• 제목/요약/키워드: Nursing Service Experience

검색결과 264건 처리시간 0.028초

보건의료체계와 코로나19 치명률의 연관성 (The Relationship between the Health System and the COVID-19 Case Fatality Rate)

  • 이한솔;이시은;박지원;이유리
    • 보건행정학회지
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    • 제33권4호
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    • pp.421-431
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    • 2023
  • Background: The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries. Methods: This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance. Results: A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR. Conclusion: Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

일부 공공보건기관 방문보건요원의 교육요구도 조사 (Education Need of the Visit ing Health Service Workers in Gwangju and Jeollanam-do Public Health Facilities)

  • 김영락;김신월;정은경;최진수
    • 농촌의학ㆍ지역보건
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    • 제27권1호
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    • pp.51-64
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    • 2002
  • 전라남도의 무작위 추출된 10개 시 군과 광주광역시 5개 구의 방문보건사업 담당직원 200명 중 우편설문조사에 응답한 144명을 연구대상으로 하여 방문보건 사업과 관련된 교육훈련경험 여부와 만족도, 응답자의 주관적 판단에 의한 방문보건서비스 관리 지식 정도 그리고 향후 방문보건사업에 필요한 교육훈련에 대한 요구도에 대해 조사하여 향후 방문보건요원의 교육훈련의 기초자료를 제공하고자 하였다. 본 연구의 주요 결과는 다음과 같다. 1. 조사대상자 중 3년 동안 한가지 이상의 중앙교육 훈련 경험자는 43명(29.9%), 광역자치단체의 교육훈련 경험자는 57명(39.6%), 그리고 지방자치단체의 교육훈련 경험자는 53명(36.8%) 등으로 나타났다. 교육과정에 대한 만족도를 점수화 한 결과 중앙 교육($2.38{\pm}0.57$)이 광역자치단체 교육($2.18{\pm}0.57$)과 기초자치단체 교육($2.13{\pm}0.54$)보다 높았다. 2. 조사대상자의 방문보건서비스 관리 지식 정도는 환자 및 질병관리 영역 중 투약 및 검사, 상처 및 욕창 관리, 환자 개인위생, 고혈압환자 관리, 당뇨환자 관리, 관절염환자 관리 그리고 전염성질환자 관리, 고위험 가족 및 가정환경 관리 영역 중 환경위생 관리, 안전 및 사고 관리 그리고 감염관리, 건강증진관리 영역이 5점 만점에 평균 3점 이상이었으며, 재활 및 요양 영역은 전반적으로 평균 3점 이하의 점수를 보였다. 3. 조사대상자의 방문보건서비스 관리 지식 정도는 간호사 자격증을 소지하고 있는 경우 높았으며, 중앙 교육 중 노인보건, 재활 등 실무영역과 정신보건전문간호사, 광역자치단체 교육 중 보건진료원보수교육, 정신 보건교육, 그리고 기초자치단체 교육의 건강증진영역, 노인보건, 재활 등 실무영역, 정신보건영역과 급성질환 관리영역에 대한 교육훈련 경험이 있는 경우 높았다. 4. 조사대상자의 교육내용에 대한 요구도는 노인건강 관리과정이 가장 높았고, 최근 업무가 새롭게 추진되고 있는 노인보건, 호스피스, 치매노인관리, 재활, 건강증진 등이 높은 것으로 조사되었으며, 방문보건사업 업무별로는 방문보건사업전반이 가장 높았고 방문보건사업에서 실제 서비스를 제공하는 분야가 교육의 요구도가 높은 것으로 나타났다. 또한 교육방법으로는 공무원 집단교육(47.0%)을, 교육전담 주체는 광역자치단체 (30.4%)를, 교육방식은 실습(57.7%)을, 교육횟수는 년 2-3회(44.5%)를, 교육기간은 3-5일(41.0%)을 선호하는 것으로 나타났다. 향후 지역사회 주민에게 효과적인 방문보건서비스를 제공하기 위해서는 방문보건사업에 대한 지식 정도를 높일 수 있는 교육훈련의 기회를 확대하고 방문보건요원의 교육요구도에 근거하여 교육훈련을 개선해야 할 것이다.

