보건소 방문 간호 사업의 질보장을 위한 연구

윤순녕,이인숙,현혜진,유인자,김재남,배정희,Yun, Soon-Nyoung,Lee, In-Sook,Hyun, Hye-Jin,You, In-Ja,Kim, Jai-Nam,Bae, Jung-Hee 한국지역사회간호학회 1995 지역사회간호학회지 Vol.6 No.2

The purpose of the study is to evaluate the visiting nurses service of a public health center. Data were collectd from the 36 clients who received services from a public health center. In terms of the process evaluation, the tool is composed 4 parts, 27 items such as assessment planning, implementation, and evaluation. It was measured through the health records by 2 peer review. In terms of the outcome evaluation, the level of client satisfaction was measured by self report or interview by 2 supervisor. The result were as follows: 1. 30% of 36 health records showed narsing process was not and out of them, nursing care plann including spectific activities were rarely established or unclear. 2. The lack of systematic data collection' showed and nursing diagnosis was not adressed in health records review. 3. Client satisfaction score was 32, 97, out of maximum score 36. 4. The lack of sufficent objective data, care plan, record of client's health status change, and evaluation was founded therefore quality assurance for visiting nurses service and in-service education are required and the development of standardized record system need.

보건소의 환경, 조직구조와 조직유효성과의 관계

윤순녕,Yun, Soon-Nyoung 한국지역사회간호학회 1995 지역사회간호학회지 Vol.6 No.1

The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found

우리나라 가정간호제도화 방안에 관한 고찰

윤순녕,황나미,현혜진,최정명,권미경,Yun, Soon-Nyoung,Hwang, Na-Mi,Hyun, Hye-Jin,Choi, Joung-Myoung,Kwon, Mi-Kyung 한국가정간호학회 1995 가정간호학회지 Vol.2 No.-

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

서울시 일개 지역에 거주하는 중장년의 건강문제 및 건강행위

윤순녕,김정희,Yun, Soon-Nyoung,Kim, Jeong-Hee 한국지역사회간호학회 2000 지역사회간호학회지 Vol.11 No.2

The purpose of this study is to identify health problems and health behaviors of the middle-aged residing in urban areas and to plan and implement health promotion programs based on their health needs. The subjects' age ranged from 30-64 years in 1.040 middle-aged residing in an area of Kangbook-ku in Seoul. The data were collected from September 1998 to February 1999 with structured questionnaire using face-to-face or telephone interviews. The data were analyzed by SPSS-PC+ and identified by $X^2$ test and ANOVA. The results were as follows: 1. 35.4% of the males and 27.8% of the female responded that they were healthy regarding their perceived health status. In the order of chronic illness prevalence in the case of males was hypertension, diabetes, and digestive disorders and. in the case of females, was digestive disorders, hypertension, arthritis, anemia, and diabetes. 2. Male and female's smoking rates were 7.3% and 3.6% each and marked the highest rate of 30 to 40 years: drinking behavior was 66.9% in males and 32.2% in females. 3. The younger males had the worse dietary habits and had the lowest frequency of regular exercise. The older the females were, the more their weight increased. According to the results, health promotion programs by sex are recommended, especially in the target population of 30 to 40 years. and focused on the strategies for promoting self-care and actual health practice: it is strongly suggested that health promotion programs for adolescent and school-aged children before middle aged health behavior begins.

독립형 가정간호시범사업소의 가정간호행위분류체계 개발과 수가 연구

윤순녕,박정호,김매자,홍경자,한경자,박성애,홍진의,Yun, Soon-Nyoung,Park, Jung-Ho,Kim, Mae-Ja,Hong, Kyung-Ja,Han, Kyung-Ja,Park, Sung-Ae,Hong, Jin-Eui 한국가정간호학회 1999 가정간호학회지 Vol.6 No.-

The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.

국내 가정간호 사업의 성과 측정 연구의 고찰

윤순녕,조명숙,김홍수,Yun, Soon-Nyoung,Cho, Myoung-Sook,Kim, Hong-Soo 한국가정간호학회 1997 가정간호학회지 Vol.4 No.-

The purpose of this study is to identify the domestic research results related to the outcomes of home care services for 1981-1996. 12 studies were analized by the characteristics of the subjects, home care services provided, and outcome variables and tools during the period of Apirl-June, 1997. The results were as follows: the subjects of 8 studies conducted before 1993 were discharged patients comparing to early discharged patients of 2 studies conducted after 1994. The main home care service delivered to the clients and their families were education before 1993. The outcome variables were used the level of sat. isfaction of home care services, quality of care, cost-effectveness, health status, quality of life, and self -care ability. A variable, health status, were mainly measured by the global outcome measures such as quality of life, health hehelief, health perception, activity of daily living, health management pattern but also foused outcome measures that could be specified by the medical diagnoses.

보건소조직구조에 따른 방문간호사업의 성과 비교

윤순녕,박성애,Yun, Soon-Nyoung,Park, Sung-Ae 한국지역사회간호학회 1996 지역사회간호학회지 Vol.7 No.1

The purpose of this study was to identify the differences of the outcomes of visiting nursing service (VNS) between the two types by the organizational structure of health centers. Type I referred to 3 health centers with departmentalization for VNS and type II of 3 health centers providing VNS under the subunit of a department. Data were collected from 38 visiting nurses at the six health centers for their perceived formalization, decision-making authority and job satisfaction, 293 clients for the satisfaction level with VNS served and their records analysis for level of quality care and frequency by the contents of VNS through the questionares during the period from June, 1 to August 30, 1993. Data were analyzed using $\chi^2$, F. t or/and Scheffe test. The result were as follows: 1) There were no significant differences in perceived formalization and decision -making authority of visiting nurses between the two types of health centers. 2) There were significant differences in the level of quality care and frequency of the VNS contents between the two types of health centers. 3) There were no significant differences in perceived clients' satisfaction and job satisfaction of the visting nurses between the two types of health centers. From this study, Not only organizational differentiation with the development of job standards and supportive system but also personnel development are suggested when new health care service in health centers begins.

