• 대한간호
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• 제31권4호
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• pp.77-99
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• 1992

The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

• 대한간호
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• 제32권5호
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• pp.66-77
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• 1994

The purpose of this study was to develop a new nursing unit which can meet changing health care needs, enhance patients' satisfaction and nurses' job satisfaction, and finally guarantee quality nursing care with present manpower. For this, one medical unit was selected as a unit for quality care. And one medical unit which is similar in staffing and patients' characteristics was selected as a control unit. To assess present problems and identify the remedies to the problems a hospital-wide survey and a workshop were performed. According to the survey results, educational programs and improvement of the facilities and equipment supply system, managereal support for interdepartmental cooperation and intensification of bed-side nursing care were adopted as main principles for operating model unit, This model unit was operated for 3 months from Sep. 1, 1992 to Nov. 30, 1992. To evaluate the effectiveness of the model unit, derect/indirect nursing care hours, patients' satisfaction to nursing care, nurses' job satisfaction, and quality care index were measured. Direct/indirect nursing care hours were compared with that of the control unit, and patients' and nurses' satisfaction and quality care index were measured before and after operating model unit and compared with each other. The results of the study were as follows; 1. In the model unit mean direct nursing care hours per cach shift was 146.88 minutes and indirect nursing care hours was 354.72 minutes. The ratio of the direct nursing care hour to indirect nursing hour was 29.6 ; 70.4 and that of the control unit was 26.9 : 73.1. Direct nursing care hour in model unit was longer than that of the control unit. But, the difference was not significant. In subcategories of direct nursing care, the time spent in mobility and exercise, conservation of body temperature, hygiene, and communication and health education were longer than that of the con" trol unit. 2. Indirect nursing care hour in model unit was shorter than that of the control unit. But, the difference was not significant. In subcategories of indirect nursing care, the time spent in drug management and ward arrangement was shorter than that of the control unit. 3. Patients' satisfaction to nursing care was increased significantly after operating the model unit (T=-3.48, P=-0.002) and satisfaction to subcategories of physical comfort measure, psychological cate, and unit management components were significantly higher than before. 4. In the model unit, nurses' total job satisfaction was increased significantly after operating the model unit(Z=2.1004, P=.0357) and satisfaction to subcategory of satisfaction to administration was significantly higher than before (Z=-2.0732, P=.0382). 5. After operating the model unit, quality care index was increased from 89 to 93. With this results, it can be summarized that all the measures tried for quality care, such as educational programs, managereal support for interdepartmental cooperation, and improvement of the equipment and facility provision resulted in partial increase in direct nursing care hours, nurses satisfaction to their job and patients' satisfaction to nursing care. In can be postulated that managereal support and motivation without proper staff supplementation is not enough for increasing direct nursing care hours. And for the enhancement of the level in clinical nursing, and staff supplement must be considered sincerely and the measures for reducing indirect nursing care hours, such as computerization of nursing care activities, improvement of facilities and equipment and facilities supply system, must be instituted in addition.

• Journal of Animal Science and Technology
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• 제45권1호
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• pp.41-48
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• 2003

