주민참여 건강사업의 성과와 과제: 경상북도 건강마을 조성사업 참여 주민의 경험

홍남수 ( Nam-soo Hong ),김건엽 ( Keon-yeop Kim ),이경수 ( Kyeong-soo Lee ),김미한 ( Mi-han Kim ),김은휘 ( Eun-hwi Kim ),박민아 ( Min-ah Park ),이수진 ( Su-jin Lee ),김지민 ( Ji-min Kim ) 한국보건정보통계학회 2020 보건정보통계학회지 Vol.45 No.2

Objectives: This study aims to evaluate the effectiveness and challenges of a community-based residents-led participatory health project. Methods: This qualitative study was analyzes three Focus Group Interviews of 19 health coordinators among residents who participated in the resident-led health project. Results: Participants recognized that the community health awareness and strength of the residents were restored and strengthened by the project, the physical living environment was improved, and health conditions and behaviors were improved. Future tasks derived from the implementation of this project include expanding and strengthening community participation, and strengthening public health centers’ role and functions for resident-led community health program. Conclusions: Although the health promotion project led by residents in Gyeongsangbuk-do Province, South Korea was successful, there are many challenges to overcome in the future, such as strengthening community participation and improving the capacity of public health centers. Various approaches are needed to assess the health and social outcomes of community involvement in health.

보건소 표준 업무 분류체계 개발

홍남수(Nam-Soo Hong),이주형(Ju-Hyung Lee),김창훈(Chang-Hoon Kim),홍지영(Jee Yong Hong),권근상(Keun-Sang Kwon) 한국보건교육건강증진학회 2019 보건교육건강증진학회지 Vol.36 No.4

Objectives: The purpose of this study is to analyze the work area of the public health center and to establish a standard work classification system. Methods: We analyzed the general workforce status and Full Time Equivalent using public health information system. At first phase we classified the work of public health center considering Regional public health act and public health functions. Finally, we considered the establishment of sub-organizations in the public health center and classified them into essential tasks and transferable tasks. Results: The work of public health center was classified into policy development, evaluation and research, creating healthy environment and ensuring essential health services. Conclusions: This study suggest a new standard work classification system of public health center in response to change in healthcare environment.

항암화학요법을 받는 혈액종양환자의 치료목적에 따른 지지적 간호요구도

김수연 ( Soo-yeon Kim ),홍남수 ( Nam-soo Hong ),배상근 ( Sang-geun Bae ) 한국보건정보통계학회 2017 보건정보통계학회지 Vol.42 No.2

Objectives: This study was performed to investigate the supportive care needs in accordance with therapeutic purposes of blood cancer patients. Methods: The study was conducted among 100 subjects treated as hematologic malignancies during 2016 in Daegu. The questionnaires included various disease-specific characteristics including Supportive Care Needs Survey-long form 59. We analyzed data using descriptive statistics, t-test, ANOVA and ANCOVA. Results: Of 6 domains in Supportive care needs survey (SCNS), the psychological domain showed the highest score followed by the patient care and support domain and the physical and daily living domain. The supportive care needs had a significant relationship with therapeutic purposes of blood cancer patients. The health system and information domain of supportive care needs was the highest in the patients who had been taking remission induction chemotherapy, while psychological domain was the highest in those who had been taking chemotherapy about consolidation therapy or relapse, and physical and daily living domain was the highest in the patients who had been taking chemotherapy before bone marrow transplantation. Conclusions: The patients with hematologic malignancy showed a distinct difference of supportive care needs depending on their therapeutic purposes. Patients` supportive care needs with hematologic malignancy should be assessed and used to provide patient-centered care.

보건소 방문건강관리 대상 여성 노인 고혈압 환자의 건강정보 문해력이 혈압조절에 미치는 영향

배화 ( Hwa Bae ),홍남수 ( Nam-soo Hong ),신은경 ( Eun-kyoung Shin ) 한국보건정보통계학회 2019 보건정보통계학회지 Vol.44 No.3

Objectives: This study was to investigate the level of health literacy among the elderly hypertensive patients and to investigate the effect of health literacy on hypertension control. Methods: This study was conducted for four weeks between February 5 and March 2nd, 2018 in cooperation with the health center of D county. The subjects of the study were 150 elderly female hypertension patients who were regularly supervised by the visiting health care project, and the material of 146 patients amon them were used for the analysis. Collected data were analyzed using t-test, ANOVA and logistic regression analyses with the SPSS 23.0 Program. Results: The literacy rate of health information was 8.70 (±2.12) out of 12 points, and the correct answer rate was 74.5%. The higher the age and the higher the level of education and the higher the salt-based practice rate, the higher the health literacy. Conclusions: Health literacy level and hypertension control are closely related. Since the people with low literacy for health information do not understand various kinds of health related information, it is highly likely that their knowledge and self-management level is insufficient.

