• 대한지역사회영양학회지
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• 제25권2호
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• pp.137-149
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• 2020

Objectives: This study explored the community food environmental factors affecting food purchasing using a qualitative research methodology for the elderly as well as the various food environments under their socioeconomic diversity. Methods: For the qualitative data collection, this study interviewed 20 elderly people aged 65 years or more, who participated in a public health program or lunch services operated by the senior welfare center in Seoul. Five dimensions, such as availability, physical accessibility, affordability, acceptability, and accommodation suggested in previous studies, were used to identify the community food environmental factors. Results: The elderly participants showed overall similarities to the concepts derived from existing studies on the five dimensions of food accessibility environment. In addition, other important food accessibility environmental factors that were not present in previous studies, such as acceptability for a product of domestic origin, delivery service to home, and small-packaged food sales, were derived. On the other hand, the concept of some subjects differed depending on the household income and specifically for the physical accessibility concept. This showed that the close distance factor from a grocery store at home might not apply to older adults in low-income households in Korea. Conclusions: This study found that five dimensions of the food environment suggested by previous studies could also be applied to vulnerable older adults in Korea. On the other hand, the socioeconomic characteristics of individuals and households would affect the perspectives of their local food environments differently. The findings of this study could help in the development of tools for evaluating the community food environment.

• Journal of Nutrition and Health
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• 제30권6호
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• pp.690-703
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• 1997

The purpose of this study were to analyze work function and labor productivity in school foodservice systems through work sampling methodology. Conventional foodservice were classified into 5 group depending on the number of meals served. Commissary school foodservices were also classified into 5 group by cluster analysis using the number of meals served, the number of satellite schools, and the duration of time for delivery of food. Work measurement through work sampling methodology was conducted in at 5 conventional and 21 commissary food -services during 3 consecutive days from September to October in 1995. Results from work measurement through work sampling methodology were as followed : The most prevalent work functions was cleaning (26.5%) and then processing (25.1%) in conventional while it was processing (30.9%) and then cleaning(25.2%) in commissary school foodservice. Delay was 22.9% and 19.7% respectively. Mean labor minutes per meal of conventional and commissary foodservics were 4.57 and 4.09 minutes, respectively : no significant difference in labor minutes per meal existed between the two systems. but mean labor minutes per meal of commissary foodsevices(1.79min) was significantly lower than that of conventional foodservice(2.33min) during work time before service (p<0.05). Productivity was significantly lower in foodservices which served less than 400 servings ; n significant differences existed among 401-70, 701-1,100 and 1,101-1,500 meals. The highest productivity was in conventional school foodservices which served 1,501-1,900meals. Labor minutes per meal of commissary school foodservice which served less than 400meals per day was significantly lower than those of foodservice which served 401-1,900meals (p<0.05). Labor minutes per meal, preparation and cleaning were positively correlation in two school foodservice systems.

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.539-545
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• 2013

Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (${\leq}10$) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Conclusions: Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.

• 대한영양사협회학술지
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• 제13권4호
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• pp.389-406
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• 2007

This study was conducted to estimate the safety level of non-cooking and cooking processed foods to propose the sanitary management of foods donated to foodbanks. The time and temperature were measured and the microbial levels of aerobic plate counts (APC), coliforms, E. coli, Salmonella spp., S. aureus, B. cereus, and E. coli O157:H7 were analyzed on ten food items donated to seven foodbanks. The amount of cooked foods donated to each foodbank was about 10 to 40 servings. All foodbanks hired a supervisor and had at least one refrigerator/freezer and one temperature-controlled vehicle, but only four foodbanks had the separate offices to manage the foodbank operation. The flow of donated foods was gone through the steps; production, meal service and holding at donator, collection by foodbank, transport (or holding after transport) and distribution to recipients. After production, the levels of APC of both non-cooking and cooking processed foods were complied with the standards by Ministry of Education & Human Resources Development, and were not increased till distribution. Only the level of coliforms in dried squid & cucumber salad (1.5×$10^3$ CFU/g) was not met the standards. E. coli and other pathogens were not detected in all tested samples. The microbial levels of delivery vessels and work tables were satisfactory, but the APC levels of two of four tested serving tables (6.9×$10^3$ and 5.3×$10^3$ CFU/100$cm^2$) and the coliforms level of one (1.1×$10^3$ CFU/100$cm^2$) were over the standards. The air-borne microflora level in serving room was estimated as satisfactory. It took about 3.0 to 6.5 hours from after-production to distribution and the temperatures of donated foods were exposed mostly to temperature danger zone, which had a high potential of microbial growth. These results imply that a checklist to monitor time and temperature in each step should be provided and the employees involving foodbank operation should be properly educated to ensure the safety of donated foods.

• 지역사회간호학회지
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• 제12권1호
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• pp.288-298
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• 2001

This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

• 지역사회간호학회지
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• 제9권1호
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.

• 디지털융복합연구
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• 제12권3호
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• pp.289-297
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• 2014

본 연구는 선택병의원제도 이후 변수들을 이용하여 의료급여수급권자의 의료이용 만족에 대하여 살펴보면서 지속적으로 수급권자의 의료이용 만족 및 건강증진을 향상시킬 수 있는 기초자료를 제공하는 데 그 의의가 있다. 조사기간은 2013년 8월 16일부터 8월23일까지이며, 결론적으로 선택병의원제도 실시 후 의료급여 수급권자의 의료이용 만족을 향상 시킬 수 있도록 하기 위해서는 의료수급권자의 의료서비스의 효과 및 미 충족 의료 욕구에 대한 보다 충분하고 정밀한 파악하는 것이 무엇보다 중요하며, 적정한 의료이용 도모를 위해 효과적인 의료접근성 파악, 행정절차의 비효율성 극복, 적정진료 보장으로 인한 합리적인 의료전달체계 확립 및 건강관리의 향상을 위해 의료기관의 적극적인 협조 및 정부의 다양한 정책 대안이 필요하다.

