학교보건사업의 역사적 고찰을 통한 정책 방향에 관한 연구

김상욱,김윤신,장창곡 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Objectives : The purpose of this study is to provide a basic structure for the establishment of the direction of school health programs, an overview of the historical changes of school health programs and their results, and a conceptual framework on school health programs. Methods : The data analysis has been done using a statistical almanac, relevant laws and regulations, operation handbook of the program, theses, reports, records of public hearings, and other reports as a technical research primarily based on evidence. The methodology of this research classifies the development and growth transition of school health programs during a historical period through the investigation of regulations, organization, manpower, and its program via its development process and to provide a basic tool to design a solid school health policy. Results : A. The growth and development of school health programs The development of school health programs was classified into three different periods including the forthcoming period (1945~1967), the completion period (1967~1993), and the actualization period based on the establishment of legislation for School Health Law, other relevant legislation, and the contents of school health programs (1993~present). B. Policy direction of school health programs School health programs have reestablished their goals and range based on basic direction, and developed the unit model of information structure for school health program management and its basic structure. Finally, the stepwise support system through the building of the school health support center is recommended. (1) The basic direction of school health programs has proposed 7 basic goals to reestablish the policy direction of health improvement based on total health. (2) The unit model of information system and the school health information system for school health program management has been developed to utilize positive management. (3) School health policy through the study of the health laws and systems has been developed. The necessity of school health support center for the policy support, functional support and operation support has also been proposed. Conclusions : It is necessary to build a school health support center that consists of health professionals in charge of policy support, functional support, and program support of school health programs in order to realize and develop new policy.

일지역 초등학교 학부모의 학교보건사업에 대한 기대

김현정,김숙,강혜영,박미영 韓國學校保健學會 2003 韓國學校保健學會誌 Vol.16 No.2

The purpose of this study was to identify the expectation about school health program of primary school parents as an important variable for growth of school health program. fore area locked primary school parents 631 by self-administered questionnaire between June 20 and September 29, 2001 The results were as follows 1. General characteristic of the Subjects Age rates of the subjects were 45.5% on 35~39 years old and 34.7% over 40 years old. Economic status were middle level 86%, participation rates of school health education for parent were 16.8%, recognition rates on significance of school health education were 89.9%. 2. Health knowledge of parents The mean score on health knowledge of the subjects was 6.8 from a total of 10. there was s statistically significant difference with regard to health knowledge among the 7school(F=3.46, p=.016). 3. Health behavior of parents The mean score on health behaviors of the subjects was 77.3 from a total of 100. there was no statistically difference in health behavior among the school. 4. The expectation about school health program of the parents The mean score on the expectation about school health program of the subjects was 51.1 from a total of 140. there was a statistically significant difference with regard to the expe ctation about school health program among the school(F=3.75, p=.010). 5. Health behaviors and the expectation about school health program from sociod emogr aphic Backgrounds of the Subjects. In the backgrounds of the subjects, the score on health behavior was higher the mothers(t=2.89, p=.004), the upper class(F=7.38, p=.000), the higher participation level of school health education of parent(F=7.38, p=.000) and the higher recognition level on significance of school health education of parent(F=9.94, p=.000). The score on the expectation about school health program was higher the lower recognition level on significance of school health education of parent and on the expectation about health screening & preventive services was significant difference by age. however, the difference was not significant in the others.

일 도시 중학생을 위한 학교정신보건사업 모형 : 광주광역시 남구효사랑 청소년정신보건센터 Center for the Hyosarang Adolescent Mental Health, Namgu, Gwangju City

