• 보건교육건강증진학회지
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• 제24권3호
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• pp.99-118
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• 2007

There are little program and services that have been developed to address the health and health care needs of vulnerable women. The access for their timely and appropriate health care and health promotion services have been a increasing concern. The purpose of this study was to suggest health promotion program for vulnerable women with collaboration of women's NGOs. At the first part of this study, we reviewed a conceptual framework for identifying vulnerable population, and issues regarding health problems, unmet needs, policies and programs that have been developed to address their need. In second part, we focused on investigating the role, subjects and activities of women's NGOs and their capacity for health promotion program. The last part of this study proposed health promotion programme with integrating above two parts of study. In describing what type of health promotion program available in women's NCOs, eight major programs and services were summarized. 1. Direct health promotion program and collaborating program with other services. 2. Education and training for empowerment of vulnerable women 3. Organizing mutual support system such as self-help group 4. Community supports. Vulnerable women living at home may benefit from linkage to community services as much as women living in facility 5. Organizing collaboration system with program for economic support and job training, social rehabilitation 6. Trainer's training for practitioners in NGOs 7. Technical, informational support from professional groups 8. A national coordinating policies for vulnerable population should be established at the central level. National support for NGOs' health promotion program are needed hi solving unmet needs of vulnerable women.

• 보건행정학회지
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• 제33권2호
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• pp.118-128
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• 2023

Background: Personal socio-economic abilities are crucial as it affects health inequalities. These multidimensional inequalities across the regions have been structured and fixed. This study aimed to analyze health vulnerabilities by regional cluster and identify regional health disparities of self-rated health, using nationally representative cross-sectional data. Methods: This study used personal and regional data. Data from the Community Health Survey 2021 were analyzed. K-means cluster analysis was applied to 250 si-gun-gu using administrative regional data. The clusters were based on three areas: physical environment, health-related behaviors and biological factors, and the psychosocial environment through the conceptual framework for action on the social determinants of health. And binary logistic regression analyses were conducted to examine the differences in self-rated health status by the regional clusters, controlling human biology, environment, lifestyle, and healthcare organization factors. Results: The most vulnerable group was group 3, the moderate vulnerable group was group 1, and the least vulnerable group was group 2. The group 2 was more likely to have high self-rated health status than the moderate vulnerable group (odds ratio [OR], 1.023; p<0.001). And the group 3 showed low self-rated health status than the moderate vulnerable group (OR, 0.775; p<0.001). However, the moderate vulnerable group had significantly higher self-rated health status than the most vulnerable group (group 2: OR, 1.023; p<0.001; group 3: OR, 0.775; p<0.001). Conclusion: These results demonstrate that community members' health status is influenced by regional determinants of health and individual levels. And these contribute to understanding the importance of specific and differentiated interventions like locally tailored support programs considering both individual and regional health determinants.

• 한국산학기술학회논문지
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• 제15권5호
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• pp.2882-2892
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• 2014

본 연구는 재가 취약계층 여성 노인을 대상으로 한 우울 자살예방 프로그램을 개발하고 그 효과를 검증하여 지역사회에서 용이하게 활용할 수 있는 프로그램을 보급하고자 하는 데 그 목적을 두고 있다. 우울 자살예방 프로그램은 인지행동 이론에 기초하고, 선행연구결과를 토대로 연구자들에 의해 개발되었다. 프로그램의 효과는 시계열설계를 이용한 실험연구설계로 12명의 재가 여성노인을 대상으로 검증하였다. 우울 자살예방 프로그램을 적용한 결과 중재 직전에 비해 중재 직후에는 대상자의 우울, 자살생각, 무망감 수준에서 통계적으로 유의한 변화가 없었으나, 중재 직전에 비해 중재 4주 후에는 우울, 자살생각, 무망감 수준에서 통계적으로 유의한 변화가 나타났다. 이상 결과에 근거하여 지역사회 정신건강증진센터 또는 복지관의 종사자들이 본 프로그램을 적극 활용할 것을 제언한다.

