• 제목/요약/키워드: Community health management

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학교기반 손상예방사업을 위한 국제안전학교모델 적용 방안 (Using International Safe School Model for School Based Injury Prevention Program)

  • 박남수
    • 한국학교보건학회지
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    • 제22권1호
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    • pp.145-153
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    • 2009
  • International Safe School(ISS) model has focused as a public health approach to develop safety intervention to address injury problems in school setting. It needs school members involvement in partnership with community resources to address the needs for school based injury prevention and safety promotion. The characteristics and principles of ISS model discussed in this paper emphasizes participation, capacity and partnership building, evidence based process, and so on. A 7 criteria is introduced as ISS implementation strategy. Multilevel and multi-facet approaches are valuable on ISS as well as process evaluation. For the application of ISS model in Korea, finding evidence, building public health partnership between school and other public or private resources in community are necessary conditions for succesful ISS for health promotion in school setting.

커뮤니티케어 활성화를 위한 농촌지역 경로당 이용 노인과 비이용 노인 간 성공적 노화 관련 요인 비교 (A Comparative Study on the Factors Affecting the Successful Aging between Users and Non-users of Kyung-ro-dang for Community Care Policy Activation)

  • 송그룸;남은우;진기남
    • 보건행정학회지
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    • 제29권4호
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    • pp.412-421
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    • 2019
  • Background: The purpose of this study was to identify the status of Successful Aging among the elderly aged 65 and over in rural areas and to compare factors related with Successful Aging between "kyung-ro-dang" users and non-users. Methods: A total of 181 elderly aged 65 or older were selected from four districts (Heung-upri, Mejiri, Sajerri, and Daeanri) of Wonju city. A survey method using face to face interviews was applied to collect information. Successful aging was measured on a 5-point Likert-type scale using the successful aging scale developed for the Korean elderly, which indicates the higher the score, the higher the level of successful aging. Descriptive statistics, bivariate, and multivariate analyses were computed; the level of significance was set at 5%. Hierarchical polynomial regression was applied to find out the factors associated with successful aging. Results: Of the total, 112 elders used kyung-ro-dang and 69 elders who did not use kyung-ro-dang. The level of successful aging of the elderly was higher among kyung-ro-dang users than non-users. The factors related to successful aging among kyung-ro-dang users were walking and social participation. Users who walk more than 4 times per week and social participation activities have a higher level of satisfaction. In the case of non-users, a higher level of monthly income, having a spouse, social support, and social participation associated with a higher level of successful aging. Conclusion: Monthly income, social participation, and social factors were found to be related to successful aging along with physical and mental health conditions among the elderly in rural areas. Therefore, it can be concluded that income, social as well as mental and physical factors, are more critical for successful aging in the rural community care in Korea.

응급의료센터 성과 평가 기준개발과 적용 (Performance Evaluation of Emergency Medical Center)

  • 강철환;김윤;이평수;권영대;김창엽;신영수
    • Journal of Preventive Medicine and Public Health
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    • 제30권4호
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로- (A Trend of Research in Community Health Nursing)

  • 이인숙;김윤아;최경원;진영란
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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사회생태적 모델을 적용한 쪽방 주민의 정신건강 영향요인 분석 (Effects of socio-ecological factors on mental health of the residents in a single room occupancy (Jjok-bang) of South Korea)

  • 허현희;차선화;정혜주;김진성;조민진;문다슬;차수진;유사라
    • 보건교육건강증진학회지
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    • 제32권2호
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    • pp.39-52
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    • 2015
  • Objectives: Residents of a single room occupancy (Jjok-bang) in Seoul are at high risk of having mental health issues. The majority of residents live in single households with past traumatic experiences including self-deprivation and social exclusion. This study was to investigate the association between mental health and socio-ecological factors at the intrapersonal and community levels. Methods: We conducted face-to-face surveys in Dongja-dong Jjok-bang area in June, 2014. Of 78 participants, 76% were male and the mean age was 60 years (SD=11.53). A multiple regression was used to analyze the association among depression, a sense of well-being, socio-ecological factors, and perceived empowerment and community solidarity. Results: Perceived empowerment (${\beta}=0.83$; 95% CI=0.40, 1.26) and community solidarity (${\beta}=0.52$; 95% CI=0.04, 1.01) were positively associated with a sense of well-being. Participants with empowerment (${\beta}=-2.55$; 95% CI=-4.86, -0.23) and those with community solidarity (${\beta}=-2.36$; 95% CI=-4.94, 0.21) were negatively associated with being depressed. Conclusion: Mental health of the residents in Jjok-bang was more influenced by empowerment and community solidarity than socio-demographic factors. It is necessary to improve public health infrastructures that can enable the residents to enhance empowerment and community solidarity utilizing socio-ecological perspectives.

