보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석

윤석옥(Suk Ok Yun),정문숙(Moon Sook Jung) 한국농촌의학 지역보건학회 1994 농촌의학·지역보건 Vol.19 No.2

산업장 근로자의 산업보건관리에 대한 지식 태도 및 실천에 관한 조사 연구 -부산지역을 중심으로-

황보선,신유선,윤석옥,이지현,김정순,김이순,김복용,강영미,Huang, Bo-Sun,Shin, Yu-Sun,Yun, Suk-Ok,Lee, Ji-Hyun,Kim, Jung-Soon,Kim, Lee-Soon,Kim, Bok-Yong,Kang, Young-Mee 한국지역사회간호학회 1993 지역사회간호학회지 Vol.4 No.2

The purpose of this study was to identify the workers the Knowledge, Attitude, and Practice of industrial health care services. The study was conducted from Dec 10, 1992 to Jan 20, 1993. The data was collected from 849 workers in 56 companies in Busan City. The data was analyzed by using the mean, S.D>, T-test, ANOVA. The tool for measuring the degree of Knowledge, Attitude and Practice of industrial health care of workers was developed by community health nursing academy and the reliability an of the tool was 0.82810. The results were as follows : 1. The general characteristics of workers : Distribution of workers consisted of laborer(55.0%), office workers(45.0%), in an age range from 25-39(55.0%), male employees were(69.7%), married employees were(62.4%), the educational level with the highest percentage was high school graduates(54.2%). The present work force had a career for 7 years or more with an income of 300-700 thousand won monthly(43.2). 2. The degree of Knowledge Attitude and Practice about industrial health care services of workers : The total score of the Knowledge, Attitude, and Practice was 49.09 points out of a possible 80(mean Score=2.46) 1) The total score of the Knowledge was 15.73 points out of 24. (Mean score=2.62) The following are the Knowledge scores: The necessity examination of occupational disease was(3.34) The knowledge of occupational disease was (3.12) The knowledge of health education was(1.29) 2) b. The total score of the Attitude was 26.01 point out of 44(mean score=2.36) The following are the Attitude scores: The necessity of health education for health examination was (3.14). The importance of health examination was(3.08) The necessity of measurement for working environment was(2.99). The satisfaction of the content in the periodic health examination was low(1.81). 3) The total score of the Practice was 7.35 points out of 12(mean score=2.45) The following are the orders of Practice scores: The participation in health examination was higher than in health education(1.33). 3. The general characteristics and the degree of knowledge, Attitude, and Practice of workers of industrial health care. 1) The level of worker's knowledge was significantly related by working part(t=2.54 P=0.000), marital status(F=4.35 P=0.029), educational level(F=3.91 and P=0.020), monthly income(F=2.98 P=0.029) 2) There were no significant difference between the general characteristics and the attitude of workers. 3) The practice was significantly related with working part(T=2.52 P=0.012), sex(T=2.28 P=0.23), marital status(F=4.25 P=0.012), monthly income (F=2.76 P=0.034) 4) The total score had a significant difference with working part(T=2.39 P=0.017), sex (T=3.84 P=0.000), marital status (F=3.18 P=0.032). Educational level (F=3.20 P=0.033), and monthly income(F=3.05 P=0.022).

현상학적 접근을 통한 노인의 삶의 경험

황보선,신유선,윤석옥,이지현,정경임,김정순,김이순,김복용,강영미,Huang, Bo-Sun,Shin, Yu-Sun,Yun, Suk-Ok,Lee, Ji-Hyun,Jung, Kyung-Yim,Kim, Jung-Soon,Kim, Lee-Soon,Kim, Bok-Yong,Kang, Young-Mee 한국지역사회간호학회 1995 지역사회간호학회지 Vol.6 No.2

