• 지역사회간호학회지
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• 제15권2호
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• pp.197-208
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• 2004

Purpose: This study was to develop an effective evaluation tool for evaluation of hypertension prevention and management program(HPMP) in community health posts (CHPs). Method: Evaluation tool composed from the literature review, the field visiting, and the in-depth interviews with the community health practitioners. Result: The evaluation tool had four domains, each with different maximum points:, hypertension prevention (35), hypertension management (40), environment of the CHPs(10), and evaluation system of the HPMP(15). The first domain was hypertension prevention with sub-domains of health education, and early detection of patients with hypertension. The second domain was hypertension management with sub-domains of management of health records of patients, education and counseling, and treatment and follow-up of patients. The third domain was the environment of the CHPs with subdomains of accessibility of CHPs to residents, accessibility of general health data to the public, and availability of health information to the public by multimedia. The fourth domain was the evaluation system of the HPMP with the subdomains of planning of program, formative evaluation, process evaluation, and summative evaluation. Conclusion: The newly developed evaluation tool will contribute not only to plan and set goals for evaluation of HPMP in CHPs.

• 보건행정학회지
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• 제3권2호
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• pp.25-56
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• 1993

Hypertension has already become a serious health problem in many countries. Treatment is effective, however, and the detection and long-term management of those at risk pose sustained challenges. Community programs can be an important strategy for primary prevention of hypertention and for monitoring the progress and promoting compliance of hypertensive patients. Hwachon Health Demonstrain Project has designed community hypertention control program, especially emphasizing role of public health sector, and operate that model from 1990 at Hwachon county, Kwangwon province. This paper appraise the effectiveness of curent activities. Many paper appraise the effectiveness of curent activities. Many hypertensive persons who have not recognized his disease were identified and began hypertension treatment. However about two thirds of patients have not complied continuously with medical advice. Consequently, the project team redirects its efforts. Less emphasis is being placed screening and identification of patients, while more emphasis is being placed on increasing compliance with treatment recommendations. Some approches to improve hypertension control program are also discussed in the context of the field experience and literature on this suvjest.

• 지역사회간호학회지
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• 제15권3호
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• pp.385-396
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• 2004

Purpose: Hypertension has been a major cause of death in Korea since the 1970s, and has resulted in being a significant economic burden to the finances of national health care. The Ministry of Health and Welfare made several efforts. but hypertension control programs in Korea are still non standardized and ineffective. We wanted to investigate the current hypertension control program in public health centers systematically and suggest the direction for future programs. Method: The design of this study is a cross sectional investigation. From September to October in 2002, we sent a set of questionnaires to all PHCs, and 179 centers responded (response rate = 74.0%). The instrument was developed based on components of National health systems. Results: 1) Resources: The department responsible for hypertension control programs is the Department of Health Promotion. Health Education Center, Community Health Center, Citizen's Health Center, etc. The chief personnel of those departments are nurses. but 27.4% of PHCs have no full time nurse for hypertension management programs. PHCs had a lot of teaching materials (nine types per a PHC) and most of the recommended contents were included. But, periodical evaluation and revision were not being made, 2) Management: Nurses' (13.03 9.46 in 23 score) actions for hypertension control were not qualitative, but regular training and evaluation were seldom carried out. Need assessment (25.9%) and evaluation (about 10-20%) for the hypertension control program were indicated as low. 3) Programs: Programs focused on individuals rather than community or public, and 2nd prevention rather than 1st, 3rd prevention. Conclusion: The Ministry of Health and Welfare has to construct the infrastructure for hypertension control programs. Related scholars and committees should develop and declare standardized manuals for hypertension control and the management system, as well.

