• 제목/요약/키워드: community health problem

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Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • 한국미생물생명공학회:학술대회논문집
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    • 한국미생물생명공학회 2000년도 Proceedings of 2000 KSAM International Symposium and Spring Meeting
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    • pp.3-6
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    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

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가출위기청소년의 자립생활 준비에 영향을 미치는 생태 체계적 변인연구 - 쉼터 청소년을 중심으로 - (A Study on Ecological Variables that Affect Runaway Youths at Risk in Preparation for a Independent Life - Centering on Youths at Shelters)

  • 오수생;변상해
    • 벤처창업연구
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    • 제7권2호
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    • pp.195-205
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    • 2012
  • 본 연구는 청소년쉼터에 입소한 가출위기청소년의 자립생활준비에 관해 살펴보고 가출위기청소년의 개인적 특성과 자립에 영향을 주는 자립의 촉진요인과 저해요인을 파악하여 이들의 건강한 성장을 위한 경제적 자립, 교육적 자립, 심리적 자립, 사회적 자립의 다차원적 관점에서 가출위기청소년의 자립에 대한 의식과 욕구수준을 파악하고 성공적인 자립을 위한 필요요인을 확인하여 자립생활 준비를 위해 개입할 수 있는 근거를 확립하고자 하였다. 본 연구의 자립생활준비에 영향을 미치는 변인을 분석한 결과는 다음과 같다. 첫째, 미시체계 변인이 자립생활 준비에 미치는 영향을 살펴본 결과 진로준비행동에 문제해결능력, 자기효능감이 영향을 미치는 것으로 나타났다. 둘째, 중시체계 변인이 자립생활 준비에 미치는 영향을 살펴본 결과 진로준비행동에는 자립준비프로그램 참여, 시설지원이 영향을 미치는 요인으로 나타났으며, 가출위기청소년의 진로성숙에는 교사와의 관계, 자립준비프로그램 참여만이 영향을 미치는 요인으로 나타났다. 셋째, 거시체계 변인이 자립생활 준비에 미치는 영향을 살펴본 결과 진로준비행동에는 지역사회조직 참여, 서비스 연계가 영향을 미치는 요인으로 나타났으며, 가출위기청소년의 진로성숙에는 지역사회조직 참여만이 영향을 미치는 예측변인으로 나타났다. 넷째, 진로준비행동에 영향을 미치는 생태체계변인을 살펴본 결과 가출위기청소년의 진로준비행동에는 중간변인과 거시변인이 가장 강력한 영향을 미치는 요인으로 나타났다. 이에 정책적 개입으로 가출위기청소년들의 자립생활준비를 위해 문제해결능력과 직업능력개발과 역량강화 교육이 필요하고 쉼터교사의 전문인력이 확대, 배치가 필요하다. 쉼터의 특성을 고려한 자립준비프로그램이 적극적이고 실질적인 프로그램개발확대가 필요하고, 지역사회의 인적자원과 서비스 프로그램 등을 활용하여 지역사회와의 지지망을 구축하는 것이 필요하다. 가출위기청소년들의 가출을 독립을 위한 전단계로 사회가 이해하고 성인이 될 때까지 사회에 안정적인 정착을 위해 주택지원이 주택복지차원에서 필요하다. 가출위기청소년의 건강한 성장을 위한 건강, 심리, 학습, 자활활동을 위한 맞춤교육으로 전문인을 양성하는 직업진로교육의 지원이 필요하다.

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노인의 근력강화운동이 일상생활기능 및 삶의 질에 미치는 효과 (An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly)

  • 김희자;홍여신
    • 지역사회간호학회지
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    • 제6권1호
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    • pp.55-73
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    • 1995
  • An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

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경기도 여성노인의 성의식에 관한 조사연구 (A Study of Sex-related Problems of Old Women in Kyeonggi Province, Korea)