• 지역사회간호학회지
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• 제26권4호
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• pp.390-397
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• 2015

Purpose: The purpose of this study was to explore practice-based evidence for health promotion in vulnerable populations with hypertension in primary health care settings. Methods: Two methodological procedures were adopted for this triangulation study. In the first phase, the sample was obtained from the computerized clinical data repository of a community nursing center. A total of 286 clients were assessed for hypertension as an actual circulation problem as coded in the Omaha System. In the second phase, a qualitative focus group was surveyed through semi-structured interviews conducted by nine advanced practice nurses who had been serving the hypertensive patients. Results: The community nurses provided essential primary healthcare services including health teaching guidance and counseling, and surveillance to vulnerable populations living in medically underserved community. There was a significant positive correlation between knowledge and behavior (r=.53, p<.01), between knowledge and health status (r=.40, p<.05), and between behavior and health status (r=.48, p<.01). Conclusion: This triangulation study encompassed not only quantitative findings from the computerized records of clients but also other information acquired from advanced practice nurses. This study contributes to understanding the importance of health promotion nursing interventions even with populations already diagnosed with chronic diseases such as hypertension.

• 지역사회간호학회지
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• 제22권4호
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• pp.438-450
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• 2011

Purpose: This study was to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit perspective. Methods: Target participants were enrolled in 2007~2008 for home visiting care and provided with a home visiting nursing service for more than 18 months in J Ward of S City. Of 391 participants, 244 who satisfied the inclusion criteria were used in the final analysis. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: After providing the home care nursing service, the blood pressure control rate increased from 50.8% to 75.4%. Of the subjects, 39.8% maintained their blood pressure level within the target range. As a whole, the net benefit of home visiting care per person ranged from 434,964.86 to 447,112.43 won and the benefit/cost ratio ranged from 2.82 to 2.84. Conclusion: Home visiting care for vulnerable populations with hypertension was effective in both maintaining blood pressure and reducing blood pressure to the target range. Therefore these results are especially useful for establishing the value of home visiting services for policy makers as well as for prioritizing vulnerable populations.

• 지역사회간호학회지
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• 제20권3호
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• pp.335-342
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• 2009

Purpose: This study was to identify the degree of the sense of mastery and health-promoting behaviors in the vulnerable female elderly of urban areas, and to determine factors influencing their health-promoting behaviors. Methods: The subjects were 253 vulnerable female elders aged over 60 in D City. Data were collected by a questionnaire survey. Analysis of data was done with the SPSS/WIN program. Results: The mean score of the sense of control was 15.8. It was significantly different according to living arrangement, and subjective health status. The mean score of health-promoting behavior was 3.8. It was significantly different according to living arrangement and subjective health status. Health-promoting behavior was affected more highly in subjects with a low degree of sense of mastery than in those with a medium degree of sense of mastery. Conclusion: These results suggest that the sense of mastery is an important variable for health-promoting behavior. These findings may give useful information for developing health-promoting programs focused on the sense of mastery in vulnerable female elderly adults.

• 지역사회간호학회지
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• 제14권4호
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• pp.587-597
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• 2003

Purpose: The purpose of this study was to estimate the demand and supply of visiting nursing services provided by health centers in urban area, aiming at strengthening infrastructure, which may improved the quality of life and health status of vulnerable population in the community. Methods: This study was conducted through nominal group discussion, focus group study. The demand and supply of visiting nursing were estimated by health economists based on the secondary analysis data from 25 health centers in Seoul. Result: Primary targets for the visiting nursing must be people who are homebound in the community. They can be classified into: a group of Level I: chronic patients who need visiting nursing care at least once a week: and a group of Level II: vulnerable families that need management periodically e. g. twice a month. Based on the estimation of demand for visiting nursing services in the community, the estimated supply required was $651{\sim}770$ visiting nurses including home health nurses in visiting nursing programs based on health centers in Seoul. Conclusions: The estimated demand and supply of visiting nursing are expected to provide basic data for establishing alternative policies on visiting nursing infrastructure that might be accomplished through demand-based visiting nursing programs by districts.