The purpose of this study was to understand the structure of the lived experience by poor elderly people. The research question was 'What is the structure of the lived experience of life of a poor elderly people.' The sample consisted of 21 single poor elderly persons in Pusan. The unstructured interviews were audio-recorded and analyzed using the Van Kaam method. This study was 368 responses which yielded of descriptive expressions and priority classifications. The result generated 74 common elements, 18 syntheses of hypothetical definitions and 5 identifications of the structural definition. The structural definitions and hypothetical definitions were as follows; 1. physical discomfort ; complaints of severe pain ; dysfunction of physical organs 2. emotional cognition ; despair ; resignation ; attitude toward death 3. support system ; interaction with family ; thinking about God ; economical difficulties ; expectancy of social services ; opinions about health service ; leisure ; interaction with neighborhood ; dissatisfaction due to inadequate environment 4. past reminiscence ; negative reminiscence of one's past ; past regret ; positive reminiscence of one's past 5. desire ; desire of unrealization life ; self satisfaction The significance of this study for nursing are; Comprehension of the lived experience of client and identification' of nursing approach method concerning the lifestyle of client.

산업장의 건강검진과 보건관리실태에 관한연구 -부산 지역을 중심으로-

황보선,신유선,윤석옥,이지현,김정순,김이순,김복용,강영미,Huang, Bo-Sun,Shin, Yu-Sun,Yun, Suk-Ok,Lee, Ji-Hyun,Kim, Jung-Soon,Kim, Lee-Soon,Kim, Bok-Yong,Kang, Young-Mee 한국지역사회간호학회 1993 지역사회간호학회지 Vol.4 No.1

The Purpose of this study was to explore the condition of periodic medical examination and the health care services of industries in order to offer some basic data on developing industrial nursing care. To achieve this goal a self - administered questionnaire (developed by the academic affairs of community health nursing) was provieded to the nurses in 56 industries from Dec. 10, 1992 to Jan. 20, 1993. The statistical computer package, SPSS, was used to manipulate the data along with T-test and ANOVA. The results were as follows : 1. General characteristics: The greater part of the industries were manufacturing company, and below 300 employees of industry were 55.4%. The shift system was mostly one shift(66.1%) and three shift(23.2%), and 50.0% them organized the Industrial Safety and Health Commitee. Average a number of employees was 631 person. 2. Periodic Medical Examination: Most of the workers were receiving periodic medical examination from the designated hospital (95.71%). From the about 12.89% were gone through a colse medical examination. In colse medical examination 58.41% were decided 'C' and 36.73% were decided 'D'. About 6.23% off those who had any clinical findings were work-time shortening(7.84%), work-transition(8.12%), recoverating at home. The majority of the workers receive the result of the periodic medical examination individually (78.5%). 3. Special medical examination: The rate of those who are receiving special medical examination were 76.82% and about 8.24% were decided 'C' and 1.23% were decided 'D' Those who had any health problems were receiving follow-up checking (9.10%) and medical treatment while working (15.04%). The health managers in the company can consult (85.7%) those who had any suspicious sign and symptoms of occupational disease. 4. Health care services: The average score of health care services were 17.57 point out of 28 point, and the score was lower in health assessment and environmental hygiene than medical diagnosis and health education. There were significant differences in environmental hygine (F=3.72, P=0.017), health care services(F=3.94, P=0.013) according to the size of the size of the industries The other's significancy is not shown by any type of industrial nurse. The level of health care services were higher in the wokers who had better health and showed no singificant differences(T=-0.73, P=0.470).

