• 제목/요약/키워드: Home visits

검색결과 188건 처리시간 0.047초

웹콘텐츠 서비스 평가 (An Evaluation Method for Web Contents Services)

  • 장희선;박종태
    • 서비스연구
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    • 제3권2호
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    • pp.33-44
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    • 2013
  • 인터넷과 모바일 서비스의 증가로 유무선 웹 콘텐츠 서비스 이용이 증가하고 보다 다양한 콘텐츠 수요가 발생하고 있다. 경쟁력 있는 콘텐츠를 제공하는 웹사이트로 살아남기 위해 그리고 접근성, 웹표준에 대한 기술적 오류를 없애고 콘텐츠 이용률이 높은 사이트가 되기 위해서는 마케팅 및 캠페인과 같은 이벤트도 필요하지만 무엇보다도 정기적인 사이트 평가를 통하여 문제점을 진단하고 이를 해결하는 노력이 요구된다. 본 논문에서는 웹콘텐츠 서비스를 제공하는 사이트 평가 방법을 크게 정량적 방법과 정성적 방법으로 구분하여 제시하고 정량적 방법의 타당성을 검증하기 위해 국내 138개 홈페이지에 대한 평가 결과를 분석하였다. 정량평가를 위하여 접근성, 표준성 및 이용성 항목으로 구분하고 접근성은 K-WAH(Korea-Web Accessibility Helper)를 이용하여 인식 운용 이해의 용이성 및 기술적 진보성 항목에서의 오류수를 진단하고 표준성은 W3C Validator를 이용하여 웹표준의 오류 및 경고수를 분석하며, 이용성은 구글 애널리틱스를 이용하여 사용자 방문수, 평균 방문시간, 이탈률 등을 평가한다. 그리고 웹사이트에 대한 비용(구축 및 운용비)을 고려하여 정량평가와 비용 사이의 상관관계를 분석한다. 분석 결과, 100점 만점으로 환산하였을 때, 평균 55점, 표준편차 14점으로 평가되었으며 정량평가 점수와 비용 사이에는 양(+)의 상관관계가 존재하나 상관계수는 0.058로 그다지 높지 않음을 알 수 있다.

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지역사회 재가 노인의 인지수준에 영향을 미치는 신체상태와 기능 및 활동의 융합요인 (Convergence factors among their physical state, function and activities influencing on the cognition of elderly residents in a community)

  • 박진경
    • 한국융합학회논문지
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    • 제6권6호
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    • pp.153-162
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    • 2015
  • 본 논문은 지역사회 재가 노인(65세 이상)의 인지수준에 영향하는 신체적 요인을 파악하기 위하여 수행되었다. 분석에 사용된 자료는 2010~2012년도 서울시 보건소 방문건강관리사업의 대상자 중 352명의 노인을 대상으로 하였다. 노인의 인지수준은 한국어판 하세가와 치매척도(HDS-K)를 사용하였으며, t-test, ANOVA, 다변량 회귀분석을 사용하여 노인의 인지수준에 영향하는 요인을 파악하였다. 연구대상자 중 13.6%에서 경도인지장애가 나타났다. 지역사회 재가 노인은 연령, 체중변화량, 체질량 지수 변화량, 걷기운동, 유연성 운동에 따라 인지수준의 차이가 나타났다. 특히 정상 체질량 지수를 보이는 노인들은 최근 2년간 체질량 지수가 3이상 감소된 그룹에서 인지수준이 가장 낮았다. 정상 체질량 지수를 보이는 노인의 인지수준에 영향하는 요인에는 연령, 최근 2년간 체중변화, 최근 2년간 체질량 지수 변화, 걷기 운동 등이 있었으며, 이들 변수들은 노인의 인지수준을 12.2% 설명하고 있었다. 그러므로, 최근 갑작스런 체질량 지수 변화가 있는 노인들의 인지 장애 예방을 위하여 이들에 대한 영양관리 및 걷기 운동 프로그램의 적용이 필요하다.