본 연구는 효모배양물을 육계에 수준별로 급여하여 두 차례의 사양실험을 시행하였다. 각각의 실험에서 처리구는 사료내 효모배양물 수준을 0, 0.1, 0.2, 0.4%로서 전체 4개의 처리구를 두었다. 실험 1에서는 처리구당 60수씩 총 240수를 환경조절형 계사에 수용하였으며, 계사내 유해가스에 미치는 영향을 고찰하였다. 실험 2에서는 처리구당 5반복, 반복당 16수로 80수씩 전체 320수를 이용하였으며, 육계의 생산성, 장내 미생물의 변화, 혈중 콜레스테롤 및 ND 항체가를 측정하였다. 사육 전기 3주간에 급여된 사료의 조단백질과 에너지 수준은 각각 21.5%, ME 3,100kcal/kg으로 하였으며 후기 2주에는 19%, ME 3,100kcal/kg 수준으로 급여하였다. 실험 1에서 효모배양물을 수준별로 급여시 0.4% 급여구에서 암모니아 가스 발생량은 다른 처리구에 비하여 감소하였고, 이산화탄소는 모든 효모배양물 급여구에서 대조구보다 유의하게 낮았다. 실험 2에서 증체량은 효모배양물 0.2% 급여구가 대조구에 비하여 증가하는 경향을 보였으나 통계적인 차이는 없었고, 사료섭취량 또한 처리구간에 차이가 없었다. 사료요구율은 효모배양물 0.2% 급여구가 대조구보다 유의적으로 개선되었다(P<0.05). 효모배양물의 급여가 육계의 장내 미생물에 미치는 영향은 0.1, 0.2% 급여구에서 회장의 E. coli가 대조구와 비교하여 유의하게 감소하였고(P<0.05), 맹장의 Latobacillus는 0.1% 급여구에서 유의하게 증가하였다. 혈중 총 콜레스테롤은 0.1% 급여구에서 유의적인 차이는 없었으나 감소하는 경향을 보였고, LDL-cholesterol 함량은 효모배양물 0.1% 급여구가 대조구에 비하여 유의하게 감소하였다. ND 항체가는 효모배양물의 급여구에서 대조구보다 높아지는 경향을 보였지만 처리구간에 통계적인 차이는 없었다. 본 연구의 결과, 육계 사료에 효모배양물의 급여로 계사내 유해가스를 감소하였으며, 사료요구율이 개선되었다. 그리고 장내 미생물과 콜레스테롤 수준에서도 변화를 나타내었다.

• 한국수정란이식학회지
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• 제21권2호
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• pp.163-168
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• 2006

본 연구는 도축되는 소 난소의 효율적인 이용을 위해서 도축장으로부터 실험실로 운반되는 난소 수송 온도에 따른 체외 수정란 생산 효율을 조사하고자 실시되었다. 도축장의 HACCP 적용으로 도축장 출입이 불가능하므로 위탁하여 난소를 공급받게 되어 취급자의 부주의로 적절한 온도 유지가 되지 않는 경우가 많다. 특히 겨울철에는 더 많은 주의가 필요하다. 따라서 본 실험에서는 겨울철 난소수송 온도에 따라서 4처리 그룹, 즉 $7{\sim}10^{\circ}C$ (T1), $11{\sim}17^{\circ}C$(T2), $18{\sim}25^{\circ}C$(T3) 그리고 $26^{\circ}C$ 이상인 경우를 control 그룹으로 구분하였다. 회수된 난포란을 체외 성숙, 수정 및 배양을 실시하여 처리 그룹간 체외 성숙율, 분할율, 배반포 발달율 및 배반포의 세포수를 비교하였으며, 동결-융해한 배 반포에 대해서도 생존성에 대하여 비교하였다. 실험 결과를 요약하면 다음과 같다. 1. 회수된 난포란을 22시간 동안 체외 성숙시켰을 때 수정 적기인 제2감수분열 중기에 도달한 비율은 $T1{\sim}T3$ 그룹에서 $60.0{\sim}68.2%$의 비율로 나타났으나, control 그룹에서는 81.8%로 다른 처리군에 비해서 유의적으로(p<0.05) 높은 결과를 보였다. 2. 체외 수정 후 48 시간에 확인한 분할율은 control 그룹이 83.6%로서 T3 그룹과는 유의적인 차이 가 없었으나, T1(52.6%) 또는 T2 그룹(54.5%)에 비해서 유의적인(p<0.05) 차이를 보였다. 수정 후 168시간과 192시간까지의 배반포 생산율은 처리군간 유의적인 차이를 보이지 않았다. 3. 생산된 blastocysts를 동결-융해하여 수정란의 생존성을 확인한 결과, T1 그룹이 46.2%로서 다른 처리군($68.8{\sim}73.1%$)에 비해서 유의적으로(p<0.05) 낮은 생존율을 나타내었다. 따라서 본 실험의 연구 결과를 살펴볼 때 도축되는 소 난소의 수송 온도는 $26^{\circ}C$ 이상을 온도를 유지하는 것이 저온에 의한 난포란 손상을 최소화하여 체외 발달율 및 동결-융해 후 생존율을 높여, 궁극적으로 수정란이식 산업과 생명 공학 분야의 실험의 효율을 증진시키는데 기여할 수 있을 것으로 사료된다.