保健診療員의 正規職化 前과 後의 保健診療員 活動 및 保健診療所 管理運營體系의 比較 分析

尹石玉,朴正漢,鄭文淑 대한보건협회 1994 대한보건연구 Vol.20 No.1

본 연구는 보건진료원의 정규직화가 보건진료원의 활동과 보건진료소 관리운영체계에 미친 영향을 알아 보기 위해 정규직화 이전(1992.1.1-3.31)과 정규직화 이후(1993.1.1-3.31)에 경상남북도의 보건진료소 중에서 50개소를 뽑아 보건진료원을 직접 면담하고 각종 기록과 보고서에서 필요한 자료를 발췌하였다. 조사대상자의 96%가 신분보장과 보수향상의 이유에서 정규직화를 원하였다. 정규직화 후에 신분보장과 봉급, 직분에 재한 만족도와 업무의 계획, 수행, 평가 및 보건진료소 관리(재점)운영에 대한 자율성 인지도가 증가했다. 그러나 보건진료원의 역할, 기능 등의 업무활동에는 큰 변화가 없었다. 보건소의 보건진료소에 대한 지원은 약간 늘었으나 업무추진 목적의 행정적, 기술적 지도는 거의 없었다. To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their job was increased from 24.0% to 46.0% after officialization. Those CHPs who felt insecure for their job decreased from 30.0% to 10.0%. Monthly salary was increased by 34.0% from 802,600 Won to 1,076,000 Won and 90.0% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increasd by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20.0% to 38.0% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 78.0% to 62.0%, and from 86.0% to 74.0%, respectively. The proportion of CHPs who maintained a coorperative relationship with Myun Health Workers was reduced from 84.0% to 72.0%. The proportition of CHPs who maintained a good cooperative relationship with the director of health center from 46.0% to 24.0%, that with the chief of public health administration section from 56.0% to 36.0%, and that with the chairman of PHP management council from 62.0% to 38.0%. Most of the CHPs (92.0% before and 82.0% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecesssary increased from 4.0% to 16.0%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

地域住民의 健康行態와 國民健康增進法에 대한 認識 및 態度

박재용,한창현,윤석옥,이관희 韓國保健敎育 ·健康增進學會 1999 보건교육건강증진학회지 Vol.16 No.2

In order to ascertain the attitudes of residents to their health and the National Health Promotion Law, surveyors interviewed 1,220 subjects, 1% of men and women in Kyungsan city, who were twenty-year-old or more. The major findings are as follows : Men and women were 48.2% and 51.8%, respectively. The recognition rate of enacting and enforcing this law is 59.2% of men and 51.3% of women. With regard to the behavioral attitude to the health in the distinction of sex and age, current smokers are 31.2% of the interviewees, 61.6% of the men and 3.3% of the women. Current drinkers are 35.1%, 59.5% of the men and 12.3% of the women, but on the other hand there is little significance in the distinction of age. The acknowledgement proportion of enacting and enforcing this law is 59.2% of male and 51.3% of female. In terms of the recognition rate of the contents according to the general characteristics of interviewees, it appears that the indication of a warning expression on a packing paper of cigarette case and a liquor bottle is 92.4% and also the designation of a smoking free area in public facilities is 94.8%. Prohibition of cigarette-sale to the teenagers who are under 19, is 96.0%. Considering these facts, the recognition rate is high. On the contrary, 48.8% is accounted for encouraging a medical check-up before marriage which is in a low position. As a result of multiple logistic regression analysis, putting general characteristics and health behavior as a independent variable, the National Health Promotion Law as a dependent variable educational level, marital status, exercise and periodic medical examination are selected as significant variables. In case of having undergone a periodic medical examination the recognition rate was high whereas frequent exercise led to the low recognition rate. Concerning the details of the undertaking in accordance with each factor of general characteristics, the greater part of them have been appraised successfully whether it is recognized or not. On the other side, no effect got answered about the result of the undertaking subjects to general and peculiar behavior attitude towards health was in effect or not. A great majority approved of more reinforcement of legal regulation about smoking and drinking regardless of whether they perceived the details of the law of promotion of National Health Promotion Law or not. Additionally there was significant difference in reinforcing legal regulation of smoking and drinking in compliance with the attitude of the substance of this law. With regard to education, public relations and evaluation about national health through public health centers by our government, the younger and the higher in education they are, the more deficient they feel. First of all, those who were aware of the enforcement of this law as well as plenty of scarcity answered that better service of disease prevention had to be expanded than ever. In consideration of the above-stated results, the education to public health and the business of public relations should be reinforced and a practical campaign for health life should also spread out for the purpose of encouraging to practise healthy life-style.