주민참여로 마을의 건강을: 1970-80년대 마을건강원 활동과 보건의료에서의 주민참여 논쟁

정다혜 대한의사학회 2022 醫史學 Vol.31 No.3

This paper aims to historically re-evaluate the issues surrounding resident participation in health care and its legacy by examining the community participation in health care. In the 1970s and 1980s, community participation was one of crucial trends and a controversial topic in the international health as well as the international aid. Throughout the 1970s, local participation was regarded as one of essential elements for the access to basic healthcare and primary health care in developing countries. Community health projects which aimed to apply primary health care were implemented in rural areas and some urban areas in the 1970s and 1980s. Village Health Workers(VHWs) were a symbolic example of community participation in these projects. They consisted of local women and led health activities with simple skills in their villages. They served as a bridge between the project team and the residents. Health professionals expected them to be health leaders for “self-help” in health of their communities. In the mid-1980s, however, as the number of health facilities and professional health care workers increased, the activities of VHSs were decreased. The mixed understanding of the responsibilities and roles of VHSs among the health professionals affected the skeptical view on the achievement and effects of community participation in health care. In the mid-1980s, as the government officially organized the VHWs, the dilemma surrounding community participation intensified. When the community health projects were ended, most of the VHW organizations were also disbanded. After the projects, the spirit of community participation was only inherited by some healthcare movement organizations, such as medical cooperatives.

Tasks to Establish the Role of Hospice and Palliative Care Social Workers in Community Care

Wonchul Kim,Sungkyu Lee,Junhee Jeon 한국호스피스완화의료학회 2025 Journal of Hospice and Palliative Care Vol.28 No.1

In 2018, the South Korean government launched a community care policy aimed at providing more extensive social services for older adults, the disabled, and mental health patients. This policy also included an expansion of home-based hospice services in response to the growing demand for hospice and palliative care. Despite these initiatives, social workers play a limited role in home-based hospice care, and those specializing in hospice and palliative care are not yet fully equipped to provide effective community care services. This study investigated both domestic and international research trends to identify key tasks for defining the roles of hospice and palliative care social workers within community care. It also examined how these social workers perceive community care. The findings suggest that previous research has called for a more precise definition of the roles of hospice and palliative care social workers. It is particularly critical to address the underutilization of social workers in home-based hospice care, which is essential for effective community care. The study also revealed that while hospice and palliative care workers recognize the necessity of community care, their understanding of the community resources needed for its implementation and their actual performance in delivering such care are lacking. Additionally, their appreciation of the importance of establishing discharge plans, which include home visits, assessments and improvements of the residential environment, and transportation arrangements, was found to be limited. They acknowledged the need to establish a community linkage system and develop an information system to effectively implement community care. To clearly establish the role of hospice and palliative care social workers in community care, several measures should be taken: First, the role and function of home-based hospice and palliative care workers need to be institutionally strengthened. Second, training focused on developing discharge plans for these social workers should be improved. Concurrently, priority in this training should be given to those workers who are at a higher risk of burnout. Third, the activation of regional hospice centers should be pursued to ensure a robust community linkage system and the implementation of a community information system.

Health Effects of Heavy Metal Exposure Among E-waste Workers and Community-dwelling Adults in Thailand: A Cross-sectional Study

Sangwijit Chonyitree,Ong-artborirak Parichat,Naksen Warangkana,Kallawicha Kraiwuth,Siewchaisakul Pallop 대한예방의학회 2025 예방의학회지 Vol.58 No.2

Objectives: Global concern is increasing about the health effects of electronic waste (e-waste). This study examines the health impacts of heavy metal (HM) exposure among e-waste workers (EWWs) and community-dwelling adults (CDAs) in Northeastern Thailand and identifies factors associated with adverse health outcomes.Methods: A cross-sectional study was conducted of 164 EWWs and 164 CDAs. A survey was employed to collect data on participant characteristics, symptoms, anxiety, depression, and sleep quality. Urine samples were analyzed for lead (Pb) and cadmium (Cd) levels using atomic absorption spectrometry. Multiple logistic regression analysis was used to identify factors impacting health.Results: Across all participants, urinary Pb and Cd levels ranged from 5.30 µg/g to 29.50 µg/g creatinine and from 0.60 µg/g to 4.00 µg/g creatinine, respectively. The most frequently reported health issues pertained to musculoskeletal disorders (MSDs) at 38.70%, central nervous system (CNS) issues at 36.60%, and skin disorders at 31.10%. Multivariable analysis indicated that the presence of MSDs was significantly associated with exposure to Pb and Cd. Poor sleep quality (PSQ) was significantly linked to CNS problems, while body mass index was significantly related to skin disorders. Factors including primary education level or below, smoking, cleaning the house more than 3 times weekly, and PSQ were significantly linked to depression. Anxiety was significantly associated with PSQ.Conclusions: Environmental exposure to Pb and Cd can have adverse health impacts in the form of MSDs. Depression and anxiety are common conditions among CDAs. Public health officials should monitor HM exposure and mental health within the community.

