• 한국의료질향상학회지
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• 제3권1호
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• pp.94-103
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• 1996

Background : Blood pressure is an important indicator in diagnosis and assessing treatment of a patient. Clinical staffs use blood pressure on the assumption that measured value is accurate and reliable. However, whether measured blood pressure is accurate has been rarely investigated in Korea. Objectives : The aims of this study are to evaluate clinical staffs' knowledge and technique as well as accuracy of sphygmomanometer. Also the program to improve the measurement is developed. Methods : Seventy-three registered nurses were asked nine multiple choice questions including Korotkoff sound, cuff size, and deflation rate. Simultaneously characteristics of nurses were examined, age, working place, duration of employment and academic degree. A testing videotape(Standardizing Measurement Video-Tutored Course) was used for evaluating the accuracy of measurement. Testees were to read and record the 12 cases of blood pressure measurement, watching a falling mercury column and hearing Korotkoff sounds. After 10 minutes' education, they were again tested with the same cases. Additionally, 83 mercury sphygmomanometers were checked to find defects such as inaccurate calibration and zero setting, leaky bladder, etc. Results: For the knowledge testing correct response rate was 41.1%. They were the lowest in selecting the proper cuff size and Korotkoff sound. In examining accuracy of blood pressure with videotape, nurses had 67.7% correct response rate. The correct response rate was significantly improved by a session of education. About 23% of sphygmomanometers was without discernable defects. Conclusion : The knowledge and skill of clinical staffs along with the accuracy of equipment have to be improved. A properly designed education program would contribute to the accuracy improvement of blood pressure measurement. Also, more concerns should be given to the precision and maintenance of equipment.

• 한국산학기술학회논문지
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• 제11권5호
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• pp.1912-1920
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• 2010

본 연구는 국민건강보험공단의 고혈압 사례관리 프로그램 참여자들을 대상으로 사례관리 프로그램의 중재 효과 및 효과의 지속성을 확인하고자 하였다. 기간은 2007년 5월 1일부터 2007년 6월 30일까지 국민건강보험공단의 고혈압 사례관리 프로그램 참여자 250명(남성 101명, 여성 149명)을 조사대상으로 하였다. 조사대상은 사례관리 1회 실시군(Group I)과 사례관리 2회 실시군(Group II)으로 구분하여 사례관리 실시 직전, 실시 직후, 6개월 및 12개월 후의 사례관리 프로그램의 중재 효과 및 효과의 지속성을 평가하였다. 연구결과, 고혈압 사례관리 프로그램 참여자들의 혈압치는 사례관리 실시 직전에 비해 실시 직후에 유의하게 개선되었으나, 6개월과 12개월 후에는 다시 증가하는 경향을 보였다. 또한 사례관리 1회 실시군(Group I)에 비해 사례관리 2회 실시군(Group II)에서 사례관리 프로그램의 중재 효과가 지속됨을 확인할 수 있었다.

• 한국직업건강간호학회지
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• 제19권2호
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• pp.258-267
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• 2010

Purpose: This paper studies the influence of the case-management program on the change of blood sugar, lifestyle, and knowledge level of diabetes mellitus (DM) for medium-sized-enterprise employees suffering from DM. Method: Subjects, divided into experimental and control groups, are 59 workers with FBS higher than 126mg/$d{\ell}$ or under DM medication treatment in the medium-sized enterprises, being managed by two distinct university hospital group occupational health management service teams. The case management program for DM patients consists of 6 different processes in which each subject is treated. Result: FBS decreased in the experimental group after the program, while that of the control group increased significantly. In the experimental group, the amount of smoking, the frequency of drinking and the amount of drinking per week decreased. Also, the knowledge level for DM and the change of nutrition management showed significant increase. In the control group, the amount of smoking increased and the frequency of drinking, the amount of drinking and nutrition level did not change significantly. And the knowledge level for DM decreased. Conclusion: We expect that taking this case management program for DM management may significantly improve diabetic patients' overall health.

