• Title/Summary/Keyword: 근거중심 보건의료

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A Study on Health Care Practices of Korean Immigrants in Transition (재미 한인들의 건강관리 실천에 관한 연구)

  • Im Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.39-57
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    • 1996
  • 미국은 이제까지 서구 백인문화 중심적으로 간호학을 발전시켜왔다. 그러나 국제적인 세계화 흐름과 함께 이제까지 경시되어 왔던 소수 민족들에게 차츰 관심을 모으고 있다. 이러한 간호학의 추세와 함께 재미 한인들의 증가는 간호학 내의 한인들에 대한 문화적 지식의 확대를 필요로 하게 하였다. 이민이라는 과정을 통해서 이민자들은 새로운 가치관. 태도. 사회적 규범을 획득하게 되는데. 이러한 변화는 신체적. 정신적 건강에 부정적으로 영향을 미치는 것으로 보고되고 있다. 또한 이러한 이민 적응과정에서 오는 어려움 들은 이민자 들이 건강관리를 효과적으로 하지 못하게 하는 주원인으로 보고되고 있다. 이 연구에서는 재미 한인들의 건강관리실천을 그들의 초기 이민 과정에서 겪게 되는 여러 경험에 초점을 맞추면서 면담조사와 사례 연구를 통하여 살펴보았다. 임의 표본 추출된 미국 캘리포니아주 오클랜드에 있는 한 한인 교회의 20명의 교민들을 대상으로 그들의 초기 이민경험과 건강관리 실천에 관한 면담 조사가 이루어졌으며 대상자 중 3인을 대상으로 하여 사례 연구가 이루어졌다. 연구 결과, 재미 한인들은 타이민자들에 비해 소규모 사업에 종사하는 경우가 많고 높은 취업 율에 비해 낮은 수인을 가지는 것으로 나타났다. 한인들은 타이민자들에 비해 좀 더 보수적이며 그들의 문화와 관습을 가능한 한 고수하는 것으로 나타났다. 또한 한인들은 사회 참여와 대인 관계에 있어서 한인 사회에만 한정되게 활동하는 것으로 나타났다. 재미 한인들은 한인 사회 내에서 강력한 사회적 유대관계를 유지하는 것으로 나타났으며, 가족의 영향력이 타민족들에 비하여 강한 것으로 나타났다 언어 장벽이 가장 큰 문제로 보고되고 있으며 비록 성공적으로 미국 사회에 적응을 하더라도 계속적인 경제적인 생존 노력과 사회적으로 소외된 그들의 위치는 그들의 삶을 계속해서 어렵게 하는 것으로 나타났다. 이러한 초기 이민 적응과정에서 오는 어려움 들은 그들의 건강을 비효과적으로 관리하게 만드는 것으로 나타났다. 첫째, 적절한 통역자를 사전에 선정, 이용함으로써 적절한 간호를 제공할 수 있도록 하여야겠다. 둘째. 한인을 대하는 간호 제공자들은 한인에 대한 문화적 지식을 겸비하고 그 지식에 근거를 둔 문화적으로 적절한 간호를 제공하여야 할 것이다. 셋째, 간호 제공자들은 한인들의 치료법 혼용을 이해하고 동시에 여러 치료법을 사용하는 경우. 잘 살펴서 적절한 조치를 취해야 할 것이다. 넷째, 가족관계를 사정하고 적절히 가족 구성원을 간소 목적을 위하여 사용할 수 있어야 하겠다 마지막으로 이들 내의 위험 집단을 우선적으로 파악. 접근하여야 할 것이다. 위험 집단으로는 경제적 문제로 적절한 의료 이용을 할 수 없는 저소득층, 문화적으로 열등한 위치에 있는 여성층과 초기 이민 적응에 가장 문제를 일으킬 소지가 있는 노년층을 들 수 있겠다. 이 연구는 몇 가지 제한점을 가진다. 첫째. 연구 대상자 선정이 어려워서 자원자를 대상으로 연구가 행해졌다. 둘째. 적은 수의 연구 대상자를 대상으로 연구가 행해졌다. 셋째. 연구기간이 짧았던 까닭에 좀더 상세한 사례 연구가 이루어질 수 없었다 좀 더 신뢰할 수 있는 표본 추출 방법을 통하여 선정된, 많은 연구 대상자를 가지고, 심도 있는 연구가 추후 반복적으로 이루어져야 할 것이다.

