• 지역사회간호학회지
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• 제9권1호
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• pp.89-103
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• 1998

The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.

• 농촌의학ㆍ지역보건
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• 제25권2호
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• pp.353-377
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• 2000

보건진료소의 보건의료환경 및 근무여건, 업무현황과 개선에 대한 보건진료원의 의견을 파악하여 향후 보건진료소의 발전 방안을 제시하는데 도움을 주고자 경상북도 소재 보건진료소(1996년 330개소, 1999년 313개소)의 운영상황보고서에 의한 업무 변화량을 분석하였으며, 보건진료원 280명의 설문자료를 분석하였다. 운영상황보고서에 의한 보건진료소의 관할인구 추이는 1996년에 비해 1999년에 전반적으로 감소하였으나 노인인구는 증가하였다. 운영상황보고서에 의한 보건진료소의 업무 활동상황은 1996년도에 비해 전반적으로 증가하였고, 진찰 및 투약관리, 검사, 성인병 및 만성질환관리, 노인건강, 가정방문이 특히 증가하였으며, 전염병 관리와 결핵관리에서 부분적인 감소를 보였다. 재정운영상태는 50.4%가 운영이 잘된다고 하였고, 1.4%만이 운영하기 곤란하다고 하였는데, 현 근무지 근무연수가 많을수록(p<0.05), 그리고 도시근교일수확, 인구가 많을수록, 진찰 및 투약건수가 많을수록(p<0.01) 운영이 잘 된다고 하였다. 보건진료원의 직업적 긍지는 전반적으로 긍정적이었는데, 그 중 하는 일의 중요함이 94.6%로 가장 긍정적이었고, 역할과 임무에 대한 만족정도는 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들의 보건기관과 민간의료기관과의 협조정도는 대체로 긍정적이었는데, 보건소와 협조정도는 연령이 많을수록, 근무 경력이 길수록 긍정적인 응답률이 유의하게 높았으며(p<0.01), 현 근무지 근무연수에 따라 차이가 있었다(p<0.05). 보건진료원들은 운영협의회, 마을건강원, 지역사회조직과도 협조적이다는 응답이 모두 70% 이상이었다. 보건진료소 사업계획서는 96.4%가 적성하였으며, 제2기 지역보건의료계획서 작성에는 11.4%만이 참여하였다. 관할지역주민의 혈압과 흡연여부를 70% 이상 파악하고 있는 보건 진료원은 각각 88.2%, 63.9% 였는데, 혈압파악률은 보건진료원의 연령이 많을수록(p<0.01), 교육정도가 전문대학 이하인 경우(p<0.05)에서 높았다. 보건진료원의 지난 3년 동안에 보수교육외 교육 참여율, 연구사업 참여율은 각각 27.5%로 저조했으며, 보건진료소 수입으로 주민환원 사업을 실시한 경우는 65.4%였다. 보건진료원들이 생각하는 보건진료소의 필요 정도는 국가적 측면, 소속시군 측면, 관할지역 측면에서 모두 95% 이상이 매우 필요 또는 필요하다고 하였으며, 53.9%가 보건진료소의 역할이 증대되어야 한다고 하였다. 지금까지 폐쇄 및 폐쇄 예정된 보건진료소에 대하여 보건진료원은 담당 부서의 보건진료소 업무에 대한 인식부족 및 행정편의, 보건진료원의 신분이 법률로 보장되지 않은 별정직이어서, 단체장의 의지 등을 주된 이유로 제시하였다. 보건진료원은 향후 보건진료소에 대한 평가기준에 대해 노인 및 만성질환자 등의 보건의료서비스 대상자수, 주민의 의견, 인구 규모, 일상생활권을 고려한 교통상황 등의 순으로 제시하였으며, 보건진료원에 대한 평가기준으로는 보건사업실적, 주민과의 유대정도, 진료실적, 행정 및 업무처리 능력 등의 순으로 제시하였다. 객관적인 평가 후 일정기준이하의 보건진료소에 대한 향후 대처 방안에 대해서 보건진료원은 현 구조 유지하면서 업무개선, 도시 의료취약지역으로의 보건진료소 위치 조정 등을 많이 제시하였다. 보건진료소의 가장 필요한 개선부문으로는 절반 이상인 52.5%가 보건진료원의 업무조정이라고 하였으며, 향후 보건진료소가 중점적으로 추진하여야 한 사업으로는 당뇨 및 고혈압 관리, 방문보건사업, 노인보건사업 등이 중요하다고 하였다. 향후 보건진료소가 일차보건의료의 가치체계를 잘 반영하는 조직이 되기 위하여는 지역사회 보건의료요구에 부합하는 업무개선이 이루어져야 하겠으며, 만성질환관리사업, 방문보건사업, 노인보건사업 등이 활성화 되어야 하겠다.