• 한국직업건강간호학회지
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• 제8권1호
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• pp.22-41
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• 1999

This study intended to analyze the health promoting behaviors, compare their factors according to the shift pattern of duties of women workers who were working in the industrial workplace and present basic data in planning systematic and effective programs of health promotion for three-shift system and day-duty. Using Quota Sampling, 219 women workers were selected as subjects from 5 workshops which had 50 settled workers up to 300 and 10 factories which had more than 300 located in Taegu and Kyung-Book Province. Data were collected by means of questionnaire from September 12 to September 30, 1998. As the instruments of the study were used Health Promotion Lifestyle Profile(HPLP) which was adapted and adjusted by Seo, Y. O. for health promoting behavior, the one developed by Moon, J. S. (1990) for health-belief, the one developed by Sherer et al.(1982) and then adapted by Oh, H. S. for self-efficacy, and the one developed by Park, J. W. (1985) for social support. The analysis of data were performed with Cronbach's ${\chi}^2$-test, t-test, ANCOVA, Kendal tau, Pearson correlation, Stepwise Multiple Regression test using SPSS program. The results of the study are as follows : 1. There was a significant difference in age(${\chi}^2=32.46$, p=0.000), career (${\chi}^2=18.47$, p=0.000), working day(t=-3.18, p=0.000) by the shift pattern of duties in terms of socio-demographic characteristics. 2. There was a statistically significant difference between the two groups on the health promoting behaviors (t=2,52, p=0.012). The score of three-shift group on health promoting behaviors was 2.27, showing that it was lower by .13 than that of day-duty group(2.40). 3. ANCOVA involving age, career and working day as covariables, which had revealed significant difference before, showed that health promoting behaviors by the shift patterns of duties was significantly different(F=4.88, p=0.028). 4. In consideration of variables that have an influence on health promoting behavior by the shift pattern of duties, social support occupied 19.4% of health promoting behavior in the three-shift group and 22.5% including the sense of self-efficacy. In the day-duty group, social support occupied 34.4% of health promoting behavior. 5. The score of three-shift group(2.94) was significantly lower than that of day-duty group(3.12) in the perceived benefit of health-belief(t= -3.29, p=0.001), while the score of three-shift group (2.48) was significantly higher than that of day-duty group(2.24) in the perceived barrier (t=4.22, p=0.000). In the sense of self-efficacy(t=-4.20, p=0.000), the score of three-shift group(3.24) was significantly lower than that of day-duty group(3.53) while in social support(t=-4.56, p=0.000) the one of three-shift group(2.64) was significantly lower than that of day-duty group(2.88). The suggestions are as follows on the basis of the results of this study : 1. It is required to develop health promoting program that takes the shift pattern of duties of women workers into consideration. In addition, there are special demands on developing nursing strategies for health promoting behavior of three-shift workers. 2. It is required to develop specific strategies for social support which is the most significant factor to the health promoting behavior for women workers. 3. It is necessary to develop some programs for improving the sense of self-efficacy, social support, and health-belief of three-shift workers. To achieve these tasks, industrial nurses should play an active role and improve the ability of self-health care of women workers.

• Korean Chemical Engineering Research
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• 제48권2호
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• pp.259-267
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• 2010

