• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.51-63
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• 2000

Ten Dongs were selected according to the systematic cluster sampling in Koryong Gun, and the survey was conducted on 571 women in the age between 30-69 years. The first survey was performed for 6 days between August 27 to September 1, 1999 with the investigation rate of 60.3%, and the second survey was performed in November with the investigation rate of 91.8%. The contents of survey included demographic characteristics, health behaviors, dyspepsia symptom score, sleeping induction time and the degree of sleep satisfaction, and degree of stress in the subjects. The dyspepsia symptom score was in the average 13.4 points out of a total 44 points and was the highest in the 50-59 year-old age group with 13.9 points. The sleep induction time was in the average of 35 minutes and was the highest in the 50-59 year-old age group with 40.9 minutes; the degree of sleep satisfaction was in the average of 7.9 points and was the lowest in the 50-59 year-old age group with 7.5 points. The stress score was in the average of 18.3 points and was highest in those subjects in their 40's and 50's with 18.7 points. When the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was analyzed, the results showed that he stress score and the degree of sleep satisfaction showed a significant negative correlation and that the stress score and dyspepsia symptom score showed a significant positive correlation. Also, a significant negative correlation was found between the degree of sleep satisfaction and dyspepsia symptom score. According to each age group, a significant correlation was revealed among the stress score, dyspepsia symptom score and the degree of sleep satisfaction in those subjects over 40 years of age compared to those subjects who were younger than 40 years of age. As for educational level, the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was higher in those subjects with less than middle school education compared to those subjects with more than high school education. When those factors that effects on the dyspepsia symptom score were analyzed with multiple regression, the results showed that the level of stress and chronic diseases were selected as significant variables. When those factors that affected on the degree of sleep satisfaction were analyzed, the sleep induction time and presence of chronic diseases and stress were selected as significant variables. Those women in their 50's who live in rural areas showed the highest level of stress, lowest the degree of sleep satisfaction, and highest level of dyspepsia, indicating that they need stress management. Also, since stress was showed to be a significant variable effecting on dyspepsia or the degree of sleep satisfaction, it is concluded that health promotion is possible through stress management. More studies are needed in the future on coping resources that would strengthen coping against stress, and by conducting studies on stress and related factors on community people, the measures of mental health promotion need to be developed.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.