보건소의 건강증진사업을 위한 보건교육전략

남정자(Jung-Ja Nam) 한국보건교육건강증진학회 1999 보건교육·건강증진학회 세미나 및 기타간행물 Vol.- No.-

청소년 비행 유형별(非行類型別) 관련요인 분석

남정자 ( Jung-ja Nam ) 한국보건사회연구원 1993 保健社會硏究 Vol.13 No.2

본 연구는 비행(非行)에 관한 사회학적 이론과 심리학적 이론을 고찰한 후 두 이론을 통합한 사회·심리적 통합모델을 제시하고 한국 청소년 비행의 유형별로 그에 영향을 미치는 요인을 파악하는 데 그 목적이 있다. 연구목적의 수행을 위하여 청소년 비행에 대한 이론적 고찰과 실증적 분석을 병행하였다. 연구결과를 토대로 볼 때, 본 연구에서 분류한 비행 유형은 한국 청소년 비행에 대한 다양한 설명과 이해를 하는 데 매우 유효했다. 또한 본 연구의 결과는 기존의 사회학과심리학에서 제시하고 있는 비행에 관한 이론들을 대부분 지지하고 있었다. 다만 긴장 이론과 자아존중 이론은 우리나라 청소년 비행과는 다소 낮은 관련성을 보여주어 이에 대한 보다 심층적인 연구가 요구된다. 본 연구에서 상정한 사회학과 심리학 이론의 통합적 접근은 한국 청소년 비행을 종합적으로 설명하는 데 매우 유용하였다. 즉 본 연구의 결과, 사회학적 변인에 심리학적 변인이 첨가됨으로써 비행의 예측력을 증가시켰을 뿐만 아니라 심리학적 변인은 사회학적 변인에 비해 비행 유형별로 보다 민감하게 작용하고 있어 비행 유형별 대책수립을 위해서는 특히 유용한 지표인 것으로 나타났다. 뿐만 아니라 본 연구의 결과는 비행 유형에 따라 원인적 요소들이 다르게 작용하고 있는 점을 분명히 보여 주었다. 따라서 향후 청소년 비행에 관한 예방대책을 수립하고자 할 때 비행 유형별 접근의 필요성과 특정 집단별 특수한 접근방법을 암시하고 있다는 점에서 활용가치가 크다고 보여진다. 결론적으로 우리나라 청소년 비행을 예방하기 위해서는 사회구조적 요인뿐만 아니라 개인의 심리적 요인에 대한 처방이 요구되며 보다 실효성 있는 비행 대책을 수립하기 위해서는 비행 유형별, 성별, 인문·실업계열별로 다르게 접근할 것이 요구된다고 하겠다. 궁극적으로 비행 현상은 사회구조적 현상일 뿐만 아니라 개인적 측면과 연관되기 때문에 비행의 심리적 요인을 간과할 수 없는 점이 본 연구를 통해 입증되고 있다. The purpose of this study is to classify the Korean juvenile delinquencies and investigate the factors affecting the various types of delinquencies by using the integrate sociopsychological model. The variables employed in the model were borrowed from several sociological theories and psychological theories of juvenile delinquency. The survey was conducted in 1989 with the sample of 1,412 eleventh grade of students from the 26 high schools located in Seoul city, Chungbuk and Junbuk province in Korea. The major findings were, 1. The Korean juvenile delinquent behaviors were classified into 7 types, “status”,“violent”, “sexual”,“run away from home”,“authority”,“drug”,and “theft” offenses by factor analysis. 2. The theory which best predicted Korean Juvenile delinquency was the social learning theory which says the delinquent bond is the prime important factors affecting all types of Korean Juvenile delinquencies. 3. The conventional bond(e.g., love/concern of parent for child, attachment to parents, success in school performance, attachment to school) was the second most important factor affecting most types of the Korean juvenile delinquencies. 4. The third most important factor appeared to be the psychological distress(agression, anxiety, depression)and psychological variables related differently to the various types of delinquencies. 5. The socioeconomic status were positively related to “violent”,“sexual”,“run away from home”,and negatively associated with “authority”,“drug”,and “theft” offenses. 6. Some variables such as psychological distress, father`s education, mother`s employment, number of siblings were related differently to the various types of delinquencies. In addition to the theoretical variables gender was the very important factors in explaining most types of juvenile delinquencies. 7. In addition to the theoretical variables gender was the very important factors in explaining most types of juvenile deliquencies. 8. The possible explanation for the small correlation between strain theory and delinquency is that the operational definition of strain may not be adequate in Korea because of the special nature of the Korean educational situation. To conclude, the delinquent behavior is inherently more complex than any single theory or group of theories can possibly anticipate. Consequently, the integrate psychosociological approach was adequate to explain the great variety of delinquent behaviors.

