건강장애 이해 프로그램이 건강장애 학생에 대한 일반 초등학생의 태도에 미치는 영향

강윤정 ( Yoon Jung Kang ),한경임 ( Kyung Im Han ) 한국특수아동학회 2014 특수아동교육연구 Vol.16 No.3

본 연구는 건강장애 이해 프로그램이 건강장애학생에 관한 일반 초등학생의 태도에 미치는 영향을 분석하는 것이다. 연구 대상은 경남 C시의 N초등학교 5학년 4개 학급으로 건강장애 학생이 소속되지 않았으며 11-12세 사이의 동일연령 집단이다. 실험집단은 52명, 통제집단은 51명이었으며, 실험집단에만 건강장애 이해 프로그램을 주당 1회, 40분, 4차시에 걸쳐 실시하였다. 연구결과, 첫째, 건강장애 이해 프로그램은 실험 집단 여학생의 건강장애 학생에 대한 전체적 태도 변화에 긍정적인 영향을 주었다. 둘째, 건강장애 이해 프로그램은 일반초등학생의 건강장애 학생에 대한 정서적 태도변화에 영향을 주지 못하였다. 셋째, 건강장애 이해 프로그램은 일반 초등학생의 건강장애 학생에 대한 인지적 태도변화에 영향을 주지 못하였다. 넷째, 건강장애 이해 프로그램은 실험집단 여학생의 건강장애 학생에 대한 행동적 태도 변화에 긍정적인 영향을 주었다. The purpose of this study was to analyze the effect of health impairment understanding program on the attitude of elementary students toward the health impairments. The participants of 4 classes in the 5th grade were divided into the experimental group and the control group. Health impairment understanding program was constructed through interview with students with health impairments and their mothers, two special education teachers. This program was composed of understanding about health impairment, e-NIE activity, screen meeting with a student with health impairments, and quiz contest about health impairment. To investigate the attitude change of elementary students` attitude toward the students with health impairments through this program, the questionnaire on the emotional, cognitive, and behavioral attitude about the health impairment with Likert 5 scale was used. The results of this study were as follows:First, the health impairment understanding program, girl students in the experimental group showed positive change on the whole attitude toward students with health impairments. Second, the health impairment understanding program hadn``t positive effect on the emotional attitude toward students with health impairments. Third, the health impairment understanding program hadn``t positive effect on the cognitive attitude toward the health impairments. Finally, through the health impairment understanding program, only students in th experimental group showed positive change on the behavioral attitude toward the health impairments. In conclusion, this program was effective to the change of the behavioral attitude of girl students toward the health impairment.