  • 박영수;최인숙
    • 한국학교ㆍ지역보건교육학회지
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    • 제5권
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    • pp.71-84
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    • 2004
  • The sexual discourse has been frequent, but the subjects of it have been limited to the young, and the sex of women and that of the old people, until now, have been overlooked. According to the data in 2,000 of the Korea Statistic Service, the older-than-sixty-five-year people consist of 37.4% men and 62.6% women. Of them, the older-than-seventy-year people consist of 33.8% men and 55.2% women. The data show the fact that as the age of the old people is higher, the number of old women is enlarging. Paying attention to the above-mentioned tendency, this study conducted a survey about the aspects of the sexual consciousness of old women. The purpose of study was focused, through the survey, on discovering the ways of old women's recognization about their sexual desire, and on presenting basic data to developing the programs which could solve the problems derived from the discovery. That is to say, the purpose of it was to prevent the sexual desire's distortion and suppression of old women, if they had any, and to present basic data to developing the programs which could convert their recognization of sex. The objects of the survey were the sample group of 301 people inhabiting in Hwaseong City, Seongnam City, Yongin City, and Suwon City, chosen out of 375,298 old women of 614,316 older-than-sixty-five-year people in Kyeonggi Province (Kyeonggi Province homepage, 2002). The data were collected by the questionnairers' interviews in the fields of old men's resting house, churches, temples, old men's niversities and so like, from September 19th to September 31th in 2003. The questionnairers as volunteers were taught the prior education, being prepared for the survey about old women's sexual consciousness. The contents of education were composed of the understanding of old women, the ways of questionnairing, and the items of questionnaire. The outcomes of the survey are following; First, concerning general items, the old women of the sample group answered that they felt greatly the difficulties of health(36.5%), economy(12.0%), and loneliness(11.3%) in turn. The 48.2% of them answered that they were healthy, but the 62.3% answered that they were suffering various illnesses. The 24.4% answered they were economically rich, and the 23.9% answered they were working. The 53.5% were living alone due to divorce or death. The 71.1% had been living for more than ten years. The 83.1% believed in their own religion. Second, the 43.8% of the sample group admitted the necessity of a heterosexual friend and sexuality The 39.0% felt sexual desire, and the 33.9% were experiencing sexuality. As the obstructing factors in performing sexuality, the objects of sample group pointed out shamefulness or morality(28.7%), anxiety that such deeds might afflict their health or the problem of health itself(20.2%), weakening of sexual potency(16.9%). This outcome shows that they have ambiguous notions about their sexual alienation and manner. Third, the 33.7% of the sample group admitted sexual education and sexual counsel, and of those that admitted them, the 85.2% said that they would take part in sexual education if it were held. It shows that the demand of sexual education and sexual counsel need be fulfilled. Therefore, through this study, the following two important suggestions can be drawn: First, systematic sexual education programs should be developed, considering old people's developing steps containing their rights of health and sex. Also those should be educated through kindergartens, primary, middle and higher education institutions. Second, sexual education and sexual counsel on prospective old people and present old people should be performed.

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한국 4년제 대학 간호교육의 현황과 발전방안 (The Present Situation and Future Strategies of 4-Year Nursing Baccalaureate Program)