한국 청소년의 자살기도에 관한 역학적 연구

남정자 ( Jung Ja Nam ),전희순 ( Hee Soon Juon ),( Margaret E. Ensminger ) 한국보건사회연구원 1992 保健社會硏究 Vol.12 No.1

본 연구에서는 우리나라 중·고등학생의 자살기도율을 파악하고 자살기도와 사회경제적 특성, 사회통합, 학교에서의 스트레스, 정신건강상의 문제 및 자살충동과의 관계를 검토하였다. 연구대상은 서울, 충북, 전북의 3개지역에 거주하는 중·고등학교 2학년에 재학 중인 학생을 모집단으로 하여 표본으로 추출한 중학생 5,209명과 고등학생 4,677명으로 총 9,886명이었다. 연구결과 자살충동경험율은 중학생은 38.5%, 고등학생은 51.3%로 나타났으며 중학생의 3.9%와 고등학생의 4.9%가 자살기도를 경험했던 것으로 나타났다. 자살기도율과 가장 관련이 깊은 요인은 자살하고 싶은 충동, 공격성향, 우울성향과 같은 정신건강상의 문제들이었다. 이와같은 연구결과는 중·고등학생의 잠재적 자살과 자살충동 또는 자살기도를 예방하기 위해서는 정신건강에 관한 문제를 조기에 발견하고 치료하는 것이 무엇보다도 중요함을 시사하는 것이라고 하겠다. We examined the prevalence of self-reported suicide attempts and the relationship between suicide attempts and background characteristics, social integration, stress at school, psychological distress, and suicidal thoughts in a nationally representative sample of Korean adolescents. As part of the Korea Institute for Health and Social Affairs` Adoles-cent Health Survey data were collected from 5,209 eighth graders and 4,677 eleventh graders from 70 junior high and senior high schools in Korea. Previous suicidal ideation was indicated by 38.5% of the 8th graders and 51.3% of the 11th graders, and 3.9% of the 8th graders and 4.9 % of the 11th graders reported that they had attempted suicide. Results, for both 8th and 11th graders, showed that factors significantly associated with suicide attempts included suicidal thoughts, hostility, and depression. These results indi-cate that early identification and treatment of psychological distress may have potential for reducing suicidal ideation as well as possible future suicides and suicide attempts.

사회조사(社會調査)를 통한 정신건강(精神健康)의 측정방안(測定方案)