이정숙,김수진,박영석 韓國學校保健學會 2004 韓國學校保健學會誌 Vol.17 No.2

Purpose : The goal of this paper is to offer practical suggestions for developing, implementing, and maintaining a successful school mental health program based on the model of a school mental health program for middle school students at the Namgu Hyosarang adolescent Mental Health Center. The model will be divided into six areas and the challenges and future direction of this program : creative approach to funding, creative staffing, education, training, needs assessment & resource mapping, collaboration and partnerships in a school mental health program, and developing an outcome evaluation research. Method : This is a descriptive study of the school mental health program model for middle school students of Namgu Hyosarang Adolescent Mental Health Center implemented over a four year period. Conclusion : Within this paper, a blueprint that can guide the development and implementation of school mental health programs has been offered. The actual application of this model will vary depending on the structure and goals of individual programs and schools. This model of our center has been identified as an effective school mental health program and the actual application program in regular learning times to middle school students. Establishing guidelines about the types of activities necessary for the successful implementation and sustainability of a school mental health program constitutes the first step in standardizing this process, and the school mental health movement continues to receive national recognition as a viable services delivery model for adolescents in need of mental health services. The recommendations outlined indicate that a school mental health program is more effective and necessary than the clinical service of a psychiatric hospital for adolescents' emotional /behavioral problems.

학교보건과 건강관리 : Model of Comprehensive School-Based Centers

홍창호 한국건강관리협회 1998 건협 Report Vol.1 No.-

학생정신건강검진 시범운영사업에 따른 추진방안

김현정,김윤영,이혜숙,현미나,남동현,김상원,안동현 韓國學校保健學會 2009 韓國學校保健學會誌 Vol.22 No.1

Purpose: The purpose of the study was to·find the strategies of mental health screening in school. Based on the literature review, we discuss the importance of screening students in schools for mental health problems. Methods: Data from the 2008 Korean Mental Health Screening in Schools(2008-KMHSS) are used to estimate the outline of this screening. We administered the questionnaire for satisfaction of 2008-KMHSS for students(N=1,280), parents(N=2,672), school nurses(N=75), teachers(N=685), district personnels(N=6), and mental health center staffs(N=37). Also we interviewed a part of them by telephone and e-mail. And we reviewed the tools and methods for screening students for emotional/behavioral problems. Results: Mental health screening in schools is a very important, yet worrisome, agenda that is in its very early stages. From the 2008 Korean Mental Health Screening in Schools, 9,588 students(12.9%) needed more evaluation in the first stage. Of these, 6,910(72.1%) completed the second stage screening. In this sample, 1,975(28.6%) utilized the mental health services in school or community. 38.3% of students and 43.7% of their parents notified the2008-KMHSS. But only 12.1% of students and 10.9% of their parents dissatisfied with the screening. 9.9% of teachers and 22.7% of school nurses dissatisfied with the screening. Among them the school nurses were mostly dissatisfied, and they complained work burden from KMHSS. Mental health center staffs complained similar issues. The Children's Problem-behavior Screening Questionnaire(CPSQ) and Adolescents' Mental-health & Problem-behavior Screening Questionnaire(AMPQ) were compatible to screen students in schools for mental health problems in first stage. Conclusion: Mental health screening in schools needs careful planning and implementation. For successful mental health screening in schools, several elements need to be considered: careful planning, collaboration, staff training, and integrative mental health programs and services in community or schools.

학교구강보건실 운영이 아동들의 구강보건지식 및 행동변화에 미치는 영향

최순례 ( Soon Lye Choi ),권현숙 ( Hyeon Sook Kwun ),송근배 ( Keun Bae Song ),이정화 ( Jung Hwa Lee ),강현경 ( Hyun Kyung Kang ),최정미 ( Jung Mi Choi ) 한국치위생학회 2006 한국치위생학회지 Vol.6 No.4

