학생정신건강사업 현황 및 관련 교육 요구도 : 초중고 보건교사와 상담교사 대상

진영란,강미경,이윤정 한국학교보건학회 2018 韓國學校保健學會誌 Vol.31 No.2

Purpose: The leading cause of death among teenagers in Korea is suicide. Also, it is known that mental health ofKorean adolescents identified based on the levels of perceived stress or depression is very poor. The purpose ofthis study was to examine the current status of student mental health programs in Korea and the associated problemsand to explore ways to make the programs more effective. Methods: The subjects of the study were a total of 115school nurses and school counselors in elementary, middle and high schools. The study examined the current statusand the associated problems of school mental health programs as well as the needs for teacher training programsrelated to student mental health. Results: Few mental health programs other than counseling for at-risk studentswere being carried out. The problems associated with student mental health management were, in terms of management,‘accountability in case of incidents such as student suicide’ and ‘parents uncooperative in their kid’s mentalhealth management (visit to hospital, etc.)’ and, in terms of manpower, ‘unclear R&R between school nurses andschool counselors’ and, more fundamentally, ‘the lack of human resources.’ The needs for teacher training programsrelated to student mental health were very high and the content required most was ‘ways to manage stress of studentsand teachers themselves,’ followed by ‘interpersonal conflicts management & conservational skills,’ and ‘ways tomanage student mental illness.’ Conclusion: In conclusion, to increase the effectiveness of student mental healthprograms, we should move on from the current system which focuses only on early discovery and intervention toa more comprehensive system that includes preventive approaches, while having clearer R&R and more workforcededicated to student mental health programs and attracting more parental cooperation and support.

노인장기요양보험 관련 미디어 내용 분석

진영란,이효영 보건의료산업학회 2016 보건의료산업학회지 Vol.10 No.2

Objectives : This study confirmed the limitation of long-term care insurance by analyzing media contents. Methods : Articles and reviews were searched with the article searching system (KINDS) from July 2008 to December, 2015. Results : Among the 155 articles examined, 61.1% highlighted the faults of suppliers, and 25.2% indicated the responsibility of the insurer. As for their purpose, 56.8% reported on accidents, and 32.3% provided information. Furthermore, 74.2% reported on negative contents and only 25.8% on neutral contents. The negative contents consisted of requesting false insurance benefits, amending the range and price indicating the very low salaries of the care givers, limitations on the care grade assessment, and problems related with assistive devices. The majority of neutral articles is for providing information. Conclusions : There were many problems starting from the early stage of the insurance. We must pay attention to these problems. Moreover, we should try to handle and prevent these problems with supportive responses from authorities.

노인장기요양보험 급여 주야간보호사업소의 운영현황

진영란,전경숙,이효영 韓國老年學會 2011 한국노년학 Vol.31 No.4

본 연구는 노인장기요양보험제도 도입 이후 주야간보호사업소 운영현황을 파악하고 가동률 관련 요인을 탐색하고자 하였다. 전국 주야간보호사업소에 2010년 7월 14일에서 7월 28일까지 설문지를 우편 발송하여 설문에 성실히 응답한 277개소의 조사지를 분석하였다(응답률 24.5%). 사업소의 운영주체는 법인이 219개소(79.1%), 개인이 48개소(17.8%), 국공립 등이 10개소(3.6%)이었으며, 평균 가동률은 국공립 등은 79.08%, 법인은 72.49%인 반면, 개인운영 사업소는 57.58%로 낮았다. 사업소 운영주체별로 전체 인력 수에는 차이가 없었으나, 국공립 사업소는 간호사 수가 1.07명인데 비해 개인 사업소는 0.08명으로 유의한 차이가 있었다. 법인 및 국공립사업소가 개인사업소보다 프로그램 실시율이 높았고, 신체활동, 음악활동, 물리치료, 레크레이션, 작업치료 등에서는 통계적으로 유의한 차이가 있었다. 본 연구결과에 기초할 때, 개인운영 사업소와 2008년 이후에 설립된 사업소에 대해 대상자 평가 및 모니터링, 프로그램 실시에 대한 교육훈련 및 서비스 질 관리를 강화할 필요성이 제기된다. 또한, 주야간보호서비스 이용자의 가족에 대한 실효성 있는 지원을 강화하여 주야간보호서비스에 대한 수요를 확대해야 할 것이다. This study was conducted to understand current management status of 'day and night care' facilities and to explore the related factors with rates of operation of them. The nationwide mailing survey was conducted with structured questionnaires from July, 14, 2010 to July, 28, 2010. The subjects were 277 facilities (response rate 24.5%). Regarding the types of operating, 79.1% of faculties was run by cooperation, and 17.8% and 3.6% for individuals and national/public institutes respectively. The average of operation rate was 70.15%. National/public institutes showed higher in the rate of operation(79.08%) than 72.49% of cooperations and 57.78% of individuals. The number of manpower was not nearly different by the types of operating bodies, but the number of nurse was significantly different among them. The national/public institutions had 1.07 nurses while individual institutions have only 0.08. We found that facilities run by national/public institutes and founded before 2008 years showed higher rate of operation. In case of providing regular monitoring and evaluation services, and music program for patients showed higher rate of operation. In addition, the number of managers, social workers, and nurses increase the rate of operation. We suggest that quality management and monitoring program for the facilities which run by individuals or established after 2008 years would be developed. We also call for development of programs for facilitating utilization of 'day and night care' facilities such as expanding the family support.

