• 대한예방한의학회지
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• 제15권2호
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• pp.115-130
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• 2011

Objective : This study aimed qualitative change of traditional korean medical public health programs (TKM-PHP) by the research of present condition, problems and improvement direction about TKM-PHP. Methods : Data were collected from 222 of 996 public health oriental medical doctors(PHOMD) using the structured questionnaire by e-mail. Collected data were analyzed through frequency analysis, T-test, and ANOVA using SPSS 12.0 and significant level was 0.05. Results : 59.5% of the respondents said that the TKM-PHP are not efficiently executed because there are not enough motivations to entice oriental medical doctors in charge of the programs and because PHOMD and the government officials in charge lack in relevant experiences and skills. A majority of the PHOMD recognize a need for activating the TKM-PHP but less actively participate in the programs since there is not a good rewarding system and there are neither standard manuals nor methodological guidelines for the programs. In order to activate the TKM-PHP, it is urgent to employ full-time oriental medical doctors and to continually and systematically appoint the professional manpower in charge. And it is also needed for the state to secure an adequate budget and prepare schemes for persistently train such professionals. Conclusion : Activating the TKM-PHP will lead to the development of TKM, but there are still such problems as lack of the professional manpower in charge, an excessive burden of the duties of PHOMD, lack of program manuals, and a poor system for evaluation. To solve these problems, it is advised to construct foundations for administerial supports, draw up a standard manual, prepare a system for evaluation in consideration of the characteristics of TKM, and hire professionals to ensure sustainable programs.

• 대한예방한의학회지
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• 제18권2호
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• pp.47-58
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• 2014

Objective : In Oriental medicine, the concept of Preventive Treatment Disease(治未病, PTD) is intended to actively deal with changes in modern disease patterns due to increase in chronic diseases. In China, preventive health service program based on PTD Theory are being carried out aimed at improving and/or preventing people's health. Method : For the introduction of PTD program based preventive service in Korea for the promotion of people's health, I would like to consider its possibility by reviewing the PTD program being conducted in China. Results : China's preventive health service programs based on PTD Theory started in 2008 for the purpose of promoting people's health and reducing medical expenses by providing medical services tailored to individuals. Regarding the effects of PTD program based preventive health service, improvement of discomforting symptoms comprised 73.04% of responses. As to service items, health guidance, Traditional Chinese Medicinal diagnosis, and preparation of health records were answered as being important. The importance of food and internal medicines for preventing and/or curing PTD Theory are also recognized. Also, as to satisfaction level, 90.64% responded as being satisfied in the order of the level of service providers, their attitudes, service processes, items, costs, and environments. Conclusion : As shown above, according to assessments on China's PTD programs, the PTD Theory is being applied to actual public health programs with highly effective results. Hence, it can be seen that such attempt could also be implemented in Korea as part of a scheme for promoting health by means of Korean medicine health promotion programs. However, further researches into concrete implementation schemes will have to be developed in the future as medical systems are different in Korea from in China.

• 보건의료산업학회지
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• 제10권2호
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• pp.15-23
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• 2016

Objectives : The purpose of this study was to evaluate the productivity changes of 18 public health centers in Gangwon-do from 2006 to 2013 using the Malmquist Productivity Index(MPI). Methods : Data were collected from Statistics Korea from 2006 to 2013. The input variables were the numbers of medical, nursing and administrative personnels. The output variables were the performances of health promotion programs. Along with the traditional input-oriented DEA analysis, the MPI was calculated. Results : First, among the 18 public health centers, the productivity index of 14 public health centers was increased. Second, the annual productivity showed a 6% increase. Third, the productivity improvements were mainly caused by Scale Efficiency Change. Conclusions : Improving the productivity of public health centers requires the support and external policies of the national and local government. Internally, public health centers need to maintain scale optimization of the center. Additionally, efforts should be made to effectively use limited resources.

• 지역사회간호학회지
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• 제18권3호
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• pp.480-491
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• 2007

Purpose: This study was to investigate the needs of health & community services among the disabled at home in rural areas. Methods: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. Results: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was $2.62{\pm}.79$: education services $(2.92{\pm}1.05)$; medical services $(2.81{\pm}.82)$ nursing care services $(2.75{\pm}1.08)$; connection services $(2.62{\pm}1.20)$;, housing services $(2.60{\pm}1.09)$; emotional services $(2.41{\pm}1.03)$; other services $(2.24{\pm}1.06)$; and support of self-sustenance service $(1.92{\pm}1.15)$. The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751. p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). Conclusion: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.

• 한국간호교육학회지
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• 제5권1호
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• pp.97-105
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• 1999

Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

• 핵의학기술
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• 제18권1호
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• pp.115-121
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• 2014

PET 영상의 질 향상과 더불어 많은 연구를 통해 다양한 프로그램의 개발이 이루어지고 있다. 그 중 Philips 사의 Astonish TF 재구성 기법은 기존보다 빠른 재구성 속도와 함께 2 mm의 영상 재구성이 가능하여 병변의 향상된 대조도를 확인할 수 있다. 본 연구에서는 전신 $^{18}F-FDG$ PET 영상에서 기존의 4 mm와 2 mm 재구성 기법에 따른 표준섭취계수(SUV)를 비교 평가하였다. GEMINI TF 64 PET/CT (Philips, Cleveland, USA)를 사용하여 팬텀실험은 NEMA IEC Body Phantom (sphere: 10, 13, 17, 22, 28, 37 mm)으로 영상을 획득하였고, 임상영상은 유방암 진단을 받은 여자 30명(연령: $55.1{\pm}11.3$세, BMI: $24.1{\pm}2.9$)을 대상으로 $^{18}F-FDG$ PET/CT 검사를 시행한 후, 각각 4 mm와 2 mm로 영상을 재구성하였다. 획득된 영상은 EBW (Extended Brilliance Workstation) NM ver.1.0을 통해 팬텀과 임상영상에 관심영역을 설정하고, 표준섭취계수를 측정하였으며, SPSS ver.17.로 통계 분석하였다. 팬텀실험에서 90 sec로 획득한 영상의 4 mm와 2 mm 재구성 영상의 $SUV_{Max}$를 비교한 결과, 열소의 크기가 작을수록 $SUV_{Max}$의 편차가 크게 나타났고, 150 sec로 획득한 영상의 4 mm와 2 mm 재구성 영상의 $SUV_{Max}$를 비교한 결과에서도 같은 성향을 나타냈다. 90 sec와 150 sec로 획득한 영상의 $SUV_{Max}$의 편차 정도는 90 sec로 영상을 획득하였을 경우 보다 150 sec로 획득한 영상에서 열소의 크기가 작을수록 큰 차이를 나타냈고, 열소의 크기가 클수록 작은 차이를 나타냈다. 임상영상에서는 4 mm와 2 mm 재구성 기법을 분석한 결과, 표준섭취계수는 4 mm보다 2 mm 재구성 기법에서 높게 나타났고, 또한 체적이 작을수록 변화율이 증가하였다. Astonish TF 재구성 기법을 적용한 팬텀실험과 임상영상의 분석 결과, 체적의 크기가 작을수록 표준섭취계수의 변화율이 증가하였다. 그러므로 임상에서 대조도 및 병변 감별력이 우수한 2 mm 재구성 기법의 정확하고 적극적인 활용을 위하여 표준섭취계수 보정에 대한 추가적인 연구가 필요할 것으로 사료된다.