건강장애 학생의 학교생활 적응 및 교육 실태

류신희,김정연 한국지체.중복.건강장애교육학회 2008 지체.중복.건강장애연구 Vol.51 No.4

The purpose of this study is to provide the basic data for the adjustment to school life of children with health impairment with researching the degrees of requirement and satisfaction on the school reentry support as well as the education and life status of them. The target of this study is 62 parents of children with health impairment living in Gwangju and Jeolla Nam Do. The data analysis was performed the statistical analysis with SPSS program ver.13.0 and the attentional level was set 5%. For the collected questionnaires, it was calculated to frequency and reaction percentage and the case percentage in case of multiple answers. And they were categorized by the similar themes so performed the relative analysis among sub-variables on the requirement of the school reentry program. The results of this study is as follow: First, medical staffs of children with health impairment sufficiently provided the information on their health status and medical treatments and encouraged them to reenter their school after the treatments. However, they hardly shared the information with children's teachers. Therefore, it is necessary to improve the effective communication between medical staffs and teachers. Second, although there are many children with health impairment who answered 'getting along with all friends' in their companionship, actually there are quite a lot of children who answered that they played alone or had just 1 or 2 friends. The reason of the hard companionship was mostly they had trouble in being in touch with other friends. It means that it is very important to encourage them to keep in touch with their friends. Also there is the opinion that other peers do not understand the diseases of children with health impairment. Therefore, it is necessary of the education of understanding their friends with health impairment for peers when their school reentry. Third, in the relations between children with health impairment and their teachers, it is shown a lot that the teachers were merely acquainted with children's diseases. Therefore, the teachers need to communicate actively on children's health status with medical staffs and be educated for understanding the children with health impairment when their school reentry. Additionally, in the teachers' expectancies for the children, they need to properly expect the children's academic achievements or activities instead of having the prejudice on their diseases. Forth, it is shown that children with health impairment were not provided properly the necessary education in their general school life. Therefore, it is urgently necessary to figure for and support the educational service for them. In addition, it is shown that it is mostly negative for the preparation of the first aids and the medical necessity of schools, so it means that it is necessary for the preparation for the first aids and the medical necessity of schools for children as well as the health care offices and the guidance offices. Fifth, the most difficult subjects for children who took health impairments to take are mathematics, physical education, and the most difficult subjects for them to participate in were experience activities for 1 night and 2 days, field trips and physical education. The reasons are the limitation of physical activities, lack of time of learning and decline of intuitive ability. Therefore, it is necessary the individual teaching and educational counter plan to support their curricular learning and school life. 본 연구는 건강장애학생의 학교생활적응 과정에 대한 부모의 인식을 바탕으로 장차 건강장애 학생의 성공적인 학교적응을 위한 다양한 교육적 서비스 방안들을 모색하는데 그 목적이 있다. 연구방법으로는 현재 광주광역시와 전라남도에 거주하고 있는 건강장애학생의 부모(N=50)를 대상으로 하였으며, 조사도구로는 설문지를 사용하였다. 본 연구를 통하여 얻은 몇 가지 중요한 결과는 다음과 같다. 첫째, 건강장애 학생의 담당 의료진은 학생의 건강상태와 치료에 대한 정보를 대체로 충분히 제공하고 있었고, 건강장애 학생이 치료 후 학교에 복귀하도록 용기를 주고 있는 것으로 나타났다. 그러나 소속 학교 교사와 의료진의 정보 공유 정도에 있어서는 부정적인 것으로 나타나 의료진과 교사와의 효과적인 의사소통 증진을 위한 노력이 필요함을 알 수 있었다. 둘째, 또래 관계에 있어서는 장기입원 등으로 인한 또래 접촉이 부족하며 질병에 대한 또래의 인식이 부족한 것으로 나타났다. 셋째, 교사와의 관계에서는 상호의견을 교환하거나 건강장애에 대해 가지고 있는 인식 정도, 교사에 대한 기대수준 등이 대체로 평균 이상인 것으로 나타났다. 논의 및 결론에서는 건강장애 학생의 학교생활 적응 및 교육 실태와 관련하여 현장에서 반영되어야 할 몇 가지 시사점을 제공하였다. 넷째, 교과 학습 면에서는 입원 중 받은 교육 형태는 병원학교, 사이버 교육, 자원봉사자에 의한 개별교육의 순으로 나타났으며, 발병 후 수학, 체육 교과 등의 수업 참여에 어려움이 많은 것으로 나타나 이에 대해 교과 학습과 학교 활동을 지원하기 위한 개별지도 및 교육대책이 필요함을 알 수 있었다. 다섯째, 학교생활 면에서는 필요한 교육이 적절하게 제공되지 못하고 있어 건강장애 학생의 교육서비스에 대한 보완 및 대책이 시급함을 알 수 있었다. 학교생활의 어려움으로는 신체적인 피로와 통증, 낮은 학업성취 순으로 나타나 기존의 병원학교 프로그램이 보다 학업을 강조하는 쪽으로 보완되어야 할 것으로 조사되었다. 또한, 학생의 의료적 욕구나 응급처치에 대한 학교의 준비가 필요하고 이를 지원할 보건실이나 상담실이 필요함을 알 수 있었다.

시각장애인의 건강문해력에 관한 체계적 문헌고찰

이한빈,박소연,라호준,전보영,한은아 한국보건경제정책학회 2022 보건경제와 정책연구 Vol.28 No.3

Health literacy is a critical factor of health outcomes, especially for persons who have visual impairments. Individuals with visual impairments have more health problems than the general public, which is linked to health knowledge disparities. The purpose of this study is to identify health literacy levels and influencing factors through systematic review for the visually impaired people, and to derive methods to improve health literacy and health management for the people who have visual impairments. The analysis was conducted for research papers published from 2000 to December 2021 in domestic database (KoreaMed, KMbase, RISS, KERIs) and foreign database (PubMed, Cochrane Library, Embase). The searched papers were first excluded by title and abstract, and secondary exclusion was made after full text verification. As a result of the analysis, eight papers were finally selected for the health literacy of the visually impaired. The selected papers evaluated the quality using ROBANS, risk of bias assessment tool for non-randomized studies. As for the quality of the literature, the risk of bias was confirmed as 4 ‘low’ and 4 ‘high’ cases. People with visual impairment had lower health literacy than non-disabled people and were less likely to follow health care recommendations (disease prevention, medication compliance, disease perception, etc.). When people who are visually handicapped and health professional were educated, access to information for the visually impaired people increased, and health literacy improved. And to improve health literacy of visually impaired, the ability to obtain health information, the attitude of medical service providers, the interaction and operation method with medical service providers, and information sources were important. Considering the effect of health literacy on health and quality of life, the results of this study showed that the health literacy of the visually impaired was lower than that of the non-disabled. This shows that it is important to understand the factors that interrupt with health literacy of visually impairments. In addition, it is necessary to improve the health literacy of the visual impaired people, and it is necessary to develop a health literacy test tool suitable for the people who are visually impaired to identify the level of health literacy and prepare a way to access more health information.