노인요양시설 사건사고에 관한 미디어 내용 분석

진영란,이효영 보건의료산업학회 2013 보건의료산업학회지 Vol.7 No.1

The purpose of this study is to analyze contents on media about the problems of long-term care facilities. For achieving this purpose, we reviewed 'KINDS(http://www.kinds.or.kr/)' from July, 2008 to May, 2012 which was an synthetic newspaper and TV news searching system. Among 320 articles, we finally analyzed 72 articles: 218 articles were duplicated and 30 articles did not directly related or were not objective. The results were divided with seven parts: 'long-term care facilities', 'employee' 'health care and accidents', 'providing and management of service', 'meals related problems', 'maltreatment of client', 'disorders & unfairness long-term care benefit. Among these seven parts, we could confirm specific and major problems, which were lack of safety management, incompleteness facilities & equipments, shortage of long-term care manpower, insufficient service providing low quality of service, hiding money from elderly's accounts, and providing some money to get national subsidies. For resolving these problems, the long-term service guidelines must be prepared and the related facilities must cooperate each other for providing high quality of service. In addition, the efficient systems must be made to find out long-term care problems and unfairness of service providing and strict management rules or sanctions must be needed.

노인장기요양보험 복지용구 급여제도 비교

진영란(Young Ran Chin)(陳瑛蘭),김광병(Kwang Byung Kim)(金廣柄) 위기관리 이론과 실천 2013 Crisisonomy Vol.9 No.6

우리나라는 일본과 독일의 제도를 기초로 우리나라의 현황에 맞게 조정하여 노인장기요양보험 복지용구 급여제도를 도입하였다. 제도 도입이후 4년이 지나 안정기에 접어든 현 시점에서 일본과 독일 두 나라의 복지용구급여제도와 우리나라의 제도를 비교분석함으로써 우리나라 복지용구 급여제도의 현주소를 진단하고, 시사점을 도출하고자 하였다. 분석 관점은 복지용구사업소 시설기준, 복지용구관련 인력기준, 복지용구 급여 대상자 및 급여한도액, 복지용구 제공 방법 및 급여 품목, 복지용구 급여수가(판매 ㆍ 대여료) 결정, 대여 복지용구의 세정소독, 급여 제품의 질 관리 등 7가지 영역이었다. 그 결과, 우리나라는 급여 복지용구의 품목과 제품의 단계적 다양화, 복지용구 선정 및 상담서비스 강화, 대여 복지용구의 세정소독 관리강화, 복지용구에 대한 질 관리 및 불의의 사고에 대한 대비, 복지용구산업 활성화 방안 모색 등이 필요한 것으로 나타났다. After long term-care insurance was introduced, about four years had passed. Among these benefits, medical devices benefits referenced the Japan's and German's extremely much before setting the benefits up. These two nation's standards or guidelines of medical devices benefits had focused on seven core points, those are facilities & manpower, subjects & the limit of benefit price, items of medical devices, service delivery types(lending, selling), offering payment, cleaning & disinfection of the devices, and quality management. The purpose of this study is comparing standards or guidelines of medical devices benefits in Korea, Japan and german, which is focused on the seven core points. Therefore, this study find out how the guidelines or standards will be revised for improving the quality of medical devices benefits. Our standards or guidelines had some shortcomings in manpower, monitoring of cleaning & disinfection, quality control of medical device itself, and counselling services. Besides, we need to diversify our medical device products so as to meet subjects demands and to develop quality control methods.

