농촌(農村)에 있어서 분만개조요원(分娩介助要員)의 봉사(奉仕)에 의(依)한 모자보건(母子保健)rhk 가족계획(家族計劃)에 관(關) 연구(硏究)

예민해,이성관,Yeh, Min-Hae,Lee, Sung Kwan 대한예방의학회 1972 예방의학회지 Vol.5 No.1

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present

Cohort Infant Mortality Rate of Gunwee and Hapchun Counties and an MCH Center in Taegu

박정한,예민해,천병렬,송정흡,김귀연,김장락,조성억,김현,정한진,조재연,Park, Jung-Han,Yeh, Min-Hae,Chun, Byung-Yeol,Song, Jung-Hub,Kim, Gui-Yeon,Kim, Jang-Rak,Cho, Sung-Euk,Kim, Hyun,Chung, Han-Jin,Cho, Jae-Yeon The Korean Society for Preventive Medicine 1990 예방의학회지 Vol.23 No.1

1985년 4월 1일부터 1987년 3월 31일 사이에 경상북도 군위군에 거주하는 49세이하의 가임여성들과 1987년 3월 1일부터 1988년 2월 28일 사이에 경상남도 합천군에 거주하는 49세이하의 가임여성들 그리고 1985년 4월 1일부터 1987년 3월 31일 사이에 대구시 남구 모자보건센터에 분만을 위해 찾아온 모든 임산부들을 대상으로 이들에게서 태어난 출생아들을 두 군지역에서는 생후 1년간 그리고 모자보건센터에서 출생한 경우는 생후 27일간 추적하여 영아사망률과 신생아 사망률을 각각 조사하였다. 조사기간중에 군위군과 합천군에서 출생한 1,359명의 영아들 가운데 생후 1년 동안에 17명이 사망하여 농촌지역의 영아사망률은 출생아 1,000명당 12.5이었다. 총 영아사망중 신생아사망이 82.4% 그리고 신생아 후기 사망이 17.6%를 차지하였다. 대구시 남구 모자보건센터에 내원한 산모들에게 태어난 6,001명의 출생아들 가운데 4,834명(80.6%)만이 생후 27일까지 추적되었는데 이들 중 36명이 사망하여 신생아 사망률은 출생아 1,000명당 7,4명이었다. 추적된 산모와 추적 안된 산모의 특성 및 신생아 체중을 비교한 결과 현저한 차이를 나타내지 않았다. 신생아 후기 사망률의 비를 6 : 4로 가정했을 때 모자보건센터에서 출생한 영아의 영아사망률은 출생아 1,000명당 12.3명으로 추정되었다. 군위군과 합천군의 영아사망률과 대구시 남구 모자보건센터에서 관찰된 신생아사망률, 영아사망의 사망시기별 분포와 영아사망원인 그리고 저체중아출생률을 고려할 때 1985년부터 1988년 사이의 한국의 영아사망률은 출생아 1,000명당 12에서 15명일 것으로 추정되었다. We followed up all the infants born to the married women under 50 years of age residing in Gunwee county, Kyungpook Province, between 1 April 1985 and 31 March 1987, and those born to the married women under 50 years residing in Hapchun County, Kyungnam Province, between 1 March 1987 and 28 February 1988, to their first birthday. Likewise, we followed up the infants born to the women who visited the MCH Center of South District Health Center in Taegu City for delivery between 1 April 1985 and 31 March 1987 to the 27th day after birth and obtained the infant mortality rate and the neonatal mortality rate, respectively. There were 17 infant deaths among 1,359 live births in Gunwee and Hapchun Counties and the infant mortality rate was 12.5 per 1,000 live births. Out of 17 infant deaths, 82.4 percent were neontal death and 17.6 percent were postnonatal deaths. Out of the 6,001 live births born to the women visited the MCH Center, 4,834 infants (80.6%) were followed up to the 27th day after birth. Of these 4,834 infants, 36 infants died before the 28th day after birth and thus the neonatal mortality rate was 7.4 per 1,000 live births. Comparison of the maternal characteristics and the birth weight between infants who were followed up and those who were lost to follow-up showed no significant differences. Assuming that the neonatal and postneounatal mortality ratio had been 6:4, the infant mortality rate for the infants born at the MCH Center would have been 12.3 per 1,000 live births. Taking such findings into consideration as the infant mortality rate observed in Gunwee and Hapchun Counties, the neonatal mortality rate at the MCH Center, the causes of infant deaths, and the low birth weight incidence rate, a conservative estimate of infant mortality rate of Korea would be between 12 and 15 per 1,000 live births in $1985{\sim}1988$.