불균일 촉매 CuO를 이용한 반응성 아조계 염료 Reactive Black 5(RB5) 폐수의 촉매습식산화에서 반응온도($190{\sim}230^{\circ}C$) 및 촉매농도(0.00~0.20 g/l)가 폐수의 색도 및 총 유기탄소 TOC 제거에 미치는 영향을 조사하였다. 폐수의 색도는 분광광도계를 사용하여 측정하였고, 습식산화속도는 TOC를 이용하여 산출하였다. 열분해 조건($230^{\circ}C$, 120 min)에서 폐수의 색도는 약 90%까지 제거되었지만 TOC는 제거되지 않았다. RB5 폐수 촉매 습식산화에서의 폐수의 색도 및 TOC 제거속도는 반응온도 및 촉매농도를 증가시킴에 따라 증가하였다. 촉매의 영향은 0.01 g CuO/l에서 이미 상당히 크게 나타났으며 0.05 g CuO/l 이상에서의 촉매농도 증가에 따른 효과는 작았다. 폐수 색도의 초기변화는 색도에 대한 1차 반응속도론으로 나타낼 수 있었으며, TOC 변화는 폐수 TOC를 쉽게 산화되는 TOC와 난분해성 TOC 로 구분한 global 모델로 묘사할 수 있었다. 반응온도의 폐수 색도 및 TOC 제거속도에 미치는 영향은 Arrhenius 상관관계식으로 묘사할 수 있었다. RB5 폐수의 열분해, 습식산화 및 0.20 g CuO/l의 촉매농도를 사용한 촉매습식산화 조건에서의 색도 제거반응의 활성화에너지는 각각 108.4, 78.3 및 74.1 kJ/mol의 값을 나타내었다. RB5 폐수 촉매습식산화에서의 TOC 제거반응에서 산화 최종산물로의 전환에 대한 난분해성 중간산물로의 전환 비는 페놀 습식산화에 비하여 상대적으로 높았다.

• 한국축산시설환경학회지
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• 제12권3호
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• pp.115-122
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• 2006

본 연구는 터널환기 무창육계사의 계사내부의 위치별 먼지 농도 분포와 배기홴에서 배출된 먼지의 확산범위를 알아보고자 수행하였으며 결과는 다음과 같다. 1. 입기구 방향의 계사 1/4 지점의 먼지농도는 TSP의 경우 $301.0{\sim}1,366.0\;{\mu}g/m^3$으로 입기구의 위치에 따라 차이가 있었다. 2. 터널홴 앞 3m 지점에서는 TSP $2065.8{\sim}3,092.2\;{\mu}g/m^3$, PM 2.5 $27.6{\sim}36.3\;{\mu}g/m^3$, PM 1.0 $8.3{\sim}11.3\;{\mu}g/m^3$으로 입기구에 비하여 증가하였다. 3. 배기홴으로부터 3m의 지점의 먼지 배출량은 TSP $354.8{\sim}574.8\;{\mu}g/m^3$으로 매우 높았으며 PM10 $94.4{\sim}156.2\;{\mu}g/m^3$, PM2.5 $14.6{\sim}18.0\;{\mu}g/m^3$, PM1.0 $6.0{\sim}6.4\;{\mu}g/m^3$ 이었다. 4. 배기홴으로부터 50m 떨어진 지점에서의 분진농도는 TSP $25.1\;{\mu}g/m^3$, PM10 $8.8\;{\mu}g/m^3$, PM2.5 $5.6\;{\mu}g/m^3$, PM1.0 $4.9\;{\mu}g/m^3$으로 매우 낮은 분진농도를 보였다. 5. 입기구와 배기구 간 분진농도의 차이는 TSP의 경우 입기구에서 $317.9\;{\mu}g/m^3$인데 비하여 배기구는 $2,678.5\;{\mu}g/m^3$로 8.42배 높았으며 PM10 7.4배, PM2.5 3.4배, PM1.0 1.6배 높았다. 6. 배기홴으로부터 거리별 분진의 배출농도는 3m 지점에서 $446.6\;{\mu}g/m^3$ 이었으나 20 m 지점에서는 $156.3\;{\mu}g/m^3$로 34.9% 수준이었고 PM10 34.9%, PM2.5 48.7%, PM1.0 86.8% 수준이었다.

