산욕기 산모와 신생아의 가정간호 알고리즘 개발

방경숙,Bang, Kyung-Sook 한국가정간호학회 1997 가정간호학회지 Vol.4 No.-

The needs for the home care of postpartum mothers and their infants are increasing, but the quality control of home care nurses is not developed yet. The objective of this study is to develop assessment - intervention algorithms for the home care of postpartum mothers and their infants. We can use these algorithms when we assess the client's condition, and find appropriate nursing interventions. Also, these algorithms can offer guidelines for home care nurses, so that standardization of home care can be attained. Common problems for postpartum mothers are postpartum hemorrhage, abnormal vaginal discharge(endometritis), episiotomy pain, breast problems, breastfeeding difficulty, edema, urinary dysfunction and defecation difficulties. Also, commom problems for infants are abnormal body temperature, tarchycardia, respiratory problem, neonatal jaundice, cord problem, abnormal stool, breast feeding, and bathing. These algorithms can be used as a basis for the development of computerized infomation system for the home health care.

취약계층 초등학생 대상 산림치유 프로그램 개발

방경숙,김성재,송민경,강경림,정예슬,Bang, Kyung-Sook,Kim, Sungjae,Song, Min Kyung,Kang, KyungIm,Jeong, Yeseul 서울대학교 간호과학연구소 2020 간호학의 지평 Vol.17 No.1

Purpose: The purpose of this study was to develop a forest-based health promotion program for vulnerable school children. Methods: The specific process for program development involved establishing a program goal, assessing the needs of the participants, analyzing existing programs and constructing a forest-based program. Results: Each session of the program, which consisted of a total of 10 sessions, included 40 to 50 minutes of indoor education for children's physical and psychosocial health and 60 to 70 minutes of forest experience activities with nursing student mentors. For the application of the program, guidelines for mentor selection and prior education, physical environment check, children's safety, criteria for evaluation of the program effects and operation of the program were developed. Conclusion: This study presents the specific procedures and contents for developing a forest-based program for vulnerable school children. The results of this study will provide useful data to develop a community-based program to promote the physical and psychosocial health of vulnerable school children.

초산모에 대한 어머니 역할 교육이 영아 돌보기 자신감 및 모유수유 실천에 미치는 효과

방경숙,한경자,Bang, Kyung-Sook,Han, Kyung-Ja 한국가정간호학회 1999 가정간호학회지 Vol.6 No.-

The purpose of this study was to find the effects of an educational program for primiparas on maternal confidence and continuity of breastfeeding. The subjects of this study were the healthy mothers, and the healthy infants whose weight was more than 2.500gm and gestational age was more than 37 weeks. The final targets were thirty seven mothers-19 of intervention group and 18 of control group. Data were collected from 15th of March to 3rd of September, 1999. To the intervention group, education on infant care and breast feeding were provided before discharge. And that, telephone advice was provided within one week after discharge, and at 2 months postpartum. And that, reeducation and counsel were provided at one month and three months postpartum by home-visiting care for the intervention group. For the control group. home visiting was also conducted only for data collection. Data were analyzed by chi-square test and t-test. The results were as follows: 1. The maternal confidence of the experimental group was higher than that of control group at one month postpartum. but the difference of confidence of these two groups were not significant at three months postpartum. 2. For both of experimental and control groups, maternal confidence significantly increased at three months postpartum than one month postpartum. 3. The rate of breastfeeding of the experimental group was higher than that of control group at one month and two months postpartum (p=.050, p=.049). But the difference was not significant at three months, although experimental group continued breastfeeding more(47.4%) than control group(27.8%). In conclusion, educational program for primiparas of this study was effective in the promotion of maternal confidence and breastfeeding.

