• 한국학교ㆍ지역보건교육학회지
• /
• 제19권1호
• /
• pp.127-144
• /
• 2018

배경 및 목적: 이 연구의 목적은 OECD "더 나은 삶의 지수 2015"에서 34개 국가 중 29위로 평가된 한국인의 주관적 건강(subjective well-being)과 치료적 지지(therapeutic support) 관계에서 장소애착(place attachment)의 매개 효과를 탐색하였다. 방법: 비확률 표본추출 방법을 사용하여 서울 시민들 중 헬스클럽 이용자를 대상으로 설문지 조사를 실시하였으며, 구조방정식 모형분석을 통해 가설을 검증하였다. 결과: 분석 결과 치료적 감독(therapeutic oversight )만이 주관적 건강에 직접적인 영향을 미치는 것으로 확인되었다(B = .281, p < .05). 장소애착의 매개효과를 통해서 검증한 결과 치료적 감독 뿐만 아니라 치료적 증언(therapeutic testimonial)에 대해서도 유의하게 검증되었다(치료적 감독 간접 효과 = .155, p < .05, 치료적 증언 간접 효과 = .175, p < .05). 결론: 연구결과 주관적 건강에 영향을 미치는 것으로 장소애착의 매개효과가 큰 것으로 나타났다. 따라서 서로를 돌보며 회원들 간의 업적을 축하 할 수 있는 장소를 기반으로 한 건강 프로그램을 실행한다면 사회 구성원들의 주관적 건강 향상에 도움이 될 것으로 사료된다.

• 대한간호학회지
• /
• 제42권7호
• /
• pp.965-973
• /
• 2012

Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

• 지역사회간호학회지
• /
• 제23권1호
• /
• pp.71-81
• /
• 2012

Purpose: The aim of this study was to evaluate the process and outcome of a mobile computerized system for individual home visiting healthcare. Methods: A nonequivalent control group non-synchronized design was employed for this study. The newly constructed system was administered to 80 healthcare providers in the experimental group for 8 weeks. Data were analyzed using descriptive analysis, t-test, and ANCOVA with the SPSS 18.0 program. Results: In the process stage, the difference in the frequency of computerized information usage between the experimental and control groups was significant as $8.88{\pm}3.20$ and $7.08{\pm}2.92$, respectively (t=3.90, p<.001). In the outcome evaluation stage, all kinds of healthy lifestyle such as alcohol use, nutrition, weight management and mental health were not improved. Conclusion: The findings of this study showed that the revised mobile computerized system was an effective device for individual visiting healthcare providers. Further advanced strategies for using this system should be developed and applied in a broad range of community healthcare.

• 보건행정학회지
• /
• 제33권1호
• /
• pp.3-18
• /
• 2023

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

• 한국노년학
• /
• 제39권2호
• /
• pp.213-229
• /
• 2019

이 연구는 서울시 찾아가는 동주민센터(이하 '찾동') 노인 방문건강관리 서비스를 이용해 본 경험이 있는 노인들을 대상으로, 건강관리 서비스 미충족에 영향을 미치는 요인을 분석하고, 향후 효과적인 커뮤니티케어 정착을 위한 동 단위 방문건강관리 사업의 방향성을 제시하고자 하는 목적으로 수행하였다. 이를 위해 찾동 2단계('16. 7. 1 ~ '17. 6. 30) 사업에 참여한 17개 자치구 만 65세, 만 70세 노인 중 1,000명을 자치구별 비례할당 및 임의 추출하여 대면 설문조사를 실시하였다. 서비스 미충족 영향요인의 경우, 개인 및 자치구 환경적 요인으로 나누어 다수준 회귀분석을 실시했다. 연구결과 서비스 미충족을 높이는 개인적 요인으로 사회경제적 수준(고소득, 독거 및 노인가구), 건강수준(복합만성질환, 건강문해력, 우울), 찾동 경험(간호사 1회 방문, 적은 서비스 제공시간 및 낮은 이해도), 사회신뢰(낮은 정부신뢰)로 나타났으며, 자치구 요인으로는 사업 시행기간이 짧을수록, 재정자주도가 낮을수록 서비스 미충족 확률이 높았다. 이를 통해, 커뮤니티케어의 효율성 제고를 위한 다음의 제언을 하고자 한다. 첫째, 건강관리 서비스 수혜 대상을 현재의 65세 및 70세 노인 전수 방문에서 중장기적으로 경제적 또는 건강 취약가구로 사업의 초점대상을 좁혀서, 제한된 예산 속에서 서비스의 질을 높이는 방안에 대한 고민이 요구된다. 둘째, 방문 대상 연령을 만 65세에서 만 66세로 전환하고 국민건강보험공단 생애주기별 건강검진사업과 결과를 공유하여, 사업의 효율성이 높이는 것을 고려할 필요가 있다. 서울시 찾동 사업은 시군구를 중심으로 운영되던 국민건강관리를 행정동 단위로 낮추어 국민들이 체감도를 높이고, 지역사회 건강관리의 패러다임을 바꾸었다는 점에서 의미가 크다. 이 연구가 향후 커뮤니티케어의 효과적인 정착을 위한 기초자료 및 정책 대안으로 활용되기를 기대한다.