65세 이상 노인의 인지장애 경험 관련 요인 및 건강관리 행태: 2019년 지역사회건강조사를 이용하여

김지온 ( Jion Kim ) 대한보건협회 2021 대한보건연구 Vol.47 No.4

연구목적 : 본 연구의 목적은 65세 이상 노인 중 인지장애를 경험한 노인들을 대상으로 인구사회학적 및 건강관련 요인을 파악하고, 건강관리 행태를 분석하기 위한 것이다. 연구방법 : 본 연구는 2019년 지역사회건강조사 자료의 65세 이상 노인 74,231명을 대상으로 정상군, 일상생활가능 인지장애 경험군, 일상생활장애 인지장애 경험군으로 분류하여, 인구사회학적 특성 및 건강상태, 건강관리 행태별 차이를 분석하고, 인지장애 관련 요인을 파악하기 위하여 다항 로지스틱 회귀분석을 실시하였다. 연구결과 : 일상생활장애 인지장애 경험에 관련된 요인으로 여성(OR=1.12), 나이가 많을수록(OR=1.07), 동지역 거주(OR=1.04), 주관적 건강수준이 나쁜 경우(OR=3.20), 우울 증상이 있는 경우(OR=3.13), 스트레스가 있는 경우(OR=1.42)에 경험이 높은 것으로 나타났으며(p<.01), 고등교육(OR=0.81), 가구균등화소득 5분위(OR=0.91), 경제활동자(OR=0.73), 유배우자(OR=0.78), 독거자(OR=0.83), 삶의 만족도 지수가 높을수록(OR=0.84) 경험이 낮은 것으로 나타났다((p<.01). 인지장애 경험자의 건강관련 삶의 질(EQ-5D) 및 건강상태, 건강관리 행태는 정상군보다 나쁜 것으로 나타났다(p<.01). 결론 : 여성, 높은 연령, 낮은 교육수준과 소득수준, 낮은 주관적 건강수준과 삶의 만족도, 우울증상과 스트레스가 있는 인지장애 경험자에 대한 건강증진 프로그램 등의 정책적 지원이 요구된다. Purpose : This study aimed to identify demographic and health-related factors and analyze the health care behaviors of elders aged 65 years or older who have experienced cognitive impairment. Methods : This study classified 74,231 elders aged 65 years or older from the 2019 Community Health Survey into normal group, cognitive impairment experience group capable of performing daily living, and cognitive impairment experience group with poor daily life performance. Multinomial logistic regression analysis was performed to analyze the differences between demographic characteristics, health status, and health care behavior, and to identify factors related to the experience of cognitive impairment. Results : Factors related to the experience of cognitive impairment with poor daily life performance showed increasing experience(p<.01) with women(OR=1.12), increasing age(OR=1.07), urban residence(OR=1.04), poor subjective health level(OR=3.20), depressive symptoms(OR=3.13), and stress(OR=1.42). The experience decreased(p<.01) with higher education(OR=0.81), fifth quintile of equivalized household income (OR=0.91), economic activity(OR=0.73), spouse(OR=0.78), living alone(OR=0.83), and high life satisfaction index(OR=0.84). The health-related quality of life(EQ-5D), health status, and health care behavior of those who experienced cognitive impairment were worse than those of the normal group(p<.01). Conclusions : Policy support is needed, such as health promotion programs for women, the elderly, low education, low-income levels, poor subjective health and life satisfaction, and those who experience depressive symptoms and stressful cognitive impairment.

Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016)

Goun Park,Wankyo Chung 한국역학회 2021 Epidemiology and Health Vol.43 No.-

OBJECTIVES: Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably. METHODS: This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status. RESULTS: For cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2). CONCLUSIONS: Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.