Midazolam의 경비투여와 경구투여 시 진정효과에 대한 비교연구 (COMPARATIVE EVALUATION OF INTRANASAL AND ORAL MIDAZOLAM)

  • 박헌동;이창섭;이상호;이난영
    • 대한소아치과학회지
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    • 제31권3호
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    • pp.431-438
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    • 2004
  • Midazolam은 현재 치과에서 널리 사용되고 있는 의식하 진정용 약물이다. 그러나 주로 경비투여로 사용될 뿐 경구투여 특히 소아에서 경구투여에 대한 지침이 언어 본 연구를 통해 midaaolam의 경구투여 시 진정효과에 대해 알아보고자 하였다. 전신상태가 양호하며 2회 이상의 치료가 필요한 남아 15명 여아 13명, 총 28명의 환아를 대상으로 midazolam($Dormicum^{(R)}$, Roche)을 경비투여 (0.2mg/kg)와 경구투여 (0.5m/kg)하여 치과치료를 시행한 후 치료과정을 6단계로 구분하여 각 단계별로 수면지수와 울음지수, 움직임지수, 전반적인 행동지수를 측정, 비교하여 다음과 같은 결과를 얻었다. 1. 전체 치료과정동안 수면지수와 울음지수, 움직임지수, 전반적인 행동지수 비교 시 I군(경비투여)과 II군(경구투여) 사이에 유의한 차이가 없었다(p>0.05). 2. 보호자 설문조사 결과 I군에서는 67.8%의 보호자가 투여 시 아이가 고통스러워한다고 답하였으며 T군에서는 17.8%의 보호자가 투여에 어려움이 있다고 답하였다. 3. 귀가 후 행동양상에 대한 질문에서 '평상시와 비슷하다'가 I군에서는 78.6%, II군에서는 57.1%로 경비투여 시 더 빠른 회복을 보이는 것으로 나타났다. 위와 같은 결과를 종합하여 볼 때 midazolam의 경구투여는 경비투여와 유사한 적절한 진정효과를 가지면서 환자에게 더 잘 받아들여지는 투여방법으로 생각된다.

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최적화된 노인여가시설 구축을 위한 서비스디자인 기초연구 (A Basic study of Service Design for Optimization of the Public Elderly Recreational Place)

  • 임백빈;김형찬;이성필
    • 감성과학
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    • 제13권4호
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    • pp.753-760
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    • 2010
  • 본 연구의 목적은 고령화 시대를 대비하고 노인들이 행복한 여가시설을 구축하는 것이 중요한 과제라 인식하고 이에 물리적으로 행복한 노인 여가시설을 구축함을 위한 기초 연구로서 현재 노인들이 공공기관에서 제공하는 여가 시설에 대하여 활용성이 떨어지는 요인에 대하여 연구하였다. 구체적인 연구 방법 및 내용으로 첫째, 국내에서 가장 성공적인 공공 노인 여가시설의 모텔로 선정된 대구의 시니어스타워를 방문하여 단순설문 및 관찰을 통하여 장단점에 대한 요소들을 정리 및 KJ기법 및 그라프기법 (Graph Theory)을 적용하여 물리적 공간에 대한 한계성의 요소에 대한 우선순위 그리고 상호관계성을 발췌하여 우선순위 가이드라인을 구축하였다. 둘째, 실제 노인들이 여가시설에서 느끼는 만족정도를 알아보기 위하여 부산시 사상구 노인여가 시설에 방문 및 현지 노인들을 대상으로 설문을 실시하였고, 발췌한 우선순위법(Priority Method) 결과와 비교한 내용을 기반으로 최종적으로 개선 할 사항을 정리 하였다. 본 연구를 통하여 첫째, 물품 및 기기를 노인의 여가공간에 효율적으로 배치하기 위한 노력과 이를 실질적으로 다룰 수 있는 전문성도 중요하다는 것을 알 수 있었다. 둘째, 물리적 기기 및 프로그램을 활용한 노인여가 시설도 중요하지만 노인의 신체적, 정신적 특성을 고려하여 자발적으로 참여하기 위한 참여 형 공간도 중요하다는 것을 알 수 있었다.