• 한국병원경영학회지
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• 제26권2호
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• pp.56-67
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• 2021

Background: Regular doctor visits are vital for hypertension patients, especially for who have never received hypertension medication or non-pharmacologic therapy. This study purposed to study factors affecting outpatient visits for patients diagnosed with hypertension. Methods: This study included 59,009 respondents with hypertension over 30 from 2019 Community Health Survey data. Outpatient visits were defined by having hypertension treatments such as medication or non-pharmacologic therapy. Logistic regression was used to examine the factors affecting outpatient visits using SAS ver. 9.3. Results: 57,081(96.73%) patients with hypertension were identified as those having a outpatient visit for hypertension treatments, whereas 1,928(3.27%) patients did not have visits. Patient's characteristics such as gender, age, periods of hypertension, education level, perception of the blood pressure, hypertension management education, place of living, body mass index, depression and diabetes were found to have statistically significant relationship with the outpatient visits. Practical Implications: There is a need to select patients with high blood pressure who are unlikely to visit for hypertension treatments based on the study results. For those, establishing a personalized management plan such as health education and counseling programs will be helpful for the successful implementation of national chronic disease management program.

• 농촌의학ㆍ지역보건
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• 제33권2호
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• pp.232-242
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• 2008

- Abstract - Objectives: We examined the effects of diabetes mellitus (DM) case management program developed by National Health Insurance Corporation in Korea. Methods: One trained nurse performed the case management for 30 DM patients recruited through the reimbursement information of National Health Insurance in a rural community. The case manager had four home visits and two telephone calls for 12 weeks. We evaluated the effectiveness of the program in terms of self-efficacy, self-care behaviors and glyco-metabolic control. Results: The self-efficacy score was significantly increased from 70.0 of pre-intervention to 80.5 of post-intervention (p<0.001). The self-care score was also significantly increased from 2.86 to 3.60 (p<0.001). The scores of its components such as nutritional care, self-test of sugar level, foot care, oral care, and aerobic exercise were significantly improved (p<0.001). However, the improvement of score in medication management was statistically marginal (p=0.071). The fasting blood sugar level and HbA1c level was significantly decreased from 128.6 mg/dl to 114.5 mg/dl (p<0.001) and from 6.78 % to 6.54 % (p<0.001) respectively. Conclusions: The case management program was effective to improve the self-efficacy and self-care behaviors, and to control blood sugar level in DM patients.

• 지역사회간호학회지
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• 제6권2호
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• pp.234-249
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• 1995

Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

• 디지털융복합연구
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• 제14권4호
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• pp.487-494
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• 2016

본 연구는 고령여성의 12주간 건강운동프로그램을 통해 인슐린저항성 및 혈중지질의 변화를 살펴보고자 하였다. 이를 위해 운동집단(EG)과 통제집단(CG)으로 구분하여 두 그룹을 선정하였다. 운동집단에는 건강운동프로그램을 12주간 적용하였으며, CG는 통제집단으로서 프로그램에 참여하지 않고 비교집단으로 활용하였다. 운동집단에 적용된 건강운동프그램은 유산소운동과 밴드운동을 주 당 4회 준비운동과 정리운동을 포함해 60분간 실시되었다. 자료분석은 고령여성의 12주간 건강운동프로그램 적용 전과 후에 측정하여 프로그램의 효과를 검증하고자 하였다. 이와 같은 절차를 통해 다음과 같은 결론을 얻었다. 첫째, 고령여성의 12주간의 건강운동프로그램은 혈중지질과(TC, HDL, LDL, TG) 혈압(SBP, DBP) 변화에 유의한 상호작용효과를 나타냈다(p<.05). 둘째, 고령여성의 12주간의 건강운동프로그램은 인슐린저항성(insulin, glucose) 변화에 유의한 상호작용효과를 나타냈다(p<.05). 본 연구는 고령여성의 건강운동프로그램을 통해 인슐린저항성 및 혈중지질 변화에서 긍정적 개선을 나타냈다.

