• 지역사회간호학회지
• /
• 제33권1호
• /
• pp.13-31
• /
• 2022

Purpose: This study conducted a job analysis of visiting nurses in the process of change. Methods: Participants were the visiting nurses working for the Seoul Metropolitan city. On the basis of the Public Health Intervention Wheel model, two times of the focus group interview (FGI) with seven visiting nurses and one time of the Developing a Curriculum (DACUM) with 34 visiting nurses were performed. A questionnaire survey of 380 visiting nurses was conducted to examine the frequency, importance and difficulty levels of the tasks created by using the FGI and DACUM. Results: Visiting nurses' job was derived as the theme of present versus transitional roles. The present role was categorized as 'providing individual- and group-focused services' and 'conducting organization management', while the transitional role was categorized as 'providing district-focused services' and 'responding to new health issues'. The job generated 13 duties, 28 tasks, and 73task elements. The tasks showed the levels of frequency (3.65 scores), importance (4.27 scores), and difficulty (3.81 scores). All the tasks were determined as important, exceeding the average 4.00 scores. The group- and district-focused services of the tasks were recognized as more difficult but less frequent tasks. Conclusion: The visiting nurses exert both present and transitional roles. The transitional roles identified in the present study should be recognized as an extended role of visiting nurses in accordance with the current changing healthcare needs in South Korea. Finally, the educational curriculum for visiting nurses that reflects the transitional roles from the present study is needed.

• 한국학교보건학회지
• /
• 제1권2호
• /
• pp.50-65
• /
• 1988

This study was conducted in order to grasp the condition of about the school nurse's service and to offer the basic materials of improving the school health service. The objects were comprised of 98 volunteered school nurses who take service in the elementary school. The material of this study was the questionaire suited to the purpose of this research which has been made through studying references and this questionaire has been corrected and revised three times. All the questionaire written by school-nurses. The results are as follows; 1. General features of the objects of study Average age was 35.9 and average career was 9.2 years. Except working as school-nurse, the past career was that average clinical-field was 3.4 years and health service was 4 months. Their educational level was as high as 72.4% of the objects were graduated from above 3 years college and 89.8% were married. 76.5% have religions and 94.8% were working at with national and public schools. 99.0% were doing only nursing service. 2. The conditions of the school health resources. The ratio of school-nurse to students was one to 2630. School-nurse to classes, one to 49.3, and school-nurse to teachers, one to 54. For total amount of a year budget of school health, from three hundred thousands to fifty nine hundred thousands won was most common. Expenses for purchasing medicine were used most. 58.2% of school-nurses hasn't known a year budget. There was an organization for school health in 74.2% of schools. 42.9% of nursing rooms were in the center of school and 88.8% were on first floor. Nursing room were used alone without being used by another purpose and the room size of 71.6% was below 10 pyong. 3. The conditions of school health service Average users of nursing room were 413 a month. The most of them had digestive trouble. Sending letters to home was 15.9 times a year. The most contents of letters was about health education. Object spent much time managing nursing room. 4. The degree of school health service When 2 points was given to "perform" and 1 point was to "not perform" the total average was 1.75, health education 1.89, environmental management 1.86, plan of project and evaluation 1.83, management of nursing room 1.82, health management 1.78, run of school health organization 1.32. 5. Correlation between the school health services and variables (1) The part of project plan and evaluation of school health service has relationship to existence or none-existence of school health organization (P<0.01), past health service career (P<0.05), number of classes (P<0.01), number of students (P<0.01), sending letters to home about health education (P<0.01) and number of users (P<0.05). (2) The part of nursing room management has relationship to ages (P<0.05) past clinical career (P<0.05), number of classes (P<0.05), number of students (P<0.05) and sending letters to home about health education (P<0.01). (3) The part of health education has relationship to existence or none-existence of school health organization (P<0.05), past clinical career (P<0.05), the ratio of health management to school nurse's all work (P<0.05) and the ratio of health education to school nurse's all work (P<0.01). (4) The part of environmental management to ages (P<0.01), career as a school-nurse (P<0.01), salary step(P<0.01), sending letters to home about health education (P<0.01), sending all letters to home (P<0.001), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.05) and area of school-nurse's room to be used. (5) The part of school health organization management to number of classes (P<0.05). (6) The part of health management to number of classes (P<0.05), sending letters to home about health education (P<0.001), sending all of letters to home (P<0.01) and the ratio of health management to school nurse's all work (P<0.05). (7) The part of school health service to ages (P<0.05), past clinical career (P<0.05), past health career (P<0.01), number of classes (P<0.05), number of student (P<0.05), sending letters to home about health education (P<0.05), sending all letters to home (P<0.05), the ratio of health management to school nurse's all work (P<0.05), the ratio of health education to school nurse's all work (P<0.01) and area of school - nurse's room to be used (P<0.05). ## Suggestion for further studies are as follows. 1. School-nurse should exert herself to advance a quality to take care of school population's health. 2. It is necessary that systematic support required to keep school population's health. 3. Home, school and community should make efforts cooperatively and the proper roles of students, teachers, health team members and parents must be achieved.