• 한국학교ㆍ지역보건교육학회지
• /
• 제15권1호
• /
• pp.121-140
• /
• 2014

Objectives: Recently, the rate of death by chronic disease, is increasing steadily. To prevent this, the public health center will have taken a leading role in the local community medical business through an establish to the national health promotion act and an amendment to the law of public health center in Korea. Results: Accordingly this research, using the Pender's health promotion model which is related with subject health behavior who government employees serve at the public health center have taken important position in the local community health promotion, have comprehended the actual condition of health behavior. For increasing the health behavior practice of subject to comprehend the factor which have effect on health behavior practice, which can be a correct role model in the local community health promotion. A survey was performed on 406 government employees who serve at five public health centers in Seoul. The period of survey was from 25th October, 2010 to 15th November, 2010. The results of this study were summarized as below. 1. Work-related stress, perceptible beneficial obstacle, and self-efficacy were composed by 5 points measure. The results show those work-related stress were $3.06{\pm}0.469$, 74perceptible beneficial obstacle were $3.74{\pm}0.471$, and self-efficacy were $3.49{\pm}0.469$. 2. As for the health behavior by general characteristic, the results have specific differences on age, education level, state of marriage, rank of the position, field of the occupation and employment forms in statics analysis. 3. As for the past health behavior by health behavior characteristic, work-related stress have specific differences on the past frequency of drinking (p<.05) in statics analysis, perceptible beneficial obstacle have specific differences on the past frequency of having breakfast(p<.05), having snacks(p<.05) and doing exercise(p<.05) in statics analysis. Self-efficacy have specific difference on the past frequency drinking(p<.01) in statics analysis. 4. According to the correlation between the factors related with health behavior and health behavior, the health behavior have specific differences on perceptible health condition(p<.01), the past health behavior and perceptible beneficial obstacle(p<.05). Work-related stress and self-efficacy don't have specific relation in health behavior practice. 5. The factors, which effect on health behavior practice have specific differences on the past health behavior, employment forms and field of the occupations. The ability of explanation occupied 54.8% what explained of the health behavior practice by general characteristic, perceptible health condition, employment forms and perceptible beneficial obstacle. Conclusions: According to the correlation between the factors related with health behavior, the health behavior have specific differences on perceptible health condition(p<.01), the past health behavior and perceptible beneficial obstacle(p<.05). The factors, which effect on health behavior practice have specific differences on the past health behavior, employment forms and field of the occupations.

• 보건행정학회지
• /
• 제1권1호
• /
• pp.95-108
• /
• 1991

The World Health Organization and its member states, in 1978, declared that primary health care is a key to attain the goal of Health for All by the goal of Health for All by the yeas 2000. As a member state of WHO, the Republic of Korea has participated in the declaration of ALMA-ATA and committed to put national efforts for devedoping and implementing primary health care approach with the spirit and content of this Declaration. Since 1978, to translate the spirit of the Declaration into realization, Korean goverment has developed a new category of health manpower such as Community Health Practitioners serving people living in remote rural areas and Village Health Workers serving voluntarily their own village, strengthened the function of Health Centers and Health Subcenters through their reorientation and improved the infrastructure by their new construction or renovation. While primary health care is viewed as an essential health care in Korea, there are some circles who follow a narrow definition in referring to the health care at the periphey of a health system, which is erroneous. Considering the PHC is accepted as the best alternative approach to health care to solve problems that modern health systems are facing, we propose the followings as desirable health policy directions that modern health systems are facing, we propose the followings as desirable health policy directions which might translate the persopective into action at the national level after reviewing past and current PHC approach in Korea : 1. To improve the equity through the reduction of gaps between those who have access to health care and those who have not. 2. To reinforce multisectoral approach and intersectoral coordination through the re- establishment of the National Health Council or establishment of equivalent organization at the central level. 3. To stengthen community participation through lacal people's empowerment by leadership training, changing planning process from the top-down approach to bottom-up and giving the priority to human resources rater than technology, 4. To reinforce the Ministries of Health and Social Affairs through upgrading its role and function to Coordinate Ministries which involve human welfare policies, and creating a Division which is in charge of PHC in the Ministry.

