• 치위생과학회지
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• 제1권1호
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• pp.46-52
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• 2001

2001년 3월 29일부터 2001년 5월 9일까지 서울 경기지역 건강사회를 위한 치과의사회에 소속되어 있는 치과의원과 치과병원에 근무하는 치과위생사 78명과 치과조무사 50명을 대상으로 설문조사를 실시하였다. 조사 내용은 일반적 특성, 자가 건강관리, 개인방호의 실천, 치과진료기구의 취급, 손 씻기에 관한 사항으로 구성되어 있다. 일반적 특성과 요인들간의 관계를 비교 관찰한 연구결과는 다음과 같다. 1. 병원 근무 전 건강검진을 받은 경우는 근무년수 5-7년 미만이 71.4%로 가장 많았고, 병원 근무 후 건강검진을 받은 경우는 근무년수 9년 이상이 61.5%로 가장 높았음을 알 수 있었다(P<0.05). 2. 병원 근무 후 B형 간염예방접종을 받은 경우는 연령별로는 35세 이상이 71.4%로 가장 많았고, 근무년수별로는 9년 이상이 57.7%로 가장 많게 나타나 연령과 근무년수에 따라 차이를 보였다(P<0.05). 3. 개인방호실천은 치과위생사와 치과조무사 사이에 유의한 차이는 없었다(P>0.05). 그러나 개인방호 실천도를 3점 만점으로 할 때 마스크 착용 2.40과 장갑착용 1.96에 비해 진료용 보안경 착용 1.48로 낮게 사용되고 있음을 알 수 있었다. 4. 사용하고 남은 마취제의 관리는 1회 사용 후 버리는 경우가 치과위생사는 89.7%, 치과조무사 70.0%로 치과위생사에서 높게 나타났다(P<0.05). 5. 손 세정제로 항균용 액체비누를 쓰는 치과위생사가 19.3%, 치과조무사 10.0%로 매우 낮았으며, 손 건조 방법으로 1회용 종이수건을 사용하는 치과위생사 37.2%, 치과조무사 36.0%로 낮게 나타났다(P>0.05).

• 대한간호학회지
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• 제8권1호
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• pp.1-15
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• 1978