• 한국축산시설환경학회지
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• 제12권3호
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• pp.123-132
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• 2006

우리나라에서 사육되고 있는 젖소 육성우의 분뇨배설량을 구명하기 위하여 육성우 6두를 공시하여 축산연구소 낙농우사에서 봄, 여름, 가을, 겨울 등 4계절에 걸쳐 각각 10일간 시험을 수행하였으며, 그 결과는 다음과 같다. 1. 건물섭취량은 평균 6.7kg으로 봄, 여름, 가을 및 겨울이 각각 4.6, 8.3, 7.1, 6.8kg으로 봄이 가장 낮은 섭취량을 보였으며, 음수량은 평균 $19.3{\ell}$로, 여름이 $21.8{\ell}$로 가장 많았고 봄과 겨울이 $18.3{\ell}$로 낮았으나 계절별 유의차는 보이지 않았다. 2. 분뇨배설량을 계절별로 조사한 결과, 봄 13.7kg, 여름 23.8kg, 가을 25.0kg, 겨울 20.2kg으로 봄이 가장 낮았으며(p<0.05), 전체 평균 분뇨배설량은 20.3kg이였고, 체중대비 분뇨의 비율은 5.6%였다. 3. 체중과 분뇨배설량간($R^2=0.7816$), 체중과 사료섭취량간($R^2=0.7296$)의 상관관계가 비교적 높았으나, 음수량과 분뇨배설량, 사료섭취량과 분뇨배설량간의 상관관계는 비교적 낮았다. 4. 분뇨의 수분 및 pH를 분석해 본 결과, 분의 뇨의 평균 수분 함량은 각각 83.5, 94.6%였으며, pH는 각각 7.4, 7.6 수준이었다. 5. 분뇨중 오염물질 농도는 분의 $BOD_5,\;COD_{Mn}$, SS, T-N 및 T-P는 각각 18,048, 50,114, 119,833, 2,519, $427mg/{\ell}$였고, 뇨는 각각 5,434, 6,550, 825, 3,616, $28mg/{\ell}$였다. 6. 분뇨중 비료성분은 분의 N, $P_2O_5,\;K_2O$가 각각 0.25, 0.10, 0.14%였고, 뇨는 각각 0.36, 0.006, 0.31%였다.도는 3m 지점에서 $446.6\;{\mu}g/m^3$ 이었으나 20 m 지점에서는 $156.3\;{\mu}g/m^3$로 34.9% 수준이었고 PM10 34.9%, PM2.5 48.7%, PM1.0 86.8% 수준이었다.

• 대한간호
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• 제29권2호
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

• 농촌의학ㆍ지역보건
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• 제8권1호
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• pp.44-65
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• 1983