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응급의료 전달체계의 충실 방안 (A Study in an Effective Programs for Emergency Care Delivery System)

  • 권숙희
    • 한국보건간호학회지
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    • 제9권1호
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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영국 성인돌봄서비스 시장에 대한 감독 개혁과 한국 장기요양의 시사점 (The reform of inspection of adult social care market in the UK and policy suggestions for long-term care in South Korea)

  • 전용호
    • 한국산학기술학회논문지
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    • 제19권4호
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    • pp.203-210
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    • 2018
  • 영국은 사회복지 돌봄에서 시장화를 유럽에서 가장 먼저 추진한 나라로 유명하다. 영국의 시장화 정책은 사회민주주의 국가에게도 영향을 끼칠 정도로 여러 나라가 시장화 정책을 도입해서 추진하고 있고 우리나라도 장기요양보험제도를 통해서 시장화 정책을 적극 도입했다. 본 연구의 목적은 영국 정부가 최근에 단행한 성인 돌봄 시장의 감독 강화 개혁을 분석하고 이를 토대로 한국 장기요양보험의 정책적인 시사점을 모색하는데 있다. 연구결과에 따르면, 영국은 시장을 적극적으로 관리 감독하고 있는 것으로 나타났다. 특히, 대규모 요양시설의 갑작스러운 파산 이후에 '2014년 돌봄 법'을 제정해서 돌봄품질위원회(Care Quality Commission)가 6단계별로 대규모 서비스 제공기관의 재정 상태와 서비스 질 등 측면에서 파산의 위험성을 사전적으로 분석하고 있다. 이를 통해서 제공기관이 일정한 수준으로 위험성이 높아지면 그 결과를 지방정부에 통보해서 파산과 같은 상황에 체계적으로 대응하도록 했다. 영국의 개혁은 장기요양 시장에 문제가 있는 한국에 시장에 대한 감독 강화, 새로운 감독 시스템 구축, 공공 감독 조직의 확대, 국민건강보험공단의 정보 공개 등의 정책적인 시사점을 제시한다.

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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우리나라 의료재활 전문인력 수요${\cdot}$공급 및 추계에 관한 연구 (An Analysis on Demand and Supply for Medical Rehabilitation Professionals in Korea)

  • 권혁철;정영일
    • The Journal of Korean Physical Therapy
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    • 제9권1호
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    • pp.19-35
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    • 1997
  • Korea will soon experience a high demand for medical rehabilitation specialists, if it tries to deliver advanced health welfare service. In order to medical rehabilitation manpower policies, this study attempts to analyse, estimate and plan a long-term supply for physiatrists, physical therapists, and occupational therapists. The study analysed both national and foreign statistical data of manpower supply for medical rehabilitation specialists. Based on the above data, the demand of and supply for each specialists were estimated for long term up to the year 2030. Based on the comparative analysis results of the future demand and supply. the author intended to develop a new supply plan for the three specialist categories. The major finding of the supply plan are as follows : First, as for the supply plan for physiatrists, the author recommends to adopt the demand estimation 1 as the most suitable. In order to prevent an oversupply of physiatrists, the supply plan 1 is recommended which annual enrollment of specialists will maintain with the quota of fixed number of 63 from the year of 1999. Second, it is estimated that there was already an oversupply of physical therapists in Korea. This oversupply is expected to continue even though there would be an increase in rehabilitation hospital beds, rehabilitation facilities for the elderly, and nursing homes, Thus, it would be desirable to cut down the number of students admitted to physical therapy schools each year. Third, there will be a high demand for occupational therapists in the near future as people become more aware of the usefulness of this therapy. Thus, it is urgent to establish a supply plan to meet the demand. Given the close relationship between physical therapy and occupational therapy, the study recommends that the universities already having the the department of physical therapy open the department of occupational therapy as well.

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콩고민주공화국 비문해력 여성의 산후관리 이용에 미치는 영향 요인 (Influencing factors on postnatal care utility of illiteracy women in the Democratic Republic of Congo)

  • 신동은;송진성;소애영;;남은우
    • 보건교육건강증진학회지
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    • 제32권3호
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    • pp.85-96
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    • 2015
  • Objectives: This study aims to identify the influencing factors of using postnatal care among illiteracy women who live in the Democratic Republic of Congo. Methods: Household survey was done from February 1 to 8, 2013 in the Kwango district of Democratic Republic of Congo, and 400 childbearing women who has under 5 years old children and pregnant women was randomly selected and answered through the interview with a questionnaire. For analysis the data, ${\chi}^2$ test and logistic regression analysis were used. Results: Woman who can read, write and mathematical calculation was 195 (47.4%) of total 411 answers and 161 (39.2%) used postnatal care for their latest pregnancy. Age at first marriage (${\chi}^2=18.481$, p<.001), religions (${\chi}^2=11.165$, p=.011), languages (${\chi}^2=35.586$, p<.001), the experience of children death (${\chi}^2=16.507$, p<.001), antenatal care over 4 times (${\chi}^2=15.315$, p<.001), postnatal care (${\chi}^2=15.558$, p<.001) is significantly different from literacy level. Among illiterate women group, who are protestant (OR=.330), using Lingala (OR=.128), took elementary education (OR=.223) and farmer (OR=.040), used less postnatal care. Conclusions: For increasing usage of postnatal care among illiterate women, new approach method should be considered such as a visual communication method and a community health workers' training program for giving an outreach service to pregnant women care.