성인 남성에서 흡연이 기도청력역치에 미치는 영향

김진석,예민해,천병렬,우극현,강윤식,김건엽,이영숙,Kim, Jin-Seok,Yeh, Min-Hae,Chun, Byung-Yeol,Woo, Kuck-Hyeun,Kang, Yune-Sik,Kim, Keon-Yeop,Lee, Young-Sook 대한예방의학회 1998 예방의학회지 Vol.31 No.2

흡연과 기도청력역치와의 연관성을 알아보기 위하여 1996년 1월 1일에서 1997년 7월 31일 사이에 종합 건강진단을 받기 위하여 내원한 성인 남성 1,887명을 연구대상으로 선정하였다. 주파수대별 순음기도청력 검사, 이완기 혈압, 총콜레스테롤, 공복혈당, 혈구용적치 그리고 비만도를 검사하였다. 설문지를 이용하여 연령, 직업, 흡연상태를 조사하였다. 흡연군이 비흡연군에 비하여 250 Hz, 500 Hz, 1000 Hz 그리고 4000 Hz 주파수에서 기도청력역치가 유의하게 높았다(p<0.05). 저주파수영역 평균청력 중간주파수영역 평균청력, 고주파수영역 평균청력에서 흡연군이 유의하게 기도청력역치가 높았다(p<0.05). 다중회귀분석 결과, 흡연상태는 연령, 직업, 이완기 혈압, 공복혈당, 총콜레스테롤, 혈구용적치, 비만도의 영향을 조정 한 후에도 유의한 변수였으며(p<0.05), 연령이 많고, 생산직이고, 혈구용적치가 높고 비만할수록 유의한 청력저하가 관찰되었다(p<0.05). 그러나 이완기혈압, 총콜레스테롤 그리고 공복혈당은 청력저하와 유의한 관련성이 없었다. 이상의 결과를 볼 때, 흡연은 성인 남성의 청력저하와 연관성이 있었다. To investigate the effect of smoking on the hearing threshold, 1,887 adult male workers who visited health care center during the period 1 January 1996 - 31 July 1997 were selected. Air-conduction hearing threshold level, diastolic blood pressure(DBP), total cholesterol, fasting blood sugar(FBS), hematocrit and obesity were measured. The data on age, occupation, and smoking were collected. Air-conduction hearing threshold in smoker was significantly higher than non-smoker in categories of 250, 500, 1000 and 4000 Hz(p<0.05). Mean values of PTA-low, PTA-mid, and PTA-high in smoker were also significantly higher than non-smoker(p<0.05). In multiple regression analysis, smoking is likely to play a significant role after controlling age, occupation, DBP, FBS, total cholesterol, hematocrit, and obesity(p<0.05). The hearing threshold was significantly increased with increasing age(p<0.05), the manufacturing worker may have higher hearing threshold(p<0.05). The higher hematocrit and the more obese, the higher hearing threshold(p<0.05). However, DBP, total cholesterol and FBS were not significantly related with hearing threshold level. In conclusion, smoking was significantly related with the hearing threshold level in adult men.

성인남성 근로자의 여가시간 중 육체적 활동양상 및 관상동맥질환 위험인자들과의 관련성

노윤경,예민해,이성국,천병렬,Rho, Yun-Kyeong,Yeh, Min-Hae,Lee, Sung-Kook,Chun, Byung-Yeol 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.3