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일부(一部) 도시(都市) 영세지역(零細地域)의 보건실태(保健實態) (Health Status in Urban Slum Area)

  • 장임원;정규철
    • Journal of Preventive Medicine and Public Health
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    • 제10권1호
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    • pp.3-15
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    • 1977
  • In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.

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탈모(脫毛) 고객(顧客)의 제품이용실태와(製品使用實態) 관리(管理) 및 만족도(滿足度) 조사(調査) (A survey of the status of hair loss product use, hair loss treatment and satisfaction level)

  • 이지숙;김성남
    • 패션비즈니스
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    • 제11권2호
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    • pp.76-91
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    • 2007
  • The domestic market for scalp care and hair loss management reached 1 trillion won. The market for hair loss management is expected to expand further. Systematic scalp and hair care services, such as scalp scaling, scalp massage, equipment maintenance, scalp care products sale, and care program based on scalp and trichology are provided. This study examined the status of hair loss management and use of hair care products by people experiencing hair loss and the level of their satisfaction. In addition, this study presents basic data for the effective hair loss management and marketing strategies for scalp and hair loss clinics. The results are as follows. 41.2% of the study subjects were in their 20s, and 66.6% of the study subjects were women. As for the hair loss symptoms, 45.2%, the largest percentage, had thin and wispy hair and more women had thin hair than men. 80.0% of men had oily hair. As for the scalp condition, 39,3% had oily scalp. As more women experience hair loss, 39.6% had female pattern hair loss and 31.0% had male pattern hair loss. As the largest percentage of people experiencing hair loss was in their 20s, 33.4%, the largest percentage, had the onset of hair loss in their early 20s. 34.1%, the largest percentage, reported having used the clinic for less than 1 month. The older the subject, the longer the length of hair clinic use. As for the average number of monthly hair loss clinic visits, 28.2%, the largest percentage, said 3 times. As for the hair loss management product use, 61.9%, said they do not use it and 38.1% said they use it. 5.6%, the largest percentage, used Davines at home and 9.6%, the largest percentage, used Kerastase at the clinic. As for the experience of hair loss product previously, 84.5% said they had no experience and 15.5% said they had eThe following are related to the satisfaction level of hair loss management. xperience. 5.0%, the largest percentage, reported having used Daenggimeori. The following are related to the satisfaction level of hair loss management. 32.8%, the largest percentage, said the effect of hair loss management lasted less than 6 monthas. As for the satisfaction levels on hair loss management program, service, skill of the hair specialist, hygiene, and hair loss management products, most people indicated between average and somewhat satisfactory levels. As for the satisfaction level on the cost of hair loss management, most people indicated average satisfaction level. As for the element essential to hair loss management, 39.0%, the largest percentage, indicated development of effective and specialized programs, 28.2%, indicated low price, 25.1%, indicated systematic and professional education of the hair specialist, 4.6%, indicated marketing and promotion, 2.5%, indicated service quality, and 0.6% indicated others.

모유수유 중재에 관한 국내 연구논문의 통합적 고찰 (Integrative Review of Domestic Research Papers on Breast-Feeding Intervention)

  • 최은영;박복순;박선정
    • 한국산학기술학회논문지
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    • 제17권1호
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    • pp.441-452
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    • 2016
  • 본 연구는 기존 문헌의 통합적인 고찰을 통하여 국내에서 산모를 대상으로 수행된 모유수유 중재 교육에 대해 보고된 연구의 특성과 중재내용을 분석 평가하여 최적의 중재를 적용하기 위한 근거자료를 제공하고자 시도되었다. 대상은 1993년 1월에서 2014년 12월까지의 보고된 국내 연구로 4개의 전자 검색 데이터베이스를 이용하였다. 검색결과 76편 중 최종 15편이 분석대상으로 선정되었으며 Whittmore와 Knaf의 통합적 고찰 지침에 따라 연구 분석 한 결과 개별교육 중재 논문이 2편, 개별교육과 집단교육이 동시에 이루어진 논문은 4편, 개별교육과 집단교육, 전화 상담 및 가정방문 교육이 복합으로 이루어진 논문이 9편이었다. 추후 연구에서는 체계적인 연구 설계를 통하여, 모유수유 증진에 보다 적합한 간호중재임을 증명할 수 있는 과학적인 근거가 축적될 수 있어야 할 것이다. 또한 산모의 모유수유 교육에 대한 정확한 결과를 도출함으로써 추후 모유수유 교육에 대한 교육 프로그램 개발의 지침이 될 것이다.