DRG 지불제도에 대한 미국의 경험과 우리 나라에의 시사점 (The U.S. Experience of the DRG Payment System and Suggestions to Korea)

  • 박은철;이선희;이상규
    • 한국병원경영학회지
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    • 제7권1호
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    • pp.105-120
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    • 2002
  • In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

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미국의 노인전문약사 제도에 대한 체계적 고찰: 인증, 교육 및 성과 (A Systematic Review on the Certified Geriatric Pharmacist Program of the U.S.: Certification, Education and Outcomes)

  • 남혜연;조은
    • 약학회지
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    • 제58권2호
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    • pp.129-140
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    • 2014
  • Background: As elderly population has been increasing, pharmacists need to possess special knowledge and skills to provide enhanced pharmaceutical care for senior patients. Purpose: This study aims to systematically review on (1) the certified geriatric pharmacists (CGP) system, (2) the curriculum related to geriatric pharmacy education, and (3) the CGP's performance in terms of clinical, economic and humanistic outcomes in the U.S. Method: The information related to CGP system and curriculum was obtained through the official websites of 'American Society of Consultant Pharmacists', 'Commission for Certification in Geriatric Pharmacy' and the selected pharmacy school samples. Articles about on the outcomes of pharmacist-provided cognitive services including Medication Therapy Management were searched through PubMed. Results: To gain the CGP credential, pharmacists need 2-year experience as pharmacist in advance and take the CGP examination. This certification must be renewed every 5 year. Most pharmacy schools provide geriatric-related curriculum through didactic or pharmacy practice classes for pharmacy students and certificate or dual degree in gerontology are given on completion. Most previous outcomes research reported that pharmacists have played a role in yielding favorable results regarding clinical, economic and humanistic outcomes for nursing facilities, hospitals and community pharmacy settings. Conclusion: Considering the organized CGP certification system and concrete educational courses established the basis for pharmacists to exert their ability for senior patients of the U.S., it is suggested to build a geriatric pharmacist credential model for pharmacists to provide the increasing elderly patients with the requisite safe and effective pharmacy care in Korea.

일 지역사회 공무원의 정신건강지식 및 정신건강사업에 대한 태도조사 (Mental health literacy of local public officials and the mental health business attitude survey)

  • 김현실;강은옥
    • 한국산학기술학회논문지
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    • 제20권2호
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    • pp.275-285
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    • 2019
  • 본 연구의 목적은 우리나라 지역사회 공무원의 정신건강지식 및 정신건강사업에 대한 인식을 알아보기 위해 시행된 서술적 조사연구이다. 조사대상자는 강원도 3개 군에 근무하는 공무원 273명을 대상으로 시행하였으며, 구조화된 설문지를 통해 2018년 7월 1일부터 8월 15일까지 자료를 수집하였다. 자료 분석은 SPSS 22.0 프로그램을 이용하였다. 연구결과 공무원의 정신건강지식은 101.45점(범위 35-160)이었다. 정신건강지식정도는 직업, 정신건강 교육 유무, 정신건강 치료경험 유무, 가족의 정신건강 치료경험 유무에서 통계적으로 유의한 차이가 있었다. 정신건강사업에 대한 인식으로 정신건강복지센터에 대해 알고 있는지에 대해 응답자의 39.9%가 이름정도만 알고 있다고 응답하였으며, 확대해야 할 정신건강서비스는 우울 등 조기발견 서비스가 35.9%로 가장 많았다. 정신건강사업으로 인한 지역사회의 변화에 대해 약간 좋아지고 있다는 응답자가 44.7%로 가장 많았다. 조사대상자들의 정신건강복지센터에 대한 인식과 정신건강 지식 점수와의 관계를 분석한 결과 정신건강지식점수에 따라 정신건강복지센터에 대한 사전지식 유무와 정신건강 관리를 위한 정부의 관리투자에 관한 문항은 통계적으로 유의한 것으로 나타났으므로(p=.012) 지역사회 공무원들의 정신건강지식을 향상시키기 위해 정신건강간호사를 활용한 교육 프로그램의 개발을 제안한다.