간호실무 : 산모의 우울이 생후 4개월 영아의 기질, 건강과 성장발달에 미치는 영향

방경숙 ( Kyung Sook Bang ) 서울대학교 간호과학연구소 2012 간호학의 지평 Vol.9 No.1

Purpose: This study was conducted to determine the impacts of maternal depression on the temperament, health problems, and development of 4-month-old infants. Methods: For this longitudinal comparative study, data collected at one month postpartum and at the 4th month of follow-up were evaluated from sixty five pairs. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the symptoms of depression. Results: Eighteen point 5 percent and15.4% of mothers were diagnosed with postpartum depression at one month postpartum and at the 4th month of follow-up, respectively. The temperament of the infants between the two groups was not different. However, the infants of the depressed mothers had more health problems after 4 months. Depressed mothers had a lower score for the acceptance of Home Observation for Measurement of the Environment (HOME), and the development score of their infants was lower than that of the non-depressed mothers. Conclusion: Maternal depression affects the health and development of infants. Women should be screened for potential risk factors and for symptoms of depression during postpartum periods so that appropriate interventions including emotional support can be initiated in a timely manner.

일개 시 미취학 아동의 사회경제적 계층별 건강관리 현황

방경숙 ( Kyung Sook Bang ) 부모자녀건강학회 2006 부모자녀건강학회지 Vol.9 No.2

Purpose: The current descriptive study examined the health and healthcare status of preschoolers in poverty group compared to those of comparison group. Method: Data were collected from 51 mothers in federal poverty group and 49 in low-income group and 200 mothers in normal income comparison group in one city. The instruments used for this study were Korean CBCL and health related questionnaire. Results: Public assistance group showed more low-birth-weight infants, developmental delay, and hospital admission experiences. Their compliance for vaccination and congenital metabolic disorder test were lower than those of comparison group. Preschoolers` behavior problems were not significantly different depending upon the income of the group. Conclusion: Preschoolers` health and healthcare status are affected by the socioeconomic characteristics of the family. It indicated an need for anticipatory guidance and early intervention that might help to prevent or ameliorate potential health problems in poverty.

임산부 우울이 자녀건강에 미치는 영향에 대한 고찰

방경숙 ( Kyung Sook Bang ) 부모자녀건강학회 2008 부모자녀건강학회지 Vol.11 No.1

Maternal depression is known to have important negative effects on mother, child and mother-child relationship. To review current research evidence of association between maternal depression and their children`s health and development, relevant studies were identified using Medline and Kiss(Korean studies Information Service System). The majority of research has reported that children of mother with depression are at risk for impaired physical functioning, growth and developmental delays, and behavioral problems compared to general population. From these studies, it is suggested that these kinds of studies are necessary in this country to examine the relation between maternal depression and children`s health and development. Recommendations are included for future research and screening programs for maternal depression.

빈곤계층 아동 양육자의 우울, 건강 상태와 양육 스트레스

방경숙 ( Kyung Sook Bang ),채선미 ( Sun Mi Chae ),박성희 ( Sung Hee Park ) 부모자녀건강학회 2011 부모자녀건강학회지 Vol.14 No.2

This is a descriptive study to identify the relationships of depression, health status, and parenting stress of caregivers of children in poverty. Methods: The participants were 42 caregivers of preschool or school age children enrolled for the Dream Start Program in a city of Kyeonggi province, which is a program of the Korean Ministry of Health & Welfare offering services for growth and development of low-income children. Data were collected from November, 2009 to February, 2010 by using a questionnaire. Results: The vast majority of the participants were mothers (n=33, 78.6%), and less than a half were married (n=16, 38.1%). Depression of the participants was at the moderate level (18.60±10.13). They perceived their health was fair (81.10±18.97). Their parenting stress was high (93.45±20.06). Their parenting stress was significantly correlated with depression (r=.57, p<.001) and perceived health status (r=.49, p=.001), which indicates their parenting stress was high as their depression was high or they perceived they were not healthy. Conclusion: The study results suggest to provide the caregivers of children in poverty with a well- developed program to manage their depression and parenting stress and ultimately to improve their mental health.