• 한국가족복지학
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• 제60호
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• pp.133-173
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• 2018

본 연구는 노후소득보장체계의 핵심인 공적연금에 해당하는 북한 년로년금에 대해 공간(公刊) 문헌에 기초하여 제도를 분석하고 북한이탈주민 인터뷰를 통해 실태를 파악함으로써 제도와실태 간 일치 및 괴리를 분석하는 것을 목적으로 하고 있다. 연구방법은 1945년부터 2013년까지 사회보장과 관련된 북한 법령과 북한 사전(정치사전, 경제사전, 재정금융사전, 조선대백과사전)을 활용한 문헌분석 및 눈덩이 표집방법을 활용한 25명의 북한이탈주민 면접자료의질적 분석이다. 연구결과, 북한 년로년금의 제도와 실태는 일부에서만 일치하는 것으로 나타났다. 사회주의 국가체제에서 국가책임의 공적연금이 제대로 작동하지 않을 경우 결국 가족의 역할이 강조될 수밖에 없다. 본 연구의 학술적 함의로는 다양한 북한 원자료에 기초한 연금제도 이해와 북한이탈주민 인터뷰를 통한 실태 해석이라고 할 수 있다. 본 연구의 결과물이 통일시대 노후소득보장 체계 구축에서 가족, 시장, 국가 간의 균형을 찾는데 기여할 수있을 것이다.

• 정신신체의학
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• 제29권2호
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• pp.77-85
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• 2021

유방암은 여성에서 가장 높은 유병율을 보이는 암으로, 진단과 치료과정 및 치료 후에도 다양한 정신사회적 디스트레스가 자주 나타난다. 유방암 환자의 치료에는 의학적 치료뿐만 아니라 정신신체의학적 통합치료가 필요하다. 유방암 환자는 스트레스, 불안장애, 우울장애, 적응 장애 등에 대한 취약성이 증가하고, 이러한 정신장애는 유방암의 악화 또는 재발과 연관이 있다. 유방암 환자의 불안과 우울에 대한 정신사회적 치료는 환자의 삶의 질을 증진시키고, 유방암의 재발과 악화를 감소시킨다. 본 연구에서는 5편의 유방암 치료 가이드라인에서 정신사회적 디스트레스에 대한 정신사회적 치료와 대체의학적 치료가 포함된 정신신체의학적 통합치료 부분에 초점을 맞추어 논의하였다. 5편의 가이드 라인에서 사용한 서로 다른 근거 기준은 US Preventive Service Task Force (USPSTF) 기준에 맞춰 연구자들이 평가하여 근거를 기술하였다. 또한 유방암 환자의 불안, 우울, 기분, 삶의 질에 대한 정신사회적 치료의 효과 크기를 요약하였고, 정신신체의학적 통합치료 서비스 제공에 대한 장벽과 이에 대한 대안을 제시하였다. 다학제 팀을 구성하고, 환자 요구도를 조사하며, 정신사회적 치료의 정보를 환자에게 제공하여 환자와 가족이 참여하는 것이 중요하다. 또한 준비된 계획에 따라 정기적으로 정신사회적 디스트레스를 평가하고, 정신신체의학 전문가 또는 자문조정 정신건강의학과 의사에 의한 정신신체의학적 통합치료가 환자에게 제공되는 것이 가장 중요하다.

• 한국사회복지학
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• 제64권3호
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• pp.79-100
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• 2012

본 연구는 개정 사회보장기본법의 사회서비스가 안고 있는 개념적 긴장이 어떤 것인가를 살펴보려는 목적을 가진 것이다. 참여정부 때부터 본격적으로 사용되기 시작한 사회서비스는 적어도 네 가지의 의미를 갖고 있었는데 개정 사회보장기본법의 사회서비스는 이 중 사회적일자리와 가장 가까운 의미를 가지고 있다. 이런 의미를 가진 개정 사회보장기본법의 사회서비스는 대단히 넓은 개념으로 정의되어 있다. 하지만 이렇게 됨으로써 개정 사회보장기본의 사회서비스는 오히려 개념적 긴장을 안게 되었다. 즉, 사회서비스는 한편으로는 복지뿐만 아니라 보건, 교육, 고용, 주거, 문화, 환경 등 매우 넓은 분야를 포괄하려는 지향성을 갖지만 다른 한편으로 서비스내용을 사회복지서비스에 적합한 것들로 나열함으로써 사회서비스를 사회복지서비스에만 제한시키려는 지향성도 갖는다. 이러한 개념적 긴장은 앞으로 지속될 가능성이 높은데, 이로 인해 복지부 및 사회서비스 전달체계의 개혁이 요구되며 동시에 일관된 사회서비스를 제공하는 데 필요한 이론적 실천적 원칙의 발전이 요구된다는 점에서 사회복지학에 중대한 도전을 던져주고 있다. 이 도전에 대응하기 위해서는 미시와 거시적 접근의 소통과 공동노력이 어느 때보다 절실히 필요하다.