심으로 수행하는 것이 좋을 것인지 사업중심으로 수행하는 것이 효율적인 것인지를 사업대상 및 범위, 지리적 여건, 현재의 보건소 업무 수행체계를 근거로 검토되는 등 다양한 측면이 재고려되어야 한다. 둘째, 지역사회의 현실적인 요구의 수준과 보건소의 현재 위상을 중심으로 자원과 예산 소요를 추정하고 타당성과 현실성을 검토할 필요가 있으며, 이와 더불어 지역주민의 요구와 수요에 부응할 수 있도록 단계적으로 보건소 방문간호사 인력의 확충방안을 강구하고, 방문간호사 교육 훈련비 및 방문차량 구입비 등을 재원확보 및 지원을 하여야 하며, 보건소 사업에서 지역담당제에 관한 연구개발 및 시범운영이 있어야 할 것으로 판단된다. 셋째, 대상자 관리의 내실화와 지역사회 주민의 서비스 욕구에 대한 만족도를 제고시키기 위하여 사업내용을 충분히 개발해야 하며, 지역담당자의 근무여건을 개선하는 등 전문인력의 배치가 요구된다. 마지막으로 과거와는 달리 환경과 보건에 대한 일반인의 관심이 급격하게 확산되고 있는 상황 속에서 소수 전문가들의 실험적 시범사업으로는 대중적인 지지기반을 확대할 수 없기 때문에 지역담당제가 일반주민의 생활속에서 대중화된 사업으로 정착시킬 수 있어야 하며, 그동안 지역담당제에 대한 논의나 연구가 소수의 연구자 및 한정된 시범지역에 의해서만 연구된 점을 지양하고 폭 넓은 연구가 지속되어야 함을 제언한다.

• 가정∙방문간호학회지
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• 제14권1호
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• pp.18-22
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• 2007

Purpose: The rapid change to an aging society generates an increase in the incidence of chronic diseases. Many chronic patients have been facing their illnesses without enough preparation. In order to solve these problems, we designed and tested a public healthcare service based on ubiquitous technology. Method: Telemedicine has emerged as new medical care system of chronic disease. However, public potential of its technology is difficult to know under current traditional health care system. In this work, we developed a Personal Digital Access (PDA) phone based healthcare system by trained visiting nurses for elderly patients. A field test was performed by SeongBuk Public Health Center in Seoul, Republic of Korea (ROK). Result: Surveys were generated to assess the effects of this system compared to conventional public health system. Findings of trials demonstrate that healthcare coordination enhanced by PDA phone technology is satisfactory to the patients and nurses compared to previous one because prompt responses arouse their recognition of health. Conclusion: Ubiquitous healthcare system applied to public health service proved to be efficient and time-saving to monitor and control the chronic illnesses of large population.

• 한국산학기술학회:학술대회논문집
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• 한국산학기술학회 2009년도 추계학술발표논문집
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• pp.474-478
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• 2009

본 연구는 2008년 맞춤형 방문건강관리사업에 사용되고 있는 관절통증을 중심으로 한 사례관리를 수정 보안하여 우리나라 실정에 맞는 관절통증 사례관리 프로그램을 개발, 제안하며, 맞춤형 방문건강 관리사업의 활성화와 완성도를 높이는데 있다. 연구방법으로는 2007년 전국 12주 관절통증 사례관리 결과자료 분석하고, 전국 253개 보건소의 맞춤형 방문건강관리사업 인력에 대한 자료 분석과 전국 보건소 전문가 자문회의와 토론 결과를 통해 설문지를 수정 보완하여 2008년도 충청남도 관절통증 12주 사례관리를 실시하였다. 자료분석은 SPSS 12.0 통계 프로그램을 이용하여, p-value가 0.05 미만과 0.01미만인 경우를 통계적으로 유의한 것으로 판정하였으며, 전국자료는 빈도분석, wilcoxon 부호순위 검정과 McNemar's 검정을 실시하였으며, 12주의 관절통증 사례관리의 연구기간동안 수집된 자료를 1주와 8주간, 1주와 12주간, 8주와 12주간을 paired t-test 검정과 McNemar's 검정을 실시하여 유의성 평가를 실시하였다. 연구결과는 다음과 같다. 12주 기간 동안 사전 사례관리 방문간호사의 교육을 통한 사례관리 서비스의 강도의 조절 및 매주로 서비스의 횟수를 조절하여 사례관리를 실시한 결과 총 109개 항목에서 1주와 8주간에 유의한 항목은 TG(mg/dl)를 비롯한 51개 항목, 1주와 12주간에는 콜레스테롤(mg/dl)을 비롯한 53개 항목, 8주와 12주간에는 지난 48시간동안 관절통증 점수를 비롯한 3개 항목으로 유의한 차이를 볼 수 있었으며, 1주와 8주간은 유의하나 1주와 12주간은 유의하지 않게 나타나는 항목은 TG(mg/dl)를 비롯한 3개 항목, 1주와 8주간은 유의하지 않다가 1주와 12주간은 유의하게 나타나는 항목은 콜레스테롤(mg/dl)를 비롯한 6개 항목, 1주, 8주, 12주간의 모든 기간에서 유의한 항목은 지난 48 시간동안 관절통증 점수를 비롯한 3개 항목으로 조사되었다. 결론적으로 현재 우리나라에서 추진되고 있는 맞춤형 방문건강관리 사업의 사업지침에 대한 보완을 위해 관절통증사례관리 프로그램에 있어 중재 서비스 또는 프로그램의 기간은 12주간에서 8주간으로 조정 되어야 하며, 추가가 필요한 항목으로는 교육, 자기역량 강화, 운동처방, 물리치료, 약물치료, 대체요법, 식이, 영양, 생활지도 등이며, 어골도 분석을 위한 기본 틀 및 주요 구성요소를 제시 및 기여 요인 및 결정요인을 위한 논리적 모형 제시가 필요하며, 개선목표를 위한 유지증진 및 관리능력, 지기 관리 수행도 개선과 대상자별 맞춤형 사례관리를 위한 표준화된 행동 체크리스트 제작 보급 및 사례별 운동, 물리치료 지도 방법 계획 수립에 대한 인력 충원이 필요하다.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.233-242
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• 2016