도시지역 저소득층 노인의 우울, 지각된 건강상태, 주관적 기억장애와의 관계

송이철 ( Yi Chol Song ) 이화간호과학연구소 2018 Health & Nursing Vol.30 No.2

Purpose: This descriptive correlation study aimed to identify the relation among the depression, perceived health status, and subjective memory impairment of urban low-income old adults. Method: Data were collected from 243 elders living in a metropolitan city, Korea by a structured questionnaire consisting of Korean- Memory Complaint Scale-A, Geriatric Depression Scale Short Form-Korea Version, and Health Status Selfappraisal Tool. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Scheffe post hoc, and Pearson's correlation coefficient. Result: The average score of subjective memory impairment was 4.89, 77.4% of subjects showed higher than mild memory complaint scale. There were significant differences in subjective memory impairment with gender (t=-4.78, p<.001), education level (F=6.78, p<.001), regular exercise (t=-3.84, p=.005) among other characteristics. There were significantly negative correlations between perceived health status and depression (r=-.58, p<.001). There were significantly negative correlations between subjective memory impairment and perceived health status (r=-0.51, p<.001). but positive correlations with depression (r=0.46, p<001). Conclusion: Based on this result, it is necessary to develop the nursing invention and substantial education program for subjective memory impairment which can predict the mild cognitive impairment and dementia. Additionally, various programs developed in view of the depression and the perceived health status, can reduce the subjective memory impairment.

시각중복장애학생 어머니의 내재적 요인이 건강관련 삶의 질에 미치는 영향

정지훈,이해균,박중휘 한국시각장애교육&재활학회 2012 시각장애연구 Vol.28 No.3

The purpose of this study is to investigate the influences of internal factors (communication method, problematic behavior, functional level, parenting burden in mothers) related to visual impairment and multiple disabilities on the mothers’ health-related quality of life, to provide basic data required for establishment of governmental support plans for the mothers of Visual Impairment students with multiple disabilities. The 146 mothers of students with visual impairment and multiple disabilities attended to 12 visual impairment schools and three living facilities for visually disabled individuals with multiple disabilities were selected as subjects of this study. Conclusions according to the results of this study are as follows. The health-related quality of life on the mothers of students with visual impairment and multiple disabilities is not affected much by internal factors such as communication method, functional level, treatment assistance service, life assistance service, and occupational assistance service of students and marital status of mothers. But it is influenced by parenting burden on the mothers of visual impairment students with multiple disabilities. The parenting burden of mothers is shown the differences across the groups on social capability, emotional limitation, psychological health, vitality, pain, and overall health awareness among sub domains of quality of life. Therefore the parenting burden of mothers have the effect on the mothers’ health-related quality of life, specially on the social capability, emotional limitation, psychological health, vitality, pain, and overall health awareness. 본 연구의 목적은 시각중복장애학생의 의사소통 방법, 문제행동, 기능 수준, 어머니의 양육부담감 요인이 시각중복장애학생 어머니의 건강관련 삶의 질에 어떠한 영향을 미치는지를 알아봄으로써 시각중복장애학생 어머니의 건강관련 삶의 질 향상을 위한 지원 계획 수립과 부모교육 프로그램 개발에 필요한 기초자료를 제공하는데 있다. 본 연구는 전국 12개 시각장애학교와 3개 시각중복장애 생활시설의 재택 학급에 재학 중인 시각중복장애학생 어머니 146명을 대상으로 하였다. 연구 결과를 통해 얻은 결론은 시각중복장애학생 어머니의 건강관련 삶의 질은 내재적 요인 중 양육 부담감의 높고 낮음에 따라서만 차이가 있으며, 의사소통 방법, 문제행동, 기능수준에 있어서는 집단간 차이가 없다. 양육 부담감 변인은 건강관련 삶의 질에 대한 하위 영역 중 사회적 수행능력, 감정적 역할제한, 정신건강, 활력, 전반적인 건강인식 영역에서 차이가 있다. 따라서 양육부담감은 시각중복장애학생 어머니의 건강관련 삶의 질에 영향을 미치며, 특히 사회적 수행능력, 감정적 역할제한, 정신건강, 할력, 전반적인 건강인식 영역에 더 많은 영향을 미친다.

Mental Health of the People with Hearing Impairment in Korea: A Population-Based Cross-Sectional Study

신현영,황희진 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.2

Background: The prevalence of hearing impairment is increasing and an association between hearing impairment and mental health has been reported. Our study aimed to determine the association between hearing impairment and mental health in Korea.Methods: This was a cross-sectional study of data from the Korean National Health and Nutrition Examination Survey 2010–2013, with a sample size of 18,563 individuals (6,395 with hearing impairment and 12,168 without hearing impairment), aged ≥20 years.Results: The female group with hearing impairment tended to have a higher rate of stress (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.11 to 1.56). The association between hearing impairment and depressive symptoms was higher in elderly males (OR, 1.60; 95% CI, 1.10 to 2.32), while the association of hearing impairment with sui-cide ideation was higher in elderly females (OR, 1.32; 95% CI, 1.00 to 1.75).Conclusion: Elderly individuals with hearing impairment are easily susceptible to poor mental health status. Early targeted intervention to address mental health problems is recommended for people with hearing impairment.