• 경영정보학연구
• /
• 제14권2호
• /
• pp.1-19
• /
• 2012

최근 의료서비스 추세는 소비자의 교육과 생활수준의 향상으로 인해 의료기관이 추구하는 일방적인 형태의 의료서비스에서 벗어나 보다 차별화되고 지속적으로 자신의 건강관리가 가능한 능동형 의료서비스 형태로 변화하고 있다. 따라서 스마트 텔레메디슨 시스템은 기존의 단순한 혈압, 혈당, 심장박동, 체온 측정기 등에 블루투스와 이동통신 모듈의 결합을 통해서 의료서비스를 제공하며, 환자가 인식하지 못하는 사이에 환자의 건강 상태 패턴을 분석하여 예방적인 건강관리가 가능한 능동형 유비쿼터스 의료서비스를 제공하게 한다. 즉 온라인과 오프라인의 의료서비스 환경이 상호 연결되어 시간과 장소에 구애 받지 않고 스마트폰과 모바일 의료검진 디바이스를 통해서 양방향으로 의료서비스를 제공한다. 특히 정보통신 기술의 발전과 더불어 새롭게 등장하는 스마트 텔레메디슨 서비스 사업자를 통해 환자들이 효과적인 의료 검진을 위해 장시간 이동하고 대기하는 시간과 비용을 절감하고 환자의 종적 건강 데이터관리를 통해서 환자 스스로가 건강관리를 하게 한다. 또한 개인화된 맞춤형 예방 건강관리 의료서비스를 이용하게 함으로써 다양한 형태의 의료서비스 비즈니스 상거래를 가능하게 하고 있다. 본 연구는 예방의학적인 스마트 텔레메디슨 시스템을 정의하고 이를 기반으로 한 비즈니스 모델 설계와 분석 및 평가모델을 제시하고자 한다.

• Journal of Hospice and Palliative Care
• /
• 제13권3호
• /
• pp.181-189
• /
• 2010

목적: 최근 보건의료 정책 결정은 근거에 기반하여 이루어지는 추세에 있으며, 말기암환자 정보시스템은 이러한 필요에 부응하기 위하여 개발되었다. 본 고에서는 말기암환자 정보시스템의 개발과정 및 6개월 데이터로부터의 통계 결과를 보고하고자 한다. 방법: 말기암환자 정보시스템의 입력항목은 실무 전문가들의 자문을 받아 개발되었으며, 이벨로스 임상연구관리시스템을 기반으로 구축하였다. 2009년 보건복지가족부에서 지정된 34개 암환자완화의료 기관에 2009년 1월 1일부터 6월 30일까지 등록된 환자들에 대한 정보가 수집되었다. 분석은 기술적 통계를 이용하였다. 결과: 총 2,940명의 전국적으로 대표성 있는 데이터로부터 아래와 같은 결과를 얻었다. 평균연령은 $64.8{\pm}12.9$ 세였고, 56.6%가 남자였다. 폐암(18.0%)이 가장 많았다. 2인 이상의 의사에 의하여 말기진단을 받은 경우는 50.3% 였으며, 입원 당시 말기라는 사실을 알고 있는 환자는 69.7%였고, 거의 절반에 가까운 환자가 특별한 의뢰 없이 입원하였다. 평균 통증 및 최고 통증은 입원 1주 후에 통계적으로 유의하게 감소하였다. 사망 퇴원한 환자가 73.4%였으며, 집으로 퇴원하는 경우는 13.3%에 불과했다. 1회당 평균 입원일수는 $20.2{\pm}21.2$일이었으며, 중위값은 13일이었다. 결론: 말기암환자 정보시스템의 운영을 통하여 완화의료 기관 이용 환자 및 가족의 특성, 서비스 제공에 관한 현황 등에 관한 전국적으로 대표성 있는 자료를 얻을 수 있었다.

