• 대한소아치과학회지
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• 제25권1호
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• pp.162-170
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• 1998

아동의 치과의료이용행태에 영향을 미치는 요인을 분석하여 아동의 구강보건행태에 관한 이해를 증진함과 동시에 이에 대한 기초자료를 확보하고자 전라북도 익산시에 거주하는 아동과 그들의 모친 1907쌍을 대상으로 앤더슨-뉴만 모형을 적용하여 조사연구를 시행하였다. 조사방법은 자기개별 기입법에 의한 설문조사법이었다. 모형에 의한 종속변수는 아동의 치과의료이용횟수였고, 독립변수는 소인성 요소, 가능성 요소 필요성 요소로 구분 된 39개 요인이었다. 소인성 요소는 인구 및 사회 경제학적 요소, 모친의 영향 요소, 아동 자신의 요 소로 세분된 32개 요인이었고 가능성 요소는 월 평균 세대소득 등 6개 요인, 필요성 요소는 구강병으로 인한 활동제약 및 활동불능일수였다. 아동의 치과의료이용행태에 대한 앤더슨-뉴만 모형의 설명력은 25%였다. 소인성 요소가 가능성 및 필요성 요소보다 아동의 치과의료용회수에 대한 설명력이 더 컸다. 직접적인 영향을 미친 변수는 치 의사에 대한 가치, 모친의 구강건강신념 중 감수 성, 아동의 구강건강신념 중 감수성과 유익성 및 장애도, 아동의 학년, 출생순위, 진료비에 대한 부담, 단골구강진료기관유무, 구강병으로 인한 활동제약 및 활동불능일수였다. 모친의 교육수준, 사회경제적지위, 가족수 등 12개 요인은 간접적인 영향을 미쳤다. 가장 큰 영향을 미친 요인은 모친의 치과의료이용횟수였고, 아동의 구강병으로 인한 활동제약 및 활동불능일수, 아동의 구강건강신념 중 감수성, 단골구강진료기관유무 등이 상대적으로 큰 영향을 미쳤다. 이상과 같이 아동의 치과의료이용에는 모친의 영 향이 매우 크며 다른 연령층과는 달리 소인성 요소에 속하는 요인들이 중요하다는 사실을 확인할 수 있었다. 그러므로 아동의 적절한 치과의료이용을 도모하기 위해서는 모친의 행동이 중시되어야 하며, 모친과 아동을 함께 고려하는 연구 및 교육 프로그램의 개발이 활발히 이루어져야 할 것으로 사료되었다.

• 보건교육건강증진학회지
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• 제7권1호
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• pp.10-26
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• 1990

In Korean education, the health contents are scattered in various course subjects throughtout the primary and junior high school curriculum. So it is very difficult to provide systematic health education. The purpose of this study was to provide a guide for health education using health topic areas and major concepts that represent the scope of material that should be covered in health instruction. The steps used in selecting these health topic areas and major concepts were as follows: 1. A review of the literature related to health and health education was done to develop the rationale underlying this study. 2. Health topic areas basic to the growth and development characteristics of children, to human needs and to societal needs for healthful living were indentified. 3. The major concepts for each health topic area based on health sciences and children's growth and development levels were selected. 4. The major concepts selected were organized in sequence to guide health education from grade one to grade nine. The results of this study were as follows: 1. The identification of eleven health topic areas essential for health education. These include: personal habits and health healthy growth and development nutrition and health prevention of disease and disorders drugs and health mental health family life and health sex education accident prevention consumer health community health 2. The identification of the major concepts(generalizations) for each health topic area: 33 major concepts were identified as a guide in determining the health content of health education programs. These are 1) body cleaniness, 2) health of the sensory organs, 3) dental health, 4) exercise and rest, 5) growth and development, 6) body structure and function, 7) developmental tasks, 8) balanced nutrition, 9) eating habits, 10) food preparation and food storage, 11) sources of disease and disorders, 12) disease preventive behavior, 13) care during illness, 14) drug use and misuse, 15) drug addiction, 16) emotional responses, 17) human relationship, 18) self concept, 19) social adjustment, 20) health habits of the family, 21) interdependence of family members, 22) origin of life, 23) characteristics of man and woman, 24) sexual instinct, 25) safety behavior, 26) emergency measures, 27) criteria for selection of health products, 28) proper use of health information, 29) utilization of health and medical services, 30) environmental conservation, 31) environmental pollution, 32) population control, 33) function of public health services. 3. The organization of the concepts(generalizations) in sequence and for continuity in health instruction at the primary and junior high school level.

• Journal of Preventive Medicine and Public Health
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• 제7권1호
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• pp.29-94
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• 1974

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.