• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.857-874
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• 1998

The objective of this study is to collect the opinions on the present condition and the improvement directions of urban health centers from and to make a comparison. Samples were drawn from the various sources of a district in seoul. 53 persons involved in district health's administration(the Members of a District Parliament, the senior officials of a District office, village chief) and 84 health center workers were surveyed with anonymous postal questionaires and 427 district private medical personnels with postal questionaires and 625 users of a health center with direct questionaires, from November 18 to 25, 1996. Additionally, 12,151 households were surveyed with self-reported questionaires including priorities on special district health services of health center, from September 1 to 7, 1996. The major findings were as follows : 1) Although the persons involved in district health administration tend to put lower priority on health service over other community activities, they well acknowledged the importance of health center. But health center workers strongly acknowledged the importance of both health service and heath center. 2) As to the level of human resoureces, equipments and ammenities of Health Center commpared with private medical institute, the persons involved in district health's administration and health center workers responded that health center was higher in following order : 54.9%, 41.6%, 36.5% and 88.0%, 80.7%, 44.1%. 3) Concerning the priorities of health center's improvement, the persons involved in district health's administration replied in the order of reinforcement of proffesional health workers (43.3%), improvement of equipments and ammenities(28.3%), and the health center workers replied in the order of reconstruction of organization(24.1%), public health education and promotion(22.8%), reinforcement of proffesional health workers(21.0%). 4) Both the persons involved in district health's administration and health center workers replied that Ministry Health and Welfare, District office, health center were essential as the most critical organizations in the activation of Health Center's Function. 5) Persons involved in district health's administration and health center workers chose, as the most important health center's Function, medical treatment and prevention of infectious disease, and prevention of acute and chrone disease control and special district health service, respectively. Both Groups replied that fammily planning and parasite control are no longer in need. 6) As the future health service requiring reinforcement, every human resources parties considered health conselling, health line, sex education as the most imortant elements in public health education. Concerning the reinforement of other health services such as medical checkup and visiting nurses, every human resources parties showed more than 80% approval rate, but for oriental medical care service, the private medical personels showed relatively low approval rate(52.9%). Therefore the planning for reinforcement of health center's function requires the reflection of human resources party's opinion and the implication of system which can control and combine the differences in party's opinions.

• Journal of Hospice and Palliative Care
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• 제8권1호
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• pp.45-51
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• 2005

목적: 말기 암 환자 간호사의 직무소진에 영향을 미치는 요인을 파악하여 말기 암 환자들에 대한 최적의 간호수준을 유지하기 위한 소진예방 기초 자료를 제공하고자 하였다. 방법: 편의표집방법에 의해 말기 암 환자 간호경험이 있는 300명의 간호사를 대상으로 자 기기입식 설문지를 통해 조사하였다. 평균, 표준편차, t-test, ANOVA, 다중회귀분석 등이 수집된 자료 분석을 위해 실시되었다. 결과: 전체 응답자의 소진평균은 2.71로 높지 않은 편이었으며 소진유형별로는 신체적 소진이 가장 높았다. 연령과 근무연한이 신체적 소진과, 연령, 근무연한 및 호스피스교육 유무가 정서적 소진에서, 연령 및 종교가 정신적 소진에서 통계적으로 유의한 차이를 나타낸 변수였다. 다중회귀분석결과 종교, 병동만족도 호스피스교육이 전체 소진을 설명하는 변수였으며 소진유형을 설명하는 변수에는 약간 차이가 있었다. 결론: 연구 결과를 일반화할 수 있는 연구방법 및 한국적 현실에 적합한 변수 및 세부 소진 영역을 보완한 후속연구가 요구된다.

• 한국의료질향상학회지
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• 제8권1호
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

• Perspectives in Nursing Science
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• 제13권2호
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• pp.88-95
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• 2016

Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.

