• 제목/요약/키워드: Rural medicine

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농촌지역 정신질환자 가족 부담 (A Study on the Family Burden of the Mentally Ill in a Rural Area)

  • 이원영;김정회;남정현;문옥륜;신영전
    • Journal of Preventive Medicine and Public Health
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    • 제32권3호
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    • pp.400-414
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    • 1999
  • Objectives: This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. Methods : Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. Results : Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of Hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. Conclusions: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.

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일부 농촌지역에서의 보건지소 의료인의 정의적인 태도가 주민의 보건지소 이용에 미치는 영향 (A Study on Desirable Attitudes of Health Subcenter Personnel, Affecting to Utilization of a Rural Health Subcenter for Primary Health Care)

  • 위자형
    • 농촌의학ㆍ지역보건
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    • 제14권1호
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    • pp.30-36
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    • 1989
  • In order to desirable attitudes of health subcenter personnel, affecting to utilization of a rural health subcenter for primary health care, a study carried out, through analyzing the specific survey datas of 228 out of 1151 total house-holders in a rural community, Su-Dong Myun, Yam-yang-ju kun, Kyung-Gi Do in Korea, and the medical re-cords of total out-patients of health subcenter in this district during 1981-1988. The following results were obtained: 1) The annual utilization rate showed decreasing tedency such as 723 per 1,000 inhabitants in 1981, 652 in 1982, 618 in 1985, 54H in 1984 and 341 in 1987, since 1981. 2) The utilization Rate in 1987 was unusually the lowest with 341 per 1,000 inhabitants in decreasing tendency, steadily. 3) In advatage on utilization of health subcenter for primary health care in a rural area, 68.8% of the respondents answered that it was in comprehensive health care with the highest rate and next order in near distance from living place with 16.7% in easy and simple process to utilize with 9.2% and in lower medical cost with 5.3%. 4) The order of desirable image of rural health subcenter personnel for primary health care was of good attitude(57.0%), of good skill(29.0 %) and of wide knowledge(14.0%), 5) The order of desirable image of doctor for primary health care in rural health subcenter was of good skill(.44.3%), of good attitude(36.8%) and of wide knowledge(18.9%), and nurse was of good attitude(76.8%), of good skill(14.0 %) and of wide knowledge(9.2%). 6) The percentage order by good attitudes of rural health subcenter personnel was the highest in responsibility(38.2%), kindness(26.3% ), proprieties(14.9%), sincerity(12.7%) and notion of duty hours(6.6%). 7) The statistical datas in health subcenter was written and kept, without distinction of definition of new and old patients, by month and for suitable method of medical expenses of medical insurance and medicaid by clerical convenience. 8) In future, the organization of health subcenter must be unified, systematized and rationlized for primary health care. Health subcenter must be organized by 3 parts of function(medical care, health service and clerical affair) and then function of health subcenter will be more activated by clerical activities.

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고혈압 노인의 도농 간 신체활동참여 관련요인 (Factors Related to Physical Activities of Elderly with Hypertension between Urban and Rural Areas)

  • 백현희;이석구
    • 농촌의학ㆍ지역보건
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    • 제40권2호
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    • pp.62-71
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    • 2015
  • 본 연구는 도시와 농촌 지역에 있어서 만성질환 노인의 일반적 특성에 따른 신체활동 실천율의 차이와 신체활동 관련요인을 알아보았다. 연구결과, 일반적 특성에 따라서는 도시의 경우 연령이 낮을수록 근력 운동을, 여자보다 남자에서 걷기, 유연성 운동, 근력 운동을, 배우자가 있는 경우 유연성 운동과 근력 운동을 각각 많이 하였다. 또한, 아파트 거주자가 걷기, 유연성 운동, 근력 운동을, 소득수준이 높을수록 유연성 운동을, 교육수준이 높을수록 걷기, 유연성 운동, 근력 운동을 각각 많이 하였다. 농촌의 경우도 아파트 거주자가 유연성 운동을, 교육수준이 높을수록 걷기, 유연성 운동, 근력 운동을 각각 많이 하였다. 신체활동 관련 요인은 도시의 경우 교육수준, 일상생활활동, 삶의 질이었고, 농촌의 경우는 활동제한, 일상생활활동이었다. 연구 결과를 종합하면 전반적으로 도시와 농촌 고혈압 노인 모두 낮은 신체활동 실천율을 보였으며, 일반적 특성에 따라서도 실천율에 차이를 보였고, 신체활동 관련 요인도 차이를 보였다. 따라서 도시와 농촌 모두 기초체력을 증진하고 유지시킬 수 있는 관련 특성을 고려한 체계적인 신체활동 프로그램 개발이 시급히 이루어져야한다.

