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姜福秀 慶北大學校 醫科大學 1980 慶北醫大誌 Vol.21 No.1
慶北 軍威部에 勤務하는 保健診療員 5名과 保健診療補助員 8名을 對象으로 1979年 12月 3日부터 8日까지 6日間 直接觀察法으로 調査한 勤務時間 活用實態의 成績을 要約하면 다음과 같다. 1. 機能別 時間配分實態에서 직접 保健奉壬를 提供하는 技術業務에 消費된 時間은 保健診療員 및 保健診療補助員이 각각 45.1% 및 30.5%로 나타났고, 行政業務는 9.8%와 7.3%, 補助 및 支援業務는 19.2%와 22.0%, 交通時間이 2.6% 및 13.8%, 그리고 기타 活動에 消費된 時間이 23.3% 및 26.4%로 各各 配分되었다. 2. 써비스 內容別 時間 配分狀態에서 保健診療員은 86.3%에 해당되는 많은 시간을 患者 診療에 소비했고, 保健診療補助員은 家族計劃事業에 40.3%의 많은 시간이 配分되었고, 患者診療 補助業務에 26.3%의 시간을 소비하였다. 患者診療의 경우 投藥 및 處置가 77.2%를 차지하여 대부분의 保健要員들이 적절한 診察이나 體溫 및 血壓등의 測定을 實施하지 않고 問診에 의한 處方과 處置가 施行되고 있는 것으로 나타났다. 母子保健事業에 있어서는 産前管理나 영유아보건을 위한 영유등록 및 身體計測에 配分된 시간이 극히 적고 주로 健康相談에 대부분의 시간이 消費되었다. 3. 써비스 1件當 所要時間은 保健診療員은 12分이 所要되었고, 保健診療補助員은 15.3分으로 나타났다. 保健診療員의 患者 1人當 診療 所要時間은 11分으로 나타났다. 4. 活動場所에 따른 勤勞時間 配分實態는 支所內勤務가 保健診療員은 89.4%, 保健診療補助員은 61.6%로 割當되었다. 支所內 活動中 保健診療員은 技術業務가 47.6%로 제일 높았으며, 保健診療補助員은 補助 및 支援業務가 30.7%, 기타 活動時間이 34.4%로 各各 配分되었다. 支所外 活動中 保健診療員은 保健奉壬에 할애된 시간보다는 기타 活動을 위하여 소비된 시간이 44.8%로 월등히 높았으며, 保健診療補助員은 地域住民을 위하여 提供한 技術業務에 61.5%의 많은 시간이 配分되었다. Time and motion study of health workers engaged in a rural demonstration health project in Gunee Gun, Kyungpook Province was conducted through diret observation method for 6 consecutive days from the time they arrived until they left the office. The study population comprised of 13 health workers, 5 community health practitioners(CHP) and 8 community health aides(CHA). The observation was made during the period from December 3 to 8, 1979. The purpose of the study was to identify the allocation of activity time by functional category, service category and location of activity. Mean activity time per case of technical services was analyzed. The results obtained are as follows: The allocation of activity time by functional category showed 45.1% and 30.5% in medical treatment, 9.8% and 7.3% in administrative work, 19.2% and 22.0% in auxillary and supportive work, 2.6% and 13.8% in travel and 23.3% and 26.4% in miscellaneous activities for CHPs and CHAs, respectively. As might be expected, the percentage of patient time was greatest in service categories as much as 86.3% for CHPs. Most of the patient time was spent on medication and treatment. CHAs spent a great deal of time as much as 40.3% for family planning activities. There was less time in the distribution in prenatal care and infant's registration for MCH. Mean activity time per case of technical services was 12 minutes and 15.3 minutes for CHPs and CHAs, respectively. Average time spent with each patient was 11 minutes for CHPs. The percentage of time spent in the office showed 89.4% of CHPs and 61.1% of CHAs. Of the indoor activities, the distribution of time spent by CHPs showed 47.6% in technical activities. On the other hand, most of the time spent by CHAs was revealed work-related personal activities. Of the outdoor activies, CHAs spent a great deal of time as much as 61.5% for health services. However, CHPs spent more time in miscellaneous activities than in health services.
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강복수,김석범,이경수,윤성호,Kang, Pock-Soo,Kim, Seok-Beom,Lee, Kyeong-Soo,Yun, Sung-Ho 대한예방의학회 2001 예방의학회지 Vol.34 No.4
Objectives : To assess the prevalence of knee osteoarthritis through proper diagnosis in a rural community and to elucidate the relevant factors of this health problem in order to develop educational methods for the prevention of female knee osteoarthritis as well to provide basic data for prospective research. Methods : Over a period of three months starting from August, 2000, 432 women over the age of 40 and living in a rural area were selected by a multistage cluster sampling method in order to investigate the prevalence of knee osteoarthritis and the related factors. The study utilized interviews and radiological examination. The criteria of knee osteoarthritis used was the American College of Rheumatology classification criteria for osteoarthritis of the knee(1995). Results : The adjusted prevalence of knee osteoarthritis among the subjects was 55.0%, and multiple logistic regression analysis showed that the odds ratio(OR) of knee osteoarthritis among subjects 50-59 years of age and subjects older than 60 years of age as compared to subjects 40-49 years of age were 2.43(95% CI: 1.30-4.70) and 4.40(95% CI: 2.47-7.83), respectively. The OR of knee osteoarthritis among factory workers or farmers as compared to others was 1.79(95% CI: 1.03-3.12). The OR of knee osteoarthritis among subjects who had a family history and subjects who had knee injury or surgical history against those subjects had neither were 2.56(95% CI: 1.42-4.03) and 4.70(95% CI:1.45-15.19), respectively. The OR of knee osteoarthritis among smokers against non smokers was 0.47(95% CI: 0.22-0.97). Conclusions : Related factors of knee osteoarthritis included age, occupation, family history, smoking, knee injury and history of surgery In order to prevent knee osteoarthritis in high risked rural woman, education concerning self-care methods and safety guideline must be provided at the work place by the public and private health sectors. Additionally, these women should be continually encouraged to exercise, including jogging and swimming regularly.
