심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가 (Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients)
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- 농촌의학ㆍ지역보건
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- 제37권3호
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- pp.167-180
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- 2012
본 연구는 대구광역시 심뇌혈관질환 고위험군 등록관리 시범사업단 고혈압 당뇨병 교육정보센터를 방문한 고위험군환자와 교육자의 교육요구도를 반영하여 질환, 영양, 운동 3영역의 기본, 심화, 개별 3단계로 단계별 교육프로그램을 개발하였다. 이 프로그램의 효과평가를 위하여 교육정보센터에 방문한 기본교육군 32명, 단계교육군 37명을 대상으로 교육 전후 임상적 지표, 행동변화단계, 자아효능감을 측정하였고 주요 연구결과는 다음과 같다. 교육요구도조사결과 고위험군과 교육자의 요구도가 높은 소그룹형태, 30분-1시간이내 수업 및 이론 50%와 실습 50%의 구성과 형태로 이루어지며 3개월의 교육과정인 질환, 영양, 운동영역의 단계 교육프로그램을 개발하였다. 교육요구도조사 결과 교육영역별 교육내용은 고위험군과 교육자의 필요도와 지식정도의 통계적으로 유의한 차이에 따라 5가지 범주로 분류하여 프로그램 구성에 적용할 수 있었다. 첫째, 고위험군과 교육자간의 요구도에 유의한 차이가 없는 항목은 기본과정내용으로 반복하게 하였고 둘째, 고위험군의 인지도가 평균점수 이하인 항목은 기본교육과정내용을 조정하여 효과적인 실습방법으로 모든 단계에서 반복할 수 있도록 하였다. 셋째, 고위험군의 지식정도 평균 편차가 큰 항목은 개별교육과정에 포함시켜 문제를 해결할 수 있는 기술습득을 목표로 이루어지도록 하였다. 넷째, 고위험군과 교육자간 지식정도의 유의한 차이가 있는 항목과 다섯째, 고위험군과 교육자간 요구도에서 유의한 차이가 있는 항목은 고위험군의 참여도가 높은 실습 중심의 심화교육으로 구성하며 교육자도 표준 매뉴얼에 따라 교육방법, 교육환경을 일관성 있게 유지하도록 교육훈련을 강화하여 교육자 간 격차를 줄이도록 하였다. 교육자와 고위험군과의 격차를 줄이기 위하여 자가관리 목표, 단기 계획 설정을 고위험군과 교육자 상호약속에 의해서 계획하여 실천동기와 문제해결능력을 향상시키도록 하는 과정을 단계마다 필수적으로 포함시켰다. 교육프로그램의 평가는 기본교육군, 단계교육군을 대상으로 임상적 지표, 행동변화단계 자기 효능감을 측정하여 비교하였다. 임상지표 중 허리둘레, 수축기혈압, 이완기혈압(p<0.05), 자기효능감 중 혈압/혈당조절 불량시 병원방문, 의사의 지시에 따라 약 복용, 식사량 일정유지(p<0.05), 정기적으로 합병증 검사, 정상적인 혈압/혈당을 유지, 허리둘레 유지, 체중 유지(p<0.01), 행동변화단계에서는 싱겁게 먹기(p<0.05)에서 유의적인 차이가 있었다. 환자와 교육자의 교육요구도를 반영하여 개발된 실습 중심의 단계별 교육프로그램은 이론중심의 기본교육프로그램과 비교한 결과 임상지표, 자기효능감, 행동변화단계에서 유의한 차이가 있었다. 대상자 수가 적고 추구관리기간이 짧았으며 임상지표측정이 부족했던 한계점은 있으나 환자가 노인이며 만성질환환자로서 유병기간이 긴 점을 감안하면 이 프로그램을 지속적으로 시행한다면 환자의 심뇌혈관질환 예방에 기여할 수 있을 것이다.
