천자서평 1 : 건강한 청소년기를 위하여 - 김응익 / 서울대학교출판부 / 1995 -

김응익 한국상담선교연구원 ( 구 한국상담선교학회 ) 1997 상담과 선교 Vol.5 No.3

우리나라 가임여성의 건강증진을 위한 Reproductive health에 관한 연구

김응익 대한보건협회 1995 대한보건연구 Vol.21 No.2

여성의 건강은 출상 자녀의 생존 및 건강에 직접적인 영향을 미칠 뿐만 아니라, 가족 구성원 및 집단의 전체 건강에 매우 중요한 역할을 하는 것으로 되어 있으나, 이러한 중요성에도 불구하고 사회, 경제 및 건강측면에서 제약요인이 많은 것이 사실이다. 우리나라 가임기 여성의 reproductive health와 관련한 주요 보건지표에서 출산력수준, 피임실천수준 등은 과거에 비해 상당히 개선되었고, 영아사망 및 모성사망수준, 산전관리, 의료기관 분만을 등에서도 같은 개선효과를 보여 주었다. 이러한 출산력과 관련한 여성의 건강 수준은 과거에 비해 증진된 반면, 임신소모율에서는 정상분만비율이 낮아지고 인공임신중절에 의한 소모비율이 증가하고 있다. 피임실천방법별 분포에서도 불임수술과 같은 정부 주도형 피임방법의 의존 수준이 상당히 높게 나타남을 볼 수 있었다. 가임기 여성의 건강과 관련한 문제해결은 있어서 출산력과 직접 관련된 출산조절 측면 뿐만 아니라 가임기간동안 건강에 영향을 미칠 수 있는 재반 사항에서도 고려되어야 할 것으로 보여진다. This study is purposed to make chronological analaysis on reproductive health transition of eligible women during the period of 1960-1995 in Korea. Total fertility rate has decreased more than one third during the period, from 6.0 in 1960 to 1.8 in 1993. The contraceptive users has increased 3.8 times during the period: when compare the users by the types of contraceptives, female sterilization shown the highest(28.6% of total users), as compared to 11.6% of male sterilization and 14.3% of condom users. One of the most dramatic increase phenomena was found on induced abortion, and the experience rate shown more than three times of increase, from 14% in 1966 to 49.2% in 1993. The pregnancy wastage rate was calculated as 19.7 per 100 pregnancies in 1966 and 49.4 in 1993. The live birth rate per 100 pregnancy has decreased from 75.1% to 38.0% for the periods. Total infant mortality rate has decreased from 50(per 1,000 births) in 1968 to 12.8 in 1991. Maternal mortality rate per 10,000 has decreased about one fourth, from 8.8 in 1968 to 2.9 in 1990. One of major facts leading the decrease depends on better health care for the rate of pregnants who received prenatal care services has incresed 1.6 times, and the average number of clinic admissions for the prenatal care services has increased 1.4 times during 1977-1986. The concept of reproductive health was discussed as to be applied not only for fertility control, but also to be expanded into health care aspects to control the various factors influencing pregnants' health status during the childbearing age, i.e. health promotion of the eligible women. The health promotion could be achieved by providing the quality of health care services for pre- and post-partum care, and with inclusion of related health care services, such as fertility regulation, STDs prevention, cares for the infertility and unwanted pregnancy, safe motherhood, safe sexual life, and also for children cares.

지역별 출생성비의 시계열적 추이에 관한 연구

김응익,박상화 한국보건통계학회 1996 한국보건정보통계학회지 Vol.20 No.1

The objective of this study was to analyze the trend of sex ratio at birth by regions from the vitae statistics of National Statistical Offices during 15 years(1980-1994). The sex ratios in total of registered birth(1980-94) were 114.06 in kyoungsang region, 109.60 in Seoul, 108.86 in Kyonggi 107.79 in kangwon, 110.58 in chungchong and 108.32 in Cholla. The regression analysis showed a statistically significant linear trend in all regions(P<0.001) : Sex ratio = a + b1(time) + b2(January) + .. + b11(November). The slope of sex ratio trends during the period was higher in Kyoungsang region and lower in Cholla region. The variation between yearly mean sex ratio and calendar month sex ratio showed a slight decline from 1980 to 1994. The variation of those was higher in Kangwon and lower in Seoul.

