• Tuberculosis and Respiratory Diseases
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• 제83권1호
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• pp.89-95
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• 2020

Background: Same-day sputum microcopy is recommended in areas where sputum smear microscopy external quality assessment (EQA) is effectively implemented and sturdy. In Addis Ababa, the status of EQA and drop-out of same-day sputum smear microcopy has not yet been assessed. The objective of this study was to assess the quality of same-day sputum smear microscopy and diagnostic drop-out of presumptive tuberculosis (TB) patients in health facilities (HFs) across Addis Ababa, Ethiopia. Methods: Amulti-analysis was conducted from September 2016 to July 2017 to determine the status of external quality assessment and diagnostic drop-out of presumptive TB patients registered for same-day sputum smear microscopy. Data was coded and entered in Microsoft Excel, and subsequently transferred and analyzed using SPSS version 20.0. Results: The drop-out of same-day sputum smear microscopy was 209 (6.2%). More than 33% of the specimens collected for purposes of same-day sputum smears were of poor quality. Among the selected HFs for the study: 13 (46.4%) used filter reagents prior to sputum smear staining while 75% of the selected HFs for the study used smear microscopy services interruption in a year. The sensitivity and specificity of the HFs participating in regional quality assessment scheme for the diagnosis of TB was 97.4% and 99.6%, respectively. Conclusion: The diagnostic drop-out of same-day sputum smear microscopy was high in Addis Ababa. Strengthening EQA, competency-based laboratory professionals training on sputum smear microscopy might reduce the reading errors in sputum smear. Awareness creation of the community on the benefits gained from completion of specimen provision for the same-day approach decreases diagnostic drop-out and enhances TB control program.

• Journal of Preventive Medicine and Public Health
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• 제55권5호
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• pp.415-423
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• 2022

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

• 지역사회간호학회지
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• 제5권1호
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• pp.53-63
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• 1994

Health could be maintained and promoted by pursuing an active healthy lifestyle. Life-style include health habits and behavior pattern such as exercise, diatry change, weight control, stress management et al. The objectives of this studies are (1) to analyze recognition and practice of lifestyle between nurses and non-nurses, (2) to analyze health status of clients which presented healthy lifestyle, (3) to analyze factors that affected healthy lifestyle. The lifestyle assessment questionnaire is divided into ten sections: competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, self-actualization, sense of purpose, relation with others, environmental control, and use of health care system. The major results are as follows : (1) The level of recognition and practice of lifestyle was not high. Nurses showed more higher score than non nurses in lifestyle area such as competence in selfcare, stress management, environmental control, and use of health care system. (2) Good health status and lifestyle presented positive relation. (3) In mutiple classifiction analysis, competence in selfcare, nutritional practices, physical activity, sleep patterns, stress management, environmental control, and use of health care system had significant relation to independent variables. (4) Change of concept for healthy lifestyle after this survey was higher in nurses group and the most concern area was stress management. To sum up, lifestyle pattern of nurses as health professional was not desirably high. Therefore nurses ownself should effort to practice healthy lifestyle prior to others, and then educate importance of lifestyle for health promotion and disease prevention. In conclusion, it will be useful to consider significant lifestyle factors that was be identified in this study to develop health promotion program.

• 한국전문물리치료학회지
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• 제23권4호
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• pp.47-54
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• 2016

Background: Losing balance during locomotive actions becomes an increasing threat to both the community-dwelling elderly and elderly with Parkinson disease (PD). Those with PD may be at a high risk of fall due to particular characteristics during the turn. Turning around during locomotive actions may be one of problematic factors causing losing balance. Objects: This study is part of a larger study, which in part aims to identify turning strategies, to compare the strategies in the elderly with and without idiopathic PD aged 51 years and older and to distinguish whether the turning strategies can predict the elderly at risk of falls. Methods: A total of 22 community-dwelling elderlies (10 elderlies with idiopathic PD and 12 healthy elderlies) were investigated for the turning strategies during the timed up and go test. Results: There were some significant differences between the two groups during turning (p<.05). The idiopathic PD group had a tendency of challenging on taking more number of steps, more time to accomplish and staggering more for the turn relative to the control group. Conclusion: Taking more number of steps and more time to turn may be useful for distinguishing the characteristics of PD from that of the healthy elderly in turning strategy.