지역보건의료계획 수립과정에서의 시민참여 : 건강 격차 해소방안을 위한 시민원탁회의 결과를 중심으로

이수진(Su-Jin Lee),홍남수(Nam-Soo Hong),김건엽(Keon-Yeop Kim),류동희(Dong Hee Ryu),배상근(Sang Geun Bae),김지민(Ji-Min Kim) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.5

본 연구는 지역보건의료계획 수립과정에서 시민들이 생각하는 건강문제와 보건 서비스 요구도를 정확히 파악하고 이를 대구광역시의 중장기 보건의료 종합계획 수립에 반영하고자 함을 목적으로 하였다. 시민참여단을 구성하여 2차례의 시민원탁회의를 실시하였으며, 시민원탁회의는 고객여정지도, DVDM (Definition, Value, Difficulty, Method) Map, 페르소나 기반 시나리오법을 통해 진행하였다. 시민들은 건강수준 향상을 위한 방안으로 보건 서비스 접근성 확대, 소생활권 중심 보건 서비스, 정신건강 서비스 확대, 건강 친화적 환경조성, 환경오염 개선, 사회적 건강개선을 제안하였으며, 건강 격차를 줄이는 방안으로는 건강 취약계층의 소통 향상 및 사회적 환경조성, 보건의료에 대한 접근성 향상, 쾌적한 물리적 공간, 사회적 역할 수행이 필요하다고 하였다. 본 연구 결과는 기존의 설문조사를 통한 주민요구도 조사와 달리 실제 주민들의 생각과 요구를 상세히 파악할 수 있었다는 점에서 의의가 있으며, 향후 지역보건사업의 기획과 수행과정에서 주민참여 수준의 단계를 평가하고, 보다 다양한 시민들의 의견을 적용할 수 있도록 주민참여 제도화 기반 수립을 위한 추가적인 연구가 필요할 것이다. The purpose of this study was to identify citizens’ needs and what they perceive the health-related problems are so public opinion can be reflected in the Daegu Community Health Plan. A citizen participation group was organized, and two roundtable discussions were held in June and July 2018. The number of participants in the first and second round was 40 and 44, respectively. Customer itinerary guidance, DVDM (Definition, Value, Difficulty, and Method) Map, and Persona-based scenario method were used for the roundtable discussions. The measures to improve the health status proposed by the citizens included expanding access to health services, establishing health services centered on small-living areas, expanding mental health services, creating health-friendly environments, resolving environmental problems, and improving social health. In addition, enhancing communication and creating harmonized environments, improving access to healthcare, generating pleasant physical environments, and assigning socials roles for vulnerable individuals were brought up as the means to resolve health disparities. The strength of the present study lies in the fact that, unlike survey methods, the citizens’ exact needs were identified by sharing their thoughts. Moreover, it was proven that practical measures would be needed to implement citizen participation in planning health-related projects.

상병 · 수술별 진료비 정보공개에 대한 의료소비자와 공급자의 견해

감신(Kam, Sin),홍남수(Hong, Nam-Soo),이경수(Lee, Kyeong-Soo),이중정(Lee, Jung-Jeong),황태윤(Hwang, Tae-Yoon),김건엽(Kim, Keon-Yeop),류동희(Ryu, Dong-Hee),이선화(Lee, Seon-Hwa),두영택(Doo, Young-Taek),서강석(Seo, Kang-Suk) 비판과 대안을 위한 사회복지학회 2016 비판사회정책 Vol.- No.51