• 대한지역사회영양학회지
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• 제16권1호
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• pp.155-168
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• 2011

This study was conducted to assess needs of self-management nutrition program for diabetic patients. The survey was conducted among 100 diabetic patients, and the mean age of the subjects was 54.2 years old. Thirty three percent of the subjects were diagnosed diabetes less than 2 years ago. The average nutrition knowledge score about diabetes was 10.2 point, and percentages of correct answers were very high in 'foods rich in fiber' (97.0%), 'relevance of exercise and insulin' (97.0%), 'quantity of insulin injection' (91.0%), and 'diabetes menu' (91.0%). The sources of nutrition information were hospitals/healthcare centers (56.1%), TV/radio (19.2%), and internet (13.1%). Sixty nine percent of the subjects have experienced nutrition education on subjects as 'menu planning skills'(22.4%), 'selecting foods' (22.4%), 'relevance of blood glucose and eating foods' (21.5%) by personal counseling (54.4%). The total score of eating behavior was higher after diagnosed diabetes (35.3) than before (30.0) (p < 0.001). The preferred topics in developing diabetes nutrition information websites were 'diabetes mellitus', 'relevance of blood glucose and foods', and 'selecting foods for diabetes'. The subjects wanted the websites developed by 'using mainly illustrations, pictures, tables' (22.8%) and 'using simple design' (19.6%). The preferred contents in developing diabetes self-management nutrition program were 'dietary life diagnosis', 'chronic disease risk diagnosis', 'calorie control by selecting foods and cooking skills', and 'dietary assessment'. In designing the program, the subjects' most wanted designs were 'be handy and simple in using' (29.3%), 'using simple design' (17.9%), and 'using mainly illustrations, pictures, tables' (15.7%).

• 한국산학기술학회논문지
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• 제15권5호
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• pp.3058-3068
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• 2014

본 연구는 Cox의 상호작용모델에 근거한 건강증진프로그램을 이상지질혈증 경계범위에 있는 대학생에게 적용하여 총콜레스테롤(TC), 중성지방(TG), 고밀도지단백(HDL), 저밀도지단백(LDL)등의 혈중지질 지표에 미치는 효과를 확인하기 위한 실험연구이다. 대상자는 총 39명으로 실험군 20명, 대조군 19명이었으며, 분석은 SPSS WIN 18.0을 사용하여 기술통계, $X^2$-test, independent t-test, paired t-test로 분석하였다. 대상자-전문가 상호작용요소인 간호중재로 건강정보 제공(운동관리, 식이관리, 건강교육), 정서적 지지(경험나누기, 자기표현하기, 격려), 의사결정 통제(전화상담), 전문가적/기술적 능력을 제공하였고, 중재 전 후에 혈중지질 지표를 측정하였다. 본 연구결과 실험군에서 TC, TG, LDL은 유의하게 감소하였고, HDL은 유의하게 증가하여 본 건강증진프로그램은 효과가 있음을 확인하였다.

• 성인간호학회지
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• 제13권1호
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• pp.108-122
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• 2001

The cause of essential hypertension is yet unknown, but in general is caused by interaction of hereditary factors, diet, obesity, lack of exercise and stress. The aging process influences various physiological mechanism related to regulation of blood pressure. So elderly hypertensives have a tendancy to consider the disease as a result of the physiological aging process. This attitude causes many complications, worsening of the disease and even early death because of inappropriate care. In order to improve self-management of elderly hypertensives in this study the researcher examined the effect of blood pressure regulation by an education program that improves self-care behavior, through increasing self-efficacy. The education program consisted of group education on hypertension and self-care strategies, and encouraging and reinforcing self-efficacy resources such as verbal persuation, performance accomplishment and vicarious experiences. A quasi-experimental pre-and post-test design was used. Thirty-two elderly hypertensives participated in the study. Eighteen in the education group and fourteen in the control group. The education program consisted of eight sessions twice a week for four weeks. There was no intervention for the control group. Data were analysed using SPSS for Windows(Version 8.0). The results were as follows. 1. There was a significant decrease in systolic and diastolic blood pressure between the experimental group and control group over three different times, and interaction by groups and over time. 2. There was no significant difference in the level of self-care behavior between the experimental group and control group over three different times, and interaction by groups and over time. 3. There was significant difference in selfefficacy of experimental and control group, depending on the measuring period, but there was no difference between these groups on interaction by groups and over time. 4. There was positive correlation between self efficacy and self care behavior depending on the measuring period. There was negative correlation between diastolic blood pressure and self-care behavior on the posttest of the program, and between systolic blood pressure and self-care behavior on the follow-up test of the program. Findings indicate that this study will contribute to develop nursing strategies for the regulation of blood pressure for the elderly, which is easy for the elderly to learn as a nonpharmacologic approach.