소아정신과 병동에 입원한 품행장애 소아 청소년의 임상 특성 (CLINICAL CHARACTERISTICS OF CHILDREN AND ADOLESCENTS WITH CONDUCT PROBLEMS ADMITTED INTO A PSYCHIATRIC UNIT)

  • 표경식;강윤형;반건호;조수철;이은정
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제9권2호
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    • pp.227-236
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    • 1998
  • 목 적: 본 연구는 소아 청소년에서 증가추세에 있는 진단 중의 하나인 품행장애의 임상특성을 파악하고자 시행되었다. 방 법:연구대상은 1993년 3월 1일부터 1998년 9월 30일까지 서울대학병원 소아정신과 병동에 입원하였던 소아 청소년 중에서 품행장애로 진단받은 45명(남 30명, 여 15명)이었다. 진단기준은 DSM-IV에 의거하였고, 환자기록지 검토를 통해 사회인구학적 특성, 주증상, 공존 정신병리, 발달력, 부모의 정신병리, 다면적 인성검사 척도, 지능지수, 퇴원후 추후치료 등을 조사하였다. 결 과:1) 대상군의 남녀비율은 2:1이었으며, 입원당시 평균연령은 $12.8{\pm}2.4$세였다. 남아는 $12.2{\pm}2.3$세, 여아는 $14.1{\pm}2.1$세로 남아의 입원당시 연령이 의미있게 낮았다(p<.05). 2) 발병시 10세 이전의 아동은 19명(42.2%)이었고, 청소년기 발병 유형은 26명(57.8%)이었다. 그 중남아는 $9.8{\pm}2.9$세, 여아는 $11.7{\pm}2.9$세로 남아의 발병시 연령이 의미있게 빨랐다(p<.05). 3) 입원시 주증상은 DSM-Ⅳ의 4가지 증상 범주 중에서'규칙의 심각한 위반'에 해당되었던 대상군이 35명(77.8%)으로 가장 많았고, 단일 증상으로는'가출'이 26명(48.9%)으로 가장 많았다. 4) 공존 정신병리는 물질 남용이 19명(42.2%)으로 가장 많았고, 주의력결핍/과잉운동장애가 16명(35.6%), 우울증 9명(20.0%), 틱 장애 5명(11.1%), 양극성장애 2명(4.4%) 순이었다. 5) 개인별로 다면적 인성검사 척도에서 가장 높은 점수 척도 2가지를 알아본 결과, 4번(Pd) 척도, 9번(Ma) 척도가 가장 높게 나타났다. 지능지수는 평균 $100.0{\pm}15.1$이었고, 여아($107.2{\pm}14.1$)가 남아($96.7{\pm}14.5$)보다 높았다(p<.05). 6) 퇴원 후 외래방문 횟수는 4회 이내가 15명(33.3%)으로 가장 많았다. 결 론:이상의 결과로 볼 때, 대상군의 여러 특성은 이전의 연구결과와 유사하였다. 주증상은'규칙의 심각한 위반'이 가장 많아 비교적 경미한 수준이었다. 상당수는 복합정신병리를 가지고 있는 것으로 나타났다. 퇴원후 외래치료는 지속적으로 이루어지지 않는 점이 이들 환아의 치료시 어려움 중의 하나이다.

