• 제목/요약/키워드: primary care

검색결과 1,542건 처리시간 0.027초

유초연계의 중요성에 대한 초등 1학년 교사의 인식이 학습자중심 수업활동을 매개로 아동의 학교적응에 미치는 영향 (Korea Institute of Child Care and Education)

  • 이완정;김미나
    • 한국보육지원학회지
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    • 제15권4호
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    • pp.21-36
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    • 2019
  • Objective: Using data from the Panel Study on Korean Children, this study investigated the influence of teacher'thoughts about the transition from ECEC to primary school in relation to learner-centered teaching methods and children's school adjustment. Methods: We analyzed the longitudinal data of 658 seven-year-olds from the 8th and 9th waves of the panel study of Korean children collected by the Korea Institute of Child Care and Education in 2015 and 2016. The main analysis method was Structural Equation Modeling(SEM). Results: First, theachers' thoughts about the transition from ECEC to primary school was noteworthy. Second, the more concern a theacher' had about transition, the higher their learner-centered teaching method. Third, teacher' concern about transition influenced children's school adjustment. Fourth, a teacher's learner-centered teaching method mediated concern about children's transition and school adjustment in the first year and the second year. Conclusion/Implications: According to the results of this study, 1st grade teachers' concern about the transition from ECEC to primary school has been found to be predictors of children's school adjustment.

어린이집 통합학급 보육교사와 특수교사의 유·초 연계 중요도에 대한 인식 차이 (Differences on the Importance of Recognition of Contingency from Early Childhood to Elementary Education Between Early Childhood and Early Childhood Special Education Teachers at Inclusive Child Care and Education Settings)

  • 김민정;조윤경
    • 한국보육지원학회지
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    • 제16권2호
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    • pp.67-87
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    • 2020
  • Objective: In order to provide basic data that can strengthen the recognition of continuity of early childhood and primary education, early childhood education and early childhood special education teachers at inclusive child care and education settings participated in this study. Methods: The researchers conducted a survey on 192 early childhood teachers and 167 early childhood special education teachers in Seoul and Gyeonggi-do province. The collected data were analyzed statistically. Results: First, early childhood special education teachers were higher than early childhood teachers statistically on the prerequisite elements of continuity. Second, early childhood education teachers were higher than early childhood special education teachers statistically regarding the prerequisite educational techniques required for continuity of early childhood and primary education. In particular, early childhood teachers put more of an emphasis on learning and sociality-communication than early childhood special education teachers did. Conclusion/Implications: It is necessary that in-service education on prerequisite elements be stressed, and there be more detailed activities and education about programming and its utilization for early childhood special education teachers.

농촌 지역 보건소 일차의료의 질 평가 (Evaluating the Primary Care Quality of a Public Health Center in a Rural Area)

  • 변영관;최용준
    • 농촌의학ㆍ지역보건
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    • 제42권1호
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    • pp.24-35
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    • 2017
  • 이 연구의 목적은 한국형 일차의료 평가 도구(KPCAT)를 이용하여 한 농촌 지역 보건소의 일차의료의 질을 평가하는 것이다. 또 이 연구에서는 KPCAT 적용 및 결과 해석과 관계된 몇 가지 방법론적 이슈를 검토하였다. 농촌 보건소 진료 의사에게 4회 이상 진료받은 환자 79명이 KPCAT 설문에 응답하였다. 응답자의 특성을 빈도와 백분율, 중앙값과 사분위 범위, 평균과 표준 편차로 제시하였다. 일차의료의 질은 KPCAT 총점과 영역별 점수의 중앙값과 사분위 범위로 제시하였고 최댓값과 최솟값, 기대 점수와 함께 방사형 도표로 제시하였다. KPCAT 문항별 점수와 중앙값과 사분위 범위, 기대 점수 이상 응답자 비율, 잘 모름 응답자 비율을 제시하였다. 연구 대상 농촌 지역 보건소 일차의료 질의 중앙값과 사분위 범위는 각각 45점, 16점이었다. KPCAT 영역별 점수 중앙값이 기대 점수에 이른 영역은 최초 접촉 하나였다. KPCAT 문항별 점수가 기대 점수 이상인 응답자 비율이 50% 미만인 문항은 포괄성 4문항 중 2개, 조정 기능 3문항 전부, 전인적 의료 5문항 중 2개, 가족 및 지역 사회 지향성 4문항 전부였다. 잘 모름 응답의 처리 방침 개선, 잘 모름 응답률이 높은 문항의 타당성 검토, 응답 척도의 내용과 점수의 일치 등이 방법론적 개선 과제였다. 농촌 지역 보건소 일차의료의 질은 개선할 여지가 많았다. 특히 조정 기능과 가족 및 지역 사회 지향성 영역의 개선 필요성이 두드러졌다. KPCAT의 방법론적 개선을 통하여 타당하고 신뢰성 있는 일차의료 평가가 이루어지기를 기대한다.

