국민 건강의 결정 요인 3 : 질병예방 및 의료이용행태

배상수,Bae, Sang-Soo 대한예방의학회 1993 예방의학회지 Vol.26 No.4

지금까지 우리나라의 국민들의 예방행태와 질병행태, 그리고 환자역할에 대하여 기존에 발표된 자료를 중심으로 재해석을 기하여 보았다. 물론 이 발표에서 사용된 자료들이 정확하며 타당한 자료인가에 대해서는 반드시 그렇다라고 답변할 수는 없다. 다만 우리나라에서의 건강관련행태를 설명하기 위해서는 자료의 한계라는 현실을 감안하지 않을 수 없다는 사실을 이해해주기 바란다. 우리나라국민들의 건강행태는 과거에 비해 상당히 변화하고 있으나 계층간의 행태의 차이, 변화의 원인 등에 대해서는 아직 연구가 미흡하다. 지금까지 이루어진 행태연구들이 정합적인 모형을 사용하고 있다고 보기 어려운 것이 그 원인의 하나 일 것이다. 새로이 개발된 모형들을 적용하기 위한 노력이 필요하며, 사용되는 변수의 타당성에 대한 연구도 필요하다. 행태와 관련된 연구에서 사용되는 변수들이 사회문화의 산물이라는 사실을 생각하면 우리나름대로의 변수정의가 있어야 한다는 것은 지극히 당연하다 하겠다. 끝으로 행태를 연구함에 있어 인간의 의식은 사회구조의 산물이라는 사실을 명심할 필요가 있다. 루카치는 자본주의 사회에서는 노동자의 계급의식 역시 자본주의 구조의 산물일 수 있다 하였다. 이런 의미에서 지식, 태도, 행태 등에 대한 연구는 사회구조의 총체성에 대한 인식을 요구한다. 만일 그렇지 않은 경우에는 행태연구를 통한 결과가 희생자비난의 논리로 악순환할 가능성이 높기 때문이다. A wide range of health professionals have interest in changing the health behavior of individuals. To intervene effectively and to make informed judgements about how to measure the success of such interventions, health professionals must have an deep understanding of health behavior. This paper provides an overview of the thories of health-related behaviors and the strength and weakness of each, how the theories relate to others, and how they can be used in practice. The theories reviewed include Suchmann's stages of illness experience, Health belief model, Attribution theory, Fishbein's theory of reasoned action, Multiattribute utility models, Consumer information processing, and Anderson's models. Finally, this paper introduces the reader to interesting research findings in our country.

새로이 발견된 고혈압 환자들의 약물치료 및 생활양식 개선의도와 순응도와의 관계

배상수,이석구,Bae, Sang-Soo,Lee, Sok-Goo 대한예방의학회 2001 예방의학회지 Vol.34 No.4

Objectives : To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. Methods : The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. Results : Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11 - month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. Conclusion : Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

신 공중보건과 국가공중보건체계

배상수,Bae, Sang Soo 한국농촌의학지역보건학회 2012 농촌의학·지역보건 Vol.39 No.4

The New Public Health(NPH) is a comprehensive approach to protecting and promoting the health status of each individual member and society as a whole. NHP is not so much a philosophy to broaden the understanding of public health as it is an action plan to address current public health system. This paper's objectives include increasing public and professional awareness of the significant changes in the national public health systems of developed countries and contributing to more effective delivery of public health services in Korea. This paper reviews articles and documents concerning NPH and the public health system, and outlines of the achievements in developed countries since NPH movement began. These include the change in the definition and function of public health, expansion of public health networks, strengthening of public health policy, reorientation of public health delivery systems, promotion of workforce capacity, and the implementation of evidence-based management. To overcome the challenges facing the public health system of Korea, we must prioritize the value of population-based approach, expand the notion of a public health system to encompass all sectors that can influence health, promote a "Health in All Policies" approach, focus on an evidence-based health policy and program, develop core competencies for public health workers, and establish performance standards for public health organizations based on the core functions of public health.

발파작업 시 충전매질에 따른 발파효과 비교 연구

배상수,한우진,장승엽,방명석,Bae, Sang-Soo,Han, Woo-Jin,Jang, Seung-Yup,Bang, Myung-Seok 한국지반신소재학회 2022 한국지반신소재학회 논문집 Vol.21 No.2

This study simulated the shock wave propagation through the tamping material between explosives and hole wall at blasting works and verified the effect of tamping materials. The Arbitrary Lagrangian-Eulerian(ALE) method was selected to model the mixture of solid (Lagrangian) and fluid (Eulerian). The time series analysis was carried out during blasting process time. Explosives and tamping materials (air or water) were modeled with finite element mesh and the hole wall was assumed as a rigid body that can determine the propagation velocity and shock force hitting the hole wall from starting point (explosives). The numerical simulation results show that the propagation velocity and shock force in case of water were larger than those in case of air. In addition, the real site at blasting work was modeled and simulated. The rock was treated as elasto-plastic material. The results demonstrate that the instantaneous shock force was larger and the demolished block size was smaller in water than in air. On the contrary, the impact in the back side of explosives hole was smaller in water, because considerable amount of shock energy was used to demolish the rock, but the propagation of compression through solid becomes smaller due to the damping effect by rock demolition. Therefore, It can be proven that the water as the tamping media was more profitable than air.