• 지역사회간호학회지
• /
• 제1권1호
• /
• pp.582-594
• /
• 1989

The purpose of this study is to analyze the factors affecting the school health teachers' self-confidence. This study was conducted with 87 school health teachers working in Jeonbuk province, from September to December, 1986, The results are follows; 1. Demographic characteristics of school health teachers 1) Age mean ; 34, range; 23-54 2) School Nursing experience mean; 11 years, range; 0-24 3) Clinical experience mean; 1.5 years, range: 0-13 2. Status of school health resources & nursing activities 1) Personnel resource school health teacher: pupils : 1 : 1,436 'classes=1:31 'general teacher=1:39 2) Budget Total school operating budget: School health budget : 100 : 4.2 (52.2 thousand Won) Half of the school health budget expend on medicine. 3) Clinic 80% of all schools have health clinic seperately. 71.32 of all schools have less than $35m^2$, 23.9%, $36-66m^2$. 4) Only 20% of all schools have organization for health 5) Average of clinic visitor for 1 year; 2,084 Major problem is on digestive system. And other problem: respiratory, skin, musculo - skeletal system, dental problem, etc... 6) Literal message for 1 year; 12 times. For health education (4), vaccination (3), examination of parasites (2), etc... 3. The degrees of the school health teachers' self-confidence 1) Program planning & evaluation; 2.9. 2) Clinic management; 2.8 3) Health education; 2.8 4) Management of school environment; 2.7 5) Health care services; 2.5. 6) Operating of school health organization; 2.3 4. Significances to self-confidence on school health nursing activities 1) Program planning & evaluation: home message (r=.228, p<.05) No. of clinic visitor (r=.220, p<.05) expending time for clinic management (r=.229, p<.05) religion (t: 2.5, p<.05) level of school (F=6.3, p<.005) 2) Clinic management: age of school health teacher (r=-.202, p<.05) school health experience (r=-.211, p<.05) salary step (r=.187, p<.05) expending time for clinic management (r=.315, p<0.1) marital status (t=3.97, p<.005) level of school (F=3,139, p<0.5) 3) Management of school environment: level of school (F=3.899, p<.05) expending time for clinic management (r=-,216, p<0.5) 4) Health care service: age of school health teacher (r=-.186, p<.05) marital status (t= 3.67, pH.005) 5) Health education: expending times for clinic management (r=-.252, p<05) level of school (F=5.343, p<.01) 6) Operating of health organization; age of school health teacher (r=-.258, p<.01)salary step (r=.188, p<.05) Based on the above results, the suggestions are as follows; 1. Need to raise ,appointment rate school health teacher. 2. Need to raise self-confidence on school health nursing activities through the inservice education or re-inforcement. 3. Need to secure adequate budget for school health. 4. Participation of school health teacher and support of school master for school health services are required. 5. Need for use the health clinic seperately, adequate facilities and free utilization by visitors.

• 대한간호학회지
• /
• 제22권4호
• /
• pp.636-652
• /
• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.