일부 통합병원 간호요원간의 집단갈등에 관한 연구

김응익,한윤우 한국보건통계학회 1987 한국보건정보통계학회지 Vol.12 No.1

The aim of this study was to investigate the primary factors affecting the group conflict between nurses and aid nurses, the level of their cognition of this conflict, and the pattern of antagonistic behavior against each other in some general hospitals. Fifty two nurses and ninety aid nurses in 8 general hospitals randomly selected from Seoul area were involved in this study. The data were collected through self administered technique with a itemized questionaires from October 15 to November 5. 1986. The results of this study were as follows; 1. The average age was 27.9 years old in nurse group and 24.1 years old in aid nurse group. 78.8 percent of the nurses were over 26 years old, but 72.2 percent of the aid nurses were under 25 years old. Between two groups didn't show a significant difference in job career and length of continuous services. 2. Between two groups showed a significant difference in the cognition to their nursing acrivities difficulty (χ^2=47.82, p<0.01). 80.7 percent of the nurses answered their level of nursing activities difficulty higher than that of aid nurse. On the contary, 51.5 percent of aid nurses answered their lever of hardness was equal to the nurses' activities, and 22.2% even estimated higher than the nurses. 3. The cognition of joint performance frequency was appeared a significant difference between two groups (χ^2=16.50, p<0.01). 67.6 percent of the nurses thought "very frequently" or "frequently", and 47.6 percent of aid nurses answered " fequently" in the cognition of joint performance. 4. In the cognition to the frequency of information interchange, 57.7 percent of the nurses and 40.0 percent of aid nurses answered "frequently." but the statistical significance of two groups was not observed. 5. A significant difference was observed between two groups in the offer and reception of assistances at the performance of duties (χ^2=16.78, p<0.01 ; χ^2=24.51, p<0.01). 6. Between two groups had a group conflict in the group identity, 72.2 percent of the aid nurses insisted on group identity, on the other hand. 84.6 percent of the nurses objected to put nurse on a par with aid nurse. 7. Most nurses tended to disapprove the aid nurses' status-incongruity, so 94.2 percent of the nurses disapproved rising of aid nurse's status. 94.2persent of the nurses regarded themselves as the superior to the aid nurses. 8. 76.9 percent of the nurses had a discredit to the aid nurses' ability, on the contrary, 43.2 percent of the aid nurses had a relative strong discredit to the nurses' ability. The attitude between two groups appeared a significant difference (χ^2=33.22, p<0.01). 9. The cognition of two groups to the "unfriendly" was conformed (χ^2=7.47, p<0.01). 10. The conflict of two groups such as inter-interference. trouble and view-oppositions were not observed.

계절변동과 초경발현에 관한 연구

김응익,박상화 한국보건통계학회 1992 보건정보통계학회지 Vol.17 No.1

The objective of the study was to analyze the relationship between seasonal variation and menarcheal occurrence. The total number of 1,026 girls was drawn from 15 classes of a high school (2nd grade) in Seoul. The distribution of birth year in total subject were 2.5 percent in 1974, 76.6 percent in 1975 and 20.9 percent in 1976. 1. The highest proportion in the distribution of menarche month was August (16.0 percent), and 14.2 percent in December, 12.0 percent in October. On the otherhand the incidence of menarche from February to July was low level at 3 to 6 percent. The first order of the menarche month during 12 birth months was August (mean order : 1.75), and 2nd in December (2.83), 2nd in October, 4th in July and 5th in January. The last rank of menarche month was February and April. 2. In the incidence rate of menarcheal month by the born month, there was not significance statistically in girls born in April, May, June and September, and was significance statistically in girls born in the other months. In the seasonal patterns of menarche occurrence, girls born in spring, summer and winter had the highest incidence rate of menarche in summer, and girls born in autumn had a tendency to occur more frequently in autumn. Season of birth was no significance associated with season of menarche(x²=15.90360 P value=0.0689). 3. The mean age of menarche in total subject was 13.44, and the mean menarcheal age by the season of birth was 13.35 in winter, 13.37 in autumn, 13.47 in summer and 13.56 in autumn, Girls born in March reached their menarche about 6 months later than those born in December. There were no significance between the menarcheal age and season or month of birth. 4. Under the assumption that the menarcheal age occur later from 1 month to 11 months than real menarcheal age, the peak distribution of menarche occurrence by the season change with a cyclic pattern.