  • 박정숙
    • 한국간호교육학회지
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    • 제1권1호
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    • pp.17-23
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    • 1995
  • One of the biggest problems of Nursing Education in Korea is the division among nursing education programs of the last 3 and 4 years. To solve this problem, Nursing community must do variable trials to achieve the unity of a 4-year educational program. With this, we need to observe the phenomena and reality of the present 4-year nursing educational program that we have. The object of this study is to analyse and discuss that we have. The object of this study is to analyse and discuss the problems and future strategies of 4-year Nursing Baccalaureate program. 1. Problems as nursing department in Medical School. 1) Many 4-year nursing baccalaureate programs are operating under the medical school as nursing department. So the academic development in nursing department is unprogressive and is not approved as unique discipline. 2) The operating system between nursing and medical department are different even though they are in the same school. 3) Inequality between nursing and medical department : In many case, the nursing professor can not attend administraion committees to discuss the medical school's operation because of many differences between nursing and medical organization. 4) Weakness of the leadership and the student activities in nursing student : The nursing student involvement is usually passive because of the difference of curriculum, less number than medical students and the difference between 4-year and 6-year education program. 5) There is the obscurity of the relationship between department of nursing and other departments in whole university. 2. Problems in nursing itself 1) We need to reconstruct nursing discipline. We must change from the disease centered model to health centered model and life cycle centered model so that we can be distinguished from medicine. We also must change from hospital centered nursing to all population centered nursing, 2) The improvement of curriculum ; When the independent framework of nursing discipline become established, we need to improve the curriculum. 3) The education of clinical practice ; Most nursing school programs are divided into professors who are lecturing the theory and clinical teachers who are teaching the nursing technique in the clinic. So, what is needed in nursing discipline is that the professors have a dual position. In America, The professor is required to be a clinical specialist and to have his or her clinic so that the professor become a good role model, teach the clinical practice effectively, and give the student the practice field. 4) To extend fields of nursing : At first, the school nurse must become the school health educator, a real teacher. The nurse must establish and operate a childern's wellbeing center or nursery school, a disabled people's house or senile's wellbeing center, a mental health center, and a health promotion clinic for healthy people. 5) The name 'nursing department' need to be considered. When the focus is to be changed from the disease model to health improvement model, we take into consideration change 'nursing college', 'nursing department' and 'nursing profession' to 'health science college' or 'health wellbeing college'. 6) We must have highly qualified academic students. Each Nursing educational faculties must have the high qualified students through the development of nursing educational program and the increment of scholarship. The Korean Nurses Association and The Korean Clinical Nurses Association need to make an endeavor for the improvement of work condition and payment of clinical nurses of hospitals who consist of 70% of all nursing manpower. 3. Improvement Strategy 1) All nursing educational program must be changed 4-year program gradually. 2) Nursing department need to try to become nursing college. 3) We need to study many researches for improvement of the problem in nursing discipline and nursing education. We need more interdisciplinary researches, and we need to be granted for that research. 4) We need to have many seminars and workshops thoughout the whole country to expand a sense of nursing education. 5) Drawing up a policies plan for the nursing educational improvement : The Korean Nurses Association, The Korean Academic Nursing Association, Korea Nursing College and department President's Committee, and Korea Academic Society of Nursing Education must try for the development of nursing educational improvement and ask for government frame the policy to develop nursing education.

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개원의의 대도시 개원 이유 : 대구시 개원의를 중심으로 (Medical Practitioners' Reasons for Practice in Great Gity(Taegu))

  • 감신;천병렬;박재용;예민해;송달효
    • 보건행정학회지
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    • 제2권1호
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    • pp.17-41
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    • 1992
  • During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.

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병원외 심정지 환자의 자발적 순환 회복에 영향을 미치는 요인 (Factors influencing the return of spontaneous circulation of patients with out-of-hospital cardiac arrest)

  • 박일수;김은주;손혜숙;강성홍
    • 디지털융복합연구
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    • 제11권9호
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    • pp.229-238
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    • 2013
  • 병원외 심정지는 오늘날 우리나라의 중대한 보건문제로서, 환자의 퇴원 시 생존율은 3.5%이며, 이 중 1%만이 신경학적 기능을 회복하는 것으로 나타났다. 이처럼 낮은 병원외 심정지 환자의 생존율을 높이기 위해서는 병원 도착 전 환자의 자발적 순환을 회복시키는 것이 매우 중요하다. 따라서 본 연구에서는 질병관리본부의 2009년도 심정지 의무기록 조사 자료를 활용하여 병원외 심정지 환자의 자발적 순환 회복률을 향상시킬 수 있는 요인들에 대한 심층 분석을 수행하였다. 심정지 환자의 자발적 순환 회복에 영향을 미치는 요인은 의사결정나무기법을 적용하여 분석하였으며, 그 결과 도착전 CPR여부, 병원 도착전 심정지 목격여부, 심정지시 활동, 과거력(암/심장질환/뇌졸중), 심정지 발생 장소, 병원전 일반인 CPR여부, 신고~현장 도착까지 걸린 시간, 연령 등이 중요한 요인으로 밝혀졌다. 이 요인들의 조합을 통해 의사결정나무모형으로 분류된 심정지 환자는 총 16개 유형이었으며, 그 중 유형 1의 특징을 갖는 집단의 자발적 순환 회복률(29.6%)이 가장 높게 나타났다. 더불어 비공공장소에서 심정지가 발생한 환자에게 일반인이 CPR을 시행하였을 경우, 심정지 환자의 자발적 순환 회복률이 향상된 것으로 보아 지역주민들에 대한 CPR교육이 중요함을 파악할 수 있었다.