• 한국측량학회지
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• 제38권5호
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• pp.487-496
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• 2020

This study introduces how GISs (Geographic Information Systems) are used to assess spatial disparities in urban green spaces in the Chicago. Green spaces provide us with a variety of benefits, namely environmental, economic, and physical benefits. This study seeks to explore socioeconomic relationships between green spaces and their surrounding communities and to evaluate spatial disparities from a variety of perspectives, such as health-related, socioeconomic, and physical environment factors. To achieve this goal, this study used spatial statistics, such as optimized hotspot analysis, network analysis, and space-time cluster analysis, which enable conclusions to be drawn from the geographic data. In particular, 12 variables within the three factors are used to assess spatial disparities in the benefits of the use of green spaces. Finally, the variables are standardized to rank the community areas and identify where the most vulnerable community areas or parks are. To evaluate the benefits given to the community areas, this study used the z- and composite scores, which are compared in the three different combinations. After identifying the most vulnerable community area, crime data is used to spatially understand when and where crimes occur near the parks selected. This work contributes to the work of urban planners who need to spatially evaluate community areas in considering the benefits of the uses of green spaces.

• 농촌의학ㆍ지역보건
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• 제43권3호
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• pp.147-157
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• 2018

본 연구는 취약계층노인의 건강정보원 탐색현황파악하고, 인구사회학적 특성을 통제한 상태에서 건강정보원의 탐색정도가 건강정보 이해능력에 미치는 정도를 파악하고자 하였다. 연구수행을 위해 지역사회의 종합사회복지관에 방문하는 200명의 취약노인을 대상으로 설문조사를 실시하여 이루어졌다. 설문조사의 분석방법으로는 빈도분석, 교차분석 및 다중로지스틱회귀분석을 사용하였으며 IBM SPSS 24.0을 활용하여 분석하였다. 본 연구의 결과 취약노인계층의 건강정보원탐색 중 인터넷을 통한 탐색이 극히 적음을 확인했다. 그리고 월별수입(OR=2.201, p<.05)과 건강정보원 탐색정도(OR=2.989, p<.01)는 건강정보이해능력에 유의미한 영향을 미치는 것으로 나타났다. 이 결과는 노인들의 건강정보 이해능력의 향상을 위해 건강정보 탐색의 전략이 필요함을 시사하며, 향후 노인들의 건강정보 이해능력 향상 프로그램개발에 활용될 수 있을 것으로 사료된다.

• 한국콘텐츠학회논문지
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• 제21권6호
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• pp.404-414
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• 2021

최근 고령 사회에서는 지역사회중심의료로의 전환에 대한 관심이 증가하고 있다. 이에 일반 노인과 취약계층 노인 각각에 대해 기능중심의 건강상태를 파악하고, 이를 기반으로 의료서비스 이용 경험 및 요구 인식에 대해 살펴보는 것은 필요하다. 본 연구는 2016년 11월부터 12월까지 서울시 일개지역에 거주하는 65세 이상 노인을 방문하여 구조화된 설문을 통해 노인의 건강기능 상태와 의료서비스 이용 행태를 파악하였다. 취약계층 노인은 일반 노인보다 인지기능, 영양, 통증, 낙상 등에서 기능적 건강상태 저하를 더 많이 경험하는 것으로 나타났다. 인지기능, 영양과 같은 기능적 건강문제를 경험한 일반 노인은 취약계층보다 유의하게 의료서비스를 이용하는 것으로 나타났다. 한편 취약계층 노인은 통증 건강문제 영역에 있어서는 일반 노인보다 의료서비스 이용의 필요성을 더 유의하게 인식하는 것으로 나타났다. 이는 지역사회 노인을 대상으로 공공 서비스 확대의 방향과 범위를 설정함에 있어, 일반 노인과 취약계층 노인 간에는 차별화된 정책이 설정되어야 함을 알 수 있었다. 또한 취약계층의 의료접근성 향상을 위해서는 경제적 장벽으로 인해 필요한 의료이용의 장애가 초래되지 않도록 공공의료기관의 적극적인 지원이 이루어져야 하겠다.