Purpose: The purpose of this study was to identify professional competencies of visiting nurses in public health centers. Methods: A methodological study for the development of visiting nurses' professional competency was conducted through the review of literature and construction of a conceptual framework for the development of professional competence. After reviewing the content validity of each question and confirming the items of the preliminary tool, the construct validity of the tool was verified through exploratory factor analysis and internal reliability was confirmed. Results: After constructing 5 factors relating to the visiting nurse's professional competence, 25 items were developed, based on verification of content validity by experts. The results of the exploratory factor analysis showed that the professional competence of the visiting nurse was influenced by factors such as "health assessment and screening," "health teaching and counseling," "interprofessional communication", "program planning and implementation", and "Professional development". These five factors accounted for 76.38% of the professional competencies of the visiting nurse. Conclusion: The professional competence of the visiting nurse is consistent with the aim of the visiting nursing project. Also our results will contribute to baseline data used to evaluate the quality of work of the visiting nurse.

• 지역사회간호학회지
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• 제15권3호
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• pp.353-364
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• 2004

Purpose: The purpose of this study was to investigate the types and frequencies of nursing intervention of home health care in Public Health Centers and its effects. Method: The data collection period for this study lasted from March 1 to December 31, 2003. The clients were sampled by a stratified randomized method among those who had been cared for at least 3 months. The data was analyzed by SPSS for description. ANOVA, paired t test, etc. Result: The types and frequencies of nursing intervention in major chronic health problems were significantly different. The main types of nursing intervention in hypertension and DM patients included education on disease management, regular exercise, stress management, diets, etc. CVA patients were intervened in pain control (ice or hot pack, massage), position changes, and ROM exercise. Cancer patients received imaginary or relaxation therapy, pain control (ice or hot pack, massage), hospice, etc. After the intervention, the drug compliance of hypertension (8.2 days per month) and DM patients (6.2 days per month) improved. Blood sugar levels (FBS 7.6, post partum 2hrs $21.4(mg/d{\ell})$ and blood pressure(systolic 9.8, diastolic 4.3 mmHg) lowered significantly. All aspects of QOL also improved (total 3.68). Conclusion: The types and frequencies of nursing intervention were determined by characteristics of the health problems, and home health care nursing intervention in Public Health Centers was effective to the elderly of the community in many aspects.

• 지역사회간호학회지
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• 제9권1호
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• 지역사회간호학회지
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• 제7권1호
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• pp.5-17
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• 1996

The purpose of this study was to identify the differences of the outcomes of visiting nursing service (VNS) between the two types by the organizational structure of health centers. Type I referred to 3 health centers with departmentalization for VNS and type II of 3 health centers providing VNS under the subunit of a department. Data were collected from 38 visiting nurses at the six health centers for their perceived formalization, decision-making authority and job satisfaction, 293 clients for the satisfaction level with VNS served and their records analysis for level of quality care and frequency by the contents of VNS through the questionares during the period from June, 1 to August 30, 1993. Data were analyzed using $\chi^2$, F. t or/and Scheffe test. The result were as follows: 1) There were no significant differences in perceived formalization and decision -making authority of visiting nurses between the two types of health centers. 2) There were significant differences in the level of quality care and frequency of the VNS contents between the two types of health centers. 3) There were no significant differences in perceived clients' satisfaction and job satisfaction of the visting nurses between the two types of health centers. From this study, Not only organizational differentiation with the development of job standards and supportive system but also personnel development are suggested when new health care service in health centers begins.