• 서비스연구
• /
• 제12권4호
• /
• pp.72-81
• /
• 2022

코로나-19, 메르스, 지진 등 새로운 재난이 현대사회에 등장하면서 불확실한 위험에 대한 국가의 관리능력이 중요해 지고 있다. 정부는 현장대응 역량을 강화하여 생활밀착형 재난안전관리 정책을 추진하고 있으나, 예측 불가한 국가적 재난·감염사태 발생 시 사망자·감염시신의 발생은 불가피하다. 이에, 최근 대형화·복잡화·탈지역화 되고 있는 재난에 보다 효과적으로 대응하기 위해서는 공공부문의 재난 관련 조직만으로는 한계가 있으므로 중앙정부, 지방자치단체는 물론 국가재난대비 지정장례식장 등의 재난대비 장례지원 역량을 총체적으로 점검하고 발전 방안을 모색할 필요가 있다. 정부는 예측 불가한 국가적 재난·감염사태 발생 시 생활밀착형 재난 안전관리 대책이 필요하며, 사망자·감염시신 발생이 불가피할 경우 시신처리 및 장례지원 대책이 필요하다. 이에, 국가재난 현장에서의 장례지원 절차와 방법 등 효율적인 대응과 전략이 필요해짐에 따라 지정장례식장을 도입하게 되었다. 대형 재난시 관련 부서의 일상 업무 수준을 넘는 다수의 사상자가 발생되고 이에 따른 구호, 의료, 장례 및 행정절차 등의 급격한 변화가 발생되므로, 대형 재난을 다루는 것은 일상 업무에 대한 부가적인 일이 아니라 비상시를 대비하는 전문적인 한 분야를 이루어야 한다. 본 연구는 본 연구는 국가재난대비 지정장례식장을 대상으로 기본 운영방향과 신속한 장례지원방안을 도출하는 것을 목적으로 하며, 재난별 상황에 맞는 장례지원 및 체계를 조직화하고 필요 물품을 체계화하여 감염을 최소화 하고자 한다. 더불어 장례서비스의 개선방안을 제시하고자 한다.

• Journal of Hospice and Palliative Care
• /
• 제10권3호
• /
• pp.137-144
• /
• 2007

목적: 본 연구는 호스피스 입원 환자와 가족의 간호요구를 파악하고, 그들의 요구를 충족시켜주는데 필요한 기초자료를 제공하기 위함이다. 방법: 2004년 5월부터 10월 말까지 일 호스피스 병동에서 퇴원한 환자 76명과 가족 76명을 대상으로 하였고, SPSS 10.0으로 분석하였다. 결과: 대상자의 연령은 70세 이상이 가장 많았으며, 초기 진단명은 폐암이 가장 많았다. 호스피스 입원환자가 경험하는 신체적 증상은 통증, 기운 없음, 식욕부진, 오심구토, 호흡곤란의 순이었고, 정서적 증상은 불안, 우울, 분노 순이었으며, 영적 증상은 신에게 의지하고 싶어함, 원목실, 성직자가 방문하여 종교의식을 원함 순이었다. 입원 환자의 요구도는 통증 조절, 통증 이외의 증상(구토, 호흡곤란, 복수 등)조절, 정서적 문제의 해결, 영적 문제의 해결 순으로 높았으며, 환자의 관심사는 본인의 건강관련문제, 혼자 남을 배우자에 대한 관심, 자녀의 장래문제 순이었다. 가족의 간호 요구도는 "환자의 상태 및 처치/간호에 대한 정보"영역이 가장 높았으며, "가족의 역할 알려주기", "영적 지지", "정서적 지지" 순이었다. 문항별로는 "환자의 예후에 대해 알려주는 것", "환자에게 행해지고 있는 각각의 간호가 왜 필요한지 알려 주는 것" 순으로 높았다. 가족들은 환자의 편안한 임종을 가장 높게 기대하였고, 서비스의 만족도는 자원봉사자 서비스가 가장 높았으며, 통증 조절, 간호사 서비스 순이었다. 결론: 의료인들은 암환자를 돌보는 가족들의 실제적인 요구를 정확히 파악하여 개별적인 대상자들의 요구와 특성을 반영하는 지속적인 관심과 지원을 줄 수 있는 실질적인 프로그램을 개발하고 운영할 때 환자와 가족 모두의 삶의 질을 향상시킬 수 있다고 생각한다.

