• 농촌의학ㆍ지역보건
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• 제17권1호
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• pp.34-45
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• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• KDI Journal of Economic Policy
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• 제12권3호
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• pp.47-69
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• 1990

한국(韓國)의 의료보험제도(醫療保險制度)는 일본제도(日本制度)를 거울삼아 서둘러 적용대상자(適用對象者)를 확대하여 1989년 전국민의료보험(全國民醫療保險)을 달성하였으나 제도(制度)와 효율적(效率的) 운영(運營)을 위한 장치가 결여되어 있고 직장(職場), 공교(公敎), 지역의보간(地域醫保間)에 형평문제(衡平問題) 제기되는 등 구조적인 과제를 안고 있다. 앞으로 제도(制度)의 개혁추진(改革推進) 노력으로 이 분야의 정책수립(政策樹立)과 집행(執行) 에 있어서 경직성을 줄이고 비용효과적(費用效果的)인 의료이용(醫療利用)을 도모해 나가지 못할 경우 낭비요인(浪費要因)이 점점 더 크게 불어나 국민의료비(國民醫療費)가 계속적으로 급속히 증대될 전망이다. 이와 같은 제도(制度)의 질적개선(質的改善)의 필요성에 비추어 최근 네덜란드가 시도하고 있는 제도개혁(制度改革)은 우리에게 여러가지 귀중한 교훈을 던져주고 있다고 판단된다. 네덜란드의 개혁안은 시장경쟁원리(市場競爭原理)를 폭넓게 수용하여 제도(制度)의 능률(能率)을 높이고 의료비(醫療費)를 절감하려는 취지를 담고 있다. 특히 의보가입자(醫保加入者)가 보험자(保險者)를 선택할 수 있고 또한 보험자(保險者)가 의료기관(醫療機關)을 선택할 수 있도록 관계(關係) 집단간(集團間) 상호경쟁(相互競爭)을 유도함으로써 효율(效率)을 증진시켜 나가겠다는 정책방향이 뚜렷히 제시되고 있어 우리의 주목을 끌고 있다.

• 한국안광학회지
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• 제5권1호
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• pp.165-171
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• 2000

본 조사는 경북 농촌지역의 백내장 분포를 알아보기 위하여 실시하였다. 백내장은 전 세계적으로 설명과 시력장애의 주원인일 뿐 아니라 노인인구의 증가로 인해 백내장 환자의 수는 현저하게 증가하였다. 이러한 추세에도 불구하고 백내장으로 인해 심하게 시기능이 저하된 상태에 있으면서도 안과적 진단 기회를 얻지 못하고 있는 환자들이 아직도 많이 있다. 이런 환자들의 선별과 분포조사를 위해 경북 칠곡과 문경 지역에서 일반 건강검진을 희망한 50세 이상 주민 636명(1272안)을 대상으로 최근 일본 Kanazawa 의과대학의 Sasaki 등이 제안한 간편한 백내장 일차선별검사를 적용하여 다음과 같은 결과를 얻었다. 전체 조사대상자 중 시력장애를 호소한 사람은 모두 493명(77.5%)이었다. 제1단계 선별검사로 448명(90.9%), 제2단계 선별검사로 308명(48.4%)의 백내장이 의심되는 시력불량군을 분류하였고, 제1, 2단계일차 선별검사에 의해 최종적으로 백내장으로 분류된 사람의 수는 421명(66.2%)이었다. 연령에 따른 유병율은 50대 27.5%, 60대 62.5%, 70대 86.1%, 80세 이상 94.3%이었다. 따라서 백내장이 실명과 시력장애의 주원인 일 뿐 아니라 국내에서도 공중보건분야의 중요한 문제인 만큼 적절한 관리와 안보건 대책이 요구되며 특히 안보건을 위한 의료활동이 농촌지역에까지 확대되어야 할 것으로 사료되었다.

