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Assessment of the Activities of General Physicians in Health Subcenters and a Scheme to Improve the Training Program (보건지소 공중보건 일반의사의 업무수행정도와 수련개선방안)

  • Park, Jung-Han;Chun, Byung-Yeol;Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.2 s.20
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    • pp.193-202
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    • 1986
  • The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

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Measuring Myun Health Worker's Performance by Time-Activity Approach (시간활동 접근법에 의한 면 보건요원의 업무량 분석)

  • Kim, Han-Joong;Kim, Moon-Shik
    • Journal of Preventive Medicine and Public Health
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    • v.10 no.1
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    • pp.34-43
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    • 1977
  • This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

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Learning Needs in Patients undergoing Bone Marrow Transplantation (골수이식환자의 교육요구도)

  • 최소은
    • Journal of Korean Academy of Nursing
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    • v.30 no.2
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    • pp.514-526
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    • 2000
  • The active treatment phase in preparation for bone marrow transplantation(BMT) of che- motherapy regimen and total body irradiation (TBI) containing regimen requires considerable teaching. There have been researches that are related to treatment onto BMT patients and to psychological change during BMT process. However, it was hard to find researches focused on learning needs of patients undergoing BMT. The purpose of this study was to provide the basic data for effective educational program about BMT by investigating the learning needs in patients undergoing BMT. The subjects consisted of 90 BMT patients have been admitted to the department of BMT at three university hospitals. Data were obtained from October 1998 to March 1999 and analyzed by SAS program for unpaired t-test, ANOVA, Duncan test. The results were as follows : 1. Learning needs related to demographic characteristics was identified as below. That of male was higher than that of female. That of under age 29, unmarried, religious and university graduated group was higher than that of opposite group but it didn't show significant difference. Learning needs of group of patients who were employed was significantly higher then that of unemployed patients. 2. According to types of diagnosis, learning needs of myelodysplastic syndrome(MDS) patients was the higher than that of others, but admission frequency was the least. Learning needs of unrelated matched BMT(UBMT) patients was higher than that of autologous BMT patients. However, it didn't show significant difference. With regard to learning needs according to process of BMT, learning needs of Pre- BMT period or Post-BMT period was significantly higher than that of BMT day. 3. Learning needs related to BMT was relatively high (total mean: 3.11 of 4.0). The order of the mean score of leaning needs was shown as follows : Restricted activities after discharge, Relapse symptom, Complications of BMT, Kinds of available drugs at home. Therefore the learning needs that is related to life after discharge and to relapse and complications after BMT was high. 4. Learning needs related to radiation therapy was high (total mean: 3.35 of 4.0). The learning needs in radiation therapy items was the Skin care of radiation therapy and Purpose of radiation therapy. 5. Learning needs related to graft versus host disease(GVHD) therapy was high (total mean: 3.55 of 4.0). The highest learning needs in GVHD therapy items was the Preventive method GVHD. less admission frequency and UBMT patients. It is necessary that education for BMT patients should be focused on life after discharge and on relapse and complications after BMT. Especially education for allogeneic BMT patients should be emphasized on GVHD. For all of these, it is necessary to develop systematic and concrete educational program.

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The Study on Effects of "the Unsafe Food Program" designed For Improving Children's Eating Habits (유아들의 식습관 개선을 위한 "위험한 먹거리 프로그램"의 효과에 대한 연구)

  • Seo, Sun Suk;Lee, Ju Rhee
    • Korean Journal of Childcare and Education
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    • v.6 no.1
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    • pp.157-176
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    • 2010
  • The purpose of this study was to estimate the effect of "The unsafe food program" designed for improving children's biased eating habits coming from defenceless exposure to the instant food, fast food and adulterated food with MSG and artificial additives with analyzing the current condition of children's biased eating habits and preference for the unsafe foods. This program was performed for 5 year old children who was attending the kindergarten run by the author every day for two months. "The unsafe food program" consisted of the surveys on the parents' attitude towards food and health and children's eating habits, and of programs that was designed to attract children's attention to their daily food intake and to provide physical fitness, information about differences between wholesome food and junk food, and junk food's bad impacts on human body for children. In order to see the changes of children's body through this program, two physical examinations was preformed: SH pharmaceutical company's hair test to measure the accumulation level of toxic metal in children's hair and children's nutrition level before starting the program, and Ilsan Health Center's 'INBODY' test to analyze children's body composition such as body weight, skeletal muscle mass, body fat mass, BMI, body fat percentage and so on before and after the program. The results from this program follow as below. First, the unsafe foods were excluded from children's diet after parents came to recognize the negative effects of the unsafe foods. Second, children became highly interested in their daily diet through the course of gathering information by themselves and discussions together while testing and analyzing foods, and children demonstrated more self-restraint on fast food and instant food. Third, children's body constitution turned out to be improved by physical fitness in addition to this program. Fourth, children formed a good habit of eating well-balanced diet consisting of vegetables, staple food and fruits through this program designed to improve children's biased eating habits. From the results of this study it was confirmed that "the unsafe food project" had effects on improving children's eating habits.