한국 여성의 재생산주기에 관한 통계학적 비교연구 (1960 - 1980)

김응익,박상화 한국보건통계학회 1984 보건정보통계학회지 Vol.9 No.1

This study was carried out to measure and compare the life cycle of reproduction and wariables associated with reproduction between 1960-1980 in Korea woman by analysis all the available census, vital statistics and data of national fertility survey since 1960. The results of this study are as follows: 1. Phase (Ⅰ) was extended about 60 percent in its length compared with 1960, because of rising of age at first marriage and decreasing of age at menarche. Phase (Ⅱ) was diminished by marking 58 percent in its length of 1980 compared with that of 1960. Phase (Ⅲ) was dimished by 29 percent in its length compared with that of 1960 with increase of age at marriage and decrease of age at fertility termination. By the way we supposed that phase(Ⅳ) was expanded in iits length compared with that of 1960 by diminishing of age at fertility termination and increasing of age at menopause. 2. Un-married and married rate in female population (15-49 years) was changed by variation of divorce remarriage of mortality and late marriage. Total fertility rate was declined significantly from 6.0 in 1960 to 2.6 in 1980. The pregnancy wastage due to induced abortion was increased gradually. Contraceptive practice rate was increased overally in all age group, especially a group of over 30 years was increased largely in contraceptive practice rate. In each method of contraceptive practice rate, female sterilization was increased on a large scale and average age of sterilization acceptor also tended to decline at begin of 30 years old. Infertile patient rate was appeared to the low level of under 5 percent.