• 보건교육건강증진학회지
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• 제30권4호
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• pp.111-123
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• 2013

Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

• 한국농촌간호학회지
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• 제6권1호
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• pp.33-43
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• 2011

Purpose: This study was done to verify the effects of a self-regulation program for management of hypertension. Method: Thirty patients with hypertension registered in a community health center were selected as the experiment group, and control group were patients in another community health center, matched for age and gender. The self-regulation program included daily blood pressure checks, periodic counseling, and health education. A self-check digital device with instructions was provided for self-monitoring of blood pressure, and the participants were interviewed before they took part in the program. Results: The first hypothesis was supported: There will be a greater reduction in both systolic and diastolic blood pressure for patients with hypertension who participate in the self-regulation program compared to patients in the control group. The second hypothesis was also supported: Patients with hypertension who participate in the self-regulation program will perform self-care activities better than those in the control group. Conclusion: The findings indicate that a self-regulation program reduces systolic and diastolic blood pressure and improves self-care in patients with hypertension. It is recommended that this self-regulation program be used in community health clinics for management of hypertension and prevention of complications.

• 대한지역사회영양학회지
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• 제16권5호
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• pp.580-591
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• 2011

This research was performed to investigate the effects of NEP (Nutritional Education Practice) program developed by KHyDDI (Korea Hypertension Diabetes Daegu Initiative) for hypertension and diabetes patients. The subjects were 116 patients (hypertension 70, diabetes 46) who had completed basic education program at the education information center and four-session program was implemented for them. Nutrient intake was analyzed and compared before and after the program by 24-hr recall method and evaluate weight, waist circumference, body fat, blood pressure and eating habits in terms of nutrition knowledge, eating behavior, salty taste assessment. The improved results after the program were observed in weight, waist circumference, body fat ratio, blood pressure, slightly salty taste in salty taste assessment, nutrition knowledge, eating behavior, sodium, energy, carbohydrate and protein intake ratio to total energy (p < 0.001). Therefore, this program is effective in the improvement of weight, waist circumference and eating behavior, and the continued management would lead to the prevention of cardio-cerebrovascular diseases in the community.

• 농촌의학ㆍ지역보건
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• 제31권3호
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• pp.237-244
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• 2006

이 연구에서는 고혈압 위험군을 대상으로 8주간의 개인별 맞춤형 DASH 식이 교육을 수행하여 고혈압 식단 관련 지식수준과 DASH 식단 실천정도, 혈압 조절 효과를 분석하고자 하였다. 프로그램 대상은 고혈압 발생 위험군으로 JNC에서 정의한 고혈압전단계로 정의한 수축기압이 120-139 mmHg, 또는 이완기혈압이 80-89 mmHg인 경우와, 체질량지수가 25이상인 경우, 그리고 허리둘레와 엉덩이둘레의 비율이 남자 0.95이상, 여자 0.85이상인 경우 중 어느 하나를 만족하는 경우로 하였다. 연구는 강원도 C시에서 2002년-2003년 주민 건강행태 및 건강조사 대상 중 기준에 해당하는 경우와 보건소 및 보건지소에서 외래 환자 중 해당자를 포함하였으며 8주 교육에 참가한 141명에 대하여 효과분석을 수행하였다. 교육프로그램 적용 후 지식수준 및 DASH 식습관 실천정도가 유의하게 증가하였으며 수축기압은 참여 전 $136.03{\pm}12.40mmHg$, 프로그램 참여 후 $126.09{\pm}11.25mmHg$로 프로그램 참여 후의 평균 혈압이 낮아졌으며 이완기 혈압 또한 프로그램 참여 전 $81.80{\pm}6.32mmHg$, 프로그램 참여 후 $76.44{\pm}10.61mmHg$로 통계적으로 유의한 감소를 나타냈다. 고혈압 환자의 혈압 조절을 위한 노력뿐 아니라 고혈압 예방을 위한 보건사업이 필요하며, 이 경우 DASH 프로그램은 효과적인 교육도구로 적용될 수 있다. 향후 관련된 교육 프로그램의 개발과 프로그램 적용이 지역사회를 대상으로 소개되고 확대 적용되기를 기대하는 바이다.

