The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)
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- Journal of agricultural medicine and community health
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- v.27 no.2
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- pp.87-105
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- 2002
In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.
The study was designed to gain necessary basic data order to grasp health knowledge, attitude, practice level of middle and high school students and to analyse th problem and to point out the method of improvement in the field of school health education. The survery was carried out through this reporter's interview for 2,400 students who attend to ten schools in Young Nam area during the period of a month from 25 the June to 25th July 1989. The result of this study can be summaried as follows. 1. The total number of answers on the question was 2,346. As for general characteristics the percent of female middle school students was 60.6% and the percent of male students was 77.7%, 45.9% of high school students was evening school students. 52.9% of middle school students and 42.3% of high school students were borne in rural area. 2. The percentage of unknown and misunderstanding for Epidemic Hepatitis infection was 46.3% of middle school students and 29.6% of high school students. 3. The percentage of unknown and misunderstanding for Epidemic Hemorrhage fever infection was 85.6% of middle school students and 66.9% of high school students. 4. The percentage of right knowledge for AIDS infection was 66.0% of middle school students and 90.4% of high school students. 5. The percentage of right knowledge for Typhoid infection was 47.8% of middle school students and 69.4% of high school students. 6. The percentage of unknown and misunderstanding for Tuberculosis infection was 71.6% of middle school students and 62.2% of high school students. 7. As for personal hygiene, the percentage of toothbrushing after every meal was high level : 44.2% of middle school students and 42.0% of high school students. 8. 60.9% of middle school students take a bath twice a week, 49.2% oh high school students take a bath a week. Times of bath of middle school students was higher than that of high school students. 9.The percentage of washing hand after using toilet was 42.1% of middle school students and 35.1% of high school students. 49.0% of middle school students and 55.1% of high school students wash hand sometimes after using toilet. 10. The percentage of change of underwear twice a week was 57.6% of middle school students and 49.8% of high school students. 11. The percentage of habit of unbalanced diet was 30.% of middle school students and 27.6% of high school students. 50.8% of middle school students and 51.7% of high school students have balanced diet. 12. Index of health practice of personal hygiene can be summarized as follows. A. A case of middle school students. 1) The percentage of health practice index in male and female was 49.6% and 48.1% respectively. Index of female students was higher than that of male students. 2) As for parent's occupation, public servants and company emplyee was upper level. Farming was low level. 3) As for income level, middle, level with 56.5% was highest in high income level and low level with 27.4% was highest in low income level. B. A case of high school students. 1) Middle level of health practice index was 46.0% of male students, upper and low level was 32.4% and 28.0% of female students respectively. 2) Middle level of health practice index was high in farming and company employee and upper level was high in commerce and service, low level with 60.0% was high in unemployed. 3) Upper practice index 35.7% appears in the rich and low practice index 38.3% appears in the poor. 13. Average points of Health practice about personal hygiene were as follows. (Full marks at 4). A. A case of middle school. Female (1.87 point) was higher than male (1.26 point). Night time (2.03 point) was higher than day time (1.66 point) and middle or small cities (2.17 point) are high than any other places. As for parent's occupation, students whose parents are company clerk get high marks (2.32) and ten students whose parent's job are service get next high marks (2.20). B. A case of high school. Female (1.53 point) was higher than male (1.22 point), as parents educational level were higher the point were higher, and as income level was higher, the points of health practice (1.78) were higher, and as for parents occupation, service get highest point (1.93) and commerce get next high point (1.86) public servant get low point (1.66). 14. The percentage of experience in smoking was 11.9% of middle school students and 60.9% of high school students. 15. The percentage of experience in inhalation of bond and administrating LSD was 4.3% of male middle school students, 8.4% of female middle school students, 6.9% of male high school students and 4.2% of female high school students. The knowledge level of communicable disease infection are very low in middle and high school students and practice level of personal hygiene are also very low. As a whole we can evaluate that middle and high school students are low level of health knowledge and practice. In conclusion, we must consider preparation for school health education program through establishing of health subjects in the carriculum, and securing of health education teachers and using materials and media program of health education. It is very important to establish macroscopic policy and strategy for public health education and to get people have right knowledge and practice for health.
This study was conducted to analyze the degree of changes in knowledge and attitude toward smoking and to examine the factors affecting knowledge and attitude for smoking after providing a smoking prevention program based on social influence model for a year to middle school students. Study population consists of 665 subjects of middle school students(aged 14 years) in Gumi city in Kyeongsangbukdo Province. Among them three-hundred sixty-seven students(intervention group) were educated to a smoking prevention program for 1 year from April 1999 to April 2000. School-based four-class program to prevent smoking was developed. The program provides instruction about short and long-term negative physiologic and social consequences of smoking and also discussed the health hazards of smoking, social pressure to smoke, peer norms regarding tobacco use, and refusal skill. A 45-item self-administered structured questionnaire was designed to evaluate the change of knowledge, attitude, smoking rate and the amount of smoking. The instrument was comprised of 11 knowledge items, thirteen attitude item and demographic items. Each scales were created by summing responses to each items within each scales and high scores on the knowledge, attitude, and smoking behavioral intention scales indicated positive responses. Based on the changes before and after the implementation of smoking prevention program between intervention and control group, the change of scores on knowledge were significantly different between the control group and the intervention group(p<0.05) and the change of scores on the attitude toward smoking was significantly different between intervention and control group. The change of smoking rate were not showing a significant difference between two groups but the amount of smoking were significantly reduced in intervention group than control group. In multiple regression analysis on changes of knowledge about smoking, the variables of smoking prevention program education, previous knowledge on smoking and students' school performance were selected the significant variables. In multiple regression to analysis of the factors influencing changes in attitude toward smoking, the variables of smoking prevention program education, previous knowledge on smoking were shown to be significant. The smoking prevention program was effective on change of knowledge and attitude of middle school students. In considering that the policy should be needed to extent of implementation of school-based health education curricula based on social influence model and it would contribute to reduce smoking of students.