The Purpose of this study is to examine closely the causes influenced upon the comfort and recovery of the woman delivered of a child in the hospital at the same time to understand environmental status of hospitals in order to promote mother's health recovery, and to improve hospital environment by emphasizing the meaning of environment and health before the medical staff and hospital administrative authority. In the method of servery of the research, 165 post paestum patients have been randomly selected who were accommodated and delivered their babies at OB(obstetric ) & GY (Gynecologic) unit the 7 general hospitals for the period of 6 December 1976 through 17 December 1976. As for the survey, it has been used of Questionnaire where we have 65 items in the respect of personal environment in the hospital such as trusting nurse, ability, reliability, kindness and etiquette of nurse and tile character of nurse the relationship with patients the other respect of physical environment included 9f temperature, moisture. air-ventilation lightening noise, cleanness. facilities, and the third realm being of mother's hearth ground to have the following conclusion 1. The feature of the collected personnel they are from OB or GY sects of from OB unit of the other 5 hospitals except the two general hospitals of the college or school Otherwise the rate of the patients to nurses would be 9 : 1. As for the nurses'ground it would be appeared of 20-25 years of age as the 76%. either 3 year course or 4 year course in the education would be each 50% and less than 2 year experience case would record as of 60 %. In the respect of hospital physical environmental status, there we have two hospitals without any thermometers, on the other han4 nowhere there's hygrometer, otherwise, the lightening is normal or over than normal As for the structure of noise protection the corridors're, generally speaking worse than rooms, nerver hueless, there's no ventilating system in the hospitals. The rooms'repainted in white and yellow, light green white, or green color. The patient's clothing were in green pink blue, light green or in white co for. There're not anything special in both decoration and equipments. Most of them used tall beds except in one hospital 2. To the extent of perception of patient's hatch 9round and hospital environment it is presented that they perceived nurse's ability in highest in total human variable, though perceived kindness or etiquette in the lowest otherwise, comparatively high in total average. 3. In the respect of physical environment it is highest perceived of lightening terms, otherwise, lowest perceived of air ventilation and total average became lowest than the one of the original record 4. To ages, in the respect of hatch ground rather old aged mother than the younger one has perceived that nurse would be trusting, in good service character, able, at the same time, liable, Otherwise, in physical environment regardless of age, they perceived lightening in high and remarkably lower in ventilation As a result of the examination of the difference in hospital environment to each age it is appeared of statistical difference at 5% level of ability in the personal environment otherwise little difference as for physical environment 5. In the respect of perceiving level to educational standard it is highly perceived of personal environment for higher ranking group rather than lower group in the educational standard. In case of physical environment it is highly perceived for lower level group rather than higher level group in educational background. The variables which have statistical significance at 5% level are from trusting kindness, etiquette and total kindness, etiquette and total all significance at 5% level are from trusting, kindness, etiquette and total human environment variable in personal environment, otherwise, there's little difference in the physical environment. 6. The perceiving level due to times of admission and accommodation at the hospital would be cleared out as gradual higher perception both physical and personal environment in the hospital. At 5% significant level of the ventilation condition in physical environmental variable it is presented of meaningful difference otherwise, there we have little difference both in Personal variable and other one. 7. In accordance with living standard, the perception degree of personal environment in tee hospital would be inclined to increase to higher living standard on the other hand, in case of the physical environment, the perception level world increase to lower living standard At 5 % level, the trustuariable and total scores in the personal eicuironmectal variable there appeared a meaningful/ significant difference otherwise, there presented little difference both in physical environmental and other variable to the living standard 8. Pertaining to family unit, the mother of an independent family unit perceived highly in all respect of the personal and the physical environment in the hospital rather than the woman of succeeding family unit. At 5 % level there appeared a difference in the respect of kindness and etiquette both in personal environment variable, on the other hand, there hardly marked a difference between other variable and physical environmental one. 9. The degree of perception to comforting level has little connection with a statistical difference the age, educational level hospital admitting times, living standard or family unit. 10. The most effective variable to mother's comforting level will be nurse's ability, reliability, trusting manner, and total physical environment variable in order.

• 한국환경보건학회지
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• 제17권2호
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• pp.54-66
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• 1991