A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran

  • Delavari, Sajad;Arab, Mohammad;Rashidian, Arash;Nedjat, Saharnaz;Souteh, Rahmatollah Gholipour
    • Journal of Preventive Medicine and Public Health
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    • 제49권6호
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    • pp.386-393
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    • 2016
  • Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

군보건소의 진료제공량 및 양·한방 진료비 분석 (Analysis of Utilization and Expenses of Medical and Oriental Medical Care Services in a Designated Rural Areas)

  • 김진순
    • 농촌의학ㆍ지역보건
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    • 제17권1호
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    • pp.17-24
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    • 1992
  • The medical care insurance system has been adopted in rural areas in 1988, since then, the utilization of medical care services has increased rapidly in rural areas. The government has restructured the 15 health centers, which are located in remoted rural areas and these 15 health centers were strengthend to provide the curative care to the residents in order to meet the curative can demand of the residents. Besides the reorganization of the health centers, the government has implemented the oriental medical care demonstration project at the health center in a designated rural areas. This study was aimed to analyze the utilization and expenses of medical and oriental medical care services in a designated rural areas. Number of annual visits of residents to health centers in 1991 showed slightly decreased compared with that in 1989. However number of annual visits to the hospitalized health centers was an increase of 49.3%~64.5%. Regarding the coverage of curative care for the residents in rural areas, the hospitalized health centers are functioning more effective than that of health center. Expenses per case of medical care rendered by health center was lower than that of oriental medical care, while the expenses of the medical care was quit higher than that of oriental medical care in the hospitalized health centers. According to the above mentioned study results, the hospitalized health centers were more effective and suitable to provide a curative care to the residents than the health centers, and also the oriental medical care could be needed to be provided by public health network in the near future.

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한국농촌여성(韓國農村女性)의 초조(初潮)와 폐경(閉經)에 관(關)한 위생학적(衛生學的) 고찰(考察) (Hygienic Observations on Menarche and Menopause among Korean rural Area)

  • 남택승
    • 농촌의학ㆍ지역보건
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    • 제3권1호
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    • pp.10-17
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    • 1978
  • There are numerous reports on menarche age in korea and other countries but only few reports are available on menopausal age. This is a result of surveys on 509 women for menarche and 341 women for manopause among the rural areas of Choongnam and Kyungbuk province. For those born between 1894 and 1929. aver age ageof menarche was 16.63 years. The earliest was 13 years and latest was 22 years old. Majority (78.8%) had their menarohe at the age of between 15 and 18. It was noted that there was gradual advancement of menarche age among those born in later years than earlier. More menarche started in the months of October and April and fewest was in the month of June. Spring was the time when the largest number of women had menarche and this was followed by Autumn. Winter, and Summer. The most common menstrual cycle was 39 days type which is followed by 28 days and 26 days. The average monpausal age among rural korean women was 46.97 years. The number of years between menarche and menopause appears to be dependent upon individual physical and mental condition. socioeconomical circumstances. and also hereditary as well as ethnic differences. 87.1 % of rural korean women had menstrual ages of between 20 to 35 years according to this statistics and the average was 29.67 years.