보건의료 주민참여의 정의와 전략에 대한 연구

김용익 ( Yong Ik Kim ) 한국보건행정학회 1992 보건행정학회지 Vol.2 No.2

Community involvement is to be the keystone of primary health care, Unfortunately, efforts to promote it failed in many countries. Author inquired into the reasons why such efforts fail, and the alternative strategies for effectively promoting it in Korean situation today. In doing so, the concept of community involvement is clarified as an amalgamation of two different con-cepts; one is that of the community development, and the other is that of approaches for over-coming the alienation of the people from the health care process. Stategies of community involvement in Korea so far followed the line of the community devel-opment, e.g. village health worker. It loses, however, the feasibility as Korea has experienced so-cial and economic developpment. The strategies of the second line of thought is now more feasible; empowering the people by providing more information and enhancing comitment to health, im-proving acceptabilty of community involvement on the part of the health professionals and the bureaucrats, and building the mechanism of community involvement into the health policy-making process.

병원에서 마을로 ― 거제 지역사회건강사업으로 본 1970년대 의료 소외지역의 지역보건 실험

정다혜 ( Jeong Dahye ) 한국사회사학회 2021 사회와 역사 Vol.- No.129

이 연구는 한국의 지역보건사업의 모태가 되는 ‘거제 지역사회건강사업’을 통해 지역보건사업의 성격을 역사적으로 해명하는 것을 목표로 한다. 거제 지역사회건강사업은 1960년대 말부터 지역주민의 요구를 바탕으로 약 10년간 실시된 의료선 교사 주도의 보건의료사업으로, 1970-80년대에 진행된 지역사회보건사업들의 시초이다. 본 사업은 기존의 병원 중심의 의료모델을 탈피하여 지역사회 중심의 보건 의료, 지역주민의 참여를 통한 건강개선을 강조하며 새로운 보건의료 모델을 실험하였다. 거제 지역사회건강사업은 1960년대 중반 이후 주목받고 있던 지역사회의 학을 적용한 것이었고, 마을건강사업을 비롯한 사업의 내용들은 1970년대 중반 이후의 정부 보건개발 정책 수립에도 영향을 주었다. 특히 지역 주민들이 보조 보건인력으로 사업에 참여하고 주민 주도로 마을의 건강상태를 개선하고자 시도한 것은 새로운 지역보건 모델로서 중요한 의미를 지니고 있었다. 그러나 사업 범위가 확대되고 정부 주도로 주체가 교체되는 과정에서 지역별 특수성과 지역주민의 이해관계는 오히려 장애 요소로 인식되었다. 행정적인 사업의 확대 과정에서 지역주민의 주체화는 큰 고려대상이 되지 못했다. 결과적으로 지역사회에 대한 이해와 지역주민 참여 문제는 거제 지역사회건강사업의 성과와 한계를 함께 보여주었다. This study elucidates the characteristics of community health programs from a historical perspective, focusing on the Koje Community Health and Development Project. A medical missionary group implemented the Koje Project to address the demands of village leaders living on Koje Island. The pilot project applied new healthcare approaches that focused on community-centered healthcare―primary health care and health improvement through community participation―instead of relying on the existing hospital-centered models. The project goals were developed in conversation with community medicine practices, and the goals’ impact went beyond the immediate community, influencing domestic and international spaces. Unlike previous healthcare policies, the degree of villagers’ involvement became the decisive factor of the project’s success. However, during the project’s expansion from a private to government-led model, its administrators regarded the village voices as obstructive. This reaction presents some of the limitations of villagers as active agents. The Koje Project illustrates the dilemma that community-centered health programs faced during project development and expansion. Understanding communities and their involvement are crucial factors that shed light on the possibilities and limitations of health and social welfare projects.