• 간호행정학회지
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• 제6권3호
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• pp.333-345
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• 2000

The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

• 치위생과학회지
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• 제9권1호
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• pp.69-74
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• 2009

본 연구는 보건의료정책에 관한 주요 언론의 선거보도를 분석하기 위하여 17대 대선과 18대 총선 기간 중 지상파 방송인 KBS, MBC, SBS의 메인 뉴스와 조선일보, 중앙일보, 동아일보, 한겨레에서 보도된 선거 기사 2,624 건을 SPSS Program을 이용하여 분석하여 다음과 같은 결론을 얻었다. 1. 17대 대선과 18대 총선 기간에 주요 언론에서 보도한 기사 중 판세중심의 보도가 35.6%로 가장 많았고, 정책중심의 보도기사는 10.8%로 가장 낮게 보도되었다. 2. 주요 언론사별 정책 중심기사를 살펴보면, 다른 언론사에 비하여 KBS와 한겨레에서 보다 많은 정책중심기사가 보도되었다. 3. 보도된 284건의 정책중심기사 중에서도 사회분야가 75건(26.4%), 경제분야가 73건(25.7%)으로 전체 정책기사 중 50%이상이었고, 그 중 9.9%(28건)만이 보건의료 정책에 관한 기사였다. 4. 보도된 보건의료정책 관련기사를 크게 의료비 관련, 건강보험제도 관련, 노인보건 관련, 보건복지 관련항목으로 나누어 분석한 결과 그 중 의료비와 관련된 기사가 39.3%로 가장 많이 보도되었다. 이상의 결론으로 종합하면, 17대 대선과 18대 총선 기간에 주요 언론에서 보도된 보건의료정책에 관한 기사는 매우 적었고, 그 내용도 의료비와 노인보건과 관련된 특정부분에 치우쳐 있었다. 따라서 보건의료에 관한 주요한 정책문제를 해결하기 위해서는 보건의료정책의 개발과 더불어 개발된 정책이 정책 의제화 되어 구현될 수 있도록 언론의 효율적 활용을 위한 노력이 필요할 것으로 사료된다.

• 한국비블리아학회지
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• 제27권4호
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• pp.105-123
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• 2016

본 연구는 영국, 미국, 우리나라에서 많이 사용되는 독서치료 도서목록에 수록된 성인 대상 독서치료용 도서의 스펙트럼을 분석한다. 영미권 독서치료 도서목록이 독서치료를 주관하는 기관이나 단체에 따라 구성상의 다양성을 보이는 것에 비해 우리나라의 성인용 독서치료 도서는 주관 기관에 따른 차이 없이 논픽션이 압도적인 비중을 차지한다. 세부적인 카테고리에서 영미권 대학 및 공공기관의 독서치료 추천도서목록에서 가장 높은 순위를 차지하는 논픽션 도서는 의학 서적을 포함하는 "건강, 운동, 다이어트" 관련 도서이며, 이것은 이들 기관에서 독서치료가 임상적 치료 효과가 있는 어느 정도 전문적인 영역으로 인정받고 있음을 보여준다. 반면에 우리나라의 독서치료 도서목록에 수록된 도서들은 인문(심리), 자기계발, 문학(에세이) 등 이른바 "자기계발 이데올로기와 결합한 심리학 서적"이 60% 이상을 차지한다. 연구자는 독서치료가 정신의학, 심리학, 문헌정보학, 인문학적 배경을 바탕으로 하는 학제적 실천이라는 인식 하에, 독서치료가 인문학적 통찰에 의존함으로써, 참자가들에게 단순히 책을 읽고 문제적 상황이나 증상 이전의 상태를 회복하게 하는 것이 아니라 삶과 세계에 대한 깊은 성찰을 통하여 내적으로 성숙한 인간으로 변모하는 데 도움을 주어야 한다고 제안한다.