소규모 지역간 결핵관리사업 성과에 대한 시계열분석 - 전국 234개 시.군.구 보건소의 환자등록자료를 중심으로 - (Time Series Analysis on Outcomes of Tuberculosis Control and Prevention Program between Small Areas in Korea - with Patient Registry Data of 234 City.County.District Public Health Centers -)

  • 김춘배;최헌;신계철;박종구;함수근;김은미
    • Tuberculosis and Respiratory Diseases
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    • 제48권6호
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    • pp.837-852
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    • 2000
  • 연구배경 : 이 연구는 우리나라 각 기초자치단체에서 발행하는 "통계연보" 등을 활용하여 결핵관리사업의 성과를 결핵예방사업, 환자발견 및 지속관리사업, 그리고 결핵 치료사업 측면에서 소규모 지역간 사계열분석 모형에 의해 연도별 인구천명당 결핵등록률 및 결핵 치료순응도 등의 성과지표로 산출하여 비교분석하고 이에 영향을 미치는 요인을 규명하고자 하였다. 방법 : 전국 234개 시 군 구 기초자치단체별로 발간된 "통계연보"나 광역자치단체별 "통계연보"를 원주시청 행정자료실, 강원도청 행정자료실, 통계청 민원실 등을 방문, 1980년도부터 2000년도까지 순차적으로 열람하여 결핵관리사업등 관련 정보를 지난 1년여동안 추적 조사하였다. 결핵관리사업의 성과지표인 연도별 결핵유병률 등을 산정, 이를 종속변수로 하여 다중 희귀모형을 구축하여 Micro TSP와 SAS 패키지를 이용하여 확률론적안 시계열분석을 하였다. 결과 : 1998년까지의 지역별 현황을 비교하면, 인구지표 중 인구이동률을 제외한 나머지 변수들의 경우 모두 구지역, 시지역, 군지역의 순으로 유의하게 감소하였다. 사회 경제학적 지표로는 인구천명당 자동차 등록대수, 지방세, 담배소비세 모두 시 군 구지역간에 유의한 차이를 보였다. 또한 보건의료지표는 시 군 구지역간 인구천명당 의사수 및 병상수 모두 통계적으로 유의하게 지역 규모의 크기에 따라 감소하였다. 지역별 관련 결핵지표의 시계열 분포의 변화를 비교하면, BCG접종률의 경우 1980년부터 1984년까지 약간의 증가 추세를 보이다가 그 이후 1993년도까지는 일정한 평형 수준 (plateau state) 을 유지한 이후 다시 감소추세를 보였다. 1985년 이전에는 시지역이, 1985년 이후에는 군지역의 접종률이 타지역에 비해 유의하게 높았다. 폐결핵양성자수 시점유병률, 폐결핵 음성자수 시점유병률 및 결핵사망률의 분포를 보면, 세가지 결핵지표 모두 1981년 이후 지속적으로 감소하는 영향을 보여주되, 군지역이 가장 높았고 시간이 경과할수록 시 군 구지역간 차이도 점차 줄어들었다. 이는 지역 특성상 민간의료기관의 분포가 적은 군 지역에서의 결핵등록 및 관리사업이 상대적으로 시 구(광역도시)지역보다 보건소 중심으로 용이하게 운영되어지고 있음을 시사한다. 결핵 치료순응도의 경우 기간유병률이나 사망률과는 반대로 1982년 이후 점차 증가하는 추세였다. 결론 : 이 연구결과는 현재 보건소 중심으로 관리되어 매년 집계, 보고, 발간되는 시 군 구 기초자치단체별 "통계연보"의 결핵보건사업 결과정보에 대한 이용의 실증연구에 해당된다. 따라서 지난 제7차까지 시행해 오던 전국결핵실태조사 대신에 향후 시행될 결핵정보 감시체계 운영등의 기초자료로서 가능성을 제공해주고 있다. 결국 이를 바탕으로 결핵관리사업과 관련 지역 특성에 맞는 지역보건의료계획 수립의 기초자료 및 정부의 국가결핵보건사업 기획의 근거를 제공함으로써 결핵관리 대책 수립시 우선순위 결정과 예산배분, 기대효과 산정에 필수적인 정보로 활용되기를 기대한다.

