• 지역사회간호학회지
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• 제32권3호
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• pp.368-381
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• 2021

Purpose: The obesity prevention and management program led by public health centers are important in the community. This study aims to identify the current status of obesity prevention and management programs at public health centers and perceptions regarding facilitators and barriers when implementing programs. Methods: This study used a concurrent mixed methods design. A survey was conducted to investigate the current status and infrastructure of the obesity prevention and management program at eighty-three public health centers nationwide. Nine program managers and six local residents with experience in the program were interviewed by using a semi-structured questionnaires. Results: Most of the infrastructure facilities for the program were inadequate, and insufficient budgets and lack of professional staff were identified as barriers. Facilitators included diversification of program delivery methods, operator competence, and visible outcomes and rewards. For the effectiveness of the program, it is vital to have adequate assistants, a sufficient budget, various promotional methods, and connections with various institutions in the community. On this basis, it is acknowledged that the public health center serves as a platform for preventing and managing obesity in the community. Conclusion: It is expected that infrastructure improvements in public health centers and the link with community resources are needed. In addition, there is an urgent need to set standards for obesity prevention and management programs implemented in public health centers to 'resolve regional disparities'.

• 지역사회간호학회지
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• 제13권2호
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• pp.260-271
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• 2002

Objectives: The purpose of this study was to identify basic health needs of adult clients to develop a community nursing center model in Seoul. Methods: Data were collected using a questionnaire survey from 894 adults registered at a public health center who were health management members, and visiting 4 community nursing centers, University of Wisconsin, Milwaukee during the period from July 1999 to January 2000. The data were analyzed using frequency, percentile, t-test, and ANOVA. Results: 1) The University of Wisconsin- Milwaukee School of Nursing has a long tradition of developing 4 community nursing centers with innovative health care programs. CNCs integrate the ability to implement and test effective intervention strategies with education, research, and practices of nursing students and faculty. They were designed to enhance the health status and quality of life for urban communities through the development of productive, outcome focused, collaborative partnerships among UWM-Nursing faculties and staff, other health and human service providers, consumers, and policy makers. It links the financial resources between UWM and 9 voluntary agencies and 12 public funding organizations including federal. state, and local governments. 2) Of the total health management members, 37.4% were reported to have at least one type of chronic disease such as hypertension, diabetes, and arthritis. Ten percent of them reported having obesity, and 44.2% reported lack of exercise. The health status of the subjects was within normal range in laboratory tests. However, female subjects showed more significant differences in obesity and cholesterol levels than male subjects. The subjects, who were in their 50s, showed more significant differences in obesity, SGOT, SGPT, and cholesterol levels than the subjects in other age groups. Conclusion: A community nursing center needs to be developed, that has a link between the nursing college and the public health center, with partnerships and a multidisciplinary approach. Based on the study results, exercise programs for middle aged adults are considered necessary. In particular, specific exercise programs for pre-menopausal women needs to be implemented in the future to prevent them from developing osteoporosis.

• 지역사회간호학회지
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• 제26권3호
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• pp.260-267
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• 2015

Purpose: This study aimed to examine the effectiveness of the workshop on the nurses' knowledge about urinary incontinence (UI) self-management, attitudes toward UI, and self-efficacy to plan and implement a UI self-help group program for their clients. Methods: A one-group pretest and posttest design was used to examine changes in knowledge, attitudes, and self-efficacy following a one-day training workshop. Twenty-seven community health nurses completed a questionnaire before and after the workshop. Before participating in the workshop, the participants were required to take a UI online continuing education program developed by the researchers. During the workshop, the participants took four sessions which consisted of an introduction of a self-help group program, demonstration of a 5-week UI self-management program contents, pelvic floor muscle training and biofeedback practice, and group discussions to plan the implementation in their workplaces. Results: A significant improvement in knowledge of and attitudes toward UI were found (t=3.53, p=.002; t=2.83, p=.009, respectively) after the workshop. Participants also demonstrated improvement in their self-efficacy to plan and operate a UI self-help group program (Z=-2.64, p=.008). Conclusion: The one-day workshop for community health nurses is a feasible strategy to increase their abilities and confidence in operating a UI self-help group program.