성인 남성들에서 여가시간의 육체적 활동량의 분포를 파악하고 관상동맥질환의 위험인자들과의 관련성을 보기위해 경상북도에 소재하는 일개 제철회사의 남성 근로자 277명을 연구대상자로 선정하였다. CARDIA 연구의 Physical Activity History questionnaire를 변형한 설문지를 이용하여 연구대상자들의 여가시간의 육체적 활동에 대해 면담조사하였다. 공복시 혈액 5ml를 채취하여 혈청 총콜레스테롤, 중성지방 및 혈당량을 측정하였고, 신장, 체중 및 혈압을 측정하였다. 흡연습관과 음주습관, 교육 수준 및 그 밖의 사항들은 설문지를 이용하여 면담조사하였다. 연구대상자들의 여가시간의 육체적 활동에 의한 에너지 소모량의 기하 평균치는 212.80 kcal/week이었고, 전체 대상자 중 여가시간에 2,000 kcal/week이상 육체적 활동을 하는 사람의 비율은 22. 4%이었다. 설문지의 항목들 중 대상자들이 여가시간에 하는 운동으로 가장 많은 것은 산보나 등산, 조깅 혹은 달리기 등이었다. 전체 대상자들에서 연령별, 교육수준별, 근무기간별, 흡연 및 음주습관별 주당 여가시간의 육체적 활동량이 유의한 차이를 보이지 않았으나, 작업 중 격렬한 노동을 하는 사람들이 안 하는 사람들에 비해 주당 여가시간의 육체적 활동량이 많은 것으로 나타났다(p<0.05). 여가시간의 육체적 활동량과 관상동맥질환의 위험인자들과의 관련성을 보고자 여가시간의 육체적 활동량을 중등도 이상의 활동을 전혀 안 하는 경우, 총 활동량이 2,000 kcal/week 미만인 경우 그리고 총 활동량이 2,000 kcal/week 미만인 경우의 세 군으로 나눈 후 BMI, 수축기 및 이완기혈압, 혈청 총콜레스테롤, 중성지방, 공복시 혈당량의 평균을 비교하였으나 통계적으로 유의한 차이를 보인 것은 없었다. This study was attempted to observe leisure time physical activity pattern and its relationship to coronary risk factors (BMI, systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, fasting blood sugar). Subjects participated in this study were 277 adult male workers of an industry in Kyungpook province, Korea. Energy expenditure were measured using modified Physical Activity History questionnaire of CARDIA study by interviewing. Serum total cholesterol, triglycerides and blood sugar level were tested with 5 ml fasting blood and height, weight and blood pressure were masured. Data on smoking and drinking habits and others were obtained. Geometric mean of leisure time physical energy expenditure were estimated as 212.80 kcal per week for study subjects and only 22.4% of them expended 2,000 kcal or more per week in leisure time physical activity. Taking walks or hikes and jogging or running were more frequent leisure time physical activities in study subjects. Statistically significant mean differences in total weekly leisure time physical activity for all coronary risk factors were not found among three groups. Because energy expenditure of leisure time was generally low in this subjects and most of them were healthy men, we did not found that leisure time physical activity was significantly associated with coronary risk factors.

고혈압의 위험요인에 대한 환자-대조군 연구

감신,예민해,이성국,천병렬,Kam, Sin,Yeh, Min-Hae,Lee, Sung-Kook,Chun, Byung-Yeol 대한예방의학회 1991 예방의학회지 Vol.24 No.2