남정자 ( Jung Ja Nam ),한영자 ( Young-ja Han ) 한국보건사회연구원 1994 保健社會硏究 Vol.14 No.2

精神健康과 身體的 健康間의 밀접한 관련성이 입증됨에 따라 國家 保健政策을 수립하기 위해서는 국민의 신체적인 健康水準뿐만이 아니라 精神健康 水準의 파악이 필수적이 되었다. 本 論文에서는 社會調査 方法을 통해 일반인의 精神健康水準을 측정할 수 있는 道具를 검토하여 제시하였다. 硏究內容을 요약하면; 첫째, 社會調査방법을 통해 精神健康水準을 測定하기 위해서는 精神健康과 精神的 安寧에 대한 定義와 槪念이 보다 명확히 구분되어야 한다. 따라서 이 분야의 硏究가 더욱 요구된다. 둘째, 一般住民을 대상으로 하는 調査에서는 精神障碑보다 精神的 安寧의 수준을 평가하는 것이 보다 적절한 것으로 파악되었다. 셋째, 社會調査를 통해 精神障操를 측정할 수 있는 도구는 DIS(Diagnostic Interview Schedule)가 거의 유일한 것으로 나타났다. 넷째, 精神的 安寧을 측정한 대부분의 調査에서는 불안, 우울, 삶의 만족감과 자기조절능력의 4가지 要素를 주로 측정하였다. 다섯째, 외국에서 개발된 旣存 道具들을 우리나라의 문화적 狀況에 알맞도록 수 정하고 표준화하여 再開發하는 작업이 필요하다. 그러한 작업을 위해서는 政府次元에서 지속적인 硏究支援을 해야 할 것이다. 끝으로, 주기적으로 全國民을 대상으로 기본적인 精神健康과 精神的 安寧의 수준을 측정할 필요가 있다. 健康에 대한 槪念이 身證的 凍康에 국한되지 않고 그 이 상으로 확대되고 있는 점을 감안한다면, 현재 3년마다 실시하는 國民健康調査 및 意識行態調査와 述行하여 精神健康과 身體的 安寧의 수준을 정기적으로 측정할 필 요가 있다. 그렇게 해야만 보다 완전한 國民健康水,을 측정했다고 할 수 있을 것 이며 여기에 기초하여 國家保健政策이 樹立,評價될 수 있을 것이다. The purpose of this paper is to discuss the concepts of mental health and mental well-being, and reviews survey instruments for their assessment. First, the diagnostic survey instruments for mental disorders were reviewed. Secondly, the overall measures of mental health and well-being were discussed. Lastly, the measures of psychological distress and quality of life which is the basic components of mental well-being were reviewed. These instruments include Diagnostic Interview Schedule, the General Health Questionnaire, and the Beck Depression Inventory. Conclusions are as follows: 1) To promote overall health status of the population, assessment of mental health is essential along with physical health assessment. 2) There is a need to distiguish the concept of mental health and mental well-being. 3) There is a need to find the best measures of mental health and mental well-being. Also, there is a need to revise existing instruments to be suitable for Korean culture. In order to develop Korean version of the existing instruments or to develop new instruments, continuous governmental supports are needed. 4) As definitions of health status expand beyond physical health and the absence of disease, there is a need to measure basic mental health and mental well-being in the population on a regular basis.

산전관리(産前管理)와 분만결과(分娩結果)와의 관련성(關聯性) 연구(硏究) 병원자료(病院資料)를 중심(中心)으로

남정자 ( Jung Ja Nam ) 한국보건사회연구원 1984 保健社會硏究 Vol.4 No.2

Analyses of 4,012 medical records of infants born during January to June 1981 in the II Sin Christian Hospital, were carried out to assess the relationship between prenatal care and birth outcome. The analyses lead to the following conclusions: Generally, adequacy of care, as measured by the three-factor maternal health services index, is strongly and consistently associated with birth outcome. However, the effect of prenatal care differ by mothers risk categories. As the effectiveness of prenatal care increases from no risk to social risk to medical risk to combined social-medical risk. Looking into the level of prenatal care, the inverse relationship exists between prenatal care index and the birth outcome. In each risk group, perinatal mortality and low birth weight proportions increase as care declines from adequate to intermediate to inadequate. According to the relative risks of perinatal mortality, the highest relative risk of perinatal death is found among infants at social medical risk with inadequate care and the lowest relative risk of death is found among infants at no-risk with adequate care. The same consistency was found when the percentage of low birth weight infants was used as an index of birth outcome. The result of the analysis indicate that assigning risk categories to pregnant women can be carried out, and guidelines for prenatal care should be established that are appropriate for the management of different risk categories.