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농촌의료(農村醫療)의 문제점(問題點)과 대책(對策) - 의료제도(醫療制度)를 중심(中心)으로- (An Analysis on the Korean Rural Health Care Delivery System)

  • 송오달
    • 농촌의학ㆍ지역보건
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    • 제2권1호
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    • pp.30-35
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    • 1977
  • Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

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농어촌 의료서비스 개선사업 성과에 대한 지역주민과 사업담당자간의 인식 비교 (Comparison of Perceptions of Local Residents and Public Health Center Staffs on the Performance of Medical Service Improvement Plan in Rural Areas)

  • 이주열;황라일
    • 농촌의학ㆍ지역보건
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    • 제43권2호
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    • pp.74-84
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    • 2018
  • Objectives: The purpose of this study is to compare the perceptions of the rural healthcare service improvement project' performance and reorganization of public health centers between project staffs and local residents. Methods: Data collection from this study was performed in 141 project areas using structured questionnaires. Data analysis was used in SPSS 22.0 version. Results: The public health center staffs were more positive about the items for improving health facilities than the local residents. Residents in the Si area generally perceived performance as more positive than residents in the Gun area, while public health center staffs in the Gun area perceived performance as more positive than public health center staffs in the Si area. Local residents expressed negative opinions about the reduction in the number of branches of public health clinics and health medical clinics. Conclusions: In conclusion, careful improvement projects for rural health care and the establishment of health care systems will be necessary, reflecting the opinions of local residents, along with a variety of regional characteristics.

농촌지역 고혈압노인을 위한 동기강화 자가관리프로그램의 개발 및 적용 (Development and Application of Motivation-enhancing Self-management Program for Rural Aged with Hypertension)

  • 장해련;김현리
    • 농촌의학ㆍ지역보건
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    • 제41권3호
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    • pp.152-161
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    • 2016
  • Objective: The purpose of this study was to develop a motivation-enhancing self-management program and apply to rural aged with hypertension to evaluate the applicability of the Program. Methods: The motivation-enhancing self-management program was on the evidence of Orem's self-care theory and Ford's Motivational system theory which consists of group education and tele-coaching conducted 12-week. The program evaluation was done by structured questionnaires of motivation (self-efficacy, perceived benefit, perceived barrier and emotional salience), self-care and blood pressure. There were totally 31 aged with hypertension in 2 rural areas enrolled in the program. Results: There was only perceived benefit statistically significant between the intervention and control group (t=2.05, p=.04) and self-care level was no difference between the two groups (t=0.21, p=.84) after program. But there are statistically significant differences of systolic blood pressure between the intervention and control group(t=-2.62, p=.01). Conclusion: The motivation-enhancing self-management program is necessary for the rural aged with hypertension, but it's needed modify and revise in the future study.

한 농촌 지역 성인들의 10년 간 비만도 변화(1990~1999) (Trends in Obesity in a Rural Korean Adults (1990~1999))

  • 김유미;전정옥;김미경;최보율
    • 농촌의학ㆍ지역보건
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    • 제30권1호
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    • pp.113-120
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    • 2005
  • 이 연구는 경기도 한 농촌지역 주민 1,663명을 대상으로 10년 간의 6차례 조사를 시행하여 체질량지수와 과체중의 변화를 파악하였다. 그 결과 체질량지수는 성별과 연령을 보정한 후에도 조사 시기에 따라 증가하는 경향을 보였다. 과체중 이상의 유병률도 각 연령군 내에서 시기별로 증가하는 경향을 나타내었고, 이는 여자에게서 뚜렷하였다. 연령별 층화한 과체중의 유병률은 남자에게서 40대와 50대에서 시간의 경과에 따른 증가가 유의하게 나타났으며, 여자에게서는 40대, 50대, 60대에서 유의한 증가를 보였다. 남자와 여자 모두 1990년에서 1999년까지의 증가폭은 40대에서 가장 높았으며, 남자의 전체 증가폭이 여자의 경우 보다 높았으나 여자의 과체중 유병률이 더욱 높았다. 전체 인구의 1990년에서 1999년까지의 과체중 유병률은 통계적으로 유의하지는 않았으나 34.1%에서 63.9%로 29.8%의 증가폭을 보였으며 시간의 증가에 따라 유의한 증가의 경향을 보였다. 농촌 지역 남자의 체질량지수와 과체중의 유병률은 다른 집단과 비슷한 양상을 띄었으나 여자에게서 유병률이 높은 것을 알 수 있었다. 그러므로 이에 대한 원인을 규명하는 연구가 시행되어야 할 것이다.

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