As a result of measuring illumination and making up a question at home visit directly by investigator who trained over twenty days period from October 4 to 24, 1990, in order to render help which illumination problem against house, society against eyes or framing of health instruction potgram by seizing natural lighting actual conditions of house and actual conditions of wearing spectacles and by investigating interrelationship, I can summarize as follows. 1) In property of investigation subject, woman 66.9%, In an age, the twenties was largest of 27.4%, the forties was 20.2%, the fifties was 18.6%, the thirties was 17.4%. In academic career, those of upper secondary school grauates was largest of 28.6%, those who possess university career was 25.9%, those who middle school career was 20.9%, decoding of Korean alphabet was 2%. 2) By a residence area, a big city was 43.3%, farming and fishing villages were 20.3%, the rest was a small town and the administrative office of town, township. In positon of house, the middle area was 43.6%, resident of suburb area was 38.0%. In form of house, a Korean-style house was 40.8%, a western-style house was 34.8%, an apartment house was 11.0%. In the a standard of living, the middle classes 77.2%, the lower classes were 15.3%. In residential house unit of area, from 21 to 30 unit of area was largest of 31.5%, from 10 to 20 unit of area was 19.9%, from 31 to 40 was 18.7%. 3) The wearing spectacles rate of study user was 44.1%. By the area, those who wearing spectacles was more than a half of 50.8% in the resident of big city area. As passing from the farm area to the city, that is being resident of big city was high wearing spectacles rate. In position of house, as being residence in central street showed high wearing spectacles rate. (central street was 51.5%, the middle area was 44.5% and the suburb area was 40.1%.) It seemed similarity difference a variable by position of house from wearing spectacles in standard of 1%. By form of house, wearing spectacles rate those who resident in apartment house was 49.5%, that rate those who resident in a western-style house was high of 49.0%, that rate those who resident in a Korean-style house was the lowest 39.0%. By social position of resident in room, in students case who study showed very high, as university students were very high of 62.3% idn wearing spectacles rate, middle and high school students 'were 50.0%, members of society were 47.6%, workers 20.3%. It seemed similarity difference from academic career in standard of 1%. By an age, the thirties was high of 54.1% in wearing spectacles rate, the twenties was 43.2%, the teenage was the lowest of 11.8%. 4) In illumination of study, over 200Lux was high of 40.1%. but below 99Lux which inappropriate illumination to see the books was 32.4%. Average by area, below 99Lux was 22.7% and over 400Lux was 50.0% in case of wooden floor. As examine by area, below 99Lux was high of 27.0% a case of wooden floor in the big city area, it was not good in illumination passing from the farm area(15.0%) to the city(19.0%). Average illlumination by area of the main living room below 99Lux was high of 37.5%, less than 200Lux was 58.5% of whole. In general, illumination of the main livingroom was inappropriate. By area, the big city was 32.5% below 99Lux, the middle and small city area were 33.8%, town and township area were 45.0%, farming and fishing area were 42.8%. By area, in the big city, illumination of study was 52.5% over 200Lux and 28.9% below 99Lux. In case of the middle and small city, study user of below 99Lux was 38.8% and over 200Lux was 46.9%. In case of the seat of town township, below 99Lux was 34.1% and over 200Lux was 39.7%. In case of farming and fishing area, illumination of study was 33.4% below 99Lux and 48.4% over 200Lux. It tends to high rate of inappropriate illumination. 5) By position of house, in case of wooden floor, less than 100Lux was 24.5% in central street. It was bad illumination than others position of house. In case of the main livingroom, less than 100Lux was 40.4% in the suburb area. It was bad iliumnation than others position of house. In case of study, less than 100Lux was 35.4% in the middle area, it was worse in illumination. In case of the main living room, is seemed similarity difference in standard of 1%. 6) By form of house, in case of wooden floor, illumination of less than 100Lux was 23.8% in a western-style house, it was bad illumination than others form of house. In case of the main livingroom, illumination of less than 100Lux was 47.4% in a Korean-style house, it was remarkably bad illumination than others form of house. In case of study, a Korean-style house was 38.8%, it was very bad illumination than others form of house. In case of the main livingroom and study, it seemed similatrity difference each as P < 0.01 and P < 0.05 in standard of 1%. 7) The wearing spectacles rate of those who use room of illumination over 400Lux was 40.7%, and that of those who use room of illumination less than 100Lux was 28.1%. It seemed similarity differecce in standard of 1%. 8) In period of wearing spectacles, 21.3% of total investigator-highest-was from before five years, 8.6% was from before three years. Among those who use of illumintion less than 99Lux, 34.0% began to wear spectacles from before two years 31.7% was from before five years, 30.3% was from before four years. It seemed similarity difference from period of wearing spectacles by illumination in standard of 1 %. 9) Among cause which sight grow worse, the first was that it was each 33.2% and 27.4% in response rate because watch TV nearly to wearing spectacles person and non-wearing person. The second was that a lot of seeing books was 25.3% in wearing spectacles person and response rate for dark illumination was 7.4% in nonwearing spectacles person. It seemed similarity difference in standard of 1%. (P < 0.01). 10) In experience which take medicine good for eyes, it was 50.1% in wearing spectacles person and 8.5% in non-wearing spectacles person. It seemed similarity difference in standard of 1%(P < 0.01). As we have seen above, inappropriate illumination can be a cause of wearing spectacles. Nevertheless, actually, is realities to indifferent against illumination of house. So it must learn knowledge about health obstacle of illumination through society instruction and school eduction against students as well as general residents. In case that natural lighting is inappropriate structural of house, we must be able to maintain appropriate illumination through artificial illumination. And so eyes which is core of human life have to be protected, related the authorities, related group, and all health medical personnel will organically cooperate with and make efforts.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.