생식단계별 수태조절 가능시기에 관한 연구

김응익,박상화 대한보건협회 1985 대한보건연구 Vol.11 No.2

在美 韓國 老人의 健康 및 生活 實態에 關한 硏究

金應翊,朴祥華,韓允愚,徐敬萬 대한보건협회 1992 대한보건연구 Vol.18 No.1

This study was perfomed to figure out the health status and life style of aged population in Korean-Americans living in Los Angeles in the United States. The number of subjects in this study were 283 persons aged 65 and over (male 141. female 142) drawn from Los Angeles Country in U.S.A. The data were collected by trained interviewers from July to August. 1991. The questionaire consisted of 1) general characteristics, 2) health status and medical health services, 3) 24 questions of CMI, and 4) the level of adaptations and difficulties to immigrant society. The results of this study are as followings: 1. In age distribution, 33.2 percent of total subjects was 65-69 age group, and 33.1 percent was 70-75 age group. The average duration of immigration were 7.89 years in male and 10.18 years in female, and percent distribution by duration of migration were 33.3 percent in 1-4 years, 30.5 percent in 5-9 years, 23.7 percent in 10-14 years, and 13.5 percent in 15 years and over. Of total subjects. 84.7 percent had permanent residence and only 13.8 percent had citizenship. In the reason of immigration of the elderly, 76.4 percent of them responded as reason for helping and joining to family, and only 8.5 percent of subjects were economic reason. The educational level of the subjects were generally high. Only 9.0 percent of the subjects recevied no or little education in the modern day education system. Primary graduates were 35.7 percent, middle and high school graduates were 37.8 percent and university(college) and over graduates constituted 16.6 percent. The educational level of the male were generally higher than that of female. A large proportion of the subjects(94.3 percent) responded as having religion, and 67.8 percent were protestant, 16.7 percent were catholic and 7.4 percent were buddhist. In the family structure. 75.6 percent of the elderly lived alone and with their spouses and 22.1 percent live in a family with 2 generation living together. The marital status of male showed that 80.7 percent of them lived with their spouses, 14.3 percent of men were widowed, and only 26.3 percent of female lived with their spouses and 71.5 percent of female were widowed. 2. One out ten of the elderly was presently smoking. Of the smokers, there were 4 times as many male smokers as female smokers. In response to a question about their drinking habits, 82.0 percent of the aged replied that they did not consume alcohol. Those who consumed alcohol 'daily' constituted 3.6 percent, 'frequently' were 4.3 percent 'sometimes' were 7.9 percent and 'scarcely' constituted 2.2 percent. Among the exercises and sports which the elderly were doing for the fitness and preservation of health. A walking was the most popular at 32.1 percent of the population. More rigorous sports such as hiking, jogging, physical cardiovascular exercises and ball games were being enjoyed by only a very few. 37.2 percent of the elderly replied that they did not exercise regularly. In the major pastime of daily life activities. 40.9 percent of the subjects responded 'none', 14.7 percent of them were domestic duty for family, about 10 percent of them were hobby, religion activities, social work and participating in social education program respectively. In the problems and difficulties of immigration, 78.1 percent of them responded 'yes' in the early times of immigration and 30.4 percent in the present time of immigration. Six major problems were identified by respondent. They were, in the rank order of their language; homesickness: transportation; income and economic and custom. 3. Most of the respondents considered themselves healthy. The proportion of the question to their health at the time of study, 36.2 percent in male and 23.2 percent in female replied that they seemed to be 'excellent healthy', 34.7 percent in male and 32.4 percent in female be 'good', and 4.3 percent in male and 2.1 percent in female be 'Very poor'. In considering specific parts of their body as having problems, many of the ederly pointed out the disease of circulatory system(17.7 percent in male and 23.2 percent in female). Comparatively few of the elderly thought that they had something wrong with their musculoskeletal system(5.7 percent in male and 16.1 percent in female), digestive system(9.2 percent in male and 5.6 percent in female) and endocrine and metabolic disease(6.4 percent in made and 9.9 percent in female). Of those elderly who perceived of some problems with their circulatory and musculoskeletal systems, there were more elderly women compared to elderly men. The largest percentage of the elderly(20.7 percent in male and 26.5 percent in female) indicated palsy as the disease they fear most. Thereafter, the order of diseases feared by the elderly was diabets. hypertension, neuralgia, cancer, and dotage. A majority of the elderly, 54.6 percent of men and 44.4 percent of women, replied that they did not visit a medical institution or a pharmacy to treat their diseases during the one month prior to the survey. Of the total survey subjects who did visit a medical facilities, those complaining of circulatory system disease constituted 13.5 percent in male and 14.8 percent in female, and digestive system diseases were 7.8 percent in male and 8.5 percent in female. For the endocrine and metablic disease, disease of nervous and sens organs and musculoskeletal system were all each less than 7 percent of all the study subjects. Of the total elderly, 49.0 percent utilized medical facilities such as hospitals, herbal clincics, pharmacies and others to treat illness within one month prior to the time of survey; the utilization of clinicl and hospital were 86.0 percent, herb clinic were 8.4 percent and pharmacy were 4.2 percent. 34.8 percent of men and 11.3 percent of female did not take a medicine for treatment and promoting nutrition at the time of the survey. 55.4 percent of total elderly used the drug for treatment of diseases, and 16.6 percent for promoting nutrition. 4. Except for group of questions concerning urinary system more women than men generally complained of problems and discomforts in each groups. More elderly suffered from problems associated with musculoskeletal system than any others, and the decreasing order of the groups of problems with which most complaints were indicated are the problems associated with mental condition, urinary system, circulatory system, nervous system, visual and auditory organs, respiratory system and digestive system.