• Perspectives in Nursing Science
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• 제7권1호
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• 중환자간호학회지
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• 제13권1호
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• pp.63-75
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• 2020

Purpose : The purpose of this study was to review mobile health (mHealth) interventions based on studies from online databases for community-dwelling patients with heart diseases. Methods : Six databases (RISS, KISS, PubMed, CINAHL, EMBASE, and SCOPUS) were searched to select studies conducted from January 1 to September 30, 2010. After this, quality appraisals were carried out using the Scottish Intercollegiate Guidelines Network checklist and a total of 11 studies were selected. Results : The selected 11 studies included 7 randomized controlled studies, 1 quasi-experimental study and 3 pilot studies. The main components of mHealth interventions included symptom monitoring at home, provisions for individualized messages for health management using text messaging, telephone or smart phone applications, and running websites for symptom monitoring or health education. Intervention periods varied from 6 weeks to 12 months. The findings of the studies suggested that the mHealth interventions were effective in improving self-management of heart diseases, quality of life, and decreasing symptoms. Conclusions : The results of the review suggested that mHealth interventions had positive effects on community-dwelling patients with heart diseases. More mHealth intervention studies need to be conducted in Korea to aid community-dwelling patients with heart diseases.

• 보건교육건강증진학회지
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• 제31권5호
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• pp.121-133
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• 2014

Objectives: The purpose of this study was to analyze the roles of workforce required for effective execution of health promotion programs of community health centers in Korea. Methods: Survey was undertaken on 92 people in community health centers and the Analytic Hierarchy Process was employed in order to obtain results regarding the relative importance of role required for health educators. Results: The analysis suggests that of all 5 categories, 'Assess needs for health education' and 'Evaluate health promotion programs and Conduct related research' were relatively more important than the other categories of role. Taking into account the weightings of the main categories and the subcategories, the analysis shows that the order of importance follows, 'Use existing health-related statistical data', 'Collect health-related data', 'Survey method and knowledge and skills related to health statistics', 'Write an evaluation report', 'Understand and apply health education planning theories'. Conclusion: As a health promotion expert of community health center, a health educator is preferentially required to perform 1) the role to analyze the needs of the community and enable the planning for a customized health promotion program, 2) the role to execute evaluation throughout a health promotion programs and disseminate evaluation findings and apply them in following programs, in consideration of higher relative importance of these roles.

• 보건교육건강증진학회지
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• 제30권2호
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• pp.23-39
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• 2013

Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

• 지역사회간호학회지
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• 제15권4호
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• pp.577-586
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• 2004

Purpose: This study is to examine the effect of a health promoting education program for middle-aged women. Methods: Health promoting education program: The subject group consisted of 116 women between 40 and 60 years of age. Three 12-week sessions consisted of a 90 minute class each week, from March 14th to November 14th, 2003. Pre- and post-education tests were collected after each session. The data was collected using structured questionnaires before and after the education sessions. Data were analyzed employing descriptive statistics, paired t-test with SPSS/PC (10.0 version) program. Results: There were significant changes in health promoting behavior, but no significant changes in the self-efficacy and the knowledge of health management. Conclusion: This study showed that a health promoting education program has partially positive effects for middle-aged women. Based on this study, a continuous education program through a community health center is needed for middle-aged women's health.

• 농촌의학ㆍ지역보건
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• 제28권2호
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• pp.155-169
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• 2003