간호대학생의 전공 및 진로에 대한 인식

방경숙(Bang, Kyung Sook),전명희(Jun, Myung Hee),김현숙(Kim, Hyun Sook),손행미(Son, Haeng-Mi),강정희(Kang, Jeonghee),유수정(Yu, Su Jeong),권미경(Kwon, Mi Kyung),김지수(Kim, Jisoo) 한국간호교육학회 2009 한국간호교육학회지 Vol.15 No.1

여대생의 인유두종 바이러스 예방접종 여부에 영향을 미치는 요인

방경숙(Bang Kyung-Sook),성수미(Sung Sumi),구보연(Koo Boyeon),김민지(Kim Minji),김유나(Kim Yuna),김진숙(Kim Jinsook),류수미(Ryu Sumi) 대한종양간호학회 2011 Asian Oncology Nursing Vol.11 No.3

Purpose: The primary prevention for cervical cancer the human papilloma virus (HPV) vaccination has been available in South Korea and its importance has been emphasized publicly. The purpose of this study was to investigate the knowledge regarding HPV vaccination and identify the factors associated with HPV vaccination in female university students. Methods: A sample of 200 women among university students in Seoul was asked to answer a questionnaire on HPV-related knowledge and attitude and influencing factors on HPV vaccination. Results: Among the respondents 12.0% were HPV vaccinated. Overall HPV-related knowledge was low and knowledge was not different between the vaccinated and unvaccinated groups. The vaccinated group demonstrated a higher score on the knowledge about the place where people could receive HPV vaccination and the cost of the vaccination than that of the unvaccinated group. The major influencing factor on vaccination was the parent's recommendation and the major barrier for vaccination was the cost of the vaccination. Conclusion: A broadened public campaign is recommended to increase the knowledge and positive attitude towards HPV vaccination for university female students as well as their parents.

에티오피아 일개 지역 보건지소 건강관리요원에 대한 직무교육의 효과

방경숙 ( Kyung Sook Bang ),이인숙 ( In Sook Lee ),채선미 ( Sun Mi Chae ),강현주 ( Hyun Ju Kang ),유주연 ( Ju Youn Yu ),박지선 ( Ji Sun Park ) 부모자녀건강학회 2013 부모자녀건강학회지 Vol.16 No.1