• 한국보건간호학회지
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• 제21권2호
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• pp.125-133
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• 2007

Purpose: To identify the compliance level with therapeutic regimen among patients with hypertension residing in rural communities. Method: A descriptive-retrospective research design was employed. One hundred patients with hypertension using 8 Primary Health Care Posts under W Public Health Center were randomly recruited on the basis of being over 35 years of age. After obtaining written consent, the patients underwent direct interviews with a structured questionnaire carried out by 8 public health practitioners. Descriptive statistics and binary logistic regression were utilized. Results: In a binary logistic regression model adjusted for age, sex, education, income, and occupation, those who were receiving medication (OR=5.34), were undergoing a weight control program (OR=4.45), restricted alcohol (OR=9.93), or smoking cessation (OR=25.59) as recommended by medical or health professionals were more compliant (p<.05) while those under a low salt diet, exercise, and stress management were not significant statistically (p>.05). Conclusions: Further research should be conducted to validate these findings so as to facilitate the development of nursing intervention strategies for improving the compliance of hypertensive patients in respect to medication and life style modification.

• 한국농촌간호학회지
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• 제2권2호
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• pp.120-126
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• 2007

Purpose: The objective of this study was to evaluate the effects of leisure programs over 8 weeks on elderly women 60 and over who lived in a rural area. Did the program affect feelings of depression and self-esteem? Method: The leisure programs in this study included rhythm gymnastics for elderly women, recreation, balloon art, paper folding, viewing movies, shuttle cock game, exhibition and evaluation activity. As a Quasi-Experimental study, the design of this study was a Nonequivalent Control Group Pretest-Posttest Design. Results: It was shown that leisure programs for elderly women for 8 weeks, consisting of rhythm gymnastics, self-introduction, hobby activities and recreation can reduce depression and enhance the feeling of self-esteem in elderly women in the rural area. Conclusion: It is concluded that public health centers in rural areas should conduct leisure programs during the farmers' slack season, and that the community halls for elders can contribute to improving the life quality of elderly women by being more affirmative and positive if they develop as healthy and active cultural centers where elderly women will want to come and participate.

• 근관절건강학회지
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• 제18권2호
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• pp.270-281
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• 2011

Purpose: This study was done to determine if osteoarthritis (OA) patients living in rural Korea would have a benefit from a structured group program focused on self-help strategies. Methods: A hundred and twenty-six patients with OA were recruited from nine Primary Health Care Posts. The experimental group received a 6-week self-help education program while the control group received usual care. T-tests and c2-tests were used to determine the homogeneity between the experimental and control groups. Independent sample t-tests were performed to determine the effect of the treatment program. To guard against such likelihood, the level of significance of t-test was determined by Bonferroni correction within the study constructs. When significant group differences were found in study variables at baseline, analysis of covariances (ANCOVAs) were used for group comparisons of outcome variables. Results: The experimental group reported more significant improvement in fatigue, difficulty with physical activity, depression, quality of life, self-efficacy, and health behaviors than did the control group. The experimental group also showed improvements in range of motion and muscle strength as compared to the control group. Conclusion: A self-help group education program was an effective and powerful strategy to promote physical and psychosocial health in OA patients