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Study on the Characteristics and Quality Level of Single Subject Researches in the Stroke Patients : The Field of health care ~ (뇌졸중 환자를 대상으로 한 단일대상연구의 특성과 질적 수준에 관한 연구: 보건의료 분야를 대상으로)

  • Sim, Kyoung-Bo
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.2
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    • pp.15-28
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    • 2018
  • Objective : This study sought to characterize and determine the qualitative level of a single target study for stroke patients. Methods : The National Science and Technology Information Center (NDSL), DBpia (DBpia), RISS (Radical Research Information Service), Korea Research Information (KISS), and the National Assembly Library's original case study from 2002 to 2017. A total of 24 single target research papers were selected through the screening process to analyze the quality level of research methods and research design. Results : ABA design was th most common study design method. One person was the most with 12(50%). and three were the second with 8(33.3%). Imagination was the most used as an independent lawyer. Dependent variables had the highest level of situability and one-sidedness. The study was also conducted with a variety of target behaviors, including 'memory', 'visual attention', 'dysphagia', 'visual-motor coordination', 'balance', 'activity of daily life' and 'edema' behaviors. It also showed a positive effect on all dependent variables. The Qualitative level was found to be above the intermediate level except for one study. Conclusion : It is academic significance that this study analyzes the items to be prepared for in the performance of a single target study and further studies may require the establishment of a weak but good-quality single target study for researchers conducting research in local communities and clinical sites.

The Analysis of Factors Affecting Quality of Life of Disabled Persons Living at Home in Rural Community - Using the PRECEDE Model - (농촌지역 재가 장애인의 삶의 질 영향 요인 분석 -PRECEDE 모형을 이용하여-)

  • Kim, Hyunli;Jung, Mi Sook;Ju, Kyoungok
    • 재활복지
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    • v.21 no.1
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    • pp.47-70
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    • 2017
  • The aim of this study was to explore the effects of the epidemiological factor (depression), the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), reinforcing factors (family support, professional support), and enabling factor (resource availability, accessibility) on quality of life in home-dwelling disabled people in rural areas. The conceptual model for this study was established on the basis of the PRECEDE model which was developed by Green and Kreuter. Data were drawn from the "Preliminary Investigation for Community-centered rehabilitation" conducted by a public health center located in the O province in 2011 and 186 of 190 disabled people who participated in the survey were included in the final analysis. Data were analyzed using Direct effects on quality of life arose from latent variables depicting the epidemiological factor (depression)and reinforcing factor (family support, professional support), while indirect effects arose from the behavioral factor (activities of daily living), the predisposing factor (self-efficacy), and enabling support (resource availability, accessibility). This model explained 85.5% of the variance in quality of life among rural disabled individuals. These findings may have shed some light on the necessity of including strategies to reduce depression and to strengthen supports from family and healthcare professionals when performing rehabilitation programs to improve quality of life in home-dwelling disabled people in rural areas. Furthermore, it suggested that it would be useful to develop specific strategies and tactics which might increase self-efficacy and to expand linkages between public health centers and other professional institutions such as hospitals for community-centered rehabilitation services for individuals with disabilities.

The Concept of 'Risk' and the Proportionality Review of Infectious Disease Prevention Measures (감염병 팬데믹에서의 '리스크' 개념과 방역조치에 대한 비례성 심사의 구체화 -집합제한조치에 대한 국내외 판결을 중심으로-)

  • You, Kihoon
    • The Korean Society of Law and Medicine
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    • v.23 no.3
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    • pp.139-207
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    • 2022
  • As various state restrictions on individual freedom were imposed during the COVID-19 pandemic, concerns have been raised that excessive infringements on fundamental rights were indiscriminately permitted based on the public interest of preventing infectious diseases. Therefore, the question of how to set acceptable limits of liberty restrictions on individuals has emerged. However, since the phenomenon of infections spreading to the population is only predicted statistically, how to deal with the risk of the infected individual as a subject of legal analysis has become a problem. In the absence of a theoretical framework of legal analysis of risk, the risk of infected individuals during the pandemic was not analyzed strictly, and proportionality review of infection prevention measures was often only an abstract comparison of the importance of public interest and individual rights. Therefore, this research aims to conduct a theoretical review on how risk can be conceptualized legally in a public health crisis, and to develop a theoretical framework for proportionality review of the risk of liberty-limiting measures during a pandemic. Chapter 2 analyzes the legal philosophical concepts of risk, which are the basis for liberty restrictions during a public health crisis, and applies and extends them to the pandemic. Chapter 3 reviews previous studies related to liberty restriction measures in the context of the COVID-19 pandemic, and points out they have a limitation that specific criteria for the proportionality review of public health measures in the pandemic have not been presented. Accordingly, Chapter 3 specifies the methodological framework for proportionality review, referring to the theoretical discussion on risks in Chapter 2. Chapter 4 reviews the legitimacy of gathering restriction orders, applying the theoretical discussion in Chapter 2 and the criteria for proportionality review established in Chapter 3. In particular, Section 4 examines logic of proportionality review in judicial precedents over the ban on gathering restrictions implemented in the COVID-19 pandemic. In analyzing the precedents, the logic of proportionality review in each case is critically reviewed and reconstructed based on the theoretical framework presented in this research.