일차 진료의원의 진료수입의 형평성 분석연구 (An Analysis on Patients Trend and Income of Primary Care Clinic)

  • 임선미;임금자;박관준;박윤형
    • 보건행정학회지
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    • 제24권1호
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    • pp.92-99
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    • 2014
  • Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

일부 보건진료소에서 실시한 건강증진프로그램이 농촌여성노인의 노쇠에 미치는 효과 (The Effect of Health Promotion Program on the Frailty of Rural Elderly Women Implemented at Primary Health Care Posts)

  • 김민경;박기수
    • 농촌의학ㆍ지역보건
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    • 제44권3호
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    • pp.115-123
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    • 2019
  • 이 연구는 J시 일부 보건진료소에서 실시한 건강증진프로그램이 농촌여성노인 노쇠정도 확인을 위한 건강상태(지각된 건강상태, 노쇠 점수, 상 하체 유연성, 최대악력, 동적평형검사 Timed Up and Go)에 미치는 효과를 규명하기 위함으로 대한노인병학회에서 개발한 한국형 노쇠측정도구 8개 항목을 통해 보건진료소 관할지역 노인들의 노쇠수준을 파악하고, 농촌 여성노인들의 노쇠수준에 맞는 12주 건강증진프로그램을 적용하였다. 건강증진프로그램(프로그램명: ${\bigcirc}{\bigcirc}$보건진료소와 주민이 함께 만드는 하하호호 백세건강마을 만들기)은 J시 보건진료소 특성화 사업의 한 부분으로 연구자인 보건진료전담공무원이 전문가의 자문을 얻어 농촌여성 노인들에게 적합하도록 수정 보완하여 실시하였다. 연구 결과 노쇠측정도구 8개 항목을 통한 노쇠점수도 실험군이 대조군에 비해서 유의한 차이를 보였는데, 8개 항목 중 주관적인 현재 건강상태와 우울한 감정의 개선이 노쇠점수가 향상에 특히 도움이 되었다. 건강상태 변화로 왼쪽 상체유연성은 실험군이 약 2배(+17cm), 오른쪽 상체유연성은 +11cm, 하체유연성은 실험군이 +6cm 증가하였고, 대조군은 거의 변화가 없어 통계적으로 유의한 차이가 있었다. 노인의 근력평가로 최대악력은 실험군이 약+4kg 증가하였고, 동적 균형 검사(Timed Up and Go test)는 실험군이 3초 빨라지고 대조군은 거의 변화가 없어 통계적으로 유의한 차이가 있었다. 따라서 이 연구에서 실시한 건강증진프로그램이 상 하체 유연성 및 근력, 민첩성 등 운동능력을 향상하는 데 도움이 되었다고 볼 수 있다. 이상의 연구 결과를 바탕으로 의료취약지역 보건 진료소 관할 인구의 평균수명 연장과 고령화로 노쇠한 농촌 노인들의 특성을 반영한 근력강화 및 유연성 운동과 인지개선 활동 등 다양한 건강증진프로그램의 지속적인 개발과 프로그램의 표준화를 통한 확대 적용이 필요하다.