각국의 금연정책 및 관련법 고찰

한영자 ( Young-ja Han ),남정자 ( Jung-ja Nam ) 한국보건사회연구원 1994 保健社會硏究 Vol.14 No.1

본 논문에서는 흡연이 건강에 미치는 영향에 대한 고찰과 우리나라와 외국의 흡연설태 및 흡연문제에 대한 대응책을 살펴보았다. 국민건강을 위협하는 가장 심각한 단일요인으로 파악되고 있는 흡연에 대한 각국의 대처방안을 분석하여 그를 근거로 다음과 같은 결론을 제시하였다. 첫째, 흡연은 각종 암과 만성질환의 주요 원인이 되고 있으며 비흡연자의 건강에도 큰 피해를 주고 있다. 또한 임부의 흡연은 유산과 조산 및 저체중출생아의 위험을 증가시키고 있다. 뿐만 아니라 흡연은 건강악화로 인한 노동생산성 감소, 국민의료비 증가, UR타결로 인한 외국산 담배의 국내시장 잠식 풍 경제적인 측면에서의 영향도 크다. 둘째, 우리나라의 흡연율은 세계 어느 나라 보다 높으며 선진국의 흡연율이 감소추세를 보임에 비해 전혀 감소의 기미를 보이지 않고 있다. 또한 우리나라 고풍학생들의 흡연율은 외국 성인흡연융 보다도 높아 우리나라 흡연실태의 심각성을 보여주고 있다. 셋째, 선진국은 흡연대책으로써 입법의 중요성을 강조하고 있으며 흡연정책의 성공사례는 금연사업과 국민건강 증진을 위한 안정된 기금확보(담배세로부터 확보) 및 광범위한 지원세력을 의도적으로 구축한 중앙정부의 조정역할이 크게 기여한 것으로 파악되었다. 마지막으로 우리나라는 아직도 국민건강 보호를 위한 종합적인 금연법이 없는 실정이므로 우리나라 실정에 맞는 입법활동을 적극 추진하여야 할 것이며 안정된 기금확보가 선결되어야 할 문제라고 사료된다. 흡연은 조기예방이 금연보다 훨씬 효과적인 방법임을 고려할때 청소년 대상 흡연대책이 절실히 요구된다. 효과적인 금연사업 전개를 위해서는 국가적인 차원에서 구체적인 장단기 흡연율 달성목표로 설정하고 이에 따른 사업계획을 수립해야 할 것이다. The purpose of this paper is to review the effect of smoking on health, to examine the status of smoking and the anti-smoking measures in Korea and other countries, especially on the anti-tobacco policy and legislation. Based on the analysis of smoking, one of the serious single factors threatening the health of the population, the following recommendations are suggested. 1) Cigarette smoking is closely related with various kinds of cancer and chronic diseases. Smoking by pregnant women increases the risk of abortion, fetal death, premature birth, and low birth weight child. Smoking also harms the health of non-smokers, and increases the socioeconomic cost due to the ill-health. 2) Korean Male Cigarette Smoking Prevalence Rate recorded one of the highest rates in the world and it does not show any decreasing tendency. The Korean government should establish an official comprehensive tobacco control policy immediately. 3) Cigarette Smoking Prevalence Rate for the Korean high school male students is higher than even that of adults in other countries. Poli- cy measures centered on the adolescents are urgently required because not to start smoking is much more effective than to stop smoking. 4) The success of the anti-smoking policy in Victoria State in Australia and California State in the USA is due to getting secure funds (from tobacco tax), and the coordinating role of the central government to establish supporting forces. The government`s role to secure funds and establish supporting forces is therefore important in Korea, too. 5) The importance of the legislation as antitobacco policy measures is emphasized in the advanced countries, especially on the cigarette tax, production, sales, price, regulation on advertising, regulation on smoking in public buildings and the workplaces, regulation on the contents of the tobacco, and health education. The Korean government should promote antismoking legislation appropriate to Korean situation based on the experience of other countries. 6) We need to secure funds and to establish supportive forces for the anti-smoking program and the coordinating role of the government is critically important for this. 7) Strengthening of anti-smoking measures is necessary not only for the health of the population, but also for the economic aspects, such as decreasing production and increasing medical costs arising from the ill health due to smoking. 8) Cigarette Smoking Prevalence Rate is high among the females and the lower socioeconomic class in the advanced countries. Recent trend is regarding smoking as anti-social behavior. We need to emphasize the anti-social aspects of smoking, to hold national anti-smoking campaigns through mass media which have proved to be most effective measures to control smoking. 9) Finally, the Korean government should set long-term and short-term target cigarette smoking rates and establish detailed program plans to achieve this.

시설부양로인(施設扶養老人)의 가족생활주기(家族生活週期)에 관한 고찰(考察)

공세권 ( Sae Kwon Kong ),남정자 ( Jung Ja Nam ),림종권 ( Jong Kwon Im ) 한국보건사회연구원 1983 保健社會硏究 Vol.3 No.2

There are many differencies between primitive society and modern society in social structure and value systems. Modernization tends to decrease the relative status of the aged and to undermine their security within the social system. The purpose of this paper was to findout some linkages between modernization and problem of aging population by examining problem group of elderly persons who became nursing home residents. This paper only focussed on their family backgrounds and family life cycles. The findings are; 1. The higher rates of divorce, the larger proportion of persons being in nevermarried, the larger proportion of persons with no ever born children were noted among nursing home residents than the same aged population in census data. 2. Due to their lower average age at the marriage of their last child and the increased longevity of themselves, the longer empty nest periods as well as the longer widowhood were noted among nursing home residents. It can be pointed out that, all of those findings are very closely related to modernization. In fact, those are the most dramatic changes to have occurred in the family life cycle patterns in modern societies. From those findings, the hypothesis can be withdrawn as "the more societies modernizes, the more nursing homes where the deprived elderly persons to stay for their rest of life, will be needed.”