一部 保健要員의 地域別 適正配置方案에 關한 硏究 : 家族計劃事業을 中心으로 Based on family Planning Program

金應翊 대한보건협회 1980 대한보건연구 Vol.6 No.2

It is quite ture that a qustion on how to attain the primary objective of the proper placement of the existing health service personnel within an organized health network will be one of main questions to be considered as an integral part of the general health service program under the assumption that the highest degree of effectiveness and efficiency of the program can be made at the time when the health service personnel are evenly and properly placed under the full consideration of their job descriptions, workloads, and individual capacity and characteristics. We also believe that the proper placement of health service personnel within the limited availability of the current manpower, especially, that of family planning workers will certainly dedicate not only to the balanced development and efficiency of the National Family Planning Program, but also to the establishment of an evaluative guideline to ask better management and utilization of family planning workers. Therefore, the followings are the summarized contents of findings from a study on a scheme for better placement of family planning workers to be applied in future National Family Planning Program. 1) Even if we admit not the general plan and scheme of the health service personnel placement and that of family planning workers would be, in some extent, different from one to another caused by the changing program contents and goals, we have strong conviction that we could attain the primary goal of the program by the systematic and efficient operation of the program through innovative revitalization of the program network as well as the proper placement of the Family Planning workers based on even assignment of their workloads. 2) We think that the formula expected to be applied in a scheme for the health service personnel placement especially in family planning workers placement permits many different variables. The primary basis is to be consisted of the dependent variables which are keenly associated with the workers' activities such as the sized of the target group for contraception, the rate/frequency of contacting potential acceptors per worker, and the total number of contraceptive achievements per worker. In the mean time the accumulated sterilization achievements unter the consideration of different surroundings and conditions by area, the rate of self-supporting contraception and its level of development will be the independent variables. Eventually, we think we can induce the following formula through good combinations of different variables established in the above: Adjustant between the extremely needed number of workers and optimum number of workers by area: It is to be applied by area after figuring out an adjusted number on the base of the established formula; r=Tw/∑Twi

우리나라 15 - 49세 여성의 사인구조 추이에 관한 연구 (1985 - 1992)

김응익,박상화 한국보건통계학회 1994 한국보건정보통계학회지 Vol.19 No.1

The objective of this study is to analyze trend of cause of death in Korean women(15~49 years) by using data from vital statistics(1985~1992) of National Statistical Office. 1. This leading cause of death in 1985 was diseases of the circulatory system, and 2nd order was neoplasms, and 3rd order was injury and poisoning. The first leading cause of death in was injury and poisoning, and the ranking of the 2nd and 3rd case of death was neoplasms and diseases of the circulatory system respectively. About 70 percent of total death died from the first three leading cause of death. 2. In the proportion(death per 1000) of cause of death between 1985 and 1992, the declines for diseases of the circulatory system, infectous and parasitic disease, diseases of digestive system, diseases of respiratory system, and disease of the genitourinary system were consistent with the linear down ward trend observed since 1985(simple linear regression y=a+bx ; X ; year, Y : death per 1000). On the other hand there were increased mortality level from neoplasms, injury and poisoning, diseases of the musculoskeletal system and connective tissue, congenital abomalies, and diseases of blood and blood forming organ. 3. The leading cause of dealth by age group(15~49 years) in 1992 was injury and poisoning in each age group 15~34, and neoplasms in each age group 35~49. The leading cause of death in 1985 was same for the 1992 in age group 15~29, while at other age group neoplasms(30~39 years) and diseases of the circulatory system(40~49 years) were leading cause of death. 4. In the proportion(death per 1000) of cause of deathe by age group between 1985 and 1992, the proportion of death from diseases of the circulatory system(390~459), cerebrovascular diseases(430~438), neoplasms(140~238), malignant neoplasm of breast(174), malignant neoplasm of uterus(179~182) were higher for the older ages than for the younger ages. But there was reverse situation in proportion of death from injury and poisoning(800~999), mother vehicle traffic accidents(810~825), suicide and self-inflicted injury(950~959), complications of pregnancy child birth and puerperium(630~679), diaseses of pulmonary circulation and other forms of heart diseases(415~429).