A Comparative Study on Primary Health Care in Republic of Korea and Republic of Uzbekistan

  • Dronina, Yuliya;Moon, Jiyoung;Nam, Eun Woo
    • 보건행정학회지
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    • 제27권3호
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    • pp.256-266
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    • 2017
  • Background: Primary health care (PHC) plays a major role to ensure the basic right and equal distribution of the essential health care services. This study presents comparative analyses of PHC in Korea and Uzbekistan, discusses the existing scenario and the challenges, and provides recommendations. Methods: This study reviewed secondary data from Korea's National Statistical Information Service and the State Committee of the Republic of Uzbekistan on Statistic, regulatory legislation, research reports, and policy papers by research and international institutions. We focus on comparing input and outcome health data, PHC structure, and health expenditure. Results: Overall health status of the population in Korea is better than in Uzbekistan; both countries achieved more than 95% immunization coverage. The reforms implemented in both countries provide initial health care service delivery. However, there are several challenges such as the distribution of the staff between urban and rural areas and interest of the graduates on specialization rather than working in PHC system. Conclusion: PHC plays an important role in the provision of medical services to the population, addressing both health and social problems; it is the best tool for achieving universal coverage for basic health needs of the population. The community health practitioners in Korea and nurses in Uzbekistan plays main role in universal coverage through providing essential health care services. Continuous reform of the PHC system should be directed to strengthen the capacity of the PHC staff in health promotion knowledge and activities as well as to encourage population to improve their own health.

요양시설 입소 노인 주보호자에 대한 사회적 지지가 부양긍정감과 부양부담에 미치는 영향 (Effects of Social Support for Elderly Residents' Primary Caregivers in Long-Term Care Facilities on Caregivers' Positive Feelings and Burden)

  • 김지향;한숙정
    • 가정간호학회지
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    • 제26권2호
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    • pp.199-209
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    • 2019
  • Purpose: This study was conducted to determine factors affecting the positive feelings and care burden of elderly residents' primary caregivers in long-term care facilities. Methods: The survey was conducted between November and December 2018. A structured questionnaire was used to collect data, and 148 individuals voluntarily participated. The collected data were examined through descriptive statistical analysis using SPSS WIN ver.24.0, t-test, one-way Anova $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression. Results: Factors that significantly affected caregivers' positive feelings included caregivers' education level(${\beta}=-.32$, p<.001), social support(${\beta}=.31$, p<.001), care burden(${\beta}=-.29$, p=.001), and total support fee(not more than 1.5million won)(${\beta}=-.18$, p=.012). The explanation power was as high as 40.0%(Adj $R^2=.40$). Factors that significantly affected caregivers' burden included social support(${\beta}=-.25$, p=.002), positive feelings(${\beta}=-.25$, p=.002), elderly individual's religion(${\beta}=-.17$, p=.007), and elderly individual's marriage status(${\beta}=.17$, p=.021). The explanation power was as high as 45.0%(Adj $R^2=.45$). Conclusion: Our results suggest that it is necessary to increase social support for elderly residents' primary caregivers in long-term care facilities. This can be helpful to decrease burden and enhance positive feelings in caregivers. We should also collect caregivers' information as well to provide appropriate assistance.

노인 주 부양자의 부양부담감, 소진감 및 삶의 질에 대한 연구 (A Study of Care Burden, Burnout, and Quality of Life among Family Caregivers for the Elderly)

  • 주경복;김귀분
    • 여성건강간호학회지
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    • 제14권4호
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    • pp.278-289
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    • 2008
  • Purpose: This study was a survey to provide basic data about nursing interventions for improving the quality of life among family caregivers for the elderly by examining their care burden, burnout, and quality of life, and by confirming the correlation between each of them. Method: The subjects were 215 people in Seoul and Gyeonggi Province who understood the purpose of this study and participated voluntarily from April 1 to June 4, 2007. Data was analyzed by the SAS program. Result: 1. Concerning primary caregivers of the elderly, it was found that their care burden was slightly high, burnout was high and quality of life was good on the whole. 2. When it comes to the correlation among care burden, burnout, and quality of life among family caregivers, it was found that burnout increases in proportion to care burden, quality of life decreases as care burden increases, and bigger burnout leads to a lower quality of life. Conclusion: The quality of life among primary caregivers should be improved by reducing their care burden and burnout. Thereby, a priority might be considered for admission to nearby, comfortable nursing homes or failing that, home visiting services, rather than family support in the home.