전 세계적으로 건강형평성의 확보가 인류의 기본권으로 간주되고 저개발국의 빈곤과 건강문제 해결을 전 세계가 공통으로 해결해야 할 목표로 설정하는 새천년 목표(Millenium Development Goal [MDG])가 채택되면서 우리나라에서도 국제보건에 대한 관심이 높아지고 있다. 본 연구에서는 국제보건을 위한 에티오피아 모자보건 역량강화사업에 참여하면서 저개발국의모자보건에서 핵심적인 역할을 담당하고 있는 HEW를 대상으로 모자보건 관련 교육을 적용하고 그 효과를 분석하였다. 에티오피아의 경우 HEW는 1년간의 교육과정을 이수한 경우가 가장 일반적이지만 단기간의 훈련만을 받고 현장에 투입되는 경우도 많아 체계적인 직무교육이 필요하다. 그러나 이들의 자질이나 역할이행에 대한 평가는 아직 제대로 이루어지지 못하였다(Medhanyie et al., 2012). 현재 HEW는 Technical and Vocational Education and Training Institutions에서 교육을 받도록 하고 있는데, 교육과정에 대해 32명을 대상으로 심층 면담한 선행연구에 따르면 2003년 교육과정이 처음 개발된 이후 아직까지도 현실에 적합하도록 개정이 이루어지지 않았으며 교육을 위한 설비가 부족하고 교육자에 대한 계속 교육이 이루어지지 않는 등 많은 제한점을 갖고 있다고 보고하였다(Damtew et al., 2011). Admassie, Abebaw와 Woldemichael (2009)는 HEW에 의한 Health services extension program을 실시한 지역에서는 실시하지 않은 지역보다 예방접종률과 말라리아 예방을 위한 모기장 보급률이 유의하게 높아 그 효과를 확인할 수 있었으나 예방적인 모성건강관리에 있어서는 그 효과가 크지 않아서 임신 시 산전관리를 위해 HEW를 처음 방문하는 시기는 더 빨랐지만 그 외의 산전 산후관리에서는 거의 차이를 보이지 않았다고 보고하였다. 또한 5세 미만 아동의 설사와 기침 질환 감소에도 기여하지 못하였다고 하여 아직은 그 효과가 부분적으로만 나타나고 있음을 알 수 있다. Koblinsky 등(2010)의 연구에서는 지역주민의 HEW에 대한 반응이 긍정적이며 프로그램 적용 이후 모자보건 관련 지표가 향상되고 있음을 보고한 바 있으며, Karim 등(2010)도 HEW의 활동이 주민의 산전 산후관리와 상관성을 보이며 모자보건에 기여하고 있다고 평가 하였으나 모성사망률 감소에는 아직 기여하지 못하고 있음을 보고하였다. Tsegay 등(2013)은 HEW 활동으로 산전관리를 받는 주민이 많아졌으며 산전관리 시 시설분만을 권고를 받은 임부들에서 그렇지 않은 임부들보다 시설분만률 비율이 더 높기는 하였지만 시설분만률 자체에 대한 효과는 미미하여 새로운 전략 마련이 필요하다고 하였다. 에티오피아 북부 지역에서 5년 이내 출산경험이 있는 산모 725명을 대상으로 한 Medhanyie 등(2012)의 연구에서도 HEW가 주민들의 가족계획, 산전간호, 그리고 HIV 검사율 증진에 기여하는 것으로 나타났으나 시설분만률과 산후관리에 대한 기여는 유의하지 않았다. 한편 에티오피아의 시골 지역에서는 HEW를 대신할 지역사회 사례관리(community case management) 자원자를 모집하여 교육 후 설사, 말라리아, 폐렴 등의 아동 건강관리에 투입하여 효과를 거둔 경우도 보고되었다(Degefie et al., 2009). 이와 같이 HEW 제도 도입 후 지역주민의 건강관리 이용률에서의 효과를 보는 연구는 상당 수 이루어졌으며 부분적으로 긍정적인 효과가 나타나고 있음을 보고하고 있으나 HEW의 지식 수준을 평가하거나 교육 프로그램 적용 후 HEW의 지식이나 수행능력의 향상 여부를 확인한 연구는 매우 제한적이다. 최근의 연구에서 Dynes 등(2013)이 HEW 대상으로 산전, 산후 관리에 대한 교육 후 사전 조사에 비해 교육 후의 사후 조사에서 수행 점수가 유의하게 증가하였음을 보고한 연구가 있는 정도이다. 본 연구에서는 에티오피아 티그라이주 KilteAwlero지역의 HEW를 대상으로 직무교육을 실시하고 그 효과를 평가하였는데, 대부분 사전에 비해 교육 후 지식 점수가 유의하게 향상된 것은 긍정적인 효과를 기대하게 하는 결과이다. 그러나 본 교육 프로그램에서는 강의만을 포함하였는데 실제 모자보건 업무를 수행하는 HEW 들은 술기도 매우 중요한 부분이므로 이들에게 보건소에서 수행하는 업무를 직접 관찰, 수행하도록 하고 부족하거나 잘못된 부분을 교정해주는 피드백이 필요하리라 생각된다. 이는 교육대상자들의 교육에 대한 평가에서도 나타난 부분으로, 향후에는 이론과 실습을 병행하는 프로그램을 개발하여 좀 더 많은 대상자에게 적용 후 효과를 평가하는 것이 필요할 것이다. Purpose: Ethiopia is one of the sub-Saharan countries most affected by high maternal and infant mortality. The government has trained health extension workers (HEWs), the community health workers, to deliver preventive and basic curative health services to community residents in Ethiopia. Very few studies have investigated on-the-job educational effects for HEWs on improvement of their knowledge and performance confidence in maternal and child health care (MCH). This study aimed at identifying the educational effects for HEWs in one health center in Tigray, Ethiopia on improvement of their knowledge in MCH. Methods: Twelve HEWs from 6 health posts participated in this study. A health center officer provided a total of 5 educational sessions on antenatal and postnatal care, family planning, and newborn care from August, 2012 to April, 2013. Ten to 12 items regarding the topics were tested before and after each education. Wilcoxon signed rank test was used to analyze the data. Results: All the HEWs were female with average 4-year working experience. Their knowledge significantly increased after education, except the first session. Their satisfaction on education was greater than 45 points out of 50. Conclusion: This study suggests a focused education for HEWs should continue to improve their capacity on MCH.