• 농촌의학ㆍ지역보건
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• 제24권2호
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• pp.269-289
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• 1999

농촌지역 재택노인들의 건강관심도, 건강실천행위, 주곤적 건강상태, 그리고 일상생활 동작능력과 이들간의 관련성을 파악하고, 이들에 영향을 미치는요인을 알아보기 위하여 일개 군의 65세 이상 재택노인 480명을 대상으로 1998년 11월 15일부터 12월 20일까지 집적 면담하여 자료를 수집하였다. 건강관심도가 높은 상위군이 44.4%, 중위군이 13.1%, 하위군이 42.5%였으며, 건강실천행위는 상위군이 3.8%, 중위군이 18.8%, 하위군이 77.5%였다. 주관적 건강상태는 좋음이 29.0%, 보통이 31.0%, 나쁨이 40.0%였으며, 일상생활동작능력은 고ADL이 91.5%, 저ADL이 8.5%였다. 단변량 분석결과 남녀 전체를 대상으로 하였을 때 건강관심도와 건강실천행위는 유의한 관련이 있어 건강관심도가 높은 사람이 건강실천행위를 많이 하였다. 남녀로 구분하였을 때 남자의 경우 건강관심도와 건강실천행위는 유의한 관련이 있었고, 여자의 경우는 유의한 관련은 없었다. 남자와 여자 모두에서 건강실천행위와 주관적 건강상태는 유의한 관련이 있었다. 즉, 건강실천행위를 많이하는 사람이 주관적 건강상태가 좋았다. 건강실천행위와 ADL의 경우는 남녀가 모두 건강실천행위를 많이 하는 사람이 유의하지는 않았지만 ADL이 좋았다. 남녀 모두에서 ADL이 좋은 경우 유의하게 주관적인 건강상태가 좋았다. 사회인구학적 변수를 독립변수로 하고 건강관심도를 종속변수로 한 다중회귀 분석에서 건강관심도는 연령이 적을수록, 의료보호보다 의료보험인 경우, 대중매체나 병원 보건소등의 건강정보원이 있는 경우, 그리고 정기적인 모임이 있는 경우에 높았다. 건강실천행위를 종속변수로 하고 사회인구학적 특성과 건강관심도를 독립변수로 한 다중회귀분석 결과, 남자의 경우에만 모형이 성립하였는데 건강관심도가 높을수록 건강실천행위를 많이 하였다. 주관적인 건강상태를 종속변수로 하고 사회인구학적 특성과 건강실천행위를 독립변수로 한 일반화 로짓 모형에서 남자는 생활비가 충분할수록, 질병이 없는 경우, 정기적인 모임이 있는 경우, 그리고 건강실천행위를 많이 하는 경우에 주관적 건강상태가 좋았다. 여자의 경우는 배우자가 없는 경우, 생활비를 본인이나 배우자가 부담하는 경우, 질병이 없는 경우, 병원이나 보건소 등의 건강정보원이 있는 경우, 그리고 건강실천행위를 많이 할수록 주관적 건강상태가 좋았다. 사회인구학적 변수에 건강실천행위를 추가한 독립변수와 ADL의 고저를 종속변수로 한 다중 로지스틱 회기분석에서 남자의 경우는 생활비를 본인이나 배우자가 부담할수록, 여자의 경우는 연령이 적을수록, 병원·보건소 등의 건강정보원이 있을수록 ADL이 좋았다. 이상의 결과를 볼 때 남녀 모두 건강에 대한 관심이 높을수록 건강실천행위를 많이 하게 되며 건강실천행위를 많이 할수록 건강수준인 일상생활 동작능력과 주관적인 건강상태가 좋았고, 일상생활 동작능력이 좋을수록 주관적인 건강상태도 좋았다. 그러므로 노인들이 건강에 대한 관심을 가지고 건강실천행위를 할 수 있도록 대중매체와 개인면담을 통한 상담과 보건교육, 지역사회 건강증진 프로그램 등 다차원적인 접근이 필요하다.

• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.79-96
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• 2001

보건진료소 관할지역주민들의 보건진료소에 대한 이용양상과 인식도를 파악하기 위하여 2000년 12월 10일부터 2001년 1월15일까지 경상북도 상주시 지역 24개 보건진료소 관할지역 753가구(가구원 1,803명)에 대해 설문조사를 실시하였다. 전체가구원의 지난 2주간의 급성질환 이환율은 29.6%이었으며 이들의 의료기관 이용률은 98.3% 이었다. 연령별로는 60-69세가 35.4%로 가장 높았는데 연령이 높을수록, 학력이 낮을수록 이환율이 높았다. 전체 가구원의 1년간 만성질환 이환율은 19.2%이었으며 이들의 의료기관 이용률은 92.8% 이었다. 만성질환 이환율은 70세 이상에서 37.2%로 가장 높았고, 연령이 높을수록, 학력이 낮을수록 유의하게 높았다. 급성질환시 의료이용은 보건진료소 이용이 89.5%로 대부분을 차지하였으며, 만성질환시에는 보건진료소 이용이 40.2%이었고 병 의원 이용이 48.9%이었다. 조사시점 이전 1년간의 보건진료소 이용 경험률은 94.8%이었고 진료목적 이외 방문 경험률은 72.2%이었으며, 73.3%의 응답자가 보건교육을 받은 경험이 있었다고 하였다. 응답자의 98.5%가 보건진료소의 위치를 알고 있었고, 건강관리에 도움이 된다는 인식이 98.6%, 지역발전과의 관련성에는 84.3%가 큰 역할을 수행한다고 하였으며, 보건진료소의 필요성에 대해서는 97.4%가 필요하다고 응답하였다. 보건진료소의 주된 업무는 질병치료, 예방접종, 건강상담 순으로 인식하였으며 보건진료소가 중점적으로 시행해주기를 원하는 업무는 주민건강상담 및 관리가 31.6%로 가장 높았다. 보건진료소 진료비에 대해서는 88.9%가 싸다고 하였고, 보건진료원의 친절도는 98.4%가 친절하다고 하였으며 서비스 만족도도 97.0%로 매우 높았다. 보건진료소에 대한 불만사항은 약의 종류가 부족하다가 42.9%로 가장 높았고 시설이 좋지않다가 15.8%이었다. 조사대상 지역주민들은 지리적 여건과 경제적 여건에 의해 보건진료소를 많이 이용하고 있었으며 보건진료소에 대한 주민들의 만족도도 높았고 필요성도 절감하고 있었다. 그리고 질병치료업무 이외의 보건사업에 대한 요구도 많았고 의약품과 의료시설 및 장비에 대한 불만이 큰 점을 감안하여 보건진료소를 계속적으로 유지 운영하되 보건진료소의 기능의 재정비, 시설 장비의 보강, 그리고 보건진료원의 교육훈련강화를 통해 벽오지 주민에게 바람직한 의료서비스를 제공할 수 있도록 적극 지원해야 할 것이다.

• 대한간호학회지
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• 제29권2호
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• pp.336-345
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• 1999

This study looks at the various alternative therapy methods used in day to day life by elderly, over 60 years of age. The elderly have come to know and practice these methods for the following reasons it is good for the health ; it is the method used in the of fen days when there wesn't modern medicine ; it has been passed down from generations ; it can be done at home without having the need to go to the hospital ; acupuncture or poulticing can be used ; it can be done at home, which was an important factor in rural areas where hospitals are few and far between ; and 〔herbal〕 medicine could be prepared at home at no cost ; it derives from experience ; it is impossible to ignore tradition passed down through the generations. Diet control and plants (herbs) are methods most often used. as they are easy to find and can be readily used in critical situations. Other methods include oriental medicine practices of moxibustion with moxa cone, negative therapy, hand and finger acupunture, finger press method. ordinary acupunture, manual healing methods of massage. diaphoretic therapy and meditation to reach a state of calm, and qigong dirigation. The reasons for its use are as follows ; it has been used before ; it is effective ; there is some improvement after the treatment ; it is not harmful to the body ; medicine cannot be obtained and it is the only thing available ; it is not good for an old person to go to the hospital everyday. the symptoms are not serious enough to go to a hospital : and acupuncture is for these things. The means that the elderly have come to practice these methods are : it has been used since the past ; it has been told by the elders ; they have been told by friends ; it was part of their knowledge ; and they have come to know by watching their mother. Further, to regain vitality lost through old age, the elderly have relied on hot soup. a hearty meal. brewed honey water, pumpkin, or ginseng. Humans, by instinct. would rub or massage the areas that caused pain. These actions, combined with a breathing technique have been recognized in Tong-Eui-Bo-Gam(the essential of eastern medicine), the complete work of early modern medicine, are a useful means to revive chi(기). This knowledge is thought to have greatly affected our heathy lifestyle. Furthermore, though the demand for medical services would increase with age, the elderly have not always been able to tend to their needs at the hospital for reasons economic or other. Hence, these alternative therapy methods seem to have been practiced as a temporary means of relief. The excellence of our traditional therapeutic custom has not received full recognition due to the argument relating to its scientific merits. As a result, it has become vital to prove their effectiveness through scientific and other experimental means. The potency of moxibustion with moxa cone and hand and finger acupunture have been proven scientifically. but diet and herbal methods appear to be practiced as a result of customs passed down from generations. In addition, it is submitted that the effectiveness of the traditional methods of disease control and our heathy lifestyle that are easily found in the nursing field must be verified.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.359-366
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• 2003

