• Pediatric Infection and Vaccine
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• 제14권2호
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• pp.145-154
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• 2007

목 적 : 로타바이러스는 전 세계적으로 영유아 및 소아 설사의 흔한 원인이며, 신생아의 원내 감염 중 가장 중요한 원인체로 알려져 있다. 본 연구는 출생한 병의원에서 퇴원 후에 즉시 산후 조리원으로 입소한 정상 신생아를 통해 출생한 병의원으로부터 기원한 로타바이러스 원내 감염을 분석하여 로타바이러스 항원 양성률, 연관인자, 증상 발현율, 임상 증상 및 감염 통제 방법에 대해 알고자 시행하였다. 방 법 : 2005년 3월부터 2006년 9월까지 서울위생병원 부설 산후 조리원에 입소한 정상 신생아 957명 중 입소하여 24시간 이내에 시행한 대변 내 로타바이러스 항원검사에서 양성을 보인 신생아 216명을 대상으로 하였다. 로타바이러스 항원검사는 면역 크로마토그래피법을 이용하여 시행하였다. 신생아에 대한 정보는 간호 기록지를 후향적으로 검토하여 입소 신생아의 성별, 출생 체중, 재태 연령 및 월별 로타바이러스 항원 양성률, 출생한 병의원, 분만 방법, 수유 방법, 증상 발현율 및 임상증상 등에 대해 조사하였다. 결 과 : 1) 입소 24시간 이내에 로타바이러스 항원 양성을 보인 신생아는 총 216명(22.6%)으로 남아가 126명(58.3%), 여아가 90명(41.7%)이었고, 출생 체중 및 재태 연령에 따른 차이는 없었다. 2) 입소한 신생아의 월별 로타바이러스 항원 양성률은 10-36%이었고, 출생한 병의원에 따른 로타바이러스 항원 양성률은 3.5-53.6%로 다양한 분포를 보였다. 3) 총 957명 중 정상 질식 분만으로 출생한 신생아는 655명(68.4%)으로 평균 재원기간은 2.4일이었고 제왕절개 분만으로 출생한 신생아는 302명(31.6%)으로 평균 재원기간은 5.7일이었다. 로타바이러스 항원 양성률은 정상 질식 분만군은 17.6%, 제왕 절개 분만군은 33.4%로 정상 질식 분만군에 비해 제왕 절개 분만군에서 로타바이러스 항원 양성률이 유의하게 높았다(P<0.001). 4) 입소 전 수유 방법에 따른 로타바이러스 항원 양성률은 모유 수유군 27명(12.5%), 분유 수유군 101명(46.8%), 혼합 수유군 88명(40.7%)이었고, 대조군에서는 모유 수유군 83명(38.4%), 분유 수유군 47명(21.8%), 혼합 수유군 86명(39.8%)으로 모유 수유군에서 로타바이러스 항원 양성률이 유의하게 낮았다(P<0.001). 5) 로타바이러스 항원 양성자 중 무증상군 및 증상군은 각각 65.3%, 34.7%이었다. 임상 증상으로 가장 많이 나타난 것은 설사로 69명(92.0%)에서 관찰되었고 수유부진 34명(45.3%), 열 30명(40.0%), 구토 19명(25.3%), 체중 증가의 지연 9명(12.0%), 소변양의 감소가 4명(5.3%)에서 나타났다. 대변의 양상은 수양변이 43명(61.3%)으로 가장 많았다. 입원 치료가 필요했던 경우는 24명(11.1%)이었고 중증 질환으로 진행된 경우는 없었다. 결 론 : 산후 조리원에 입소하는 신생아들 중 일부는 이미 출생한 병의원의 신생아실에서 로타바이러스 원내감염이 된 상태에서 입소하는 경우로 산후 조리원에서 신생아의 관리가 제대로 이루어지지 못할 때에는 2차적으로 산후 조리원 내 감염으로 급속히 전파될 수 있다. 따라서 로타바이러스의 감염 전파를 예방하기 위하여 모유 수유를 권장하고, 최근 증가하는 산후 조리원의 상황을 인지하여 항원 양성자를 격리하여 관리하는 것이 도움이 될 것으로 생각된다. 또한 산후 조리원에 대한 규제와 관리, 철저한 위생 교육 및 앞으로 좀 더 많은 연구가 필요하다.