델파이기법을 활용한 시각장애인 건강지표 개발

전혜원,호승희,양선영,김정국,김예순 한국시각장애교육&재활학회 2015 시각장애연구 Vol.31 No.3

Visual impairment is an important global public health problem, affected economic and educational opportunities, reduce quality of life and increase the risk of falls, accidents, depression, and mortality. The aim of the study was to develop the health indicators to identify the health needs and measure health status, compare with non-disabled people for people with visual impairment. For the development of health indicators, first of all `the development by social goal area', in the classification of social indicators system, was set to the theoretical model. Next we collected 51 preliminary indicators, using analysis of domestic and foreign health indicators for people with disability. literature review, the experts interview. And we 2-round Delphi online survey was conducted with 30 multidisciplinary experts to select indicators using structured questionnaires. Finally, there were developed 41 health indicators, composed of 4 concerns and 12 sub-concerns. Health indicators developed through this study is to determine the health status of people with visual impairment and expects to be utilized as the basis for policy making, such as health monitoring system for solving health disparities in future. 본 연구는 시각장애인의 건강 욕구를 파악하고, 건강수준을 측정할 뿐 아니라 장애가 없는 인구집단과의 비교가 가능한 지표를 개발하고자 하였다. 시각장애인을 위한 건강지표 개발을 위해 사회지표체계 분류 중 사회목적에 따른 지표개발을 이론적 모형으로 사례연구 및 문헌연구, 전문가 의견연구를 통해 예비지표를 구성하였고 델파이기법을 활용한 전문가조사를 거쳐 최종적으로 4개 영역, 12개 세부영역으로 구성된 41개 지표로 구성된 시각장애인 건강지표 선정(안)이 도출되었다. 본 연구를 통해 개발된 시각장애인 건강지표는 시각장애인의 건강수준을 파악하고 시각장애인의 건강권 확보와 보건 및 건강 증진을 위한 통계생산에 기여할 뿐 아니라 향후 시각장애인의 건강격차 해소를 위한 건강 감시체계 등과 같은 정책 수립의 기초로 활용될 것으로 사료된다.

건강장애 학생 또는 아동과 관련된 연구 방향성에 대한 검토

강종구,김영표 사단법인 인문사회과학기술융합학회 2016 예술인문사회융합멀티미디어논문지 Vol.6 No.9

This study attempted to explore the research direction regarding student or child with health impairment. For the purpose of this study, it collected documents published in domestic and international journals since 2010. According to the data collection process designed in this study, 14 domestic articles and 3 foreign articles were selected as the subjects of literature review. The result of literature review was as follow. First, the articles related to student or child with health impairment were dealt since 2014 more than the period from 2010 to 2013. Second, domestic articles generally tended to the education of students with health impairment, but foreign articles usually dealt with health of children with health impairment. This study shows that domestic studies need to extensively handle with various themes such as health problems that students with health impairment experience as well as educational difficulties that students with health impairment experience. 본 연구는 건강장애를 가진 학생 또는 아동에 대한 연구 방향성을 검토하고자 하는 연구이다. 이를 위해 국내학술지와 국제학술지에 2010년 이후 발표된 문헌들을 수집하였다. 본 연구에서 설정한 문헌 수집 절차에 따라 문헌들을 선정한 결과 국내 논문 14편, 외국 논문 3편이 문헌검토 대상으로 선정되었다. 문헌 검토 결과는 다음과 같다. 첫째 건강장애 학생 또는 아동과 관련된 논문들은 2010년부터 2013년까지의 기간보다는 2014년 이후에 보다 많이 다루어지고 있음을 알 수 있었다. 둘째 국내 논문들의 경우 건강장애를 가진 학생의 교육을 주로 다루는 경향이 있지만, 외국 논문들의 경우 건강장애를 가진 아동의 건강을 주로 다루고 있음을 알 수 있었다. 본 연구는 국내 연구들은 건강장애 학생들이 경험하는 교육적 어려움뿐만 아니라 건강장애 학생들이 경험하는 건강 문제 등 다양한 주제들에 대하여서도 폭넓게 다룰 필요가 있음을 보여주고 있다.