• 한국농촌간호학회지
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• 제2권2호
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• pp.111-119
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• 2007

Purpose: In this study consumers' preference for housing for elderly people was analyzed as well as the recognition by elders of silver town facilities, and their preference for service provided by silver town. The study was done to provide basic data for the development of silver town facilities that are low in cost and high in efficiency. Methods: A sample research was used in this study to analyze the understanding of old age, silver town, and service preference. Results: First, interest and intention to live in silver town was very positive, however low cost was also preferred and that is quite different to current silver towns of Korea. Second, women have more understanding of, requests for, and intention to move into silver town facilities than men. Women's demands for silver town facilities must be reflected in the development strategy of silver towns. Third, the most important part of activating silver town facilities is price strategy. Government political support is required in order to keep silver town move-in costs affordable. Fourth, silver towns must function as total service complex towns. Conclusion: This study is meaningful as efficient operation of silver town is suggested rather than facility degradation to achieve price reduction. This result is important to the development of silver towns based on consumer preference, as it suggests a development direction that is focused on securing differentiated services and programs.

• 지역사회간호학회지
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• 제13권4호
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• pp.757-766
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• 2002

Purpose: Recently there have been many changes in health care environments in Korea. To perform public health programs effectively and efficiently, it is necessary to analyze and identify the demand and supply for the public health nurses. Method: The study analyzed experts' opinions regarding the supply of public health nurses, as well as national and foreign statistical data on workforce supply of public health nurses. Two methods for estimating the amount of demand for public health nurses were used: one was applying the indicators of developed countries for public health nurses based on population: the other was to refer to regulations and/or recommended guidelines in Korea. Result: 1) The number of public health centers, public health sub-centers, and primary health care posts have decreased between 1990 and 2001, from 260 to 242, 1318 to 1270, 2038 to 1907, respectively. 2) Between 1997 and 2002, the number of public health nurses has also decreased from 5572 to 5112. 3) In the case of applying regulations, the number (5112) of existing public health nurses falls shortly by 942. 4) In 2001, the Korean population per one public health nurse was 9262. 5) In the case of applying regulations, the number of public health nurses required to meet the demand for health services in 2001 and 2020 is estimated at 5932 and 6347, respectively. 6) In the case of applying the indicators of developed countries, the number of public health nurses required to meet the demand for health service in 2001 and 2020 is estimated at 9.469 and 10.310, respectively. Conclusion and suggestions: Because of the importance of public health industry, public health nurses have been approved as a field specialist and specialized nurse practitioner by the newly revised legal regulation, there have been absence of approval of their role differentiation and capability. In addition, organizational activity and insufficient number of the public health nurses have contributed to the inactive utilization of them. As community public health is focused on caring individuals as well as organizations, it requires more autonomy and special skills than other fields. Therefore, public health nurses need to enhance the capability as health educator, consultant, and information management persons through advanced education course for public health nurses. Public health nurses need to be prepared as advanced nurse practitioners by receiving advanced education courses and field experiences.

• 보건행정학회지
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• 제16권4호
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• pp.112-127
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• 2006

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.125-142
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• 2002