• 여성건강간호학회지
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• 제7권1호
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• pp.30-43
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• 2001

This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

• Child Health Nursing Research
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• 제6권2호
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• pp.167-185
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• 2000

The goal of this research was to provide the basic data of sexual education for late schooler by finding out what they want to know about sex, or to see, if any, its relevancy between female and male students and between each grade. The sample for this research was a total of 453 students in 4th, 5th and 6th grade from 12 different classes at two elementary schools which were located in C city and in B province. The children were requested to write down three points on what they want to know or to learn most about sex, and their answers were put through two analytical stages in order to classify and to examine. The followings are the conclusions from the data. 1. The female cluster took 44.2% out of the whole sample, and there were 151 students per each grade. The specific girl ratios for each grade were 42.4%, 50.3% and 39.7% respectively. 2. It was noted that a total of 1,195 questions were gathered from the students writings, 45% of the questions was raised by the female students. The 4th grade students raised 432questions (43.8% by the girl) while the 5th. and the 6th grade students raised 387 (53.2% by the girl) and 376 questions (42.3% by the girl) respectively. The average number of questions per students was 2.6 while the female students raised 2.8 questions which was more than the average 2.5 questions by male students. It was the 4th grade female student cluster, which raised the most question (3.0) while the 6th grade male students raised the least question (2.4) in average. 3. The questions raised by the children could be divided into seven categories of the knowledge need on sex. They were Reproduction (310 questions, 25.9%), Sexual Culture (230, 19.2%), Concept of sex (125, 18.0%), Changes of Puberty (172, 14.4%), Sexual Health (119, 10.0%), Anatomy and Physiology of Reproductive System (78, 6.5%) and Sexual Tendency and behavior (71, 5.9%). 4. 'Reproduction' was the most frequently raised questions not only by both sex groups but also by the 5th grade students. Both sexes in the 4th grade showed the highest interest in Sexual Culture while it was Changes in Puberty for the both sexes in the 6th grade. The knowledge need on sex of the children indicated what they understand sexuality. They apprehended sex as sex, gender and sexuality in an inclusive way. They showed a major interest in the biological sex and the sexual activities. It seems that the children managed to understand clearly the meaning of gender, furthermore, they even pointed out that the streotyped sex role, patrimonial system and the sexual discrimination were unreasonable. The students possessed not only the least but also the most negative understanding in regard of sexuality. Two suggestions were made from the above conclusions for the practical sex education as well as its research. 1. For the practice: The sex education for the elementary upper grade school student should be relevant with their cognitive characteristics, also it should be more specific on the reproductive organs of both sexes, the actual scenes of the pregnancy and child delivery procedures. The gender concept should be added to the biological sex education, which will lead them to understand the unreasonableness of today's male-superior phenomenon and correct them. It is also necessary to develop educational programs for this age group so as to help them to understand sex in the sense of sexuality as well. 2. For the research: It is not easy to draw out a through conclusion since this study was carried out as one-time data collection. Yet it is undeniably helpful for the sex education if we can understand what the children want to know about sex, how much they know about it by conducting deep-interview researches through a small number of sample.