At the initial stage of Internet advertising, banner advertising came into fashion. As the Internet developed into a central part of daily lives and the competition in the on-line advertising market was getting fierce, there was not enough space for banner advertising, which rushed to portal sites only. All these factors was responsible for an upsurge in advertising prices. Consequently, the high-cost and low-efficiency problems with banner advertising were raised, which led to an emergence of keyword advertising as a new type of Internet advertising to replace its predecessor. In the beginning of 2000s, when Internet advertising came to be activated, display advertisement including banner advertising dominated the Net. However, display advertising showed signs of gradual decline, and registered minus growth in the year 2009, whereas keyword advertising showed rapid growth and started to outdo display advertising as of the year 2005. Keyword advertising refers to the advertising technique that exposes relevant advertisements on the top of research sites when one searches for a keyword. Instead of exposing advertisements to unspecified individuals like banner advertising, keyword advertising, or targeted advertising technique, shows advertisements only when customers search for a desired keyword so that only highly prospective customers are given a chance to see them. In this context, it is also referred to as search advertising. It is regarded as more aggressive advertising with a high hit rate than previous advertising in that, instead of the seller discovering customers and running an advertisement for them like TV, radios or banner advertising, it exposes advertisements to visiting customers. Keyword advertising makes it possible for a company to seek publicity on line simply by making use of a single word and to achieve a maximum of efficiency at a minimum cost. The strong point of keyword advertising is that customers are allowed to directly contact the products in question through its more efficient advertising when compared to the advertisements of mass media such as TV and radio, etc. The weak point of keyword advertising is that a company should have its advertisement registered on each and every portal site and finds it hard to exercise substantial supervision over its advertisement, there being a possibility of its advertising expenses exceeding its profits. Keyword advertising severs as the most appropriate methods of advertising for the sales and publicity of small and medium enterprises which are in need of a maximum of advertising effect at a low advertising cost. At present, keyword advertising is divided into CPC advertising and CPM advertising. The former is known as the most efficient technique, which is also referred to as advertising based on the meter rate system; A company is supposed to pay for the number of clicks on a searched keyword which users have searched. This is representatively adopted by Overture, Google's Adwords, Naver's Clickchoice, and Daum's Clicks, etc. CPM advertising is dependent upon the flat rate payment system, making a company pay for its advertisement on the basis of the number of exposure, not on the basis of the number of clicks. This method fixes a price for advertisement on the basis of 1,000-time exposure, and is mainly adopted by Naver's Timechoice, Daum's Speciallink, and Nate's Speedup, etc, At present, the CPC method is most frequently adopted. The weak point of the CPC method is that advertising cost can rise through constant clicks from the same IP. If a company makes good use of strategies for maximizing the strong points of keyword advertising and complementing its weak points, it is highly likely to turn its visitors into prospective customers. Accordingly, an advertiser should make an analysis of customers' behavior and approach them in a variety of ways, trying hard to find out what they want. With this in mind, her or she has to put multiple keywords into use when running for ads. When he or she first runs an ad, he or she should first give priority to which keyword to select. The advertiser should consider how many individuals using a search engine will click the keyword in question and how much money he or she has to pay for the advertisement. As the popular keywords that the users of search engines are frequently using are expensive in terms of a unit cost per click, the advertisers without much money for advertising at the initial phrase should pay attention to detailed keywords suitable to their budget. Detailed keywords are also referred to as peripheral keywords or extension keywords, which can be called a combination of major keywords. Most keywords are in the form of texts. The biggest strong point of text-based advertising is that it looks like search results, causing little antipathy to it. But it fails to attract much attention because of the fact that most keyword advertising is in the form of texts. Image-embedded advertising is easy to notice due to images, but it is exposed on the lower part of a web page and regarded as an advertisement, which leads to a low click through rate. However, its strong point is that its prices are lower than those of text-based advertising. If a company owns a logo or a product that is easy enough for people to recognize, the company is well advised to make good use of image-embedded advertising so as to attract Internet users' attention. Advertisers should make an analysis of their logos and examine customers' responses based on the events of sites in question and the composition of products as a vehicle for monitoring their behavior in detail. Besides, keyword advertising allows them to analyze the advertising effects of exposed keywords through the analysis of logos. The logo analysis refers to a close analysis of the current situation of a site by making an analysis of information about visitors on the basis of the analysis of the number of visitors and page view, and that of cookie values. It is in the log files generated through each Web server that a user's IP, used pages, the time when he or she uses it, and cookie values are stored. The log files contain a huge amount of data. As it is almost impossible to make a direct analysis of these log files, one is supposed to make an analysis of them by using solutions for a log analysis. The generic information that can be extracted from tools for each logo analysis includes the number of viewing the total pages, the number of average page view per day, the number of basic page view, the number of page view per visit, the total number of hits, the number of average hits per day, the number of hits per visit, the number of visits, the number of average visits per day, the net number of visitors, average visitors per day, one-time visitors, visitors who have come more than twice, and average using hours, etc. These sites are deemed to be useful for utilizing data for the analysis of the situation and current status of rival companies as well as benchmarking. As keyword advertising exposes advertisements exclusively on search-result pages, competition among advertisers attempting to preoccupy popular keywords is very fierce. Some portal sites keep on giving priority to the existing advertisers, whereas others provide chances to purchase keywords in question to all the advertisers after the advertising contract is over. If an advertiser tries to rely on keywords sensitive to seasons and timeliness in case of sites providing priority to the established advertisers, he or she may as well make a purchase of a vacant place for advertising lest he or she should miss appropriate timing for advertising. However, Naver doesn't provide priority to the existing advertisers as far as all the keyword advertisements are concerned. In this case, one can preoccupy keywords if he or she enters into a contract after confirming the contract period for advertising. This study is designed to take a look at marketing for keyword advertising and to present effective strategies for keyword advertising marketing. At present, the Korean CPC advertising market is virtually monopolized by Overture. Its strong points are that Overture is based on the CPC charging model and that advertisements are registered on the top of the most representative portal sites in Korea. These advantages serve as the most appropriate medium for small and medium enterprises to use. However, the CPC method of Overture has its weak points, too. That is, the CPC method is not the only perfect advertising model among the search advertisements in the on-line market. So it is absolutely necessary that small and medium enterprises including independent shopping malls should complement the weaknesses of the CPC method and make good use of strategies for maximizing its strengths so as to increase their sales and to create a point of contact with customers.