의료이용(醫療利用)에 영향(影響)을 미치는 요인(要因)에 관(關)한 분석(分析)

배상수,Bae, Sang-Soo 대한예방의학회 1985 Journal of Preventive Medicine and Public Health Vol.18 No.1

This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Anderson Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows : First, the causal models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted $R^2$ is .144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the valiance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and edabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.

사회생태학적 모형에 기반한 한국인 위암검진 수검의 관련 요인

배상수,조희숙,김동현,최용준,이훈재,이태진,이혜진,Bae, Sang-Soo,Jo, Heui-Sug,Kim, Dong-Hyun,Choi, Yong-Jun,Lee, Hun-Jae,Lee, Tae-Jin,Lee, Hye-Jean 대한예방의학회 2008 예방의학회지 Vol.41 No.2

Objectives : We measured behavioral factors associated with Koreans receiving gastric cancer screening based on a socio-ecological model, in part to develop strategies to improve cancer screening rates. Methods : A telephone survey was conducted with 2,576 people chosen through stratified random sampling from April 1 - May 31, 2004. Collected information included gastric cancer screening, socio-demographic factors, and socio-ecological factors at intrapersonal, interpersonal, community, and public policy levels. Results : Among 985 survey respondents(380 men and 605 women), 402 had received gastric cancer screening. Logistic analysis was performed to compare those screened and unscreened. 'Age' was the only demographic factor that showed a statistically significant association with getting screening. People in their fifties (OR=1.731, 95% CI=1.190-2.520) and sixties (OR=2.098, 95% CI=1.301-3.385) showed a higher likelihood of getting screened, compared to those in the forties. 'Accessibility to a medical institution' was a significant factor related to having gastric cancer screening at the intrapersonal level. At the interpersonal level, recommendations by family members to be screened and a family practice of routine cancer screening were significantly related. People with frequent education about cancer screening or with stronger social feelings that cancer screening is necessary also demonstrated significantly higher tendencies to be screened. Conclusions : In conclusion, a socio-ecological model seems appropriate for explaining gastric cancer screening behavior and associated factors. Health planners should develop integrated strategies to improve cancer screening rates based on socio-ecological factors, especially at the interpersonal and community levels.

슬래그 채움재를 사용한 게비온 옹벽의 안정해석

배상수(Bae Sang Soo),임기석(Lim Gi Seok),송시훈(Song Si Hoon),지홍기(Jee Hong Kee),이순탁(Lee Soon Tak) 대한토목학회 2002 대한토목학회 학술대회 Vol.2002 No.11

공중보건체계의 개념과 발전 과제

배상수 ( Sang Soo Bae ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.4

The study of public health systems is an important, but very difficult task. The concept and functions of public health systems are influenced by the views, interests, and influence of the various stakeholders belonging to public health systems and broader social, economic, political, and environmental sectors. To define public health system with conceptual clarification, we must take into account the dynamic and complex aspect of the public health system. This paper reviews health systems and public health systems literature to suggest the concept, goals, and functions of public health systems. In addition, this paper recognizes some challenges, such as leadership and management, resource development, economic support, and service delivery to strengthen public health systems for improving health and well-being of population.

전단응력법을 이용한 매트리스 채움재 평균입경 산정에 관한 연구

배상수(Bae Sang Soo),서영제(Suh Yeoung Je),지홍기(Jee Hong Kee),이순탁(Lee Soontak) 대한토목학회 2006 대한토목학회 학술대회 Vol.2006 No.10

지역사회 치매관리 모형 개발: 광명시의 경우

배상수 ( Sang Soo Bae ),김동현 ( Dong Hyun Kim ),우영국 ( Young Kuk Woo ),오진주 ( Jin Joo Oh ),민경목 ( Kyung Bok Min ),이수현 ( Soo Hyun Lee ),이미라 ( Mi La Lee ),이강슥 ( Sang Suk Lee ),표옥정 ( Ok Jung Pyo ),박찬병 ( Chan Byu 한국보건행정학회 1999 보건행정학회지 Vol.9 No.1