• 모자간호학회지
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• 제3권2호
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• pp.172-186
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• 1993

The survey was performed on 201 cases of mothers who visited pediatric hospitals and public health clinics in Pusan and Kyeong-nam provinces from Dec. 10 to Dec. 30 of 1993. If this study, each infant weighed over 2500gm and between 2 months and 12 months old. The research was statistically analyzed according to the percentage, Pearson correlation, $x^2$-test. The result of this study were as follows ; 1. Feeding method related to the job of mother (p<0.01). 2. Feeding method related to the way of bringing up child(p<0.05). 3. Whether the mother and child shared the same room effected the feeding method (p<0.01). 4. The shape of nipple before breast feeding related to feeding method. 5. The reason for stopping breast feeding related to feeding method(p<0.01). 6. First breast feeding related to period of seperation after delivery(p<0.05). 7. Plan of breast feeding related to birth weight (p<0.05).

• 한국의료질향상학회지
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• 제7권2호
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• pp.190-202
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• 2000

Background : The objectives of this study were to examine patients' satisfaction with the DRG based payment method and its association with their awareness of the method, to examine patient reported changes in doctors' caring attitude, level of their out-of-pocket payments, providers' acceptance of patients' request for additional services after the program, and to examine changes in service utilization recorded in medical records. Method : One hundred-four patients who had cesarean sections before and after the demonstration program at two hospitals located in Seoul participated in the study. Patients were surveyed before discharges when their charges were finalized. Their medical records were reviewed as well to collect data for service utilization during hospital stays. The association between patients' satisfaction with the payment method and their awareness of the method was analyzed by ${\chi}^2$-test, and the significance of changes in providers' acceptance of patients' request for additional services and service utilization after the program were examined by ${\chi}^2$-test and t-test, respectively. Results : A large proportion of patients did not know of the DRG based payment method at the time of survey and a significantly larger proportion of patients who came to the hospitals with the knowledge satisfied with the method. About the same proportion of patients reported improvement and deterioration in doctors' caring attitude compare to the previous hospitalizations and a similar result was found concerning out-of-pocket payments. Providers' acceptance of patients' request for medication, PCA and painless delivery decreased significantly after the program whereas the acceptance for additional hospital days and laboratory and radiology tests did not. Length of stay, the numbers of days on antibiotics and antianemic medication, and the number of blood tests decreased significantly after the program, however, decreases in the rate of antianemic medication and the number of urine analyses were not statistically significant. Re-operation, in-hospital death, and complications were not observed before and after the program. Conclusion : The study findings indicated a need for better patient education and publicity about the newly introduced payment method to improve their satisfaction with the system. Other study findings concerning service utilization and quality of care indicators were consistent with the government funded evaluation studies.

• 치위생과학회지
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• 제16권3호
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• pp.249-255
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• 2016

본 사례보고는 대전 동구보건소에서 7년간 실시하고 있으며 매년 천 명 이상이 참가하는 노인 불소도포 스케일링 사업의 진행과 만족도, 논의사항 등을 보고하여 노인 구강보건사업 실행에 도움을 주고자 함이다. 2009년 시범사업은 대한노인회 대전동구지회와의 협의를 통해 각 경로당에 관련 공문을 보내고 신청 경로당에 직접 방문하거나 인근지역의 여러 경로당을 합하여 주민센터에서 사업을 진행하였으나 이후에는 경로당 중심 사업보다는 복지관이나 주민센터를 중심으로 진행하였다. 대전 동구치과의사회와 사전 협의 후 사업이 진행되었기 때문에 사업진행에 문제가 없었으나, 스케일링 후 지혈이 되지 않는 1건의 의료사고가 있었으며 이후로 지혈관련 전신질환이나 약물복용에 관한 사전 조사를 강화하였다. 2013년 본 사업에 대한 만족도 조사 동의자 355명 중 홍보 95.2%, 대기시간 73.2%, 스케일링 99.7%, 불소도포 91.5%, 틀니관리교육 96.6%, 칫솔질교육 98.6%가 만족한다고 하였다. 사업 참여 이유에 대한 구두대면조사 대상자 137명 중 44.9%는 무료라서, 12.5%는 치과에 가면 불필요한 치료를 받으라고 할까 봐 마음이 불편해서, 8.1%는 치과보다 제대로 치아관리를 해주는 것 같아서, 8.1%는 이동이 편리해서, 7.4%는 노인 우대를 잘 해주어서 등의 순으로 나타났다. 본 사업에 다시 참여하지 않겠다는 의견은 치과에 가서 하면 된다 1.5%, 다른 치료를 해주지 않는다 1.5%, 답변 거부 1.5% 등의 순으로 나타났다. 본 사업담당자의 의견은 사업의 지속적 참가자들의 구강환경관리 향상에 사업이 효율적이라 판단되나 농촌지역이나 취약계층 밀집지역의 경로당들은 사업 신청을 하지 않거나 신청인원 부족으로 사업의 효율성 때문에 배제되는 점, 스케일링의 보험급여화 이후 사업의 비용에 대한 고려가 필요하다고 하였다. 따라서, 취약계층을 사업에 포함하기 위한 방안 마련과 건강보험 급여화와 중복이 되는 보건소 사업에 대한 평가가 필요하다고 제안한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1437-1443
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• 2016