이 연구는 소비자에게 실질적인 도움을 줄 수 있는 상병 · 수술별 비급여를 포함한 진료비 정보공개체계 구축의 필요성이 제기되고 있는 상황에서 진료비 정보공개에 대한 의료소비자와 공급자의 견해를 파악하여 공개의 필요성과 방법, 항목 등 구체적인 정보공개 관리체계 개발을 위한 자료로 활용하는 것을 목적으로 수행되었다. 의료소비자의 인식과 견해를 확인하기 위하여 전국의 일반시민 500명을 대상으로 전화설문조사를 시행하였고, 대구시의 3개 시민단체 활동가를 대상으로 인터뷰와 서면조사를 진행하였다. 의료공급자의 의견은 병의원경영 관련자(의사) 인터뷰를 통해서 확인하였다. 일반인을 대상으로 한 전화설문조사 결과 응답자의 85.1%가 비급여를 포함한 진료비 정보제공에 대해서 필요하다고 응답하였으며, 공개해야 할 우선순위 질환은 암, 치과질환, 뇌혈관질환 순이었다. 시민단체 활동가들은 의료기관별 진료비 공개를 제도화해야 하고, 진료비 공개는 궁극적으로 의료기관 경영의 투명성과 합리성을 제고하고 의료서비스 질을 개선하는 계기로 작용할 것이라고 하였다. 반면에 의료공급자는 의료소비자가 진료비를 제대로 이해하기 어려운 상황에서 진료비 공개는 의료소비자의 공급자에 대한 불신을 키우는 결과를 초래할 것이며, 의료서비스의 하향평준화, 특정병원 환자쏠림 등 부정적인 영향이 클 것이라고 생각하였다. 의료소비자의 알권리를 충족시키고 의료기관 선택에 도움이 되며, 병원 이용 전에 진료비를 예측 가능하게 하고 이용 후에 진료비 내역의 적정성에 대한 올바른 판단을 위해서는 비급여를 포함한 진료비를 공개하는 것이 바람직하겠지만 진료비 공개제도에 따른 파급효과, 부작용에 대한 충분한 논의와 검토를 거친 후에 진료비 정보공개의 구체적인 방안을 마련해야 할 것이다. Objective: The purpose of this study was to investigate opinions of consumers and providers on an establishment of a public access system to medical costs including payment for uncovered services which would help consumers make wiser decisions on medical service utilization. The study results are expected to be used as fundamental data for specifying contents and determining means to go on public regarding the system. Method: A total of 500 general population underwent telephone interviews. Document investigations as well as in-person interviews were conducted for three activists from civil organizations. The opinions of physicians on an establishment of a public access system to medical cost were also examined. Results: The telephone survey results revealed 85.1% of respondents agreed on the necessity of the information access system. Cancers, odontopathies, and cerebrovascular diseases were selected as ones whose total medical costs should be revealed with priority. The civil organization activists addressed that an establishment of a legal policy enforcing each medical facility to reveal their total medical costs is required, and it would, therefore, be an opportunity to examine transparency and rationality of hospital managements and to improve service quality. The medical service providers, on the other hands, worried that the information access system would deteriorate the relationship in between consumers and physicians since medical consumers are not capable of fully understanding provided information regarding medical costs due to difficult medical terms and lack of related knowledge. Moreover, they also mentioned that the system would have negative influences on the market by causing problems such as downward equalization of medical services and patient- flock to certain hospitals. Conclusion: It is required to reveal information regarding total medical costs including out-of-pocket expenses since it would satisfy consumers" right to know and help them to make right decisions when choosing hospitals and to predict medical costs in advance. They could also make appropriate judgements about medical costs afterwards. However, as pointed out by the physicians, there could be unexpected negative effects regarding the system. Therefore, relevant investigations and sufficient discussions with involved must precede the system establishment.

비전형적인 부위에 발생한 사면발이증 2예

이호표,백승철,조백기,이정기,홍남수 ( Ho Pyo Lee,Seung Churl Paik,Baik Kee Cho,Jung Gee Lee,Nam Soo Hong ) 대한피부과학회 1997 대한피부과학회지 Vol.35 No.3

The pubic louse, Pthirus pubis is a blood-sucking ectoparasite adapted to hold onto pubic, axillary and body hairs. It is usually confined to the pubic and inguinal region. However, it may also rarely involve the scalp and eyelashes. We report two cases of phthiriasis occurring on unusual sites, the first case occurring on the scalp of a 5 month-old male infant, and the second case on the eyelashes of a 49-year-old fe- male. (Kor J Dermatol 1997;35(3): 579-583)

Hair Follicle Nevus

조익(Ik Jo),홍남수(Nam Soo Hong),서은주(Eun Joo Seo),조백기(Baik Kee Cho) 대한피부과학회 1983 대한피부과학회지 Vol.21 No.4

Hair follicle nevus is one of several nevi, in which hair and hair follicle are involved. Crowding of numerous tiny but mature hair follicles with thick fibrous root sheath are the characteristie histologic finding of the nevus. The patient was one month old male infant with pedunculated. mass l cm in size on the left preauricular area. Histologically the skin of the lesion is covered by acanthotic epidermis. In the corium are numerous small mature hair follicles with thick fibrous sheath and a few small Iobules of sebaceous gland embedded in a fibrovascular stroma. There are, however, no central plate of cartilage and adipose tissue.