고혈압과 관련된 위험요인을 조사하기 위하여 1908년 5월 1일부터 11월 30일까지 대추시내 일반근로자들 가운데 고혈압환자 330명(남자 247명, 여자 83명)과 정상인 1,336명(남자 887명, 여자 449명)을 대상으로 환자-대조군 연구를 실시하였다 성, 연령을 제한요인으로 하여 조사한 위험요인들은 근무부서, 비만도, 음주력, 흡연력, 우유섭취빈도, 식염섭취정도, 고혈압가족력이었다. 다변량분석기법가운데 지수형회귀분석 (logistic regression analysis)에 의해 분석한 결과 남자에서는 음주(odds ratio=3.23), 비만도(odds ratio=2.31), 그리고 식염(odds ratio=1.75)이 고혈압의 위험을 증가시키는데 비해 여자에서는 음주(odds ratio=16.49), 고혈압가족력 (odds ratio=3.70). 비만도(odds ratio=1.74), 그리고 식염(odds ratio=1.73)이 고혈압의 위험을 증가시켰다(p<0.05). 그리고 남녀 모두에서 우유가 고혈압의 위험을 감소시키는 유의한 변수이며(남자 odds ratio=0.69, 여자 odds ratio=0.65) 용량-반응 관계가 있음으로 보아 (p<0.05) 고혈압의 예방요인으로 생각된다. 남녀 모두에서 흡연은 고혈압과 관련이 없었다. 그런데 단순분석결과 여자에서 근무부서가 고협압과 유의한 관련이 있었는데 다변량분석에서는 유의한 관련성이 없었다. A case-control study was conducted to investigate the risk factors (Part of job, Obesity, Alcohol, Smoking, Milk, Salt. and Family history) for hypertension. We selected 330 hypertension cases (male;247, female;83) and 1,336 controls (male;887, female;449) from employees in Taegu city from 1 May to 30 November, 1908. Data was analysed using a logistic regression model. Statistically significant elevated odds ratio were noted for alcohol (odds ratio=3.23), obesity (odds ratio=2.31), salt(odds ratio=1.75) in male (p<0.05) and those in female were noted for alcohol (odds ratio=16.49), family history(odds ratio=3.70), obesity (odds ratio=1.74) and salt (odds ratio=1.73) (p<0.05). Statistically significant reduced odds ratio was noted for milk in both sexes (odds ratio=0.69 for male and 0.65 for female)(p<0.05) and the dose-response relationship between milk intake and hypertension was confirmed (p<0.05). Therefore, milk seems to be preventive factor for hypertension. Smoking was not significantly associated with hypertension in both sexes. The part of job was significantly associated with hypertension in female by simple analysis (P<0.05) but the relationship was disappeared when multivariate analysis (logistic regression analysis) was done.

지역의료보험(地域醫療保險) 재정지출(財政支出)의 결정요인(決定要因)

감신,박재용,예민해,Kam, Sin,Park, Jae-Yong,Yeh, Min-Hae 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.1

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

장애인의 건강관심도, 건강실천행위 그리고 건강수준간의 구조분석

천병렬,감신,예민해,강윤식,김건엽,손재희,이영숙,박기수,Chun, Byung-Yeol,Kam, Sin,Yeh, Min-Hae,Kang, Yun-Sik,Kim, Keon-Yeop,Son, Jae-Hee,Lee, Young-Suk,Park, Ki-Soo 대한예방의학회 1999 예방의학회지 Vol.32 No.3

Objectives: This study was performed to determine the relationships among health concern, health practice and health status of the disabled. Methods: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. Results: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect or health status(T>2.0). In men and women, health practice was significantly increased with increasing health concern and the more health practice, the higher health status(T>2.0). Conclusions: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.

농촌 지역 주민들의 고혈압 발생 위험요인 - 1년간 전향성 추적 조사 -

오희숙,감신,예민해,강윤식,김건엽,이영숙,박기수,손재희,이상원,안문영,천병렬,Oh, Hee-Sook,Kam, Sin,Yeh, Min-Hae,Kang, Yun-Sik,Kim, Keon-Yeop,Lee, Young-Sook,Park, Ki-Soo,Son, Jae-Hee,Lee, Sang-Won,Ahn, Moon-Young,Chun, Byung-Yeol 대한예방의학회 2000 예방의학회지 Vol.33 No.2