Analysis of the Use of Insured Herbal Extracts and Korean Medicinal Treatments in Patients with Allergic Rhinitis : Data from Health Insurance Review and Assessment Service (알레르기 비염 환자의 보험 한약 제제 및 한의 처치 이용 현황 : 건강보험심사평가원 자료 분석)

  • Kim, Jeong-Hun;Ryu, Ji-In;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.38-52
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    • 2021
  • Objectives : The purpose of this study is to analyze the use of insured herbal extracts and Korean medicinal treatments, which are mainly used to treat allergic rhinitis in Korean medicine. Methods : Among all HIRA(Health Insurance Review and Assessment Service) claims data in 2016, we included all statements that included J30(vasomotor and allergic rhinitis) or a subcategory of J30(J30.0, J30.1, J30.2, J30.3, or J30.4) as the main disease, using the Korean Standard Classification of Diseases(KCD-7). This study analyzed the most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis in Korean medicine. We performed a frequency analysis on subgroups based on treatment type(inpatient or outpatient), sex, age, insurance type, and medical institution type. Results : The result shows the 10 most frequently used insured herbal extracts and Korean medicinal treatments for allergic rhinitis. The total number of insured herbal extracts prescriptions was 82,533, and the most commonly prescribed insured herbal extracts was socheongryong-tang(35,131 prescriptions), followed by hyeonggaeyeongyo-tang(18,157 prescriptions), samsoeum(6,257 prescriptions), and galgeun-tang(4,465 prescriptions). The total number of Korean medicinal treatments prescriptions was 1,878,541, of which the most common Korean medicinal treatments was acupuncture(922,977 prescriptions), followed by moxibustion(372,120 prescriptions), cupping(242,094 prescriptions), and segmental acupuncture(161,553 prescriptions). Conclusions : It is expected that the results of this study can be used as a basis for establishing the priorities of evidence-based clinical research topics in the field of Korean medicine and making health care policy decisions to strengthen coverage in the future.

Herbal Medicine for Premenstrual Syndrome: A Systematic Review and Meta-analysis (월경전증후군에 대한 한약 치료의 효과 : 체계적 문헌 고찰과 메타 분석)

  • Ji-In Seo;Yun-Jae Lee;Seo-Lim Ko;Nu-Ree Kim;Jeong-Hun Kim;Mi-Ju Son;Young-Eun Kim;An-Na Kim;Eun-Hee Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.4
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    • pp.96-120
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    • 2023
  • Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

The Study on the Relationship between COVID-19 Risk Perception, Job Instability, and Mental Health - Focusing on hotel workers - (코로나19 위험인식과 직업불안정, 정신건강 간의 관계 연구 - 호텔종사자를 중심으로 -)

  • Jung-Min Lee;Min-Hee Hong
    • Advanced Industrial SCIence
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    • v.2 no.4
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    • pp.1-10
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    • 2023
  • The purpose of this study is to verify the mediating effects of job insecurity on the relationship between COVID-19 risk perception and mental health in hotel workers. For this study, a sample of 633 hotel workers completed the questionnaires: COVID-19 risk perception, job insecurity, depression, anxiety, somatic symptoms. The data was analyzed by SPSS 25.0 program and PROCESS macro program. The main results can be summarized as follows. 1. The risk group of the job insecurity had a significantly higher level of mental health(depression, anxiety, somatic symptoms) compared with the normal group. 2. COVID-19 risk perception showed a significant effects on job insecurity and mental health(depression, anxiety, somatic symptoms). 3. The results showed a partial mediating effects of job insecurity on the relationship between COVID-19 risk perception and mental health(depression, anxiety, somatic symptoms). On the basis of the results, we discuss that hotel workers have the vulnerability of mental health in disaster situations such as COVID-19 pandemic, and that mental health risk increases due to the job insecurity caused by COVID-19. we propose the need to support human resource management measures and psychological programs for hotel workers.

Development of a Climate Change Vulnerability Index on the Health Care Sector (기후변화 건강 취약성 평가지표 개발)

  • Shin, Hosung;Lee, Suehyung
    • Journal of Environmental Policy
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    • v.13 no.1
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    • pp.69-93
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    • 2014
  • The aim of this research was to develop a climate change vulnerability index at the district level (Si, Gun, Gu) with respect to the health care sector in Korea. The climate change vulnerability index was esimated based on the four major causes of climate-related illnesses : vector, flood, heat waves, and air pollution/allergies. The vulnerability assessment framework consists of six layers, all of which are based on the IPCC vulnerability concepts (exposure, sensitivity, and adaptive capacity) and the pathway of direct and indirect impacts of climate change modulators on health. We collected proxy variables based on the conceptual framework of climate change vulnerability. Data were standardized using the min-max normalization method. We applied the analytic hierarchy process (AHP) weight and aggregated the variables using the non-compensatory multi-criteria approach. To verify the index, sensitivity analysis was conducted by using another aggregation method (geometric transformation method, which was applied to the index of multiple deprivation in the UK) and weight, calculated by the Budget Allocation method. The results showed that it would be possible to identify the vulnerable areas by applying the developed climate change vulnerability assessment index. The climate change vulnerability index could then be used as a valuable tool in setting climate change adaptation policies in the health care sector.

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