보건진료원의 지역사회 몰입과정

윤순녕,김영임,최정명,Yun, Soon-Nyoung,Kim, Young-Im,Choi, Jeong-Myung 한국지역사회간호학회 1995 지역사회간호학회지 Vol.6 No.2

Primary health care(PHC) has been established since A Health Law for rural residents has been legislated in 1980 following the WHO declaration, 'Health for All 2000'. in 1978. PHC services are presently assumed to be provided by 2038 Community Health Practitioners(CHP) to about 28% out of rural population in Korea. Most CHPs have confronted the adaptation process to the community being practiced although a CHP's role is to evoke community participation for the improvement of their health by themselves. So the purpose of this study is to describe and explain of the commitment of CHPs into the community. Data were collected by direct interview and tape-recording under subjects' permission till theoretical saturation were occured from 6 CHPs. The subjects were 41 years old and have served in the community for 9 years in average. Main questions and concepts were explored from data according to the procedure of the grounded theory methodology. The results are as follows. 1) The number of the main concepts were twenty four that identified Motive, Desire, Personal characteristics, Unfamiliarity, Denial, Feeling of isolation, Self-sacrifice, Kindness, Patience, Assimilation, Respect for the residents, Support by the family, Support by the residents, Achievement, Acceptance of realities, Use of resources, Inducement of cooperation from the residents, Changes of the difference from time orientation between CHP and residents, Attitude as a official, Technical support, Cost management, Satisfaction level, Acknowledgement by the residents and discrepancy. 2) The twenty four concepts were categorized to seven groups such as Motivation, Feeling of Heterogeneity, Self-discipline, Social support, Induced changes in the attitudes of residents, Familarity and Persistent discrepancy. 3) The categorized groups were analyzed on the base of the Causal Conditions, Central Phenomena, Contexts, Intervening Conditions, Action / Interaction Strategies, and Consequences. Central phenomenon in this study was identified to be the feeling of heterogeneity. Community health practitioners experienced unfamiliarity and denial from the community and felt themselves isolated in the first. In time, they won the trust of residents by their efforts including self-sacrifice, kindness, patience, and assimilation. Afterward, practitioners got self-confidence and familiarity with lesser feeling of heterogeneity. Nevertheless, practitioners could not commit themselves completely because of the persistent discrepancy between CHP and residents. 4) On the commitment process, the CHPs' feeling of heterogeneity were decresed and social support increesed and newly evolved induced change of residents through the continuous interaction between CHP and them The contribution of this study would be concluded as follows. 1) It is expected that effective strategies for more rapid committment into the community can be developed based on this study. 2) More easy committment would be possible for the newly appointed CHP through understanding of the committment process identified on this study.

전국 보건소의 신체활동 및 운동프로그램에 관한 실태조사

윤순녕(Yun, Soon Nyoung),전태원(Jeon, Tea Woun),이홍자(Lee, Hong Ja) 한국보건간호학회 2002 韓國保健看護學會誌 Vol.16 No.1

제조업 근로자의 직무스트레스 요인과 대처전략, 스트레스 반응간의 관계

김정희,윤순녕,Kim, Jeong-Hee,Yun, Soon-Nyoung 한국지역사회간호학회 1999 지역사회간호학회지 Vol.10 No.2

The purpose of this study is to identify the relationships of job stressor. coping strategies. and stress responses of manufactoring workers. Data were collected through self-reported questionnaires from 262 of the manufacturing workers in a local electronic company from July to August. 1999. For data analysis. Cronbach's a. Factor Analysis. Descriptive statistics. ANOVA. and Pearson's correlation coefficient with SPSS/PC+ 7.5 version program were used. The results were as follows: 1. Regard to the stress responses and coping strategies by sociodemographic variables. 'the overall stress responses' showed significant differences by sex. age. marrital state. The use of 'control coping strategy' showed significant differences by sex and the type of work. The use of 'avoid coping strategy' showed significant differences by sex. age. married state. year of career. and income. 2. The average scores of 'the job characteristics and participation in decision making factor'. 'the physical environmental factor'. and 'the role and leadership factor' were 2.66. 2.59. 2.59 in order. The average scores for 'the avoid coping strategy' and 'the control coping strategy' were 3.03. 2.97. The average scores for 'the overall. psychosoical. and physical stress responses' were 2.18. 2.18. 2.23. 3. The 'control coping strategy' was negatively related to 'the job characteristics and participation in decision making factor'. 'the role and leadership factor'. 'the psychosocial stress responses'. and 'the overall responses'. 'The control coping strategy' was positively related to all of 'the job stressors'. 'the physical stress responses', and' the overall stress responses'. 'The physical environment factor' was positively related to all of 'the stress reponses'. 'the role and leadership factor'. and 'the job characteristics and participation in decision making factor'. According to the results of this study, the suggestions were as follows: 1. The coping strategies of manufacturing workers in the specific job stress situation should be considered to future studies. 2. In order to applying the stress management program in the workplace. The organizational intervention focused on 'the job characteristics and participation in decision making' will be needed. 3. To support and use of 'control coping strategy' of the workers. the organizational efforts should be required.