• 성인간호학회지
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• 제12권4호
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• pp.606-618
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• 2000

The purpose of the study was to investigate the characteristics of the clients registered in the department of home health care nursing in a hospital and to analyze nursing intervention activities recorded in charts by application of Nursing Intervention Classification (NIC) system. For the descriptive survey study, data were collected by reviewing charts of 572 home health care clients between May, 1997 and July, 2000 at K hospital in Seoul. The average age of the clients was 66 years and the number of clients in their 70s ranked first with 28.2 percent(158 people). The mean length of home care service was 47 days with the highest frequency of less than four weeks (56 %). With regard to medical diagnosis, cancer showed the highest frequency (48%, 271 people), followed by cerebrovascular disease (19%), and pulmonary disease (6.9%). According to analysis of nursing interventions by the NIC system, the most frequently used nursing interventions in level 1 were interventions in the Physiological: Complex domain which were used 3,663 times (33%) among 11,107 total interventions. The Safety domain was the second most frequently used intervention, followed by the Physiological: Basic, and the Behavioral domains. In level 2, the Risk Management class was the most frequently used interventions with 3,108 interventions (27.9%), followed by Drug Management, and Tissue Perfusion Management classes. In level 3 interventions, Vital Sign Monitoring was the most frequently used intervention, 569 times (5.1%), followed by Health Screening, and Neurological Monitoring interventions. In sum, half of the clients in the study had cancer and were in their 70s. The most frequent reason for ending home care was death (40%), followed by readmission (28%). These findings represent clients with severe conditions referred to the home care nursing department as it was a University teaching hospital. Further research on analyzing nursing interventions performed in each institution needs to be conducted to develop a standardized list of nursing interventions to use in home health care settings.

• 대한간호학회지
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• 제29권4호
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• pp.880-891
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• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• 한국재난정보학회 논문집
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• 제1권1호
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• pp.3-26
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• 2005

In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.

• 한국문헌정보학회지
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• 제45권2호
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• pp.415-437
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• 2011

소비자건강정보(CHI)에 대한 관심 증가로 소비자건강정보원이 급격하게 증가하였고, 정보획득방법도 매우 다양해졌으며, CHI 획득경로 중의 하나가 공공도서관이다. 공공도서관에서의 CHI에 대한 참고서비스 요구는 점점 증가하고 있고, 미국에서는 공공도서관에서의 CHI 서비스 증진을 위해 다양한 프로젝트가 진행되었다. 반면에 국내 공공도서관에서의 CHI서비스는 매우 기본적인 수준이고 관련연구도 그다지 많지 않음을 발견할 수 있었다. 이에 본 연구에서는 선행연구분석 및 해외 공공도서관에서의 CHI서비스 사례분석을 통해 시사점을 도출하고 국내 공공도서관에서의 CHI 서비스 현황을 분석하였다. 연구결과 첫째, 국내 공공도서관에서 CHI 서비스 제공비율은 17.25%로 나타나 CHI서비스에 대한 요구나 서비스 제공에 대한 인식은 매우 낮은 것으로 분석되었다. 둘째, CHI 제공방법의 다양성을 조사했을 때, CHI 관련 웹사이트 제공, 이용자대상 교육, 그리고 홍보 및 마케팅 등 세 가지 서비스만을 제공하고 있는 것으로 나타났고, 이중 2가지 이상의 서비스를 제공하는 도서관은 13개의 도서관(1.74%)으로 조사되었다. 셋째, CHI 담당사서는 없는 것으로 조사되었고, 공공도서관 사서가 CHI 관련 교육을 받지 못하고 있는 것으로 조사되었다. 넷째, 아웃리치서비스나 ILL 서비스, 의료기관을 포함한 관련기관과의 협력네트워크 구축 등과 관련된 CHI 서비스는 전혀 발견할 수 없었다. 본 연구결과는 국내 공공도서관에서의 CHI서비스 제공방안에 대한 연구가 활성화되어야 함을 시사한다.