• 농촌의학ㆍ지역보건
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• 제38권2호
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• pp.85-96
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• 2013

간호대학생의 아동학대에 대한 인식과 관심 및 경험실태를 파악하고, 이와 관련된 요인을 검토하고자 2개 간호학과 임상실습을 경험한 3-4학년 학생을 대상으로 아동학대인식 측정도구를 번안한 44항목으로 구성된 설문지를 전문조사자에 의해 실시한 결과 370명을 최종 분석대상으로 하였다. 분석은 관련요인 특성 별 아동학대 인식 비교는 독립표본 t-검정 방법을, 관련 요인 파악은 후진제거방식 회귀분석을 이용하였다. 간호대학생들은 아동학대에 대한 관심은 있었지만 법에 대해서 잘 모르고 있었으며, 교육이나 연수를 받은 경험도 상당히 낮은 것으로 조사되었다. 그러다 보니 아동학대에 대한 신고경험도 거의 전무하였다. 교육이나 훈련경험, 법에 대한 인지도는 고학년이 더 높은 것으로 나타났는데, 이는 아동간호학에서 일부 다루어지기 때문인 것으로 보인다. 전체적으로 아동학대 인식은 3.01점으로 도구에 포함된 행동을 '가끔'이라도 하면 학대로 인식하는 수준이었다. 하부 영역에서는 성적 학대에 대한 인식이 가장 높았으며, 신체학대, 심리적 학대가 그 다음 이었고, 방임에 대한 인식은 아주 낮은 수준이었다. 또한 평소 아동학대에 관심이 있거나, 학대가 의심될 때 관심이 있는 학생의 인식 점수가 유의하게 높았다. 간호대학생은 미래 신고의무자가 될 의료인으로서 아동학대에 대한 관심과 인식수준을 높이기 위한 방안으로 교육을 강화하여 아동학대에 대한 전문성을 높여야 할 것이다.

• 한국산업보건학회지
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• 제27권1호
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• pp.13-22
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• 2017

Objectives: The objective of this study was to evaluate the exposure levels of door-to-door deliverers to fine particulate matter (PM2.5). Another objective was to confirm the general working patterns of door-to-door deliverers via survey. Methods: In the city of Daegu, ten door-to-door deliverers who wished to join the study were recruited. The general working characteristics of door-to-door deliverers were surveyed using self-reported questionnaires. In the cabin of each car driven by a deliverer, a real-time PM2.5 sampler (Sidepak, Model AM510, TSI Inc., MN, USA) and a GPS device (GPS 741, Ascen, Korea) were installed. Each deliverer was monitored for four days per week so that each day could be monitored at least four times. Results: A total of 40 measurements of PM2.5 concentrations were taken during delivery of parcels. The average exposure levels of door-to-door deliverers to PM2.5 was $44.62{\mu}g/m^3$ ($7-9443{\mu}g/m^3$. Exposure levels to PM2.5 according to the day of the week and coverage areas were not significantly different (p>0.05). Door-to-door deliverers using trucks with older diesel engines manufactured before 2006 had significantly higher exposure levels to PM2.5 than in the case of trucks with diesel engines manufactured after 2006 (p<0.05). Many of the door-to-door deliverers reported the status of having windows open during the delivery task. During delivery services, the working hours spent in residential areas were higher than on roadsides, but exposure levels to PM2.5 in residential areas and on roadsides were $46.17{\mu}g/m^3$ and $49.90{\mu}g/m^3$, respectively. Real-time PM2.5 exposure levels were significantly different between roadways and residential areas (p<0.001). Conclusions: PM2.5 exposure levels of door-to-door deliverers were found to be affected by higher vehicle emissions from the roadsides near their vehicle during deliveries and while driving to other locations compared to by PM2.5 from the diesel engines of their own trucks. Particle concentrations from roadsides and emissions from nearby vehicles through open windows were the main source of PM2.5.

• Clinical and Experimental Pediatrics
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• 제53권5호
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• pp.639-643
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• 2010

Purpose: Hand-foot-mouth disease (HFMD) is a common viral illness in children, which is usually mild and self-limiting. However, in recent epidemics of HFMD in Asia, enterovirus 71 (EV71) has been recognized as a causative agent with severe neurological symptoms with or without cardiopulmonary involvement. HFMD was epidemic in Korea in the spring of 2009. Severe cases with complications including death have been reported. The clinical characteristics in children with neurologic manifestations of EV71 were studied in Ewha Womans University Mokdong Hospital. Methods: Examinations for EV71 were performed from the stools, respiratory secretion or CSF of children who presented neurologic symptoms associated with HFMD by realtime PCR. Clinical and radiologic data of the patients were collected and analyzed. Results: EV71 was isolated from the stool of 16 patients but not from respiratory secretion or CSF. Among the 16 patients, meningitis (n=10) was the most common manifestation, followed by Guillain-Barre syndrome (n=3), meningoencephalitis (n=2), poliomyelitis-like paralytic disease (n=1), and myoclonus (n=1). Gene analysis showed that most of them were caused by EV71 subgenotype C4a, which was prevalent in China in 2008. Conclusion: Because EV71 causes severe complications and death in children, a surveillance system to predict upcoming outbreaks should be established and maintained and adequate public health measures are needed to control disease.