As a part of the epidemiological studies of clonorchiasis, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Gimhae Gun and delta area a high endemic area in Korea in recent years, prior to the introduction of praziquantel which will eventually influence the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author(Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The prevalence rate of clonorchiasis in the general population of the villages was 48.1% on the average out of a total of 484 persons examined. The average of those of the riverside-delta area was 65.2% and 43.0% in the inland area. Among the schoolchildren, the prevalence rate was 8.2% on the average out of a total of 1,423 examined. By area, the prevalence rate was 10.8% in the riverside delta area and 2.8% in the inland area. By sex, difference in the prevalence was seen only in the inhabitants of the inland area showing 52.4% in the male and 33.5% in the female. 2) In the natural transition of the infection, the prevalence rate among the inhabitants has decreased from 68.8% in 1967 to 48.1% in 1983, and in the schoolchildren from 56.4% in 1967 to 8.2% in 1983. The reduction rate was higher in the riverside-delta area than in the inland area. 3) In the prevalence rate by age, 11.9% was first seen in the 5-9 age group and the rate gradually increased up to 75.0% in the 50-59 age group. By sex, the rate was higher in the male than in the female in the 20-29 age group and over. 4) In the natural transition of the prevalence rate by age, the reduction rate of the infection during the past 16 years was greater in the younger age groups up to the 40-49 age group and reached the same level in the age group 50-59. Reduction was seen again in the age group over 60s. By sex, the reduction rate was greater in the female than in the male in the 20-29 age group and over. By area, the reduction rate was greater in the riverside delta area than in the inland area, particularly in the young age groups. 5) In the intensity of the infection among the cases, the mean egg out-put per mg feces per infected cases(EPmg) in the inhabitants was 6.3. EPmg of those of the river-side-delta area was 15.4 and that of the in-land was 2.8. On the other hand, in the schoolchildren, EPmg was 3.2, and no difference was seen between the two areas, the river-side-delta area and the inland area. 6) In the transition of the intensity of the infection by area, EPmg among the inhabitants inexplically increased from 7.8 in 1967 to 15.4 in 1983. This was probably caused by uneven specimen collection in the process of sampling the population. EPmg of the inhabitants in the inland area and those of the schoolchildren of both riverside delta and inland areas showed a similar decrease in the past 16 years. 7) The intensity of the infection by age showed a relatively low level in the 20-29 age group and below, and EPmg 5.1-9.5 was seen in the 30-39 age group and over. Sex, Epmg was 5.8 in the male and 4.7 the female. By in 8) In the transition of the intensity of the infection, EPmg decreased from 6.2 in 1967 to 5.4 in 1983. By age, in contrast to the figures of 1967 in which EPmg gradually increased with some fluctuation from 1.1 in the 0-4 age group to peak 10.5 in the 50-59 age group, in 1983 lower intensity of the infection was seen in the age group from 10-14 to 20-29 with the EPmg range of 0.6-2.7. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 43.2% of the cases were in 0.1 0.9 and 34.6% in 1.0-4.9. As a whole by cumulative percent, 44.6% of them were under 0.9 as light infection and 86.1% of them under 9.9 up to moderate infection. By sex, no difference was seen in Epmg. 10) In the transition of the distribution by the range of Epmg, the cases were distributed up to the range 80.0-99.9 in 1967 and to 60.0-79.9 in 1983. By cumulative percent, in the range of 0.1-0.9 and less, light infection, 34.3% of them were distributed in 1967 and 44.6% in 1983 with about 10% increase. In the range of 5.0-9.9 and less, up to moderate infection, 83.2% in 1967 and 86.1% in 1983 of the cases were seen, respectively. 11) The practice of raw freshwater fish consumption among the inhabitants seems to have decreased in recent years. Those who admitted to raw freshwater fish consumption in the last two years among the infected inhabitants were 59.3%, although 86.8% of them professed to have experience with raw freshwater fish consumption. 31.7% of those who have had experience of the raw freshwater fish consumption denied any further consumption in recent years. From an interview of 543 school-children, 24.1% of them admitted to an experience of raw freshwater fish consumption. However, those who have practised in the past two years comprized 17.9%. Those who denied raw freshwater fish consumption in recent years among those who had such experience were 26.0% out of 131 interviewed. The rate of raw freshwater fish consumption in both inhabitants and schoolchildren were higher in the male than in the female. On the contrary, the rate of those who did not practise in recent years among those who had experience of raw freshwater fish consumption was higher in the female than in the male. 12) The major reason for the reduction of raw freshwater fish consumption among the local inhabitants was the risk of the fluke infection. However, it has become apparent that such change of taste has resulted from water pollution impact which has affected throughout the areas of the freshwater systems in this locality since last several years. 13) In animal survey, Clonorchis infection was seen in 14.8% of 88 dogs examined and 3.7% of 27 house rats examined. It was noted that populations of dogs and cats have increased in the villages surveyed. Although the prevalence rate was lower in the present survey than those of 1967, the significance of the animals as the reservoir host has not changed. 14) Prevalence rate of Clonorchis infection by cercariae in the first intermediate host, Parafossarulus manchouricus, was 0.6% out of 517 snails examined. The infection rate was lower in comparison with 2.3% out of 2,124 examined in 1967. Moreover, sharp decreases in number and distribution of the intermediate host snails in many watershed areas of the huge freshwater systems in this locality seemed to reduce transmission of Clonorchis in connection with the intermediate host stage of its life cycle. 15) Clonorchis infection in the second intermediate fish hosts was relatively low. The mean number of Clonorchis metacercaria per fish in Pseudorasbora parva was 517 in 1983, whereas it was 1943 in 1968 through 1969. Environmental water pollution has also caused the decreased fish population density in these areas, and this has also apparently affected to the practice of raw freshwater fish consumption among the local inhabitants. 16) In conclusion, endemicity of Clonorchis infection in Gimhae Gum and delta area of the Nagdong River has sharply decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the land water systems of this locality. The pollution has upset the ecosystems comprizing of the intermediate hosts of Clonorchis in many areas, and also affected to a significant extent to the discontinuance of the local inhabitants for raw freshwater fish consumption.