Objectives : This study was conducted to review the diffusion process and factors affecting the adoption of the Health Center Information System (HIS). Methods : Data were collected from POSDATA (private company), MOHW, other Ministries and local governments. To specify the date of adoption, supplementary information was collected from 40 health centers. The following three kinds of factors were analyzed. Internal factors included type, size, and innovativeness of health centers. Community factors were composed of population sire, economic status, and level of education. Organizational environmental factors consisted of information score of the municipalities, financial support of the from central government, and the neighborhoodness of innovator health centers. Results : All health centers in the metropolitan cities of Seoul, Gwangju and Jeju adopted the HIS. The laggards were those in the metropolitan cities of Busan (18.8%), Incheon (20.0%) and Daejun (20.0%), and cities with population more than 300,000 (54.8%) and counties with health center hospitals (47.1%). Financially supported rural health centers adopted the HIS more rapidly than those not supported. The factors identified as being statistically significant (p<0.05), from a univariate analysis by Kaplan-Meier method, were: (1) internal factors of the type, size and innovativeness of health centers; (2) community factors of population size and economic status; (3) organizational environmental factors of the central government financial support and the neighborhoodness of innovator health centers. A multivariate analysis, using a Cox proportional hazard method, proved the innovativeness of health centers, central government financial support and the neighborhoodness of innovator health centers, were statistically significant (p<0.05). Conclusions : The innovativeness of health centers, financial support from central government and the neighborhoodness of innovator health centers, rather than community factors related to regional socioeconomic status, affected ffe adoption of the HIS in health centers. Further in-depth studies, modifying the MOHW's strategy to propagate the HIS to the laggard health confers, are recommended.

• 지역사회간호학회지
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• 제13권1호
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• pp.89-97
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• 2002

Purpose: The purpose of this study is to explore the validity of the application of the Denver II developmental screening test to Korean children. This screening test. which was developed and standardized in United States. was designed to screen for developmental delay in Korea. and to compare the levels of development of Korean children with the development of children from the U.S. Method: Quota sampling. NP To facilitate field sampling. the age range used from 0 to 6 years old. was split into 10 different age groups. Sample size was estimated according to residence. 1.054 children were recruited from Seoul's metropolitan. urban and rural areas. NP To fill the quota established. the Recruitment and testing of children was done at public health centers, pediatric outpatient clinics of general hospitals and a child care center. The 25, 50, 75 and 90 percentiles were identified by using logistic regression analysis and were calculated as norms. The items in which the ages of both 50 and 90 percent passing differed more than 20 percent by the calculation was identified for comparison. NP Result: There were significant differences found in 45 items between Korean children and the children from the City of Denver as it relates to age differences. 90% of the sample passed items among 125 items from 4 sectors, e.g., personal- social. fine motor adaptive, language, and gross motor sectors. Korean children were found to be advanced in 9 items, whereas there were significant differences found in 38 items in our comparison of the two countries for age differences when 50% of sample pass items. Korean children were found to be advanced in 16 items. NP Conclusion: The result showed that there was a discrepancy in the developmental norms. It could be explained by the differences in the developmental environment. including child rearing patterns and ethnicity. Therefore, a restandardization of the Denver Screening Test is necessary as it relates to its application on Korean children. This restandardization is necessary in order to avoid both under and over-referrals of children with developmental abnormality. The modification of items in the language sector is especially suggested.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.719-722
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• 2016