This study was carried out to purpose drawing up the efficient method of rural residents' health management, analyzing factors having influences on the behavioral intention and the behavior of hepatitis B vaccination of rural residents, using the theory of planned behavior(TPB). Surveying the first questionnaire about TPB to 439 people of rural adults over 40-year old who participated to hepatitis B examination program was made from March 14 to April 23 in 2001 at two primary health care posts in a city in Gyeongsangbuk-do and the second survey for hepatitis B vaccination was made to the last subjects of 332 people(75.6%) that had been proved as subjects of inoculation against the hepatitis B as the result of examination after two months of notification. In the behavioral intention rate of hepatitis B vaccination of the subjects within a month, 100%(the top) was 45.2%, 80-90%(the middle) was 21.1% and under 70%(the low) was 33.7%. In simple analysis, vaccination intention was related with significantly health security type and economic status(p<0.05). And vaccination intention was related with significantly all variables of attitude toward behavior and subjective norm, and economic power of utilizing medical facilities and perceived power variable of perceived behavioral control(p<0.01). The vaccination rate of the subjects within a month was 31.3%. In simple analysis, the vaccination rate was higher significantly in the lower the age was, the higher the educational level was(p<0.01), the larger the family was, and subjects having transport(p<0.05). And the vaccination rate was higher in the higher the economic power was and the higher the perceived ability was. As the results of making generalized logit analysis for behavioral intention, the more positive the subjective norm was, the higher was the score of the perceived behavioral control, the intention was higher significantly in the top class on a basis of the low class of behavioral intention. In multiple logistic regression analysis for vaccination(behavior) using intention and perceived behavioral control as dependent variables, it showed that perceived behavioral control variable only influenced significantly. The higher was the score of perceived behavioral control, it showed that they got the more vaccination(p<0.01). And even in the result having analyzed, adding the significant general characteristics variables in the simple analysis to the independent variable, the higher was the score of perceived behavioral control, it showed that they got vaccination more.

• 보건교육건강증진학회지
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• 제27권5호
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• pp.41-50
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• 2010

목적: 한국 농촌지역에 있는 보건진료소에서 수행하고 있는 고혈압 예방 및 관리 사업 평가도구를 개발하고, 이를 활용하여 현장에서 수행되고 있는 프로그램을 평가하고자 한다. 방법: 문헌고찰, 현장방문과 보건진료소에서 근무하는 보건진료원과의 심층면담을 통해 예비문항을 작성하고, 전문가(중앙기관의 업무행정담당자 5인, 보건진료원 6인, 이론과 연구전문가 5인)집단을 통해 2회 내용타당도 검정을 실시하였다. 전문가들에 의해 80%이상 동의한 항목만을 선정한 결과, 4개 영역, 12개 항목, 41개 세부평가 항목으로 구성된 평가도구가 완성되었다. 4개 영역은 고혈압 예방사업, 고혈압 관리사업, 사업여건조성, 자체평가로 분류되었고. 고혈압 예방사업 영역은 보건교육, 고혈압환자 조기발견 항목이 포함되었고, 고혈압 관리사업 영역은 고혈압환자 등록 및 관리사업, 교육 및 상담, 고혈압환자 치료 및 추구관리 항목이 포함되었다. 사업여건조성 영역은 지역주민의 접근성, 보건교육자료의 비치, 홍보 항목이 있고, 자체평가는 사업계획서 수립, 중간평가, 결과평가 항목으로 구성하였다. 영역별 가중치는 전문가타당도 검정을 통해 각기 다르게 설정하였으며, 연구대상은 전국 보건진료소를 모집단으로 비례층화추출법에 의해 700개소를 선정하였다. 연구의 윤리적인 측면을 고려하여 설문지 표지에 연구에 대한 구체적인 소개, 익명성보장과 자발성을 제시하고 자가 보고식의 우편설문조사를 실시하였다. 최종적으로 215개의 설문지를 자료 분석에 활용하였다. 결과: 영역별 평가결과에 의하면 고혈압 관리 사업이 평균 28.81점(72%), 고혈압 예방사업은 평균 23.44점(67%), 사업여건조성이 평균 4.29점(43%), 자체평가 5.10점(34%) 순으로 나타났다. 항목별 평가에서 가장 낮은 결과를 보인 것은 보건교육을 위한 교육매체 보유, 공식적인 연계망, 고혈압사업의 여건조성을 위한 물리적 환경조성과 사업결과로 나타났다. 결론: 보건진료소에서 실시하고 있는 고혈압 예방 및 관리 사업을 좀 더 효과적으로 수행하기 위해서는 사업여건 조성과 자체평가 영역을 향상시켜야 할 것으로 사료된다.