지역사회 정신건강서비스 기관 종사자의 직무외상 경험이 외상 후 성장에 미치는 영향

변유경(Yukyeong Byeon),이지하(Jieha Lee) 충남대학교 사회과학연구소 2018 사회과학연구 Vol.29 No.1

This study examined the effects of the traumatic job experience of community-based mental health service workers through the work on post-traumatic growth, in particular, to research the moderating effect of optimism and supervision on the relationship with traumatic job experience and post-traumatic growth. The participants of this study were 336 workers of a national community-based mental health service institution for the analysis of the materials. The results of this study are as follows. First, in terms of the traumatic job status, the community-based mental health service workers reported traumatic job experiences, such as the clients verbal and behavioral violence, clients suicide attempt and death, and etc. Second, the community-based mental health service workers reported greater pain at the time of the traumatic job incident, higher optimism, optimism, social support, supervision function. In addition, post-traumatic stress had a more significant effect on post-traumatic growth. Third, an examination of the traumatic job experience and optimism as well as the moderating effect of supervision function on post-traumatic growth revealed the moderating effect of the traumatic job experience and optimism, but the moderating effect of the traumatic job experience and supervision function was not significant. Based on this study, the efforts in the personal and organizational dimensions will be needed to promote the post-traumatic growth of community-based mental health service workers.

지역아동센터 종사자의 역할스트레스, 정서적 소진, 정신건강 간의 관련성 : 대전시 지역아동센터 종사자를 중심으로

박지선(Park, Ji-Sun),류한수(Ryu, Han-Su) 한국정치사회연구소 2021 한국과 국제사회 Vol.5 No.5

본 연구에서는 지역아동센터 종사자의 정서적 소진 및 정신건강 예방책을 마련하는데 필요한 기초자료를 확보하고자 SSO모델을 근거로 역할스트레스와 정서적 소진 및 정신건강의 관련성을 검증하였다. 대전지역의 지역아동센터 종사자를 대상으로 실시한 조사자료 중 140명의 자료를 활용하여 역할스트레스(Stress)→정서적 소진(Strain)→정신건강(Outcome)의 인과관계모형에 대해 구조방정식 모형으로 검증하였다. 그 결과, 연구모형의 적합도가 통계학적으로 유의미했으며 변수 간 관련성에 있어서도 역할스트레스가 정서적 소진을 통해 정신건강에 영향을 미치는 것으로 나타났다. 또한 역할과부하는 정신건강에 직접적인 영향을 미치는 것으로 나타났다. 이러한 결과를 토대로 정서적 소진과 정신건강에 영향을 주는 역할스트레스를 낮출 수 있는 지원방안을 논의하였다. This study, the relationship between role stress, emotional exhaustion, and mental health was verified based on the SSO model in order to secure basic data necessary to prepare preventive measures for emotional exhaustion and mental health of Community children s center workers. A survey of workers employed in a community children s center located in Daejeon, South Korea, was conducted, and a causal relationship model including the variables of role stress (Stress), emotional exhaustion (Strain), and mental health (Outcome) was tested by the structural equation model using the data from 140 respondents. In the analysis results, the research model’s goodness-of-fit was statistically significant. In an examination of the correlation among the variables, the role stress was proven to affect mental health through emotional exhaustion. Furthermore, role overload had a direct effect on mental health. Based on these results, this paper discussed various support plans to reduce role stress, which is an influential factor of emotional exhaustion and mental health.

지역사회 정신건강사회복지사의 생애경험에 관한 연구 - 직업적 삶을 중심으로

이미경 사회복지정책실천회 2023 사회복지정책과 실천 Vol.9 No.3

본 연구는 생애사 연구방법을 적용하여 정신건강사회복지사로서의 삶을살아온 개인의 삶을 반추해보고, 정신건강사회복지의 정책·제도·시대적 상황 등을 탐색하고자 한다. 또한 사회환경과 정신건강사회복지사 삶의 상호작용을 분석하고자 한다. Mandelbaum의 분석방법에 근거하여 분석한 연구결과는 첫째 삶의 영역은 “전문성의 확장”, “보건과 복지의 양면성”, “기울어진 실천현장”, “실천현장에서 살아남기”로 분석된다. 둘째, 전환점 영역은 “기회와 운”, “복지정체성 찾기”로 분석된다. 셋째, 적응영역은 “연대와 도전”으로 분석되었다. 연구결과에 근거하여 첫째, 정신건강사회복지사의 복지중심 실천 강화, 둘째, 정신건강증진시설 특히 정신건강복지 센터의 승진제한 구조의 해결, 셋째, 사회복지사의 정체성 강화를 위한 교육체계 마련, 넷째, 정신건강사회복지 실천현장의 연대 강화 등의 제언 및 함의를 제시하였다. This study applies life history research methods to reflect on the individual’s life as a mental health social worker and explores the policies, systems, and historical circumstances of mental health social welfare. This also aims to analyze the interaction between the social environment and the lives of mental health social workers. The research results analyzed based on Mandelbaum’s analysis method show that the first, ‘dimension of ​life’ is analyzed as “expansion of expertise,” “two sides of health and welfare,” “inclined practice field,” and “survival in the practice field.” Second, ‘turning point’ area is analyzed as “Opportunity and Luck” and “Finding Welfare Identity.” Third, ‘adaptation’ was analyzed as “solidarity and challenge.” Based on the research results, four implications were suggested: Reorganization the medical-centered delivery system into a welfare-centered delivery system; Resolution of the advancement opportunity in Mental Health Welfare Center; Establishment of an education system to strengthen the identity of social workers; Reinforcement solidarity in mental health social welfare practice sites