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BCG의 결핵예방(結核豫防) 효과에 관(關)한 연구(硏究)
강복수,이성관,Kang, Pock-Soo,Lee, Sung-Kwan 대한예방의학회 1982 예방의학회지 Vol.15 No.1
1975년(年)부터 1980년(年)까지 6년간(年間) 대구시내(大邱市內) 3개(個) 종합병원(綜合病院)에 입원(入院)되어 결핵(結核)으로 확진(確診)된 14세이하(歲以下) 환자(患者) 416중(中) BCG접종여부(接種與否)가 명확(明確)한 314명(名)을 대상(對象)으로 대조군(對照群)의 성별(性別), 년령별(年齡別) BCG접종율(接種率)을 기준(基準)삼아 BCG효과를 평가(評價)한 결과(結果) 그 성적(成績)을 요약(要約)하면 다음과 같다. 총(總) 314명(名)의 결핵환자(結核患者)에 대하여 BCG의 결핵방지효과를 평가(評價)한 결과(結果) BCG비접종군(非接種群)이 접종군(接種群)에 비하여 결핵(結核)에 걸릴 위험도(危險度)가 3.5배(倍)나 높았으며, BCG의 발병방지효과는 71.8%로 나타났다. 결핵성뇌막염(結核性腦膜炎)의 경우 BCG비접종군(非接種群)이 접종군(接種群)보다 비교위험도(比較危險度)가 3.9배(倍) 높으며, BCG효과면에서는 74.3%의 발병방지효과를 나타내었다. 여아군(女兒群)이 남아군(男兒群)에 비하여 BCG효과가 높음을 인정(認定)할 수 있었다(p<0.05). 조립결핵(粟粒結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)의 경우 비교위험도(比較危驗度)는 6.9이었으며 BCG효과는 85.6%로 나타났다. 폐결핵(肺結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)의 경우 비교위험도(比較危驗度)는 7.4이였으며 발병방지효과는 86.5%로 나타났고, 남아군(男兒群)이 여아군(女兒群)보다 그 효과가 현저(顯著)히 높았다(p<0.05). 조립결핵(粟粒結核)의 경우 비교위험도(比較危驗度)는 2.1이며 발병방지효과는 51.9%였으며, 폐결핵(肺結核)의 경우는 각각(各各) 2.2 및 54.7%로 나타났다. 폐결핵(肺結核)을 제외한 전결핵(全結核)의 경우 비교위험도(比較危驗度)는 4.1, BCG효과는 75.3%로 나타났으며,폐결핵(肺結核)에 비하여 결핵성뇌막염(結核性腦膜炎) 및 타결핵(他結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)에서 발병방지효과가 현저(顯著)하게 높았다(p<0.05). 이상을 종합(綜合)하면 BCG효과에 부정적(否定的)인 역할(投割)을 할 여러가지 방해요인(妨害要因)이 있음에도 불구하고 질적(質的)으로 중증(重症)인 결핵성뇌막염(結核性腦膜炎)에서는 거의 80%의 예방력(豫防力), 조립결핵(粟粒結核) 및 폐결핵(肺結核)에서는 약 50%의 발병방지효과를 관찰(觀察)할 수 있었다. 따라서 결핵관리사업(結核管理事業)으로 BCG접종(接種)의 권장(勸奬)이 계속(繼續) 요망(要望)된다. In Korea BCG vaccination has been employed as the main control measure for tuberculosis since 1962. Recently, the protective efficacy of BCG against tuberculosis has been controversial worldwide. A case-control study was conducted to evaluate the efficacy of BCG in Korea which has a high prevalence of tuberculosis(2.5%). The study subjects were children under the age of 14 years who were hospitalized and diagnosed as tuberculosis in three general hospitals in Taegu City during last 6 years ($1975{\sim}1980$). Among 416 hospitalized tuberculous patients, 314 cases were confirmed as to the presence or absence of the BCG scar. A control group was selected from the same hospital patients of the same period as the cases. The control group was other than tuberculous patients whose distribution of age, sex and residence were the same as the cases. The results obtained are as follows: For all forms of tuberculosis, the relative risk and the protective efficacy of BCG were 3.5 and 71.8%. The efficacy was higher among female than among male (78.6% vs. 65.8%). The efficacy was higher among the one year and above than among less than 1 year of age. For tuberculous meningitis, the relative risk and the protective efficacy of BCG were 3.9 and 74.3 %. The efficacy was statistically significantly higher among female than among male (p<0.05). The relative risk and the protective efficacyt of BCG for uberculous meningitis combined with miliary tuberculosis and combined with pulmonary tuberculosis represented 6.9, 85.6%, and 7.4, 86.5%, respectively. On the other hand, the relative risk and the protective efficacy of BCG for miliary tuberculosis were 2.1 and 51.6%, and for pulmonary tuberculosis, 2.3 and 54.7%, respectively. From these results, it appears that BCG vaccination is an efficient preventive measure in Korea where tubercluosis is prevalent. Thus the routine BCG vaccination should be continued.
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