오마하 시스템(OMAHA SYSTEM)를 이용한 지역사회 주민들의 건강관리 요구조사

조원정,유일영,채선미,함옥경,서구민 연세대학교 간호정책연구소 2002 간호학탐구 Vol.11 No.1

최근 우리나라는 경제·사회적 발전, 인구구조의 변화, 그리고 질병양상의 변화에 따른 국민 건강요구의 증가를 경험하고 있다. 국민의 건강요구를 충족시키기 위해서는 무엇보다도 지역주민의 요구에 근거한 보건사업의 제공이 요구된다. 이를 위해서는 고위험 집단의 건강문제, 만성질환관리, 영유아보건, 정신보건, 가족문제, 자녀문제, 노인문제, 일상생활습관 및 영양, 운동 등의 건강관리뿐만 아니라, 사회, 경제적 문제와 환경문제 등을 포괄하는 종합적 가족사정이 필요하다. 특히 스스로 건강문제를 해결하지 못하는 소외계층을 우선 순위로하여 필요하다면 가정방문을 통하여 자료를 수집할 필요가 있다. 본 연구의 목적은 지역사회주민의 건강요구와 건강문제를 규명하는데 있어 오마하 분류체계의 적용가능성을 검증하기 위한 것으로 서울시의 한 개 등을 선정하여 주민들의 건강문제와 건강요구를 파악하였다. 간호대학 연구자들과 마포구 보건소 간호사가 합동 연구팀을 구성하여, 사업계획 수립 및 방문간호사들을 등기화시키기 위한 모임을 가졌고, 지역사회 지도자들 만나 연구 목적을 설명하여 정보수집을 위한 협조를 얻었다. 훈련된 공공근로 방문간호사 11명이 표준화된 도구를 이용하여 서울에 위치한 1개동 주민 총 1,499세대 4,024명에 대한 건강실태 및 건강관리요구조사를 하였으며, 자료수집도구로는 가족건강기록부, 연령별 건강력 조사지(임부, 산모, 신생아, 영유아, 성인용), 간이치매 사정도구(65세 이상), 및 방문간호서비스 요구 조사지가 이용되었다. 지역사회 내 가족 간호문제는 오마하 진단체계를 이용하여 빈곤, 주거환경 불량, 지지자원의 부족, 정서적 불안정, 부적절한 건강관리, 통증, 물질남용의 위험성 등의 간호진단이 도출되었다. 도출된 간호진단에 근거하여 건강교육, 건강증진 및 환경개선을 위한 프로그램을 제언하였다. 본 연구의 연구결과에 근거하여, 한국에서 지역사회주민의 건강요구를 규명하기 위해 오마하 분류체계를 이용하는 것은 적절한 것으로 판명되었다. The advancement of medical science, improved economic status, demographic transition, and changes in disease patterns have changed the expectations and demands of health and quality of life of people. Health promotion and prevention of illness are important aspects of public health. Provision of comprehensive health services tailored to the target community is required to many community health centers. The main purpose of this study was to test the feasibility of utilizing the OMAHA classification system to identify community health needs and health problems. The joint research team was organized by nurse educators and public health nurses at one community health center. From the beginning, frequent meetings were held to motivate public health nurses which was the key to success of this problem. A workshop for community leaders and stakeholders was held to gain cooperation for data collection. A survey of households was conducted to assess family and personal health history, and visiting nursing service needs. Trained eleven visiting nurses conducted data collection through home visiting. A total of 4,024 community residents from 1,449 households reside in one district of Seoul participated in the survey. Instruments used for the study include family health record, health history record for each age group, and requests for specific visiting nurses service. Using OMAHA system, seven community diagnosis were drawn. They were poverty, poor living conditions, lack of community resources, emotional instability, inappropriate management of health problems, pain, and high risk of substance abuse. Based on the results of this study, it is appropriate to use OMAHA classification system in identifying community health needs in Korea.

산후조리원의 모자건강관리 현황과 제도화방안 - 지역사회중심의 모자건강관리센터(TMIC) 개발을 위한 전략 -

유은광,안영미 한국간호과학회 2001 Journal of Korean Academy of Nursing Vol.5 No.1

The purpose of this study was 1) analyze the current state of Sanhojoriwon; and 2) to suggest the new model for the community based mother infants health care delivery system: strategies of TMIC are related to Public Health policy, cost-effectiveness, mother infant care provision of medical professionalism, and so on. Method: Forty-seven workers from seventeen Sanhojoriwon participated to analyze several aspects of Sanhojoriwon. Using a questionnaire developed at Korean Sanhojori Research Forum (KSARF), such as the traditional and medical concept of the Sanhojori, postpartum care, Korean traditional postpartum care, job description on women and infant care at Sanhojoriwon, professional management, health care policy and the educational need. Results: Based on the descriptive study results, the TMIC, the community based transitional mother infants care center was suggested as a new model for the cyclic public health care system related on the reproductive health, using an already existing related center, Sanhojoriwon. Also, several strategies were presented on the TMIC.