Background: Cholangiocarcinoma (CCA) is a serious health problem in Thailand, particularly in northeastern and northern regions, but epidemiological studies are scarce and the spatial distribution of CCA remains to be determined. A database for the population at risk is required for monitoring, surveillance and organization of home health care. This study aim was to geo-visually display the distribution of CCA in northeast Thailand, using a geographic information system and Google Earth. Materials and Methods: A cross-sectional survey was carried out in 9 sub-districts and 133 villages in Chum Phuang district, Nakhon Ratchasima province during June and October 2015. Data on demography, and the population at risk for CCA were combined with the points of villages, sub-district boundaries, district boundaries, and points of hospitals in districts, then fed into a geographical information system. After the conversion, all of the data were imported into Google Earth for geo-visualization. Results: A total of 11,960 from 83,096 population were included in this study. Females and male were 52.5%, and 47.8%, the age group 41-50 years old 33.3%. Individual risk for CCA was identifed and classified by using the Korat CCA verbal screening test as low (92.8%), followed by high risk (6.74%), and no (0.49%), respectively. Gender ($X^2$-test=1143.63, p-value= 0.001), age group ($X^2$-test==211.36, p-value=0.0001), and sub-district ($X^2$-test=1471.858, p-value=0.0001) were significantly associated with CCA risk. Spatial distribution of the population at risk for CCA in Chum Phuang district was viewed with Google Earth. Geo-visual display followed Layer 1: District, Layer 2: Sub-district, Layer 3: Number of low risk in village, Layer 4: Number of high risk in village, and Layer 5: Hospital in Chum Phuang District and their related catchment areas. Conclusions: We present the first risk geo-visual display of CCA in this rural community, which is important for spatial targeting of control efforts. Risk appears to be strongly associated with gender, age group, and sub-district. Therefor, spatial distribution is suitable for the use in the further monitoring, surveillance, and home health care for CCA.

• 농촌의학ㆍ지역보건
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• 제44권4호
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• pp.209-219
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• 2019

이 연구는 치과위생사의 직무스트레스와 상지의 근골격계 기능 장애의 관련성을 알아보고자 수행하였다. 연구 대상자는 부산·경남 지역의 병원급 이상, 치과의원에 근무하는 치과위생사를 220명을 편의 표집하여 설문지를 배포한 후 최종 수거된 200부에서 응답이 부실한 2부를 제외하고 최종적으로 198명의 자료를 분석하였다. 설문문항으로는 일반적 특성, 직무스트레스, 작업관련 상지 근골격계 통증, 동작수행능력에 따른 기능평가 문항으로 구성하였다. 치과위생사의 대한 상지근골격계질환 통증은 목 39.4%, 어깨 54.6%, 팔/팔꿈치 14.7%, 손/손목/손가락 50.0% 였다. 그리고, 상지의 기능 장애는 치과위생사에서 호발하는 건강관련 문제로 불편한 작업자세와 상지 부위별 근골격계 통증을 보정하더라도 직무스트레스와 유의한 관련이 있었다. 즉, 팔꿈치를 굽혔다 펴는 반복 작업, 팔꿈치 부위에 통증이 있는 경우외에도 직무스트레스 역시 상지의 기능 장애와 관련이 있었다. 치과위생사의 직무스트레스는 이들의 상지 기능 장애로 이어져 결과적으로 의료서비스의 저하로 이어지므로, 장단기 계획하에 근무환경개선 등을 통하여 직무 스트레스를 감소시킬 수 있는 방안을 모색하여야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제7권2호
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• pp.333-342
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• 1974