COVID-19 보건소 대응인력의 초과근무시간과 지각된 스트레스, 우울, 불안과의 관련성

송민주,김준희,김현수,김성환,박재홍 대한생물치료정신의학회 2023 생물치료정신의학 Vol.29 No.3

Objectives: This study aimed to examine the association between overtime hours and perceived stress, depression, and anxiety among coronavirus disease 2019 (COVID-19) community health workers. Methods: Self-report data were collected from 1,181 community health workers in Busan between 15 June and 2 July 2021. The data collected were analyzed using analysis of variance and logistic regression to examine how average weekly overtime hours affect perceived stress, depression, and anxiety. Results: The proportion of individuals who perceived a high degree of stress was higher in the groups with average weekly overtime of 5-10 hours (odds ratio [OR] 1.81, 95% confidence interval [CI] 1.09-3.01) and 10 or more hours (OR 2.26, 95% CI 1.33-3.82) than in the group with average weekly overtime of less than 5 hours. Among the groups with average weekly overtime of 5-10 hours and 10 or more hours, the proportion of individuals at a high risk of depression was OR 1.74 (95% CI 1.31-2.31) and OR 3.39 (95% CI 2.53-4.54), respectively. In the same two groups, the proportion of individuals at a high risk of anxiety was OR 1.75 (95% CI 1.31-2.33) and OR 3.34 (95% CI 2.51-4.46), respectively. Conclusions: This study shows that perceived stress, depression, and anxiety levels significantly increase as average weekly overtime hours increase among COVID-19 community health workers.

지역아동센터 종사자의 아동정신건강 인식 연구: ADHD 관련 인식을 중심으로

배은경,최인숙 한국정서행동장애학회 2016 정서ㆍ행동장애연구 Vol.32 No.3

The purposes of this study were to examine the community child Center workers’ child guidance and their perception of ADHD and education for supporting children’s mental health, and to analyze the difference between the group with and without education for supporting children’s mental health. Data were collected using a convenience cluster sampling method from 157 community child center workers from Gwangju. The results are as follows. First, most of workers thought the attention deficit behavior and the lack of emotional control as problem behaviors in need of help. Second, around half of them considered ADHD as illness. They also felt not enough knowledge about ADHD or treatments for it. Third, although half of workers had experience in education for supporting children’s mental health, most education programs they participated in were the lecture type without role-play on the contrary to their demand. Forth, the group of workers with training education perceived drug treatment for ADHD more positively and teaching children with ADHD more competently than those without education. Implications for training education for supporting children’s mental health have been discussed. 본 연구의 목적은 지역아동센터 종사자의 아동지도, ADHD, 아동정신건강지원교육 등에 관한 인식을 살펴보고, 아동정신건강지원교육 경험여부에 따른 차이를 분석함에 있다. 이를 기반으로 지역아동센터 종사자를 대상으로 욕구에 기반한 아동정신건강교육 프로그램을 개발, 실행하기 위한 기초자료를 마련하고자 한다. 이를 위하여 G광역시 지역아동센터 종사자를 대상으로 수집한 157부의 자료를 분석하였다. 연구결과 첫째, 연구참여자들이 도움이 필요하다고 인식하는 아동문제행동은 주의산만, 감정조절, 이해할 수 없는 행동 등의 순으로 나타났다. 둘째, 연구참여자의 절반 가량이 주의가 산만하고 활동량이 과다하게 많은 증상을 병이라고 인식하고 있었고, 대부분은 이러한 아동을 위한 특별한 개입의 필요성을 인식하고 있는 것으로 나타났다. 셋째, 아동정신건강지원교육 참여경험은 대부분 실연 없는 강의로 진행되어 ‘직접적인 교사역할 훈련’을 지속적으로 받기를 선호하는 연구참여자의 욕구와는 차이가 있는 것으로 나타났다. 넷째, 아동정신건강교육 참여경험이 있는 연구참여자는 교육경험이 없는 연구참여자에 비해 ADHD 약물치료와 ADHD 성향 아동 지도에 대해 긍정적으로 인식하고, ADHD 지식 중 증상 및 진단 지식에 있어 정답률이 더 높은 것으로 나타났다. 연구결과를 바탕으로 지역아동센터 종사자의 욕구에 기반하여 아동정신건강지원교육을 개발하기 위한 제언을 하고자 하였다.