재가노인 기능상태 평가도구를 이용한 재가노인 사례관리 프로그램의 효과 평가 (Effects of Case Management using Resident Assessment Instrument-Home Care(RAI-HC) in Home Health Services for Older People)

  • 전경자;이지윤;윤종률
    • 대한간호학회지
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    • 제39권3호
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    • pp.366-375
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    • 2009
  • Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

Is the Legal Basis for Physical Therapist's Home-Based Rehabilitation Appropriately Prepared?

  • Kim, Won-Su;Shin, Jun-Bum;Yun, Hye-Lyeong
    • The Journal of Korean Physical Therapy
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    • 제32권4호
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    • pp.258-265
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    • 2020
  • Purpose: This study examined the legal basis related to a physical therapist's home-based rehabilitation. Methods: The policy data were referenced to the comprehensive plan for national health promotion and the guidebook Community Health Promotion Project issued by the Korea Health Promotion Institute and other institutes. The legal data were referenced to the Bill information system on the National Assembly website. Results: The physical therapist's home-based rehabilitation did not have a legal basis in the community-based rehabilitation project (CBR) of the HP 2020 project. On the other hand, according to the Home health care part of the community health promotion project that began in 2013, physical therapists were allowed to play a role from 2020 under Article 16-2 (Public Officials in Exclusive Charge of Visiting Health Management) of the REGIONAL PUBLIC HEALTH ACT. Conclusion: Policies and laws are being developed in the field of healthcare, but the necessary policies and laws in the field of rehabilitation are still insufficient. A bill to rehabilitate in a variety of fields and spaces by modifying the scope of work of physical therapists will be needed.

일본의 생활개선사업 현황과 21세기 전망 (Current Status and Perspectives for the 21st Century of Rural Living Improvement Program in Japan)

  • 이금옥
    • 농촌지도와개발
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    • 제11권1호
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    • pp.37-52
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    • 2004
  • The rural living improvement in Japan operates in considerations of socio-eoonomic circumstances of rural community as in Korea. After 1945 the program emphasized the improvement of living conditions such as poverty alienation improvement of house and toilet nutrition after war, From 1955, health programs including better cooking and nutrition, house modification and improved living conditions corresponding to the goal of the developed country were carried out. In 1965. the goal of the rural home economics was focused on the harmonized production and living, improvement of the levels of rural living, health and building rural community. From 1975, the goals of the program were to organize the farming in the better ways and improvement of rural women's role. In 1985, making agreeable living conditions was emphasized under the goal of vital rural society. From the period of Heysey(1989${\sim}$), for better living of rural people the government is emphasizing the programs including farm labor management, utilization of farm products, farm management and rural environments. Recognizing the important influencing resources of agents in extension services, on the job and education was implemented step by step from basic to planning to upgrade competencies. The government is trying to construct better with infrastructures, encouraging direct selling the value-added processed food from local farm products with rural people's real name and other countryside resources. Major programs in the 21st centuries are building better rural society with men and women together and considering elders as well as new farmers.

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한국에서의 ACT(Assertive Community Treatment) 적용에 대한 사례관리자의 경험에 관한 연구 (A qualitative study on the case managers' experiences of implementing Assertive Community Treatment model in Korea)

  • 하경희
    • 사회복지연구
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    • 제41권3호
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    • pp.107-133
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    • 2010
  • 최근에 정신보건 영역에서 사례관리에 대한 관심이 높아지고 그 중요성이 강조되고 있는 시점에서 본 연구는 ACT 모델을 지속적으로 적용해오고 있는 S 정신보건센터의 사례관리자들의 경험에 대하여 질적 연구를 실시하였다. 연구결과, 한국에서의 ACT 모델의 적용가능성을 확인할 수 있었으며, ACT 모델의 주요 특징인 팀 접근과 적극적인 서비스는 사례관리자의 역량을 높이고 클라이언트와의 관계의 질을 높임으로써 서비스의 효과를 가져 오는 것으로 나타났다. 하지만 적극적인 서비스의 과정에서 전문가 주도와 클라이언트의 의존 사이에서 갈등을 나타냈으며 한국의 가족주의와 정신보건체계의 특성에 대한 고려가 중요한 것으로 나타났다. 이를 바탕으로 ACT의 확대 적용을 위한 논의를 하였다.