보건소 방문보건사업 효과와 간호중재 분석

진영란,이인숙,장현숙 지역사회간호학회 2004 지역사회간호학회지 Vol.15 No.3

Purpose: The purpose of this study was to investigate the types and frequencies of nursing intervention of home health care in Public Health Centers and its effects. Method: The data collection period for this study lasted from March 1 to December 31, 2003. The clients were sampled by a stratified randomized method among those who had been cared for at least 3 months. The data was analyzed by SPSS for description, ANOVA, paired t- test, etc. Result: The types and frequencies of nursing intervention in major chronic health problems were significantly different. The main types of nursing intervention in hypertension and DM patients included education on disease management, regular exercise, stress management, diets, etc. CVA patients were intervened in pain control (ice or hot pack, massage), position changes, and ROM exercise Cancer patients received imaginary or relaxation therapy, pain control (ice or hot pack, massage), hospice, etc. After the intervention, the drug compliance of hypertension (8.2 days per month) and DM patients (6.2 days per month) improved. Blood sugar levels (FBS 7.6, post ?partum 2hrs 21.4 (㎎/㎗) and blood pressure(systolic 9.8, diastolic 4.3 ㎜Hg) lowered significantly. All aspects of QOL also improved (total 3.68). Conclusion: The types and frequencies of nursing intervention were determined by characteristics of the health problems, and home health care nursing intervention in Public Health Centers was effective to the elderly of the community in many aspects.

노인요양시설 입소자의 장기요양등급 개선과 서비스 질 관련요인

진영란,최경원 보건의료산업학회 2014 보건의료산업학회지 Vol.8 No.1

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.

요양보호사 교육기관 교육서비스 질 평가 도구개발

진영란,이효영 보건의료산업학회 2013 보건의료산업학회지 Vol.7 No.4

The purpose of this study is to identify the important factors of education service quality and to develop the evaluation instrument in learning facilities for care workers. This study was processed as four steps. First, the important factors were confirmed through literature reviews and the expert board discussions. Second, the evaluation instrument was developed and validity & reliability of the instrument were checked by factor analysis and Cronbach's α. Lastly, the instrument was rechecked by the expert board in language usages and importance of the items. The results indicated that the important quality factors were divided with infrastructure and service process. Especially, the process contained providing appropriate education information & counseling, providing appropriate contract & paying fees, keeping specified service principles and so on. The study instrument was developed with 28 items. This instrument will be helpful to improve the education service quality. Besides, the staffs must continuously try to improve and manage their education services using the results of this kind of evaluation instrument.

당뇨교육자료 자료의 이독성과 적합성 평가

진영란,최경원 보건의료산업학회 2014 보건의료산업학회지 Vol.8 No.2

The aim of this study was to evaluate the readability and suitability of patients' education materials on DM. A total of 34 materials on DM from public health centers, general hospitals, and internet web sites were evaluated for readability by 'graded system of vocabulary', and suitability by 'The Korean version of SAM(Suitability Assessment of Materials)'. On the average, 28.3% of 1st grade reading level words, 27.1% of 5th grade level and over were included in educational materials. For suitability, 6(17.6%) were judged superior, 20(58.8%) adequate, 8(23.6%) inadequate. The reading level of the materials was higher than the recommended reading level(6th grade reading level). For suitability, most of materials were inadequate in some of items such as 'summary or review included', 'context given', 'interaction used'. It is proposed that in the development of patients' educational materials, health literacy of target population should be considered.

The Relationship between the Prevalence of Suicidal Ideation among Older Adults and Individual · Regional Factors

진영란,김춘미,박일수,한송이 한국지역사회간호학회 2020 지역사회간호학회지 Vol.31 No.S

Purpose: The purpose of this study was to find out the suicidal ideation rate of the elderly including individual and regional factors by sex. Methods: This is secondary analysis study that combines the data of the 2017 Community Health Survey with the e-indicator data set of the National Statistical Office, and a descriptive correlation study. Statistical analysis used hierarchical logistic regression by SAS 9.4. Results: The 11.5% of the elderly had suicidal ideation within the last year, and 18.4% in Chungnam is the highest. Individual characteristics include females, older people, lower education levels, no job or housewife, no spouse, less than seven hours of sleep per day on the average, low subjective health, high subjective stress, and the worse their economic conditions, the more they had suicide ideation. Considering regional characteristics, suicidal ideation tended to increase significantly as the number of hospital beds per 1,000 people and the rate of obesity was lower, the rate of stress perception was higher, and the odds value was small. When both individual and regional factors were considered, the model conformity of the suicidal ideation improved (ICC=0.0814). Conclusion: In order to lower the suicidal rate of the elderly, it seems that both individual and community factors need to be comprehensively approached from the stage of suicidal ideation in the community.