본 연구는 농촌지역의 고혈압 관리실태를 파악하기 위하여 전국의 보건진료소 1,849개소를 모집단으로 하여 비례층화표출법에 의해 700개소의 보건진료소를 선정하여 자가보고식 설문지를 2003년 3월 13일부터 5월 13일까지 두 달간 실시하여 수집된 205개의 설문지를 분석하여 다음과 같은 결론을 얻었다. 첫째, 보건진료원의 평균 연령은 42세였고, 근무경력은 11년에서 20년 사이가 62%를 차지하였고 20년 이상의 근무경력자도 17.2%로 나타났다. 교육수준은 간호대 3년제 졸업이 61.3%이고 대학원이상이 7.0%였다. 둘째, 조사대상지역의 생업별 지리적 특성은 농촌인 곳이 77.3%, 어촌이 14.7%이고, 행정적 관할인구는 501-1,000명이 44.3%였고, 실제적 관할인구는 501-1,000명이 53.3%였다. 65세 이상인구의 비율은 평균 26.7%이고, 담당하고 있는 리는 평균 4개이고, 마을건강원의 수는 평균 6명인 것으로 응답하였다. 셋째, 기타 고혈압 사업과 관련된 특성으로는 월평균 혈압측정자 비율은 평균 25.4%, 월평균 방문가구 중 고혈압 관리를 위해 방문하는 가구 비율은 평균 42.4%, 월평균 내소자 중에서 혈압으로 인해 보건진료소를 내소하는 비율은 평균 15.6%였다. 고혈압 사업을 하는데 있어서 운영협의회의 역할이 있다고 응답한 곳은 15.7%였고, 사업을 수행하는데 마을건강원이 도움된다고 응답한 곳이 52.7%이고 보건진료원 자신이 고혈압 사업을 수행하는데 능력이 충분하다고 응답한 곳이 76.2%였다. 보건지소와의 협조는 잘 된다고 한 곳이 43.4%, 안 된다고 한 곳이 56.7%인 것으로 나타났다. 넷째, 일반주민을 대상으로 한 고혈압환자 예방사업 중에서 보건교육과 관련된 항목 중 보건교육내용선정과 교육시간선정은 보건진료원의 판단 하에 결정하는 경우가 50% 이상이었고, 1년 동안 4회 이상의 보건교육을 실시하는 곳이 56.7%이며, 교육방법은 강의와 시청각 매체를 이용하고 주로 사용하는 시청각 매체는 비디오라고 83.6%가 응답하였다. 교육자료는 보건소에서 배부 받아 사용하는 경우가 64.5%였고 교육 후에 평가를 실시하는 곳은 22.1%였다. 고혈압환자 조기발견은 96.1%가 보건진료소를 내소하는 경우에 혈압측정을 통해 발견하였고, 89.3%는 가정방문을 통해 환자를 발견, 49.1%는 지역사회 보건의료기관 및 일반자원으로부터 의뢰를 통해 환자를 발견하였다. 그 외에 집단 행사를 통해 환자를 발견하는 경우는 39.5%이고, 기존 자료를 통해 환자를 발견하는 경우는 35.7%였다. 다섯째, 고혈압환자를 대상으로 한 고혈압환자 등록 및 관리사업에서 고혈압 환자만을 위해 전용기록지를 사용하는 곳이 35.6%이고, 50% 이상이 타의료기관에서 관리받는 환자까지 보건진료소에 등록해서 관리하고 있었다. 고혈압관리수첩은 사용하지 않는 경우가 34.8%였고 고혈압환자 관리를 위해 전산프로그램을 사용하는 경우는 68.5%이고, 사용용도는 월보작성이나 환자치료 및 추구관리를 위해 사용한다고 60%이상이 응답하였고 10.6%는미치료자를색출하는데사용한다고응답하였다. 여섯째, 모든 의뢰환자에게 의뢰서를 발급하는 경우가 22%이고, 반드시 회신서를 확인해서 환자기록지에 보관하는 경우가 26.2%였다. 그외에 민간의료기관과의 공식적, 비공식적인 의뢰체계를 구축한 곳이 64.7%였다. 고혈압환자 치료 및 추구관리에서 투약관리와 혈압 상태관리는 95% 이상이 수행하고 있었으나 생활요법 중에서 스트레스나 비만관리, 식이관리는 약 7%정도가 전혀 확인을 안 하고 있다고 응답하였다. 또한 작년 한해 동안 고혈압환자 및 가족을 대상으로 교육을 실시한 경우가 약 30%였고, 고혈압 환자만을 대상으로 교육을 실시한 곳은 70.7%였다.

• 대한예방한의학회지
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• 제18권2호
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• pp.69-80
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• 2014

Objective : The purpose of this study was to investigate the effects of Intensive management program of home visiting health service for community dwelling Clients with Arthralgia. Method : A nonequivalent control group pretest-posttest design was used for this study. Elderly people who agreed to participated in the study were assigned to an experimental group (n=30) or a control group (n=30). For an experimental group, The Intensive Management program was given as a home visiting health service once a week for 8 weeks. Study outcomes were measured by structured questionnaires from August, 2013 to october. For data analysis, Chi-square test, Fisher's exact probability test, independent t-test, and paired t-test were performed using SPSS version 17.0. Results : Changes in pain, fatigue, medical service utilization and self management compliance were significantly different between the two groups in pretest and posttest(t=-4.828, p < .001), (t=-4.944, p =.001), (t=2.176, p =.039), (t=3.141, p =.003). And there were significant difference between the two groups in left extension and flexion of knee(t=-2.241, p < .031), (t=2.166, p < .037). Conclusion : The intensive management program was effective on decreasing pain, fatigue, medical service utilization, and increasing flexibility of knee joint and self-management compliance of community dwelling clients with arthralgia.