Background: We investigated four factors, height, weight gain since age 20, physical activity, and alcohol drinking, for associations with risk of breast cancer (BC) according to menopausal status, using the latest data of the Japan Collaborative Cohort Study (JACC Study). Materials and Methods: We confined the analysis to 24 areas available of cancer incidence information, excluding women with a previous diagnosis of BC. Baseline data were collected from 38,610 (9,367 premenopausal, and 29,243 postmenopausal) women during 1988 and 1990. The study subjects were followed-up at the end of 2009, and 273 (84 premenopausal, and 189 postmenopausal) cases of BC were newly diagnosed in 501,907 person-years. The Cox model was used to estimate a hazards ratio (HR) and its 95% confidence interval (CI) of BC risk. Results: As a result of the multivariate analysis adjusting for age at baseline survey, age at menarche, number of live births, and, age at first delivery, weight gain since age 20 of 6.7 kg-9.9 kg, and ${\geq}10.0kg$ were significantly associated with increased risk for postmenopausal BC (HR=2.48, 95% CI 1.40-4.41, and, HR=2.94, 95% CI 1.84-4.70, respectively). Significantly increased trend of BC risk was also observed in weight gain since age 20 (p for trend, p<0.001). Amount of ethanol intake per day${\geq}15.0g$ was significantly associated with increased risk for postmenopausal BC in the multivariable-adjusted analysis (HR=2.74, 95% CI 1.32-5.70). Conclusions: Higher weight gain in adulthood and larger amounts of ethanol intake were significantly associated with increased risk of BC in Japanese postmenopausal women. None of the investigated factors were significantly associated with BC risk in Japanese premenopausal women.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.97-119
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• 1991

본 연구는 농촌지역의 보건의료수준이 의료자원의 양적, 질적 격차와 의료이용과 의료접근도 및 건강수준의 면 등에서 도시지역보다 낙후되어 있다는 사실을 각종 통계지표를 이용하여 논증하였다. 다음으로 이러한 격차를 빚은 농촌보건사업의 문제점을 파악하여 이에 대한 대처방안을 농촌보건사업의 조직, 인력, 시설 및 장비, 재원 및 그리고 관리라는 5가지 부문으로 나누어서 모색해 보았는데 구체적으로는 첫째, 농촌보건 인력의 자질향상과 적정배치방안의 수립, 둘째, 농촌보건인력의 생산성 증대, 셋째, 보건소 및 지소의 운영개선, 넷째, 취약지 민간병원의 운영 개선, 다섯째, 사회, 경제여건의 변화에 따른 새로운 보건사업의 개발, 여섯째, 통합적인 보건의료인력관리 전담기관의 설립 등의 정책대안을 제시하고 있다.