• 한국보육지원학회지
• /
• 제9권5호
• /
• pp.513-538
• /
• 2013

우리나라는 1921년 태화기독교 여성관 탁아프로그램으로 보육이 시작된 이후 1991년 영유아보육법이 제정되는 등 질적인 보육을 제공할 수 있는 정책적 기반이 꾸준히 발전해왔다. 약 90년 정도 된 보육의 역사에서 보육정책을 담당하는 부처는 시대에 따라, 그리고 관련 법의 규정에 따라 보건사회부, 농업진흥청, 내무부, 문교부, 노동부 등 여러 부처로 분산되어 왔으나, 1991년 제정된 영유아보육법에 의해 보건복지부로 일원화되었고 2004년에는 여성가족부로, 2007년에는 다시 보건복지부로 이관되었다. 우리나라의 보육정책은 1991년 제정된 영유아보육법을 기점으로 교육부 관할의 유치원과 보건복지부 관할의 어린이집의 이원체제로 운영되어 왔다. 최근 출산율의 급속한 저하로 인해 출산율 회복을 위한 정책 개발과 보육의 질적 향상을 도모할 수 있는 방안에 대한 필요성에 의해 다양한 보육정책이 시행되고 있다. 본 연구에서는 우리나라 현재 보육정책의 주요 특징과 앞으로 다가올 시대를 위해 보육정책이 나아가야 할 방향과 과제에 대해 논의하였다.

• Journal of Nutrition and Health
• /
• 제13권1호
• /
• pp.15-26
• /
• 1980

The main purposes of the nutrition and clinical surveys were to provide baseline information on the nutritional status of pre-school children in rural health demonstration project areas of the Korea Health Development Institute (KHDI) for nutrition guidance services for the MCH target group. The survey covered a total of 222 pre-school children and 135 mothers in Okgu Gun, Cholla Pukto Province from August 10 to August 17, 1979. The survey results are summarized as follows: 1) Family Environment Seventy percent of the households had more than three children, and the mean family sire was 6. Sixty-nine percent of the mothers and 47% of the fathers of the surveyed households were educated at or below the primary school level. The majority, 70% of the mothers, were aged between 20 years and 35 years. 2) Anthropometric Measurements and Hemoglobin Value 4.5% of the children were lower than 80% weight for age of the Korean standard, and 5.4% were lower than 85% arm circumference for age of the Jelliffe's standard resectively, and those were suffering from protein-energy malnutrition. Angular stomatitis were observed on 66.2% of the subjects. Mean hemoglobin value was 11.1g/100m1, and 44.2% of the subjects were categorized as anaemia. 3) Food and Nutrient Intake of animal foods was very low, ranging from 2.9 to 17%. Consumption of eggs was less than 2% of total food intake, and intake of legumes was also very scanty, between 0.8 to 3.7%. These data present evidence of very poor protein intake, quality as well as quantity. Energy intake of children was 60.0 to 64.4% of the recommended allowance, and mean protein intake only met 47.4% of the recommendation. Low intake of vitamins except thiamin were also found. 4) Mother's Nutrition Knowledge Eighty-five percent of the mothers were entirely ignorant regarding the 'five basic food group' which is most important fact on food and nutrition guidance. Mean knowledge score from 14 basic questions about food and nutrition was as low as 5.1. There was a significant positive correlation between mother's educational level and nutrition knowledge score. 5) Family Planning Variable There were significant correlation among maternal, family planning variables, and some of the nutritional and physical measurements. The study revealed that the mother's educational level and nutrition knowledge score are more crucial factors than the family planning variables on effecting food intakes on children. Recommendation : According to the results of the surveys, there were high incident rates of nutritional anaemia and angular stomatitis among pre-school children, and most of rural women had very limited knowledge about food and nutrition. As a main part of the health education activities, the community health workers should provide nutrition education to the village mothers to improve the nutrional status of young children in rural areas. Nutrional promotion at the primary health care level should be mainly based on appropriate nutrition education.