• 가정∙방문간호학회지
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• 제22권2호
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• pp.196-205
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• 2015

Purpose: This study investigated evidence for the effects of community-based cognitive rehabilitation programs for demented elderly. Methods: The literature review covered studies between 2004 and 2014, and searched international databases including Ovid-MEDLINE, EMBASE, and the Cochrane Library. The Risk of Bias Assessment Tool for Non-Randomized Studies was used by two reviewers to evaluate independently the quality of the selected articles. Results: Eighteen studies were selected through a systematic search of the literature. About three quarters of the studies showed that the community-based cognitive rehabilitation programs provided by nurses were significantly effective in enhancing cognition among elderly individuals with dementia. Conclusion: Based on these results, we suggest that nurse is an appropriate profession to manage cognitive rehabilitation or cognitive enhancement programs for demented elderly individuals. Therefore, the current system in which caregivers provide cognitive rehabilitation programs for demented elderly individuals must be reformed.

• Advances in environmental research
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• 제6권3호
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• pp.203-216
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• 2017

For survival of human beings clean water is an essential commodity whereas contamination in drinking water threatens to mankind. The main cause of water contamination is social and development activities of human being along with increasing population. The community in the study area has acute shortage of drinking water along with about 40 to 60% has no access to safe drinking water. This study indicates drinking water quality of two major sources of coastal belt of Karachi one is supplied by Karachi Water & Sewerage Board (KWSB) as tap water and the other through groundwater. The physicochemical analysis was carried out by following the standard methods for checking the quality of drinking water. The analyzed results showed that the quality of groundwater was unfit as potable water. The most critical situation was observed as high level of contamination followed by high turbidity and increased salinity levels. TDS in surface water were found 12% above and TDS in groundwater was 20% below the National Drinking Water Quality Standards (NDWQS) of Pakistan as well as the permissible WHO drinking water quality guidelines.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.21-31
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• 2002

일부 농촌 지역사회 거주 노인들의 신체적, 정신적, 기능적, 사회환경적 상태를 포함하는 포괄적 노인평가를 시행하여 지역사회 중심 노인보건사업의 기초자료를 얻고자 하였다. 전라남도 일개 군에서 층화 집락추출한 지역사회 거주 65세 이상 노인 388명을 대상으로 조사를 하였다. 조사내용은 노인들의 인구사회학적 특성, 현병력, 신체적, 정신적 건강상태, 일상생활활동(ADL), 도구적 일상생활활동(IADL) 및 대상노인들의 사회적, 환경적 평가를 포함하였다. 주요 연구결과는 다음과 같다. 1. 전체 388명 중 남자가 169명(43.6%)이었고 여자가 219명(56.4%)이었으며, 평균연령은 남자 $73.5{\pm}6.4$세, 여자 $74.0{\pm}6.2$세였다. 2. 조사노인 1인당 평균 1.6개의 질환을 가지고 있었으며, 3개 이상의 질환을 가지고 있는 노인들은 약 19%나 되었다. 3. 신체적 건강상태는 시각기능의 감소가 남녀 각각 50.9%, 65.3%로 다른 기능에 비해 가장 많았고, 씹거나 삼키는 데 어려움이 있는 구강기능의 감소도 34.3%, 39.3%로 그 다음을 차지하였으며, 상대적으로 상지, 하지 기능의 감소는 1-6% 정도로 적은 편이었다. 4. 정신적 건강상태는 단기 기억력으로 살펴 본 인지기능의 감소가 33.7%, 44.7%로 적지 않았고, 노인우울 평가를 이용하여 우울증 여부를 조사한 결과 남자에서 19.1%, 여자에서 24.9%이었다. 5. 일상생활활동(ADL) 평가 결과 6가지 모두 독립적으로 수행할 수 있는 노인이 남자 72.2%, 여자 58.9% 이었으며, 도구적 일상생활활동(IADL)은 식사준비하기가 가능한 경우가 남자에서 81.1%로 여자의 92.7%에 비해 낮았고, 반대로 금전관리가 가능한 경우는 여자에서68.9%로남자의 83.5%에비해낮았다. 6. 사회적 지지체계의 평가에서는 도움이 필요할 때 제공할 수 있는 수발자가 있는 경우가 26.3%이었고, 수발자와의 관계는 배우자가 가장 많고 다음은 며느리 였다. 가족과의 거주형태별로는 49.5%가 노부부만 사는 경우였고, 다음은 노인 혼자 사는 경우로 22.9%를 차지하였다. 환경적 평가에서는 위험요소 네 가지 중 하나이상을 가진경우가83.5%나되었다. 따라서 농촌지역 거주 노인들에 대한 포괄적 평가는 지역사회 중심 노인보건프로그램을 개발하기 위한 기초자료를 제공하였다.