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Cardiomyopathies in children

  • Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제56권2호
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    • pp.52-59
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    • 2013
  • Cardiomyopathy (CMP) is a heterogeneous disease caused by a functional abnormality of the cardiac muscle. CMP is of 2 major types, dilated and hypertrophic, and is further classified as either primary or secondary. Secondary CMP is caused by extrinsic factors, including infection, ischemia, hypertension, and metabolic disorders. Primary CMP is diagnosed when the extrinsic factors of secondary CMP are absent. Furthermore, the World Health Organization, American Heart Association, and European Cardiology Association have different systems for clinically classifying primary CMP. Primary CMP is rare and associated with a family history of the disease, implying that genetic factors might affect its incidence. In addition, the incidence of CMP varies widely according to patient ethnicity. Genetic testing plays an important role in the care of patients with CMP and their families because it confirms diagnosis, determines the appropriate care for the patient, and possibly affects patient prognosis. The diagnosis and genetic identification of CMP in patients' families allow the possibility to identify novel genes that may lead to new treatments. This review focuses on the epidemiology, pathophysiology, diagnosis, and treatment of CMP, with the aim of providing pediatricians with insights that may be helpful in the early identification and management of idiopathic CMP in children.

Age of initiation, Determinants and Prevalence of Cigarette Smoking among Teenagers in Mushin Local Government Area of Lagos State, Nigeria

  • Abiola, AO;Balogun, OS;Odukoya, OO;Olatona, FA;Odugbemi, TO;Moronkola, RK;Solanke, AA;Akintunde, OJ;Fatoba, OO
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1209-1214
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    • 2016
  • Background: Cigarette smoking constitutes a major threat to the health and wellbeing of teenagers. While smoking has been on decline in the developed countries, the reverse is the case in developing countries. The aim of this study was to determine the age of initiation, determinants and prevalence of cigarette smoking among teenagers in Mushin Local Government Area of Lagos state, Nigeria. Materials and Methods: This was a descriptive cross-sectional study among 475 teenagers selected by multistage sampling. A pre-tested, structured, interviewer-administered questionnaire was used for data collection. The study was carried out in November, 2014. Results: Response rate was 84.6%. Mean age of the respondents was $16.4{\pm}1.65years$. Range and mean age of initiation of cigarette smoking were 7 to 17 years and $12.0{\pm}3.32years$ respectively. Teenagers who were above 15 years (OR:5.13, 95%CI: 0.87-30.26), males (OR:5.19, 95%CI: 1.57-17.18), married (OR:8.41, 95%CI: 1.04-63.35), had ${\leq}$primary school education(OR:4.31, 95%CI: 1.07-17.33), influenced by friends(OR:308.84, 95%CI:84.87-1123.81), and influenced by advertisements (OR:27.83, 95%CI: 3.92-197.64) were more likely to have initiated cigarette smoking. Furthermore, teenagers who were males (OR:12.77, 95%CI: 2.90-56.28), married (OR:19.24, 95%CI: 2.05-180.45), had ${\leq}$primary school education(OR:7.85, 95%CI: 2.37-26.01), influenced by friends(OR:28.56, 95%CI: 10.86-75.07), and influenced by advertisements (OR:5.95, 95%CI: 1.72-20.61) were more likely to be current cigarette smokers. In addition, 24.9% had initiated cigarette smoking while 14.7% were current smokers of cigarette. Conclusions: Mean age of initiation of cigarette smoking was $12.0{\pm}3.32years$. Determinants of cigarette smoking were age, gender, marital status, educational background, friends and advertisements. Life time prevalence of cigarette smoking was higher than prevalence of current cigarette smokers. Cigarette smoking reduction programs should take these factors into consideration.