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일부지역주민의 구강보건인식도 및 치과의료 이용양상 (Knowledge and Pattern of Dental Health Care of the Community People)

  • 김일준;남철현
    • 보건교육건강증진학회지
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    • 제10권1호
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    • pp.34-60
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    • 1993
  • This study was done for the improvement of dental health of rural villagers and the dental health education, through finding of the types of brushing teeth and dental treatment of 812 people in Sunsan, Kyungpook province for 35days from March 27 to April 30 in 1992. Summaries are as follows ; 1. 58.5 percent of respondents were women, 56.3 percent were 40′s, 28.0 percent were 30′s, 12.3 percent were 50′s, and the over 60′s were 3.4 percent Elementary school graduates were 36.1 percent and most of them were middle school graduates, 33.5 percent. In view of the occupation, farmers were 56.5 percent, factory workers were 17.9 percent, the middle class (monthly pay amounting to 500,000∼990,000 won) were 49 percent and the lower class(less than 500,000 won) were 30.9 percent. In the standpoint of religion, Buddhists were 42.5 percent. 2. In the number and times of respondents brushing, 35.5 percent is "after dinner", 25.6 percent is "Before going to bed", 15.8 percent is "After breakfast", 13.3 percent is "After every meal", 5.2 percent is "Before breakfast" and 4.7 percent is "The sometimes it occurs to them". 3. The acquirement process of knowledge on the dental health were clinics or health center dentists (27.6%), TV(24.5%), magazine(9.2%), school(7.8%), relatives(5.3%). and 25.6 percent has never acquired. 28.3 percent of the farmers learned something by clinics and 28.1 percent of them haven′t heard about dental health. 4. The rate of persons who experienced oral diseases during 1 year period was 76.1 percent, and that of the educated was 19.9 percent and that of the uneducated 80.1 percent. The authorities concerned with treatment were dentist′s(41.6%), health center(30.3%), and the unlicensed person(2.9%). The rate of negligence was 6.3 percent, farmers experienced oral disease was 75.2 percent and they utilized the health center most often(36.2%). 5. The rate of person who had experienced dental prosthesis during ten year period was 71.9 percent, and the final place or man for dental prosthesis was dental clinic(59.4%), the unlicensed person(27.1%), and health center(13.5%). The rate of farmers experienced dental prosthesis was 70.4 percent. They utilized the dental clinic, the unlicensed person and the health center with the rates of 51.5 percent, 32.2 percent, and 16.7 percent respectively. 6. As to the results of dental prosthesis using the dental clinic, "being satisfied now" was 72.4 percent, "being dissatisfied" 14.4 percent, "being unable to use it" 3.1 percent, "its being somewhat usable" 10.1 percent, "having some problem" 38.7 percent, and "there being no problems" 61.3 percent. About utilizing the unlicensed person, "being satisfied now" was 65.8 percent, "being dissatisfied" was 10.7 percent, "being unable to use it" 5.1 percent and "its being some what usable" was 18.4 percent. 7. The rate of missing teeth holders amounted to 89.8 percent, the rate of the educated to the uneducated was 19.2 percent to 80.8 percent The reasons of neglecting that illness were due to "Endurable"(28.3%), and "No money" (24.3%). In the case of farmers 89.1 percent of them were the missing-teeth holders, the "Endurable" were 29.8 7. percent, and "No money" lay in 27.4 percent. 8. Their hopeful centers for dental prosthesis were the dental clinics(76.6%), and the health center(16.9%).