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중학교용 에너지 교육 자료 개발 연구 (A Study on Development of Energy Education Materials for Middle School Students)

  • 최돈형;이양락
    • 한국환경교육학회지:환경교육
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    • 제7권1호
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    • pp.46-87
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    • 1994
  • Our country has been consuming a huge amount of energy in the course of industrialization and its demand is expected to increase enormously in the future. However, the deposits of energy resources are so limited that the settlement of energy problem comes up the essential subject. To solve the energy problem, it is requested that new resources to gain energy stably should be developed and also energy should be economized and used effectively. The effective use of energy and an the wisdom of economy in energy are requested to everybody and these things should be habitualized from very young age through education. Nevertheless, almost every school in our country hasn’t been concerned about energy education. Even though they have a concern, they are very short of the energy education materials and the quality of the materials is not so good. Therefore it is very meaningful to the settlement of energy problem of the country to make the students who will lead our country to make the students who will lead our country in the future realize the seriousness of energy problem and to provide them the necessary knowledge and methods to solve this problem so that they practice those things in everyday life. Having these necessities, this research, supported by The Korea Energy Management Corporation(KEMCO), was performed for 8 months from April 17, 1994 to December 17, 1994. Many peoples participated in this study such as 30 staffs of researchers and authors, 5 staffs of photographers and illustrators, and 3 VCR program producers developing an energy education material set for middle school students that includes a printed material for student, a diskette for computer simulation, a teacher's guidebook, VCR material and its guidebook. The following main development direction was established : First, the material for student should be consisted of units that let students know the seriousness of energy problem. Second, the focus should be put on the necessary method and practice to economize energy actually in real life based on the basic knowledge learned in elementary school. Third, material for student should be consisted of modules to be student activity-oriented teaching-learning rather than lecture-oriented one. The activity, to maximize student's interests, should be presented in various forms such as experiments, investigation, play, data interpretation, computer simulation, visits, expression and appreciation, etc. To develop the energy education materials for middle school students, a research plan was made first. After literature review about domestic and foreign energy education materials, several research trips home and abroad, and discussion meetings, the basic theory of energy education such as the principle, objective, contents, teaching-learning method, and evaluation method was established. Material for student was developed through the following procedures : The activities in the existing energy education materials were analysed and were divided into four categories related to energy using places of home, school, community, and country, and which were again divided into three categories related to time of past, present, and future, Considering these division, nine modules which are structure units of material for student were chosen, Each module comprises 2-4 activities. Totally 31 activities were designed in this way. The syllabi were made out for each activity and writing was asked for to experts related to each activity after several discussions and revision. To complement the draft, another several discussions and revision were also made on it and then pictures and illustrations were asked for. All these procedures complete the material for student, titled ; Energy Inquiry of Middle School Students', which totals 129 pages and is all in color. As the manuscript of material for student was fixed, writing for teacher's guidebook was asked for to the same writers. The draft of teacher's guidebook was also complemented through the several concentrated works and discussions. Teacher's guidebook focused on the teaching-learning principle and methods of energy education and on the concrete instruction cases for effective instruction of material for student. It is organized with two parts : the one is 'general outline' which introduces theoretical contents and the other is 'details' which are practically helpful to teaching-learning. It is totally 131 pages including both 'general outline' and 'details'. The VCR material and its guidebook consist of contents that cultivate the good attitude trying to economize energy and raise student's interests with a purpose of strong motivation to recognize the necessity of economy and practice it. After establishing development direction of VCR material through discussion meetings and research trips, its script was made by relevant experts. Then the script was also reviewed two times. The drafted VCR material made by a video material developing expert was examined and modified by previews twice. After completion of VCR material, the VCR guidebook was made. All these procedures led to the development of VCR material which runs 20 minutes in VHS type. The VCR guidebook shows a production purpose of the program, structure of contents, evaluation methods, and contents of the program in detail to give help to instructors when they use this VCR material, When these energy education materials are used, it is desirable that the VCR material should be presented first to induce student's motive, and then material for student is introduced Since the material for student is composed of activity-oriented modules and each module is independent one another in general, and each activity is, too. the necessary module or activity can be chosen and utilized in any order according to school or class conditions. This energy education materials will contribute to the development of student's ability to solve energy problem in everyday life and teacher's ability to teach the fundamental knowledge and method in solving energy problem.

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우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案) (Problems in the field of maternal and child health care and its improvement in rural Korea)

  • 이성관
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.29-36
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    • 1976
  • Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

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