• 보건교육건강증진학회지
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• 제27권5호
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• pp.41-50
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• 2010

목적: 한국 농촌지역에 있는 보건진료소에서 수행하고 있는 고혈압 예방 및 관리 사업 평가도구를 개발하고, 이를 활용하여 현장에서 수행되고 있는 프로그램을 평가하고자 한다. 방법: 문헌고찰, 현장방문과 보건진료소에서 근무하는 보건진료원과의 심층면담을 통해 예비문항을 작성하고, 전문가(중앙기관의 업무행정담당자 5인, 보건진료원 6인, 이론과 연구전문가 5인)집단을 통해 2회 내용타당도 검정을 실시하였다. 전문가들에 의해 80%이상 동의한 항목만을 선정한 결과, 4개 영역, 12개 항목, 41개 세부평가 항목으로 구성된 평가도구가 완성되었다. 4개 영역은 고혈압 예방사업, 고혈압 관리사업, 사업여건조성, 자체평가로 분류되었고. 고혈압 예방사업 영역은 보건교육, 고혈압환자 조기발견 항목이 포함되었고, 고혈압 관리사업 영역은 고혈압환자 등록 및 관리사업, 교육 및 상담, 고혈압환자 치료 및 추구관리 항목이 포함되었다. 사업여건조성 영역은 지역주민의 접근성, 보건교육자료의 비치, 홍보 항목이 있고, 자체평가는 사업계획서 수립, 중간평가, 결과평가 항목으로 구성하였다. 영역별 가중치는 전문가타당도 검정을 통해 각기 다르게 설정하였으며, 연구대상은 전국 보건진료소를 모집단으로 비례층화추출법에 의해 700개소를 선정하였다. 연구의 윤리적인 측면을 고려하여 설문지 표지에 연구에 대한 구체적인 소개, 익명성보장과 자발성을 제시하고 자가 보고식의 우편설문조사를 실시하였다. 최종적으로 215개의 설문지를 자료 분석에 활용하였다. 결과: 영역별 평가결과에 의하면 고혈압 관리 사업이 평균 28.81점(72%), 고혈압 예방사업은 평균 23.44점(67%), 사업여건조성이 평균 4.29점(43%), 자체평가 5.10점(34%) 순으로 나타났다. 항목별 평가에서 가장 낮은 결과를 보인 것은 보건교육을 위한 교육매체 보유, 공식적인 연계망, 고혈압사업의 여건조성을 위한 물리적 환경조성과 사업결과로 나타났다. 결론: 보건진료소에서 실시하고 있는 고혈압 예방 및 관리 사업을 좀 더 효과적으로 수행하기 위해서는 사업여건 조성과 자체평가 영역을 향상시켜야 할 것으로 사료된다.

• 보건행정학회지
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• 제33권1호
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• pp.3-18
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• 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.

• 한국보건교육건강증진학회:학술대회논문집
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• 한국보건교육건강증진학회 2001년도 제4회 국제학술 심포지움
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• pp.1-9
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• 2001

Health Insurance System in Korea was introduced in 1977 and expanded health insurance benefits for all people in 1989. The development of medical service and technology takes a growing concerning for public health and medicine. And also, it helps to extend the average life span of Koreans. Therefore, the old people are steadily increased over seven percent of total population and will take more than 14% in 2023. Generally, the old people have the chronic disease such as diabetes and hypertension. Also, smoking, stress, environmental pollution and lack of exercise, leading cause of cancer, cardiovascular disease and respiratory infections have affected to state economy negatively. Therefore, health promotion law was established for a variety of health promotion process, including education, program implementation and community development. The goals and strategies for health promotion are as following: . Practice of healthy life: - Strengthen publicity activities on smoking and exercise. - Program development for nonsmoking and exercise. - Program extent for community health. Strengthen of mental health: - Planning of national survey for mental patient. - Prevention of alcoholism - Setting up special hospital for alcoholism . Constant cancer management under government - Developing medical treatment and prevention program. - Early diagnosis for the whole nation . Management of chronic disease - Strengthen of Prevention Program . Reinforcing of oral health - A national survey of oral health - Oral health education