• 보건행정학회지
• /
• 제33권2호
• /
• pp.118-128
• /
• 2023

Background: Personal socio-economic abilities are crucial as it affects health inequalities. These multidimensional inequalities across the regions have been structured and fixed. This study aimed to analyze health vulnerabilities by regional cluster and identify regional health disparities of self-rated health, using nationally representative cross-sectional data. Methods: This study used personal and regional data. Data from the Community Health Survey 2021 were analyzed. K-means cluster analysis was applied to 250 si-gun-gu using administrative regional data. The clusters were based on three areas: physical environment, health-related behaviors and biological factors, and the psychosocial environment through the conceptual framework for action on the social determinants of health. And binary logistic regression analyses were conducted to examine the differences in self-rated health status by the regional clusters, controlling human biology, environment, lifestyle, and healthcare organization factors. Results: The most vulnerable group was group 3, the moderate vulnerable group was group 1, and the least vulnerable group was group 2. The group 2 was more likely to have high self-rated health status than the moderate vulnerable group (odds ratio [OR], 1.023; p<0.001). And the group 3 showed low self-rated health status than the moderate vulnerable group (OR, 0.775; p<0.001). However, the moderate vulnerable group had significantly higher self-rated health status than the most vulnerable group (group 2: OR, 1.023; p<0.001; group 3: OR, 0.775; p<0.001). Conclusion: These results demonstrate that community members' health status is influenced by regional determinants of health and individual levels. And these contribute to understanding the importance of specific and differentiated interventions like locally tailored support programs considering both individual and regional health determinants.

• 보건교육건강증진학회지
• /
• 제24권4호
• /
• pp.219-230
• /
• 2007

The purpose of this study was to identify the current problems of school health education policies and practices in Korea, and to establish the strategies to improve the effectiveness and efficiency of school health education program. The severity of adolescents's health problems including obesity, smoking, drug abuse, teen pregnancy, etc has been increased recently and coping strategies to deal with these problems became urgent. The role of school as a key setting for health education should be empathized. However, there were limitations for the effectiveness of school health education in Korea because of the lack of recognition about the importance, guiding principles of the school health education by the school health related law, life skill-focused curriculum, capacity of teachers for health education, and linkage between school and community. In order to improve the effectiveness of school health education, establishment of infrastructure, national and local health education standard, and operating principles for the school health education program should be provided. Life skill-focused health education curriculum should be developed for the effective health education. Teacher training and education also should be the essential component of school health education program. For the improvement of efficiency in school health education practices, cooperation with family and community support system would be necessary.

• Child Health Nursing Research
• /
• 제6권1호
• /
• pp.103-111
• /
• 2000

The aim of the study is to analyze and evaluate the Child Health Management Service that was promoted as a part of Mother-Child Health Guidance Project by the Public Health Center of BukCheju-gun in 1999, to reflect the problems needed to be improved, and, thus, to present the integral program model for the Child Health Management Service that guides childhood health, regarded as the foundation of that of the adulthood period, to the optimum level. The common results of the evaluation of the Child Health Management Service of BukCheju-gun public health center are as below: 1. In the aspect of public information, the existing simple material and method of public information was not effective. 2. The opportunities for the necessary training and education to develop the persons concerned and their ability for the Child Health Management were not enough.3. The environment under which the service, aimed to promote Child's health, was carried out was not clearly divided from that of the services related with the prevention and treatment of disease. And the service environment for the child health was threatening to the clients.4. Still, the actual result was pursued more than the quality management, while carrying out the project. With the reflection of the above result, the research has presented the program model of Child Health Management Program for the next. The main concept of the model is, through the establishment of the network for information offerings and effective convergence of a variety of opinions for the community around the Public Health Center and for the correct evaluation of the project and the reflection of the result from it, to achieve the ultimate goal of the optimal growth and development of the childhood by expanding the support necessary for carrying out Child Health Management Program more effectively.