Demand for appropriate health care has gradually increased in Korea. In addition, developments of community- and school-based oral health programs have also focused oral health care for the oral health promotion. Especially, school-based oral health programs are the underpinnings of promoting oral health and preventing oral diseases among schoolchildren. School-based oral health programs have had three major components: oral health education, oral health services, and a healthful environments. These included oral health education(one-to-one communication, group communication, and use of mass communication), oral examination, fluoride mouthrinsing, pit-and-fissure sealants, fluoride gel application, mechanical plaque control, and chewing xylitol candy. In this study, we evaluate the effects of oral health programs among primary schoolchildren by comparing the oral health knowledge, oral health behaviors, and perception of caries prevention procedures. Data for this study were obtained from 699 primary schoolchildren at the two primary school in Daegu, Korea. One is experimental group, N primary school, that was established school-based oral health center under supervision of Nam-gu Public Health Center, the other is control group, N` primary school, that was yet to establish school-based oral health center. We surveyed children`s oral health knowledge and behaviors, and perception of caries prevention procedures using self-administrated questionnaire and then analyzed differences of each item among two groups. The brief findings of this study were summarized as follows. There are several advantage to a comprehensive school-based oral health program. (1) School-based oral health programs facilitate and increase the effectiveness of teaching oral health subjects. (2) Schoolchildren are available for prevention or treatment procedure. (3) School-based oral health center may be less threating than private dental clinic. (4) With comprehensive school-based oral health programs the decayed, missing, and filled teeth(DMFT) of schoolchildren should demonstrate a substantial and steady decrease over time(Choi et al, 2004). In conclusion, treatment is not the answer to solving children`s oral health programs; rather primary prevention is the key. Many countries and communities are focusing on hoe millions of underprivileged children can be provided with health care. Schoolchildren gain the knowledge and behaviors to attain and maintain good oral health in schools. For these reasons, the role of school-based oral health center is not only important but also a necessity.

영양교육, 급식 만족도, 잔반, 정신적,신체적 건강에 관한 자각증상간의 관련성

권순자(Sun Ja Kwon),성순정(Soon Jung Sung),이선영(Sun Yung Ly) 대한지역사회영양학회 2010 대한지역사회영양학회지 Vol.15 No.1

The purpose of this study was to examine the interrelations among current status of nutrition education, satisfaction with school lunch, school lunch leftovers and self-rated mental or physical health in order to find out the effective method of nutrition education. For this, a questionnaire survey of 623 primary school 5th and 6th-graders in Daejeon area was carried out. The eating places were classrooms (41.1%) and restaurants (58.9%). A 59.2% of students have received nutrition education and the opportunity of receiving nutrition education was more in 5th-graders than in 6th-graders (p<0.001). The score of nutrition knowledge was 9.4±2.8 out of 15. When the score of nutrition knowledge was higher, the practical use of nutrition knowledge was higher (r=0.134, p<0.01); the score of school lunch leftovers were less (r=-0.116, p<0.01); and the score of self-rated mental health was more positive (r=0.198, p<0.01). The practical use of nutrition knowledge was 2.9±1.1 out of 5. When the practical use of nutrition knowledge was higher, satisfaction with school lunch was higher (r=0.105, p<0.01); school lunch leftovers were less (r=-0.103, p<0.01); the score of self-rated positive mental health was higher (r=0.293, p<0.01); and the scores of self-rated negative mental health (r=-0.119, p<0.05) and physical health (r=-0.126, p<0.01) were lower, thus rating their health more positively. The score of satisfaction with school lunch was 3.4±1.0 out of 5. When the satisfaction with school lunch was higher, the score of school lunch leftovers was less (r=-0.216, p<0.01); the score of self-rated positive mental health was higher (r=0.147, p<0.01); and the score of self-rated negative health was lower (r=-0.121, p<0.01). The score of school lunch leftovers was 2.9±1.4 out of 5. When the school lunch leftovers were less, self-rated positive mental health was significantly higher (r=-0.146, p<0.01); and the scores of self-rated negative mental health (r=0.135, p<0.01) and physical health (r=0.223, p<0.01) were significantly lower, thus presenting positive health. Therefore, in order to maintain positive health condition, it is necessary to carry out nutrition education, which is able to raise the nutrition knowledge and practical use of nutrition knowledge, school lunch satisfaction and to reduce the school lunch leftovers. (Korean J Community Nutrition 15(1): 94~107, 2010)

일반논문 : 초,중,고등학교의 보건교육 실시현황 및 정착방안에 관한 조사연구

김영숙 ( Young Sook Kim ),하영미 ( Yeong Mi Ha ),박현주 ( Hyun Ju Park ),정혜선 ( Hye Sun Jung ),권은하 ( Eun Ha Kwon ) 인하대학교 교육연구소 2011 교육문화연구 Vol.17 No.3