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대구·경북지역 보건소 성교육 담당자의 훈련 및 업무현황과 개선방안 (Training, Working State and Ways of Improving Work of Sex Education Counselors in Health Centers)

  • 염석헌;김창윤;이경수
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.159-175
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    • 2002
  • 본 연구는 대구광역시와 경상북도 보건소의 성교육 상당 담당자들의 구체적인 직무 현황과 실태를 조사하고 비교 분석하여 제반 문제점을 파악한 후 개선 방안을 도출하고, 이를 통하여 성교육 및 상담의 효율적인 수행방안을 제시하고자 수행되었다. 정상북도의 경우 총 53명을 교육하여 보건소당 평균 2.3명을 교육하였고, 보건소별로는 1명부터 5명까지 배치되어 있었다. 대구광역시의 경우도 10명을 교육하였으나, 보건소별로는 0명부터 3명까지 차이를 보였다. 성교육과 상담교육을 이수한 근무자 중에서 교육이수 후 성상담 업무를 담당한 경험이 있는 경우는 38명으로 66.7%를 차지하였다. 전체 31개 보건소 중 현재 성교육 업무를 담당하고 있는 담당자 27명이 응답한 내용을 분석해 보면 다음과 같다. 성교육이나 상담시 사용하는 자료에 대한 복수응답 결과 비디오를 이용한 경우가 25건(92.6%), 책이나 소 책자가 23건(85.2%), 사진을 이용한 경우가 10건(37.0%), 빔프로젝트 8건(29.6%), 슬라이드를 이용한 경우가 7건(25.9%) 순이었다. 성교육과 상담업무 담당자의 업무별 투입시간 비율을 보면, 성교육 외의 업무가 76.2%, 학교현장에서의 성교육 7.6%, 성교육 자료수집 5.7%, 성교육 자료개발 3.5%, 청소년 상담 3.0%순이었다. 성교육과 상담실시 여부를 분석한 결과 27개 보건소 중에서 유치원 학생에 대하여 성교육을 실시하고 있는 보건소는 12개로 44.4%, 초등학교는 13개로 48.1%, 중학교는 19개로 70.4%, 고등학교는 14개로 51.9%, 성인 대상의 교육과 상담은 10개 보건소에서 교육을 실시하고 있어 37.0%로 나타났다. '99년도 한해 동안 각 보건소에서 실시한 성상담 건수는 평균 301건이었으며, 보건소에서 실시한 현장 성 교육 횟수는 유치원이 13.1회, 초등학교 7.5회, 중학교 4.8회, 고등학교 10.9회, 그리고 성인을 대상으로 한 교육횟수가 21.0회였다. '99년 한해 동안 각 보건소에서 실시한 성교육 인원은 유치원이 평균 782명, 초등학교가 235명, 중학교 240명, 고등학교 448명, 그리고 성인 교육이 1,534명으로 나타났다. 성교육 담당자들의 업무에 가장 큰 문제점에 대한 응답 중 '업무량이 과중하다'가 9명(33.3%), '성교육 자료 부족'이 8명(29.6%)으로 가장 많았다. 성교육 담당자의 업무와 관련된 개선방안에 대한 응답에서 성교육을 담당하는 기관이 더욱 전문적이고 체계적이어야 한다는 지적이 70.4%로 가장 높았고, 교육 자료가 더욱 구체적이고 세분화되어야 한다고 응답이 44.4%, 보건소 성상담요원의 업무량의 감소로 인한 성 상담과 교육에의 전문화와 체계화에 대한 의견이 37.0%, 다음으로는 학교, 교사와 보건소와의 협조 강화가 29.6%였다. 이상의 결과로 볼 때, 현재 보건소의 성교육 상담 인력의 훈련과 배치 및 활용은 효율적이지 못하다고 판단되며, 인력의 효율적 활용을 위한 인사교류 방안의 개선과 지역의 성교육과 상담 수요에 따른 인력 양성 계획이 필요하다. 또한 보건소의 성교육을 효율적으로 수행하기 위한 전문성 확보를 위해 담당자의 지속적인 교육과 업무수행을 위한 교육자료의 개발과 보급이 필요하다.

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