농촌지역 성인들에서 고혈압 발생과 관련이 있는 위험요인을 조사하기 위하여 1996년 경상북도 청송군의 20세이상 성인 3,573명을 대상으로 면담조사와 신체검사를 실시하였다. 연구대상 코호트는 고혈압이 없는 2,580명으로 하였는데, 1년 후 1,781명(69.0%)의 추적조사가 완료되었다. 조사한 독립변수들은 일반적 특성(연령, 성, 교육수준, 경제적상태, 결혼상태), 고혈압 가족력, 식이, 술, 담배, 커피, 스트레스, 그리고 여성에서 경구용 피임약, 폐경상태가 추가되었다. 그리고, 키, 몸무게, 허리둘레, 엉덩이둘레, 초기혈압, 혈청 총 콜레스테롤이었다. 다중 로지스틱 회귀분석 결과, 남자에서는 연령의 비교위험도가 1.50(95% 신뢰구간; 1.15-1.96), 고혈압 가족력이 2.11(95% 신뢰구간; 1.04-4.26), 허리-엉덩이 둘레비가 2.09(95% 신뢰구간; 1.15-3.79), 초기 수축기 혈압은 120mmHg 미만을 기준으로 하였을 때 130-139mmHg가 3.34(95% 신뢰구간; 1.47-7.60)로 경계형이상 고혈압의 발생과 유의한 관련이 있는 위험요인이었다. 여자에서는 연령의 비교 위험도가 1.06(95% 신뢰 구간; 1.03-1.09), 추적 기간동안 새로이 폐경을 경험한 경우는 3.32(95% 신뢰구간; 1.01-10.87), 초기 수축기 혈압은 120mmHg미만을 기준으로 하였을 때 120-129mmHg가 2.00(95% 신뢰구간; 1.02-3.90), 130-139mmHg가 2.64(95% 신뢰구간; 1.34-5.20), 그리고 초기 이완기 혈압은 80mmHg미만을 기준으로 하였을 때 85-89mmHg가 4.09(95% 신뢰구간; 1.86-8.96)로 유의한 관련이 있는 위험요인이었다. 결론적으로 경 계형 이상 고혈압 발생과 관련된 위험요인으로는 남자에서는 연령, 고혈압 가족력, 허리-엉덩이 둘레비 그리고 높은 정상 혈압이었다. 여자에서는 연령, 폐경이 새롭게 일어난 경우 그리고 높은 정상 혈압이었다. Objectives : This study was peformed to identify the risk factors related to the development of hypertension in a rural area. Method : Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. Results : Multivariate analysis using logistic regression model indicated that age(RH=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95%, CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status$(no{\rightarrow}yes/no{\rightarrow}no)$ (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. Conclusions : Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

농촌지역 주민의 고혈압 치료순응도와 관련요인

이상원,천병렬,예민해,강윤식,김건엽,이영숙,박기수,손재희,오희숙,안문영,임부돌,감신,Lee, Sang-Won,Chun, Byung-Yeol,Yeh, Min-Hae,Kang, Yun-Sik,Kim, Keon-Yeop,Lee, Young-Sook,Park, Ki-Soo,Son, Jae-Hee,Oh, Hee-Sook,Ahn, Moon-Young,Lim, Pu-D 대한예방의학회 2000 예방의학회지 Vol.33 No.2

Objective : The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. Method : A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. Result : The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). Conclusion : In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.

전공의들의 전문직인식이 직업만족도에 미치는 영향

강윤식,감신,예민해,Kang, Yune-Sik,Kam, Sin,Yeh, Min-Hae 대한예방의학회 1997 예방의학회지 Vol.30 No.1

In ordo to investigate the professional job perception and job satisfaction of interns and residents and its related factors, the author conducted survey using self administered questionnaire for 2 months(August and September, 1996). The study subjects were 562 interns and residents who worked at one university hospital(tertiary hospital) and two general hospitals(secondary hospital) in Taegu, Korea. Among them, 297 (52.8%) responded completely. The results were as follows ; Respondents thought that people component was most important, science and status components were next among professional value scales which meant the desirable attitudes required to conduct professional works. But, the score of professional value scales was generally high and not affected by other variables in multiple linear regression analysis. They seemed to have very normative and ideal perceptions about professional values. The score of professionalism scales, which were attitudinal and behavioral traits about professional job, of high grade residents was significantly higher than that of interns and lower grade residents. The score of reference to professional organization and autonomy factor were increasing significantly as the grade increased. Working conditions and perception for socioeconomic status of doctors influenced the score of professionalism scale significantly. It seemed that professional socialization was made during the training periods of interns and residents. Most of respondents answered that current socioeconomic status of doctors were middle and high strata but they responded that the socioeconomic status of doctors would fall in the future. They seemed to have a pessimistic thought about doctor's status. Generally the respondents thought that they were satisfied with doctor job and fit to the job, but 51.9% answered that if possible they would get other jobs. It seemed to reflect their critical thinking on doctors' status. Perceptions about socioeconomic status of doctors, professional value and professionalism influenced job satisfaction significantly. The interns and residents had high sense of calling to doctors and thought that doctors were socially important job. Generally they were satisfied with their job. Interns and residents had normative thoughts about the trait which compentent doctors must have. During the training period, they seemed to have attitude and perception as a professional and to make professional socializations.