한국과 일본의 건강증진정책 비교

남은우(Eun Woo Nam),조은주(Eun Ju Jo),남정자(Jung Ja Nam),Hasegawa Toshihiko 한국보건교육건강증진학회 2004 보건교육건강증진학회지 Vol.21 No.3

한국인 관절염 환자의 영양 상태

윤정이 ( Jeong E Yun ),곽은주 ( Eun Joo Kwak ),남정자 ( Jung Ja Nam ),김혜련 ( Hye Ryun Kim ),최호순 ( Ho Soon Choi ),배상철 ( Sang Cheol Bae ) 대한류마티스학회 2001 대한류마티스학회지 Vol.8 No.4

Objective: Based on the data of National Health and Nutrition Survey (NHNS), which was conducted by Ministry of Health and Welfare in 1998, we analyzed nutritional status among arthritis patients in Korea. Method: Nutrition survey was performed through interview which was subdivided to food intake survey, frequency of food intake survey, and dietary habits survey. Nutrient intake was calculated from the recall of food ingested in previous 1-day. Overall, 1,025 patients with arthritis and 2,773 normal controls recorded a detailed dietary history. Information collected was analyzed for intake of energy, fats, protein, carbohydrate, vitamins and minerals, which was then statistically compared between the arthritis patients and the control group. Results: In patients with arthritis, body mass index (BMI) was significantly greater than in control in both men and women. Patients with arthritis ingested significantly less energy from fat and more energy from carbohydrates. They ingested less dietary intakes of the following nutrients: protein, fat, carbohydrates, calcium, iron, vitamin A, B1, B2, and niacin. Especially, the intake of calcium and vitamin B2 were only about 60% of the Reference Daily Intake (RDI). Deficiency of calcium intake was predominantly revealed in all age groups, even in normal controls. Female patients with arthritis seemed to take less dietary intake than male. Conclusion: Using these national data, we showed that the deficiency of calcium intake was revealed in our population, and female patient with arthritis had a tendency to ingest less nutrient intake.

한국인 관절염의 본인인지 유병률과 역학적 특성: 『1998 국민건강,영양조사』

엄완식 ( Wan Sik Uhm ),윤정이 ( Jeong E Yun ),박용욱 ( Yong Wook Park ),김혜련 ( Hye Ryun Kim ),남정자 ( Jung Ja Nam ),이혜순 ( Hye Soon Lee ),김태환 ( Tae Hwan Kim ),전재범 ( Jae Bum Jun ),유대현 ( Dae Hyun Yoo ),배상철 ( Sang Ch 대한류마티스학회 2004 대한류마티스학회지 Vol.11 No.2

Objective: The aim of our study was to define the prevalence, demographic data, selection of the medical services and disability of the patients with self-reported arthritis which were based on the data of National Health and Nutrition Survey (NHNS) conducted by Korea Institute for Health and Social Affairs (KIHASA) and Ministry of Health and Welfare in 1998. Methods: By a stratified multistage probability sampling method, 200 sample districts which consisted of total 13,523 households were selected all over the country. The investigation started with a basic household survey which was completed in 12,189 households with exclusion of non-kinship family. The Health Interview Survey was subdivided to 5 parts including the basic household survey (n=39,060), the diseases survey (n=26,448), and the disability survey (n=694). Results: An estimated 8.0% of Koreans had some form of self-reported arthritis in 1998 and this proportion was higher than that of other chronic medical conditions such as peptic ulcer disease, hypertension, and diabetes mellitus (DM) -7.0%, 4.5%, and 2.2%, respectively. Arthritis was more prevalent among people with female, increasing age, lower income (less than 500 thousand ￦ per month), lower educational attainment (less than 9 years), and lower standard of living. Especially, arthritis ranked first in prevalence as the cause of the chronic disease in the population aged over 45 years, with the prevalence rate of 22.6%. People with arthritis were more likely to report functional limitations such as activities of daily living (ADL) and instrumental activities of daily living (IADL) (5.4%), compared with people who had other musculoskeletal diseases, such as low back pain (3.8%), and herniated intervertebral disc (2.8%). The loss of productivity from arthritis was estimated to reach 0.25% of gross domestic product (GDP) amounts to ￦ 1,133 billion per year which was remarkably higher than that of cardiovascular diseases or cancers. Conclusion: Arthritis has a major impact on the health profile of our population. High burden of arthritis in our society should be considered as an important factor in planning health care services and setting research priorities.