In September 1974, a survey was conducted towards 900 women respondents, each representing a household, residing in 18 selected Myuns(townships) of 18 Guns(counties) in Kyunggi-Do. Fifty households were selected randomly in each Myun and the sample Myuns were also randomly selected from the 18 Guns home-visiting interviews were carried out by Myun level maternal and child health workers with questionnair forms designed to measure the maternal and child health status at each household. Major findings obtained from this survey can be summarized as follows: 1. Of the women responents who were investigated in this survey, 13.1% of them were comprised in the illiterates, indicating no difference in literacy rate from that in most urban areas. 2. Most(93.8%) of the respondents were found to have married at ages of 20-24 years old. 3. Most(85.8%) of the respondents were found to have delivered their first babies at ages of 20-24, while only 13.4% had their first babies at 25-29. 4. About 22% of the respondents had 2 children, while 19% and another 19% had 2 and 4 children, respectively. 5. A great majority of the respondents (78%) experienced not a single death of a child within the family, while about 17% experienced death of one child. 0.7% of the women experienced deaths of 4 or more children. 6. 18% and 17% of the women experienced 4 and 3 pregnancies, respectively, and 12% of them experienced 7 or more pregnancies. 7. About 29% of the women experienced an induced abortion at least once. Nearly 2% of them were found to have experience of 4 or more induced abortions. 8. One half (51%) of the women were found to have received prenatal guidances in the latest pregnancies by (Ub(town) and Myun (township) level maternal and child health workers at least once or more times. 9. 52% women received professional prenatal care in the latest pregnancies: 24% at hospitals or clinics and 20% at health centers. 10. Most (89%) of the last-born children were delivered at home, while only 8.7% were delivered at hospital or clinics. 11. Materials used at delivery comprise vinyl (40%), cement bags (32%) ana gauzed or absorbent cottons (19%). 12. The largest preportion of the attendants at delivery comprises mothers in-law (48). Only 24% were found to be attended by either doctors, midwives or maternal and child health workers. 13. In most (90%) of the deliveries scissors were used to cut the umbilicus. But most (7%) of them used unsterilized scissors, 6 while only 20% of them used sterilized ones. 14. About 68% of the last-born babies were breast-fed for 12 months or more. Those who weaned during 6-12 months were 21%. 15. During 12 months after birth, 65% of the last-born babies were breast-fed, while 24% were given a combination of breast milk and cooked rice. 16. About nine out of the 10 births were found to be registered. 17. 71% of babies received BCG vaccination, while 79% and 56% received samllpox and DPT vaccinations, respectively within a year after birth. Those who were vaccinated against poliomyelitis were about 50%. 18. About 87% of the respondents recogninized the existence of government-sponsored maternal and child health guidance program.

• 농촌의학ㆍ지역보건
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• 제8권1호
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• pp.28-34
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• 1983

농약사용량(農藥便用量)의 증가(增加)에 따라 농약중독자(農藥中毒者)가 전 세계적으로 증가(增加)하는 추세인데 우리나라에서는 아직까지 농약중독자(農藥中毒者)에 대한 역학조사(疫學調査) 보고(報告)가 없는 실정이다. 1981년(年)부터 1982년(年)까지 2년간(年間) 경상북도(慶尙北道) 전지역(全地域)을 대상으로 의원(醫院), 병원(病院) 및 보건소(保健所)의 의무기록(醫務記錄)을 조사(調査)하여 농약중독자(農藥中毒者)를 파악하여 그 실태를 분석(分析)하였다. 1981년(年)에 765명, 1982년에 853명의 중독자(中毒者)가 발생(發生)하였다. 연령별(年令別)로는 20대(代)가 제일 많았고 성별(性別)로는 남자가 70% 여자가 30%였다. 중독경위별로는 직업적인 중독이 27.8%, 우연에 의한 사고(事故)가 5.6%였고 자살목적(自殺目的)이 66.6% 였다. 월별(月別)로는 6, 7, 8, 9월(月)에 발생(發生)이 많고 7월(月)이 제일 많고, 월평균(月平均) 67명이 발생(發生)하였다. 의료기관이용(醫療機關利用)은 개인의원이 49%, 병원이 43%였다. 치명율(致命率)은 직업적인 중독이 0.9%, 사고(事故)에 의한 중독(中毒)이 5.6% 자살목적(自殺目的)의 중독(中毒)에서 20.3%로 평균(平均) 14.1%였다. 인구 100,000 당 농약중독(農藥中毒) 발생(發生)은 년간(年間) 25.4였다.

• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.3-15
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• 1977

In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.