• Child Health Nursing Research
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• 제6권2호
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• pp.212-223
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• 2000

The purposes of this research were to add to the developing knowledge base about the burden and social support of grandmothers involved with caring grandchildren, and to examine whether a significant relationship exists between their burden and social support perceived by the grandmothers. A convenience sample of 102 grandmothers was recruited from five collective apartment areas at a small city in Korea. The criteria of selection of sample were that the grandmothers were raising their grandchildren under the age of 36 months for 3 months or longer at own or gandchildren's home. The instruments used were a 15-item multidemensional burden scale and a 8-item social support scale. Both scales were self report, five point Likert type scales. The higher the score, the higher the degree of burden and social support. Data was collected by two prepared research assistants visiting subjects' home from December 10, 1998 to March 20, 1999. The collected data were analysed using mean, t-test, one-way ANOVA, and Pearson's correlation coefficient computed by SPSS software. The results were as follows. 1. In the age distribution of grandmothers, the over half of subjects(58.8%) were under 60 years old. The majority(69.6%) of subjects were married at time of data collection. 79(77.5%) of the sample reported that their perceived health status was good or over. 2. The burden of the grandmothers was not scored high, and the item means on burden scale were ranged from 2.26 to 4.19 out of 5. 'Short of private time'(4.19) had the highest score, followed by 'fatigue'(3.92), 'short of rest'(3.75), and 'short of contact with friends and neighbors'(3.62). The lowest item was 'family doesn't help me'(2.26), and followed by 'family doesn't understand me'(2.33), 'angry with family' (2.43), and 'angry while caring for grandchild'(2.60). 3. There were significant relationships between the burden and present health status(p<.01), childcaring confidence(p<.01), and motive of caring(p<.01). 4. The score of social support, was ranging from 3.61 to 4.01 out of 5. 5. The relationship between burden and social support was found to be correlated negatively. The relationship was statistically significant(γ= - .2833, p<.001). In conclusion, it was found that the burden was not high and burden of grandmothers caring grandchildren was correlated negatively to social support. Therefore, these results provide a basis for developing a nursing intervention to reduce the burden of grandmothers.

• Journal of Preventive Medicine and Public Health
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• 제34권2호
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• pp.175-181
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• 2001

Objectives : To compare the multiple outcomes of patients with cataract surgery at perioperative time,3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). Methods : For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was peformed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was 'conducted at 4 stages' : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. Results : The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 mouths. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom sure were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(09.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. Conclusions : In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.

• 한국치위생학회지
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• 제15권2호
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• pp.271-278
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• 2015

Objectives: The aim of this study was to investigate the effect of water fluoridation program(WFP) on dental caries prevention in Ulsan, Korea. Methods: The data of control group were extracted from 2012 Korean National Oral Health Survey(KNOHS). Since 1998, WFP was implemented in Ulsan. The subjects were 670 subjects including 10 to 12-years old children in 2009. The control subjects were 4,871 people in non-fluoridated metropolitan cities comparable to Ulsan. The control subjects were selected from 2012 KNOHS. A self-reported questionnaire was completed by the variables including oral health behaviors on daily frequency of toothbrushing, eating snacks and beverages. Oral health examination was carried out by two dentists who received a training in KNOHS with an inter-examiner-agreement. Caries preventive fraction was calculated by the difference of DMFT and DMFS index. The preventive effects of the WFP program were focused on gender, number of fissure sealed teeth, daily frequency of toothbrushing, eating snacks and beverages. Data were analyzed using SPSS $19.0^{(R)}$(SPSS Inc., Chicago, IL, USA) statistical package. Results: DMFT indices of 12-year-old subjects(n=670) in WFP and control population(n=4,871) were 2.11 and 1.23, respectively with an estimated prevention effect of 41.7%. Conclusions: WFP in Ulsan reduced the prevalence of dental caries. WFP should be recommended for the public oral health program in other metropolitan cities.