Effect of Breast-feeding Education and Follow-up care on the Breast-feeding Rate and the Breast-feeding Method - Focused on Home Visit and Phone Counselling - (모유수유교육과 추후간호방법이 산모의 모유수유실천율과 모유수유방법에 미치는 효과 - 가정방문과 전화상담을 중심으로 -)

  • Park, Sook-Hee;Koh, Hyo-Jung
    • Women's Health Nursing
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    • v.7 no.1
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    • pp.30-43
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    • 2001
  • This was a pre-experimental study to confirm the breast-feeding ability and effect of follow up care on the breast-feeding rate and the breast-feeding method by the mother-infant breast-feeding assessment tool for the mothers who got the breast-feeding education. The subjects were 46 mothers who experienced normal delivery of infants at a college hospital in K-city, Kyungsangbuk-do, from July 1 to October 21, 2000. The instrument for data obtainment were The Mother-Infant Breast-Feeding Assessment Tool of Johnson et al. (1999), and The Breast- Feeding Method Measurement Tool of Jeong, Geum-hee(1997). This instrument was reliable, showing Cronbach $\alpha$.751. This study classified them into 3 groups: at high risk for breast-feeding failure, at risk for breast-feeding problems, and at low risk for breast-feeding failure by the mother-infant breast-feeding assessment tool on the day of discharge from the hospital after delivering individual breast-feeding education to the subjects. This study investigated the breast-feeding rate and the breast-feeding method through mail questionnaire at the four week after childbirth, and through the phone counselling and the home visit for follow up care at the first week and the second week after childbirth. The sixth week after childbirth, this study investigated the breast-feeding rate by phone. The data analyzed the hypothesizes by $x^2$-test, paired t-test, ANOVA, Wilcoxon signed rank test, Wilcoxon rank sum test and trend analysis using SPSS/PC+ WIN 10.0 program. The results were as follows : 1) Hypothesis 1-1, "there won't be any difference the breast-feeding rate of a group at risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t= -1.501, p=.270). Hypothesis 1-2, "there won't be any difference the breast-feeding rate of group at low risk for breast-feeding failure by the time elapsed" was supported through constant the breast-feeding rate, because changes in the breast-feeding rate by the time elapsed after childbirth wasn't statistically significant(t=-1.732, p=.225). 2) Hypothesis 2-1, "there won't be any difference between the breast-feeding method of group at risk for breast-feeding failure for four weeks after childbirth and just after childbirth” was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-7.267, p=.000). Hypothesis 2-2, "there won't be any difference between the breast-feeding method of the group at low risk for breast-feeding failure for four weeks after childbirth and just after childbirth" was rejected, because the mean point of post test appeared to be higher than that of pre test(t=-2.501, p=.012). 3)The 3rd hypothesis, "there won't be any difference between breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure at the 4th week after childbirth and just after childbirth" didn't show any difference between the breast-feeding method of groups at risk for breast-feeding problems and at low risk for breast-feeding failure in the advance test(t=-1.521, p=.130) but there was difference between them in post test (t=-2.012, p=.044). As a result, the 3rd hypothesis was supported by pre test, but it was rejected by post test. In conclusion, this study confirmed breast- feeding education and follow up care just after childbirth were effective for the breast-feeding rate and method. Accordingly, it is proposed that successful nursing intervention of breast-feeding to be necessary by continuously providing follow up care through the mother-infant breast-feeding assessment tool as well as to execute individual breast-feeding education to mothers just after childbirth.