• 보건교육건강증진학회지
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• 제20권3호
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• pp.125-143
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• 2003

With the shift of cause of death from infection to chronic, the health expenditure has risen dramatically. To curb the increasing health expenditure, programs and campaigns to promote health were proposed and implemented. Most of them, however, were not successful in achieving satisfactory results. Customer Relationship Management has been gradually accepted as an innovative approach to health promotion. The objective of this research was to develop a Customer Relationship Management system for providing comprehensive health care services to the residents in the community. Detailed objectives were as follows： The first objective was the development of the CRM system for health promotion. The second objective was the satisfaction assessment for the health promotion program using the CRM system. The third was the proposal for the effective utilization of the CRM system. The development methodology of the CRM system was Rapid Warehouse Developing Method. As a CRM system equipment, a workstation with GIS of Windows 2000 was selected. SQL Server 2000 was used as a development tool and database. The subjects of study were diabetic mellitus patients, hypertension patients, and vaccin patients. The campaign channel of patients was an autocalling system. For the satisfaction assessment, a survey was performed. The main content of the survey was satisfaction level. The satisfaction level of the health promotion program using CRM system was 79.3%. In consideration of the above findings, we suggested ways of improving the Health Promotion Program by using CRM. The first was the efficient selection of the subjects of the Health Promotion Program. The second was the development for health promotion program using CRM system(life time health of individual etc).

• 지역사회간호학회지
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• 제27권3호
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• pp.202-212
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• 2016

Purpose: The purpose of this study is to examine the association of family support, self-efficacy, health literacy and perceived health status with health-promoting behavior (HPB) in married immigrant women. Methods: A cross-sectional based survey was conducted to collect data from married immigrant women living in Gyeongsang province. Questionnaires included Health promoting lifestyle profile II, General self - efficacy scale, Korean Health literacy assessment and perceived health status. Results: 157 subjects participated in the study (mean age, $30.47{\pm}6.83$). Their duration of living in Korea was $63.05{\pm}50.11$ months. Of the participants, 59.2% were Vietnamese. The level of HPB, perceived health status, health literacy, support of family and self-efficacy were $2.58{\pm}0.42$, $3.39{\pm}0.86$, $25.12{\pm}20.99$, $3.83{\pm}0.70$ and $3.61{\pm}0.53$ respectively. Factors affecting the HPB of the participants were support from family (${\beta}=.45$, p<.001) and self-efficacy (${\beta}=.16$, p<.05). The explanatory power of these two variables was 34.2%. Conclusion: This study suggests that the factors influencing the HPB of married immigrant women include support from family and self-efficacy. A variety of programs should be provided for families so that they can support those women to help them increase their HPB. It is recommended that more various programs be provided to increase their self- efficacy.

• 지역사회간호학회지
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• 제12권2호
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• pp.417-427
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• 2001

Purpose: The aim of this study is to identify the influence of visual and hearing impairment on the activities of daily living of community dwelling elderly. Methods: Data were collected by home visiting interviewers from 452 older people aged 65 years or older living in community. Resident Assessment Instrument MDS-HC(2.0version) was used for data collection. Data analysis for descriptive statistics, Chi-square test and multiple regression was made by SAS 6.2 Results: 34.7% of the subject had hearing impairment and 64.3% had visual impairment Among IADL. one half of them were dependent in ordinary house work and meal preparation. In the case of ADL. 13.9% of subjects were dependent in bathing and 8.9% in personal hygiene. There was significant difference in IADL performance by visual and hearing impairment On the other hand, ADL performance showed the significant difference. only in the case of hearing impairment. As the result of input of visual and hearing impairment in the process of regression. variances were increased from 3% to 11%. Conclusions: Large proportions of older people living in the community have visual and hearing impairment. It could be confirmed that hearing and vision were significant factors influencing on IADL performance of older people. Intervention and support policy for elderly needs to focus on improvement of visual and hearing impairment.