본 연구는 2007년 학교보건법 개정이후의 서울 지역을 중심으로 초·중·고등학교의 보건교육 실시현황을 조사하고, 학교 보건교육 정착을 위한 개선방안을 파악하고자 하였다. 2010년 10월 27일-11월 22일 약 1달동안 보건교사를 대상으로 설문조사가 진행되었으며, 최종적으로 478개교(초등학교 238개교, 중학교 142개교, 고등학교 98개교)의 자료를 분석하였다. 서울지역 초등학교의 경우 개정 학교보건법에서 규정한 연간 17차시이상으로 보건교육을 실시하고 있는 초등학교는 84%인 것으로 조사되었고, 중·고등학교의 경우 2.1%의 학교가 보건을 선택교과로 채택하여 보건교육을 수행하였다. 보건교육 정착을 위한 16개 방안중에서 초·중·고등학교 보건교사들은 13개 방안에 대해 학교 보건교육 정착을 위해서 필요하다고 응답했으며, 그중에서 초·중·고등학교 보건교사들에게서 4.5점 이상의 높은 요구도를 보였던 정착방안은 ``보건교육중 응급사고에 대한법적 체계 마련’ ``과대학급 학교에 보건교사 2인 배치’와 ``보건교육실 설치’ 3가지 방안이었다. 특히, 2순위 보건교육 정착방안(과대학급학교에 보건교사 2인 배치)은 학교급, 초등학교의 연간 보건교육 실시현황, 1주당 보건교육시간에 따라 통계적으로 유의한 차이를 보였다. 본 연구를 통해 도출된 결과를 바탕으로 향후 성공적인 보건교육 정착을 위해서 다음과 같이 제언하고자 한다: 인적측면에서 37학급이상의 과대학급 학교에 보조인력을 추가로 지원한다; 물적자원 지원 측면에서 보건교육실을 설치한다. 제도적 측면에서 중ㆍ고등학교의 보건교육을 지원하기 위해서 보건교과를 필수적으로 최소학점으로 이수하는 ‘보건교육 집중이수제’를 도입한다. The purpose of this study was to provide basic information about the current state of school health education after addendum to 2007 school health law, and to suggest strategies for strengthening school health education in elementary, middle and high schools. During October 2010 to November 2010, data were collected from 238 elementary schools, 142 middle schools, and 98 high schools in Seoul. The collected data were analyzed using SAS 9.1 program. Nearly 85% of elementary schools provided a school health education on 17 hours of health education per year, whereas only 2% of school nurses in middle and high schools offered it. Top 3 ways for strengthening school health education were ``Making emergency protocols during school health education``, ``Putting one more school nurses into big size schools``, and ``Room for school health education``. The strategy of ``Putting one more school nurses into big size schools``was associated with types of schools, hours of health education per year in elementary schools, hours of health education by a school nurse. In conclusion, policies for strengthening health education are needed to help students learn of good health behaviors for achieving lifelong health and well-being: ⑴ hire an assistant for supporting a school nurse; ⑵ remodel or make a room for health education; and ⑶ establish a health education as a required course before middle and highschool graduation, especially middle and high schools.

