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.

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

정다혜(JEONG Dahye) 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.

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.

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 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.

보건소 종사자의 직무만족에 영향을 주는 요인

이아름,박진경,김경란,이도영 사단법인 인문사회과학기술융합학회 2015 예술인문사회융합멀티미디어논문지 Vol.5 No.4

The purpose of this study was to identify factors influencing job satisfaction in community health workers. The focus was on emotional labor and job stress. We surveyed 211 community health workers using structured questionnaires from March through April, 2014. Data analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression with the SPSS/Win 19.0 program. Significantly differences in job satisfaction score were observed according to gender(p= .028), age(p= .016), income(p< .001), work duration(p= .001), employment type(p= .001) and personality type(p= .005). Emotional labor showed a negative correlation with job satisfaction (r=-0.141). job stress showed a negative correlation with job satisfaction (r=-0.216). The factors influencing job satisfaction were gender (β= 0.218, p= .002), income (β=0.270, p= .001) and job stress(β=-0.290, p= .001). The associated factors identified in this study significantly explained 22.5% of job satisfaction. The findings of this study indicate a need to develop strategies to prevent and control job stress in order to increase job satisfaction for community health workers. 본 연구의 목적은 보건소 종사자의 직무만족도와 관련요인을 확인하는 것으로 이와 관련된 주요 변수는 감정노동과 직무스트레스이다. 보건소 종사자 211명을 대상으로 구조화된 설문을 통해 2014년 3월부터 4월까지 수집된 자료를 SPSS/Win 19.0프로그램을 통해 기술통계, t-test, ANOVA, 상관관계분석, 다중회귀분석을 하였다. 그 결과 대상자 특성에 따른 직무만족도 차이는 성별 (p= .028), 연령 (p= .016), 소득 (p< .001), 근무 시간 (p= .001), 고용 형태 (p= .001), 성격 유형 (p= .005)으로 확인되었다. 감정 노동은 직무만족도와 음의 상관관계를 보였고(R=-0.141), 직무스트레스는 직무만족도와 음의 상관관계를 보였다(R=-0.216). 직업 만족도에 영향을 미치는 요인은 성별(β= 0.218, p= .002), 소득 (β= 0.270, p= .001)과 직무스트레스 (β=-0.290, p= .001)로 확인되었고, 이 요인들은 직무만족도를 22.5 %를 설명하고 있다. 따라서 보건소 종사자의 직무만족도를 높이기 위하여 직무스트레스를 예방하고 관리하는 노력이 필요하다.

정신건강증진센터 종사자의 감정노동과 직무스트레스가 직무소진에 미치는 영향

조선미(Cho, Seon Mi),정춘화(Jung Chun Hwa) 학습자중심교과교육학회 2018 학습자중심교과교육연구 Vol.18 No.11

본 연구는 정신건강증진센터 종사자의 감정노동과 직무스트레스가 직무소진에 미치는 영향을 파악하는 서술적 조사연구이다. 자료수집은 37개 정신건강증진센터 종사자 236명을 대상으로 2015년 10월 1일~10월 15일까지 실시하였다. 자료분석은 SPSS 18.0 프로그램을 이용하여 평균 및 표준편차, t-test, ANOVA, pearson correlation, multiple regression으로 분석하였다. 연구결과는 감정노동과 직무스트레스는 정적 상관관계, 직무스트레스와 직무소진은 정적 상관관계를 나타났다. 직무소진에 영향을 미치는 요인은 직무스트레스, 현재근무경력, 연령이었으며 설명력은 52.1%이었다. 결론적으로 정신건강증진센터 종사자의 직무소진을 예방하기 위해서는 직무스트레스, 현재근무경력, 연령을 고려한 체계적인 전략과 대책이 필요함을 시사한다. The purpose of this study was to investigate the effect of emotional labor and job stress on job burnout in community mental health promotion center workers. Data collection was conducted from October 1, 2015 to October 15 in 236 community mental health promotion centers. Data were analyzed using mean and standard deviation, t-test, ANOVA, Pearson correlation and multiple regression using SPSS 18.0 program. Results showed that emotional labor and job stress were statistically correlated, and job stress and job burnout were statistically correlated. Factors influencing job burnout were job stress, current job experience, and age, and explanatory power was 52.1%. In conclusion, job stress was the factor affecting job burnout of community mental health promotion center workers. It is suggested that systematic strategies and countermeasures in consideration of job stress, current work experience, and age are very necessary to prevent job burnout of workers in community mental health promotion center.