지역사회 건강증진 간호활동의 프로그램 개발

박정희,Park, Jeong-Hee 한국지역사회간호학회 1999 지역사회간호학회지 Vol.10 No.2

Health promotion has come to the fore through new concept approach in consequence of the increase of chronic diseases. increase of medical cost and social trend of putting more emphasis on the individual responsibility for health. Studies of health promotion can be classified into two types: one is micro intervention method which is mainly focused on modifying individual life style and the other. macro intervention method in which they put another emphasis on the environment the individual is surrounded. in addition to modifying individual life style. This study belongs to the later. This study aims to develop nursing activities and program it for the purpose of community health promotion. The process of the study can be briefed as follows: to draw out nursing contents to intervene for community health promotion: to promote community health to develop nursing action indicators; to develop nursing action indicators for the development of main nursing activities. And those developed nursing activities are programmed systematically. The community health promotion program is composed of a hierarchical structure with nursing process that the nurses are supposed to apply to perform professional nursing. the level of nursing perform. the main items of nursing process. health promotion nursing indicators. health promotion nursing activities. The conclusion of this study according to objectives are as follows. First. community health promotion contents at individual and community level are remained revised and complemented and those at organizational level are developed. The developed main contents of community health promotion nursing are as follows. 1) Revised individual level nursing contents: 35 items. 2) Developed organizational level nursing contents: 24 items. 3) Revised community level nursing contents: 36 items. Second. for the development of the health promotion nursing action indicators. principles were set up and applied as follows. 1. Developed indicators should be provided with such qualities as comprehensiveness. diversity. developability, availability. practicability. 2. Developed indicators should be provided with functional abilities to measure the conditions and changes in any phenomena or state. inspect the development of the states. control the implementing program. evaluate the result of program and grasp what nurses should do. 3. Developed indicators should be provided with relevance and sequence. 4. Developed indicators should be undergo inspections from the expert. The developed community health promotion action indicators developed in this study. observing above mentioned principles. are total 330 indicators of 95 items. Third. when the main nursing activities were developed for each nursing action indicator. five priciples were set up in accordance with each nursing action indicators to decide main nursing activities. Main nursing activities developed observing those principles. are total 1273. Forth. for the programming of the developed nursing activities. three principles were set up. 1. The nursing activities are systematized in line with (nursing process) (nursing client) (key items of nursing process) (nursing action indicators for health promotion) (nursing activities). 2. The program is constructed in downward and hierarchical order. 3. The program is constructed not in relation to same level activities but in relation to high and low level activities. The process step of programming of developed main health promotion nursing activities are; Step 1. The Developed nursing action indicators are classified into nursing process. Step 2. The main nursing activities are allocated per each nursing action indicators. Step 3. The statement of main nursing activities are inspected. Step 4. The items of main nursing activities allocated by a certain nursing action indicators are sequenced. taking into consideration the elaborateness of activity. the sequency of activity. familiarity of activity. the difficulty of

산후조리원의 모자건강관리 현황과 제도화방안

유은광(Yoo Eun-Kwang),안영미(Ahn Young-Mee) 한국간호과학회 2001 Journal of Korean Academy of Nursing Vol.31 No.5

학령전기 아동을 위한 사회학습이론 기반 눈건강프로그램의 개발과 효과

이성화(Lee, Sunghwa),이해정(Lee, Haejung),서형식(Seo, Hyungsik),정재호(Jung, Jaeho) 한국간호과학회 2018 Journal of Korean Academy of Nursing Vol.48 No.4

건강형평성 보장을 위한 지역간 보건의료인력 수급 불균형 해소 방향 : 간호사를 중심으로

박소영 한국인문사회질학회 2023 사회적질연구 Vol.7 No.2

The purpose of this study is to classify types of imbalance among nurses through an analysis of the status of health and medical resources by regions, which is a major factor in terms of ensuring health equity, and to suggest solutions for each type of imbalance. To this end, the study analyzed the numbers of medical institutions and beds, of nurses working in medical institutions (nurse demand), of nursing college graduates, and of available nurses (nurse supply) by regions. Solutions based on the analysis results were sought and the study found that among the regions that promoted a policy to secure regional nurses through the supply of nurses, the policy was most effective in such regions as Gyeonggi, Incheon, Ulsan, and Sejong. However, these regions have also been the ones with the lowest ratio of nurse enrollment quota increase over the past 10 years. Through this, it was confirmed that the policy to increase the admission quota of regional nursing colleges alone is not effective when it comes to securing regional nurses. Instead, it is necessary to prepare a plan to secure regional nurses by classifying areas into four different areas as follows; first, areas where an increase in the number of nursing college admissions and medical institutions is required, second, areas that require plans to utilize idle nurses, third, areas that needs to have more medical institutions with more than 300 beds, and lastly, areas that improvement in working conditions at medical institutions is required. This is how we can ensure equity in health across regions.