초등학생의 사회자본과 보건실 이용 및 학교적응의 관계

신미수 ( Meesu Sheen ) 한국보건교육학회 2016 한국보건교육학회지 Vol.2 No.1

본 연구는 최근 사회변화로 학교의 돌봄 기능이 강화되어 학교 내외부로 각종 「돌봄과 복지」를 위한 정책이 시행되고 있지만, 정작 아이가 가정과 학교에서 사회자본이 부족하다고 느끼고 부적응을 경험할 때 다른 곳이 아닌, 학교 내에서 교사와의 집중적인 일대일 대면, 돌봄과 쉼이 있는 보건실을 자주 이용하는 점에 주목하였다. 그리고 실제 현장교사들은 보건실 방문자나 업무량의 증가에도 불구하고 어떤 정책적 지원이 이루어 지지 않아 변화된 역할요구를 수행하는 데에 어려움을 토로하고 있다. 이에 본 연구는 사회변화에 따라 사회자본이 부족하여 학교생활에서 어려움을 겪는 아이들이 건강하게 성장할 수 있도록 학교보건실이 사회자본의 보완제로서 제대로 기능하기 위한 정책적 개선방안을 찾고자 하는 데 목적이 있다. 연구방법은 일 학교의 보건일지를 분석하여 대상자 139명을 선정, 학생설문지를 통하여 일반적 배경에 따른 사회자본, 학교적응, 보건실이용행태를 측정하였다. 또한 학생 6명과 교사 4명에 대한 인터뷰를 실시하였다. 자료 처리 및 분석은 일반적 배경에 따라 사회자본, 학교적응, 보건실 이용행태를 t검증 및 ANOVA검증을 통하여 평균 차이를 확인하였고, 사회자본의 정도에 따라 두 집단별 학교적응, 보건실이용횟수 및 이용형태를 알아보기 위하여 t검증 및 상관관계를 확인하였다. 또한 학생 인터뷰을 통하여 설문조사 내용을 보완, 확인하고 사회변화에 따른 보건교사의 인식과 정책 제언을 위하여 보건교사 4인과 전화인터뷰를 통하여 보완, 정리하였다. 연구결과를 바탕으로 변화된 학교보건실의 역할을 위하여 학교보건실에 대한 안정적이고 체계적인 인력지원과 담임교사, 보건교사, 상담교사와 가정 간의 연계 시스템, 보건교육의 강화와 보건교육지원센터 설립 등 정책지원을 제언하였다. Along with recent changes in our society, schools’ caregiving function is getting enhanced, and policies for all sorts of 「caregiving and welfare」 are being enforced both in the inside and outside of schools. But when children get to feel the shortage of social capital in their family and school and experience maladaptation, they often use their school health room where they can have an intensive one-to-one confrontation with the teacher and can be provided with caregiving and resting. Moreover, teachers in the field are expressing difficulties in playing their changed roles demanded because there is not any political support for them despite the increase of health room visitors or their workload. Focusing on this phenomenon, this author aims to find out ways to improve school health rooms so that they can function properly as a complement of social capital and also children can grow healthily despite having difficulties at school for the shortage of social capital attributed to the changes of our society. Regarding study methods, this researcher selected 139 subjects analyzing a school’s health care daily records, and with a student survey, this author measured their social capital, school adjustment, and health room-using behavior in accordance with their general background. Also, six students and four teacher were interviewed. Concerning data processing and analysis, their social capital, school adjustment, and health room-using behavior were examined in accordance with their general background to see the mean difference based on the t-test and ANOVA. To figure out the two groups’ school adjustment and health room-using frequency and behavior in accordance with the degree of their social capital, the t-test and correlation analysis were performed. Also, the student interview was used to complement and confirm the contents of the survey. To examine health teachers’ recognition of social changes and provide political implications, a telephone interview was conducted to four health teachers for further complement and arrangement. Based on the study results, this author provides implications for political support so that school health rooms can play their changed roles, for example, providing stable and systematic manpower support for school health rooms, building up a system to connect teachers in charge, health teachers, and counseling teachers with families, strengthening health education, and also building centers to support health education.