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Behavior Problem According to Children's Temperament and Self-Regulation (유아의 기질과 자기조절능력에 따른 문제행동)

  • Jung, Hye-Jin;Lee, Wan-Jeong
    • Journal of Families and Better Life
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    • v.27 no.3
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    • pp.159-170
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    • 2009
  • The purpose of this study was (1) to investigate the difference of temperament, self-regulation, and problem behavior according to children's gender and age, (2) to investigate the relationship among three variables by use of canonical correlation analysis. The subjects were 210 children ages from 3 to 5 in five day-care center in Incheon city. The SPSS WIN 12.0 Program was used to analyze the collected data. The statistical methods were Frequency, Percentage, Cronbach's ${\alpha}$, Two-way ANOVA, Correlation analysis, and Canonical Correlation analysis. The major results of this research are summarized as follows: (1) Children's temperament were significantly different by their gender and age. The boys got higher score than girls in adaptability, activity, and total temperament. Girls got higher score than boys in reactivity. The age 3 got higher score than the age 5 in activity and the ages 3, 4 got higher than the age 5 in total temperament. (2) Children's self-regulation were significantly different by their age. The children who were older got higher scores in self-regulation ability. (3) Children's problems behavior were significantly different by their gender and age. The boys got higher score than girls in anxiety behavior, aggressive behavior, hyperactive/distractive behavior, and total problem behavior. And the ages 3, 4 got higher score than the age 5 in anxiety behavior and hyperactive/distractive behavior. The age 4 got higher score the ages 3, 5 in aggressive behavior and the age 3 got higher score the ages 4, 5 in total problem behavior. (4) Canonical correlation results showed that stable temperament and self-regulation were positively correlated and self-regulation and problem behavior were negatively correlated.

Female College Students' Knowledge, Self-efficacy and Health Behaviors related to Bone Health (일 대학 여대생의 골 (骨) 건강 관련 지식, 자기효능감 및 건강행위)

  • Oh, Eui-Geum;Ko, Il-Sun;Chu, Sang-Hui;Lee, Jung-Eun;Yoo, Jae-Yong
    • Women's Health Nursing
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    • v.18 no.1
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    • pp.38-48
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    • 2012
  • Purpose: This study described female college students' knowledge, self-efficacy and health behaviors related to bone health. Methods: A descriptive cross-sectional survey design was used. A total of 214 students were conveniently recruited from a school of nursing in Korea. Participants (mean age=21.2, SD=1.9 years) bone mineral density (BMD) was measured using dual energy x-ray absorptionmetry. Participants also completed a questionnaire consisting of knowledge test, self-efficacy scale and health behaviors related to bone health. Data were analyzed using SPSS/WIN 17.0 program. Results: The mean BMD at left femoral neck site was $0.86g/cm^2$ and 6.1~12.6%. Results showed that participants were below the expected range of BMD. Level of knowledge (correct rate=54%) and self-efficacy were moderate (mean 54.8 out of 84). More than 84% of subjects drank alcohol more than once a month and 58.4% did participate in regular exercise. Only 7.9% participants took calcium and vitamin-D rich foods every day. There were significant positive correlations between knowledge and self-efficacy (r=.17), health behaviors (r=.14) and self-efficacy and health behaviors (r=.28, all p<.05). Conclusion: These results suggest that health care professionals need to provide effective interventions for young women in order to enhance knowledge, self-efficacy and health behaviors related to bone health.

An Analysis of Meal Guidance and Meal Management of Early Childhood Teachers (영유아교사의 급식 운영 실태와 급식 지도 분석)

  • Kim, Ji-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4487-4495
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    • 2012
  • This study analyzes the meal guidance and meal service management of early childhood teachers. The subjects were 171 early childhood teachers who were working in kindergartens and day care centers in Gwangju. A questionnaire was made by the researcher on the basis of relevant materials. The data was analyzed by statistical methods such as frequency, Cronbach's ${\alpha}$, $x^2$, ANOVA and Duncan with the SPSS for Windows 18.0 program. The results are as follow: First, there are significant differences in meal hours, amount of food and meal admeasurer according to workplace type of early childhood teacher. Also, there are significant differences in meal hours, amount of food, meal admeasurer and guidance for late eating infants according to children's age. Second, early childhood teacher consider in order content after meal, content before meal and content during meal. Also, there are significant difference content after meal according to workplace type of early childhood teacher. And there are significant differences in content before meal and content during meal according to children's age.