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,
Needless to say, the management of national forest in all countries is very important in view of the national mission and management purposes. Korean national forest is also in particular significant in promoting national economy for the continuous increasing of the demand for wood, conservation of the land and social welfare. But there's no denying the fact that the leading aim of the Korean forest policy has been based upon the conservation of forest resources and recovery of land conservation function instead of improvement of the forest productive capacity. Therefore, the management of national forest should be aimed as an industry in the chain of the Korean national economy. And the increment of the forest productive capacity based on rationalized forest management is also urgently needed. Not only the increment of the timber production but also the establishment of the good forest in quality and quantity are to bring naturally many functions of conservation and other public benefits. In 1908 Korean national forest was historically established for the first time as a result of the notification for ownership, and was divided into two kinds in 1911-1924, such as indisposable national forest for land conservation, forest management, scientific research and public welfare, and the other national forest to be disposed. Indisposable forest is mostly under the jurisdiction of national forest stations (Chungbu, Tongbu, Nambu), and the tother national forests are under custody of respective cities and provinces, and under custody of the other government authorities. As of the end of 1971, national forest land is 19.5% (1,297,708 ha) of the total forest land area, but growing stock is 50.1% (
From the beginning of the chosun dynasty, an agriculture-first policy was imposed by being written farming books, for instance, Nongsajiksul, matched with real conditions of local agriculture, which provided the grounds of new, intensive farming technologies. This farming book was the collection of good fanning technologies that were experienced in rural farm areas at that time. According to Nongsajiksul, rice culture systems were divided into "Musarmi"(Water-Seeded rice), /"Kunsarmi"(dry-seeded rice), /transplanted rice and mountainous rice (upland rice) culture. The characteristics of these rice cultures with high technologies were based of scientific weeding methods, improved fertilization, and cultivation works using cattle power and manpower tools systematically. Reclamation of coastal swampy and barren land was possible in virtue of fire cultivation farming(火耕) and a weeding tool called "Yoonmok"(輪木). Also, there was an improved hoe to do weeding works as well as thinning and heaping-up of soil at seeding stages of rice. Direct-seeded rice culture in flat paddy fields were expanded by constructing the irrigation reservoirs and ponds, and the valley paddy fields was reclaimed by constructing "Boh(洑)". These were possible due to weed control by irrigation waters, keeping soil fertility by inorganic fertilization during irrigation, and increased productivity of rice fields by supplying good physiological conditions for rice. Also, labor-saving culture of rice was feasible by transplanting but in national-wide, rice should not basically be transplanted because of the restriction of water use. Thus, direct-seeded rice in dry soils was established, in which rice was direct-seeded and grown in dry soils by seedling stages and was grown in flooded fields when rained, as in the book "Nongsajiksul". During the middle of the dynasty(AD 1495-1725), the excellent labor-saving farmings include check-rowing transplanting because of weeding efficiency and availability in rice("Hanjongrok"), and, nurserybed techniques (early transplanting of rice) were emphasized on the basis of rice transplanting ["Nongajibsung"]. The techniques for deep plowing with cattle powers and for putting more fertilizers were to improve the productivity of labor and land, The matters advanced in "Sanlimkyungje" more than in "Nongajibsung" were, development of "drybed of rice nursery stock", like "upland rice nursery" today, transplanting, establishment of "winter barly on drained paddy field, and improvement of labor and land-productivity in rice". This resulted in the community of large-scale farming by changing the pattern of small-farming into the production system of rice management. Woo-hayoung(1741-1812) in his book "Chonilrok" tried to reform from large-scale farmings into intensive farmings, of which as eminent view was to divide the land use into transplanting (paddy) and groove-seeding methods(dry field). Especially as insisted by Seo-yugo ("Sanlimkyungjeji"), the advantages of transplanting were curtailment of weeding labors, good growth of rice because of soil fertility of both nurserybed and paddy field, and newly active growth because rice plants were pulled out and replanted. Of course, there were reestimation of transplanting, limitation of two croppings a year, restriction of "paddy-upland alternation", and a ban for large-scale farming. At that period, Lee-jiyum had written on rice farming technologies in dry upland with consider of the land, water physiology of rice, and convenience for weeding, and it was a creative cropping system to secure the farm income most safely. As a integrated considerations, the followings must be introduced to practice the improved farming methods ; namely, improvement of farming tools, putting more fertilizers, introduction of cultural technologies more rational and efficient, management of labor power, improvement of cropping system to enhance use of irrigation water and land, introduction of new crops and new varieties.