아동·청소년 정신건강 증진을 위한 법제도에 관한 소고 –독일법과의 비교를 중심으로-

한명진 성균관대학교 법학연구원 2023 성균관법학 Vol.35 No.4

본 논문은 아동·청소년 정신건강 증진에 대해 포괄·통합적인 차원에서 규율하고 있는 법률이 있는지 혹은 해당 법률이, 그 기본적 토대를 가지고 향후 아동·청소년 정신건강 증진을 위한 주요법률로 개정될 가능성이 있는지 판단하는 것을 주된 연구의 목적으로 하였다. 독일에서는 아동·청소년의 정신건강에 대해 하나의 통합법을 통하여 따로 규율하지는 않고 각각의 개별법을 통하여 일반인의 정신건강 범위와 원칙에 준하여 처리되고 있다. 특히 아동·청소년의 건강과 관련해서는 주 법인 「학교법」 규정이 상당히 유의미하다. 독일은 우리나라의 「학교보건법」과 같은 단일의 법률을 통해 아동·청소년의 정신건강 증진에 관한 규율을 하는 것이 아니라, 각 주가 제정한 「학교법」에서 정한 아동·청소년들을 위한 학교보건를 통하여 아동·청소년들의 질병을 예방하고 조기에 인식하여 치료할 수 있도록 하고 있다. ‘학교건강’에 대해 별도의 조항을 두어 규율하면서 아동·청소년을 대상으로 정신건강을 포함하는 의미에서의 건강증진을 위하여 학교의사 임명, 건강검진의무실시 등의 내용을 규정하고 있다. 예컨대 작센 주 학교법은 제3부 ‘학교의무’ 부분에서 제26조a 학교보건에 대해 규율하면서, 정신건강을 포함하는 의미에서의 아동·청소년 건강관리가 학교의 의무사항임을 명시하고 있다. 한편 이외에도 학부모의 아동·청소년 건강에 대한 의무도 강제되어 있다. 예컨대 노르트라인-베스트팔렌 주 「학교법」에서는 아동·청소년의 입학건강검진 의무를 부모가 고의 또는 과실로 이행하지 않는 경우, 질서위반금을 부과하도록 규정하고 있고, 또한 작센주 「학교법」 에서도 학부모참여의무에 대한 강제사항을 준수하지 않는 경우 질서위반금을 부과하도록 규정하고 있으며, 이외에도 학교 생활에 영향을 미칠 수 있는 아동·청소년의 건강상의 문제를 학교에 알리도록 부모의 의무사항을 규정하고 있다. 한편, 노르트라인-베스트팔렌 주의 「학교법」 에서는 학교장이 다른 아동·청소년이나 정신적 안전에 구체적 위험이 될 수 있는 아동·청소년에 대한 등교중지를 할 수 있도록 규정해놓고 있다. 우리나라의 경우 관련 법률에서 학부모의 아동·청소년의 정신건강과 관련한 사항에 대해 고지할 의무를 규정하고 있지 않다는 점과 등교중지에 관하여도 감염병 예방을 위하여서만 이루어진다는 점등을 고려할 때, 실효적·유기적·체계적인 아동·청소년 정신건강 증진을 위하여 독일의 입법례는 상당한 시사점을 제공해주겠다. 독일의 「학교법」입법례를 참고하여 우리의 「학교보건법」을 중심으로 하여 아동·청소년 정신건강 증진에 관한 주요내용을 규율할 것을 제안해본다. This paper aims to assess the existence of comprehensive legal regulations for promoting mental health in children and adolescents and to determine the potential for future amendments to key laws related to mental health promotion for this demographic. In Germany, mental health for children and adolescents is not regulated through a unified law but is addressed individually through various laws, aligning with general principles of mental health for the general population. Notably, the German "School Law" provisions play a significant role in regulating the health of children and adolescents. Unlike South Korea, where the "School Health Law" governs mental health promotion for children and adolescents through a single law, Germany addresses these aspects through each state's individually enacted "School Law," focusing on school health to prevent and detect diseases in children and adolescents promptly. Germany includes provisions specifically regulating "school health," addressing mental health promotion for children and adolescents within the broader context of health. This includes the appointment of a school physician and regulations for mandatory health examinations. For example, the Lower Saxony School Law, in Part 3 on "School Obligations," explicitly specifies the obligation of schools to manage the health of children and adolescents, emphasizing mental health. Moreover, German laws mandate parental responsibilities for child and adolescent health, such as compulsory health check-ups upon admission to school. Failure to comply with these obligations may result in penalties, such as fines. Additionally, German school laws grant school authorities the power to suspend attendance for children and adolescents who may pose a concrete risk to themselves or others due to mental health concerns. In contrast, South Korea lacks legal provisions requiring parental notification of child and adolescent mental health issues and restricts school suspensions primarily for infectious disease prevention. Considering these differences, Germany's legislative examples provide valuable insights for proposing effective, systematic regulations on mental health promotion for children and adolescents, focusing on South Korea's "School Health Law."