• 보건행정학회지
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• 제28권3호
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• pp.222-225
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• 2018

Health policy is a historical product in the process of development, including the political and economic factors of the state as well as the social and cultural elements of the country. Bioethics began to debate the ethical questions that arise in the overall process of life's birth and death, and gradually evolved by presenting ethical directions for various social phenomena. Especially, according to the moral awakening of 'scientific medicine' which caused in some human problems in the rapidized scientific society from the late 19th century to the early 20th century, as a result of distress including the concept of various social relations, it is possible to say that it has reached the bioethics. Although health policy and bioethics are different in terms of starting and concept, they can be found in common with social, cultural, and political diversity in the times. In 2004, 'Bioethics Law' was enacted through the issue of research ethics in the life sciences. Therefore, in order to examine ethical aspects of current health policy direction and major issues, it can be divided into before and after enactment of 'Bioethics Law' in 2004. The authors would like to examine how the evolution of the ethical viewpoint on the health policy has changed in line with the enactment of the 'Bioethics Law' and how it is trying to solve it from an ethical point of view. Through the various events that took place in the 1990s and the 2000s, various discussions on bioethics were conducted in Korea. Prior to the enactment of the 'Bioethics Law,' ethical judgments of professions, distribution of healthcare resources, if the discussion focused on the ethical judgment of abortion, and the various events that appeared in the early 2000s became the beginning to inform that the ethical debate about the life, death, and dignity of human beings began in earnest in Korea with the enactment of the 'Bioethics Law.' Since then, 'Hospice and Palliative care Law' which was enacted in 2017, is based on the fact that the health policy of our country focuses on the treatment of the past diseases, health promotion, and delivery of health care services. It was an opportunity to let them know that even the quality problems were included. Therefore, considering the various circumstances, the ethical issue facing Korea's health care system in the future is the change of the demographic structure due to aging and what is to be considered as the beginning and the process of life in the overall process of life. It is the worry about how to die and when it sees as death. This has far exceeded the paradigm of traditional health care policies such as disease prevention and management and health promotion, and calls for innovative policy response at the national level that reflects the new paradigm, which in many cases creates a predictable ethical environment. And health policy should be shifted in the direction of future ethical review considering sustainability in the development process of future health care rather than coercive management.

• 한국산업보건학회지
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• 제22권2호
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• pp.156-163
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• 2012

Objectives: The aim of the present study was undertaken to investigate the association between communication for chemical hazard information and characteristics of occupational safety and health managers. Subjects and Methods: We surveyed 78 occupational safety and health managers(64 male and 14 female) in 78 chemical manufacturing plants. Data were obtained using a self-reported questionnaire about size and type of company, products, communication system for chemicals and work-related characteristics of occupational safety and health managers. All analyses in this study were performed using SPSS program 12.0. Results: 64.1% of the study participants were occupational health managers aged 39.3 years on average and were graduated from college and university around 90%. 30.0% and of them were majoring in chemistry (engineering chemistry), 18.0% occupational health, 16% nursing and 30.0% others. Occupational safety managers were aged 39.4 years on average, 42.9% of them were majoring in chemistry (engineering chemistry), 21.4% environmental engineering, 10.7% occupational safety and 25% others. 86% of occupational health managers and 71.4% of occupational safety managers were classified as office job. Over 94% of the hazards information for chemicals were delivered by occupational safety and health managers, but about 28.2% workers preferred outside experts who have a profound knowledge about occupational safety and health and understandable. Occupational safety and health managers and workers had difficulties in understanding toxicological information, hazards identification, stability/reactivity, composition/information on ingredients, physical/chemical properties and ecological information. On multiple logistic regression analysis for the 16 heading of material safety data sheet, content of material safety data sheet was significantly associated with education level (odds ratio=0.286, 95% confidence interval=0.105-0.780). The hazard identification (odds ratio=3.947, 95% confidence interval=1.092-14.271) and toxicological information (odds ratio=0.841, 95% confidence interval=0.705-0.998) were significantly associated with type of occupation. Conclusions: This finding implies that the education level, type of occupation and speciality of occupational safety and health managers may affects hazards information delivery.