다발성 골연골종증 환자의 삶의 질에 대한 분석

정원주(Won-Ju Jeong),홍남수(Nam-Soo Hong),박일형(Il-Hyung Park),서일(Il Seo),오창욱(Chang-Wug Oh),윤종필(Jong Pil Yoon),경희수(Hee-Soo Kyung),김하정(Ha-Jeong Kim) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.2

목적: 다발성 골연골종증 환자들의 동통, 신체적 사회적 기능, 삶의 질을 연구하여 예후, 치료, 장기적 관리에 도움이 고되자 한다. 대상 및 방법: 1993년 3월부터 2014년 6월까지 다발성 골연골종증을 진단받은 45명을 대상으로 하였다. Research and development-36을 통해 신체 기능, 정신 건강, 생활 활력, 사회적 역할, 동통, 전반적인 건강 상태가 환자의 예후에 영향을 미치는지 분석하였다. 관련 인자는 나이, 성별, 체질량지수, 수술 여부, 침범된 관절 변형 발생 여부, 재발 여부, 가족력 유무, 종양의 위치, 병변의 개수로 하였다. 통계는 SAS ver. 9.3 (SAS Inc., Cary, NC, USA)을 사용하고 p값이 0.05 미만일 경우 의미 있는 것으로 해석하였다. 결과: 가족력이 있는 환자군에서 종합 평가, 신체적 기능, 생활 활력, 사회적 활동, 건강 상태가 저조한 결과를 보였고 통계적으로 유의하였다. 또한 동통, 정서적 건강, 전반적인 건강 상태의 평가결과 통계적으로 유의하지는 않았지만 열등한 경향이 있는 것으로 나타났다. 결론: 가족력을 인지할 만큼 중증도가 높은 환자일수록 예후가 불량하였다. 다발성 골연골종이 동통만이 문제가 아니라 사회적, 심리적인 문제를 포함한 삶에 전체적인 영향을 줄 수 있는 질병임을 알 수 있었다. Purpose: The purpose of this study is to help predict the prognosis of multiple osteochondromatosis patients with the investigation of social function, pain, physical function and quality of life of patients. Materials and Methods: Forty-five cases were diagnosed as multiple osteochondromatosis from March 1993 to June 2014. We performed a survey on pain, daily life, school or work life assessment of research and development-36. Forty-five people who responded to the survey completely were enrolled. Variable factors, including physical functioning, role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health state were considered as elements related to quality of life. In addition, we investigated significant factors for multiple osteochondromatosis patients, and analyzed the survey by scoring. Related factors included age (over 18 years and under 18 years), gender, body mass index, operation, joint deformity, recurrence of disease, family history, the number of involved joints and the location of tumor. Statistical analyses were performed using SAS ver. 9.3 (SAS Inc., Cary, NC, USA). p-values of <0.05 were deemed statistically significant. Results: Patients with a family history of multiple osteochondromatosis showed a significantly decreased result of assessment, physical function, vitality of life, social activities, and health state. In addition, there was a tendency of a poor influence in pain, emotional wellbeing, and general health. Conclusion: The results suggest that family history is a significant factor influencing and predicting the quality of life. In other words, the developed patients in the household including patients with severe enough for the rest of the family to know have poor prognosis. Through this study multiple osteochondromatosis is a chronic disease having a profound impact on quality of life.

비전문건강조언자를 활용한 암검진 독려사업의 효과

장지현 ( Ji Hyun Chang ),홍남수 ( Nam Soo Hong ),감신 ( Sin Kam ),김건엽 ( Keon Yeop Kim ),이원기 ( Won Kee Lee ),김기수 ( Ki Su Kim ),배상근 ( Sang Geun Bae ) 한국보건정보통계학회 2016 보건정보통계학회지 Vol.41 No.1

Objectives: To evaluate effects of an intervention using lay health advisors on promoting cancer screening and to develop effective strategies and health services. Methods: The number of subjects included in the final analysis was 188. Of those, 72 were applied to health services provided by public health centers (control group) and 116 composed the experimental group. They were selected from residents of Daegu and Gyeonsangbuk-do aged older than 40 years. We designed a questionnaire applying Trans-theoretical Model and Health Belief Model in order to determine the subjects’ intentions to participate in the national cancer screening program. Any thought changes occurred after the interventions were compared with the intial responses. For statistical analysis, paired t-test, ANCOVA and multiple logistic regression analyses were conducted. Results: After the intervention using lay health advisors, knowledge about cancer screening and its benefits were improved and self-efficacy increased with statistical significance. Moreover, barriers to cancer screening decreased. Compared to application of health services provided by public health centers, encouraging cancer screening by lay health advisors was 1.64 times more likely to generate forward stage movement in cancer screening, but there was no statistical significance. Conclusions: Even though, effects of the intervention using lay health advisors on promoting cancer screening were not clearly determined, it is a precedent study for emphasizing application of community resources and participation of residents in promoting cancer screening. Further studies are required to specify effects of the intervention.