Effects of a Sensory Stimulation on Weight, Stress Hormone and Behavioral State in Premature Infants (감각자극이 미숙아의 체중, 스트레스호르몬 및 행동상태에 미치는 효과)

  • 이군자
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.445-455
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    • 1999
  • This study has been conducted on the nonequivalent control group pretest-posttest design in quasi experimental basis and newly born premature infants from intensive care unit of G Medical University Hospital in Inchon Metropolitan were selected in two groups of 21 infants each. The first group for experimental and the other for control. Data has been collected form October 30, 1997 to August 29, 1998. For the experimental group tactile and kinesthetic stimulation was applied 2 times a day for 10 days(10 : 00~11 : 00 hours in the morning and 17 : 00~18 : 00 in the afternoon). As a weight weighing instrument. electronic indicator scale(Cas Co. korea) was used. To determine urine cortisol concentration level in stress hormone, radio immune assay method was used. And high performance liquid chlomatography was used to determine urine norepinephrine, concentration level To determine behavior status, tools developed by Anderson et at(1990) and remodeled by Kim Hee-Sook(1996) were used. Collected data were analyzed with the SAS program using x$^2$-test, student t-test, repeated measures ANOVA and paired t -test. The result were as follow. 1. As for the daily weight gain. the experimental group showed first change in weight and this group also showed higher weight in the average weight than the control group. Statistically, however, there was no significant factor between the two group. 2. The cortisol concentration in urine showed decrease in the experimental group norepinephrine concentration in urine showed increase in both experimental and control groups. No statistical significance was shown between the two groups. 3. In the aspect of behavior status. the experimental group showed statistical significance by showing inactive in the state of alert and conversion to a positive state than the control group. In conclusion, the sensory stimulation in this study showed a positive aspect through there was no statistical significance in the weight gain and urine stress hormone concentration. In the behavior status, there was statistical significance in the frequency of staying inactive in the state of alert and conversion to a positive state.

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Association between Oral Health Behavior and Oral Health Status in Adolescent (청소년의 구강건강행태와 구강보건상태와의 관련요인)

  • Oh, Jungsuk
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.4
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    • pp.103-112
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    • 2017
  • Purpose : This study was conducted to improve cognitive oral healthcare care by analyzing the correlation between oral health behavior and oral health status Korean adolescents. The subjects were 65,528 youths in 798 schools monitored in the Twelfth Korea Youth Risk Behavior Web-based Survey in 2016. Methods : The general characteristics consisted of 9 items including sex, grade, and academic performance. The academic performance and economic status were restructured into "upper, middle, lower". Subjective health perception and subjective oral health perception were reorganized as "health", "normal", "no health". The sub-areas of oral health behavior include five times of daily brushing during the day yesterday. The number of brushing times was "0", "1-2", "3", "more than 4" After lunch at school, brushing was restructured as "always," "sometimes," "not." The oral health status subscale consisted of 6 items including tooth breakage and toothache at the time of eating. Result : Tooth fracture(43.7 %), pain in mastication(43.7 %), tooth tingling(47.4 %), gum pain and bleeding(45 %), pain in buccal mucosa(43.8 %) and halitosis(46.6 %) were rare in adolescent having healthy oral health status cognitively(P<.001). Nosymptom adolescents without dental sealant showed low tooth fracture(0.64 times), pain in mastication(0.67 times), tooth tingling(0.59 times), gum pain and bleeding(0.84 times), pain in buccal mucosa(0.76 times), and halitosis(0.90 times). Nosymptom adolescents without scaling showed low tooth fracture(0.88 times), pain in mastication(1.03 times), tooth tingling(0.82 times), gum pain and bleeding(0.64 times), pain in buccal mucosa(0.70 times) and halitosis(0.82 times). Conclusion : This study revealed that oral health status is correlated with oral health behavior. Development of educational media and program, and aggressive promotion required to establish oral health Korean adolescent.