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이 연구는 경호경비직 종사자집단과 경호학과 학생집단의 신체적, 정신적 자각상태 호소를 통해 건강프로그램이 개인의 건강에 미치는 영향과 남여 간의 차이를 규명하는데 그 목적이 있다. 따라서 본 연구는 2년 이상의 경호경비 경력자 358명과 경호학과 학생 220명을 대상으로 T.H.I.에 의한 설문지 조사를 하였으며, 자료의 분석은 건강프로그램 처치여부, 성별, 경호경력에 따른 심신자각증상 호소점수의 차이를 비교하기 위해 변량분석(Analys of Variance/ANOVA)을 실시하였고, 통계적으로 유의한 차이가 나타났을 경우 사후비교 검정방법으로 Scheffe의 다중비교법을 사용하여 다음과 같은 결론을 얻었다. 1. 전체적으로 경호학과 학생집단이 경호경비원 집단보다 심신자각상태 호소점수의 분포에서 낮은 평균치를 나타내었으며, 특히 정서불안정, 다자각증상, 생활불규칙, 우울성, 호흡기, 눈과 피부, 공격성에서 유의하게 낮게 나타났다. 2. 건강프로그램 처치 후 남여간 심신자각상태의 비교에서는 모든 항목에서 남성이 여성보다 낮게 나타났으며, 허구성 및 호흡기 항목에서만 통계적으로 유의 하지 않았고, 그 외 항목에서는 유의한 차를 보여주었다. 3. 경호경비 경력에 따른 경호경비원의 심신자각상태 비교에서는 정서불안정, 우울성, 허구성 항목에서 유의한 차이가 나타났는데 정서불안정 및 우울성은 경호경비 경력이 많을수록 낮았고, 허구성은 오히려 경호경비경력이 많을수록 높게 나타났다.

This research is for examining the effect on personal health and differences between men and women by health care program in security guards and students, who are specializing security in college, appealing consciousness state physically and mentally. The following results are attained by conducting a questionnaire survey(T.H.I) of 358 men engaged in security guard services and 220 students specializing security (The data analysis is operated by Analysis of Variance(ANOVA) to make a comparative study of health care program, sex distinction and security careers. The implication of the study are as follows. 1. Generally students show less average rate than security guards in appealing the consciousness state especially in Mental Irritability, Irregular Life, Depression, Respiratory, Eyes and Skin, Aggressiveness. 2. In comparing men with women of consciousness state after the step of health care program, men show lower average rate than women except Life Scale and Respiratory. 3. In differences of consciousness state by security career, the more respondents have careers, the less the average rate of Mental Irritability and Depresaion is. But in Life Scale, the result is reverse.

Purpose: This study aimed to develop and apply a self-management competency enhancement program based on Johnson’s Model of Health Care Empowerment for vulnerable elderly women with hypertension. Methods: A quasi-experimental, non-equivalent control group design was used. Participants were 38 elderly women aged 65 and older receiving customized home visiting health care in G city. They were assigned to either the intervention or control group. The program consisted of eight 60-minute sessions, and was held twice a week for four weeks. Blood pressure (BP) and lipid levels, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured at three time points: before, immediately after, and four weeks after the intervention. Health literacy, self-efficacy, and depressive symptoms were assessed using structured questionnaires. Data were analyzed using repeated measures analysis of variance (ANOVA), independent t-tests, the Friedman test, and the Mann-Whitney test. Results: The program significantly improved health literacy (p<0.01) and self-efficacy (p<0.01). However, no significant differences were observed between groups in blood pressure, lipid levels, or depressive symptoms. Conclusion: The health care empowerment program is a viable community health nursing intervention for enhancing health literacy and self-efficacy in vulnerable elderly women with hypertension.

Purpose: The purpose of this study was to evaluate a self-care program for elders with osteoarthritis managed by primary health care workers, Community Health Practitioners (CHPs), in rural Korea. Methods: The self-care program, consisting of 7 areas, was evaluated with a randomized experimental study for patients over age 60 with osteoarthritis in which 150 participants in the experimental group and 140 in the control group were compared. The self-care program was implemented for six weeks, 2 hours per week, at community health posts by CHPs. Data were collected using an interview questionnaire given by the CHPs and laboratory tests before and after the intervention for both groups. Propensity score matching analysis was done to test effectiveness after controlling for confounding variables. Results: The intervention group showed a significant decrease in the number of painful joints (p<.001) and a significant increase in self-care ability (p<.05) compared to the control group. Conclusion: Study results indicate that training and utilizing primary health care workers in rural areas is valuable in increasing the generalization and continuity of intervention programs. As arthritis should be managed life-long, CHP directed self-care programs are useful interventions for rural elders with arthritis to learn self-care management.

Purpose To evaluate the effects of a home-based palliative care program, delivered by a community health center in Korea, in terms of quality of life and health care utilization. Methods A cross-sectional comparative study was utilized. Data were collected from 30 terminally ill cancer patients who had received palliative care from the community health center and 46 terminally ill cancer patients not receiving palliative care from the center. The measurements used in the study were a Revised Korean version of Quality of Life at the End of Life survey, self-reports on days of hospital admission and the frequency of outpatient care and ER visits during the past 6 months. Results The palliative care group had a higher quality of life only in a physical aspect. The palliative care group had a lower frequency of outpatient visits and ER visits in the last 6 months than the nonpalliative group, but no significant statistical differences were found. Conclusions A home-based palliative service program delivered by the community health center appears to be an appropriate care model for managing physical symptoms. Reinforcing services for psychosocial and spiritual counseling and encouraging affiliation with free-standing inpatient healthcare providers are warranted.

Purpose: The research purpose was analysis of the effect of a health education program for newly-married executed from 2003 to 2005 as a part of health care service from community health center and providing the fundamental source for health education needed during newly-married. Method: The data collection with structured questionnaires was conducted during October to December in 2006. From the health center 106 brides who participate the program and 130 brides who didn't participate. Health care program for newly married couple were composed health examinations and health educations. Health examinations were CBC, LFT and Ag & Ab prevallence rates of hepatitis B, rubella. Health educations were done two times, the first individual health education was done at enrolled in health center for establishment of desirable couple relationship, family planning, contraception method and management of pre-pregnancy. The second individual health education was done for explanation of blood examination results, prevention of the congenital deformity and the vertical transmission of hepatitis B, management for pregnancy, breast feeding method, introduction to safety delivery method and encouraging self-study using by materials made by health center after two weeks at revisiting health center. SPSS/PC(ver. 12.0) and X²-test, t-test was used to analyze the collected and tabulated data. Socio-demographic characteristics and regional characteristics of residence area of two groups shows no significant difference. Result: As a variables of experimental effect, The natural childbirth rates of participants group was significantly higher than Non-participants group(p=.012). Breast feeding rates for participants group was also statistically significant higher than Non- participants group. Contraception rates showed no significant difference. The rubella vaccination rates (p=.001) and The hepatitis B vaccination rates (p= .012) shows statistical differences. Conclusion: Therefore health care program for newly married couple in a community health care center was effective generally. We supposed that explore participation ways for non- participants, expand the program to community health care center in whole country.

Purpose: This study was conducted in order to investigate changes in the physical, psychosocial and spiritual health of people with mental disorder in community participating in the Integrated Health Care Program (IHCP). Methods: This study applied the non-equivalent control group pretest-posttest quasi-experimental design. The participants were 37 chronic psychiatric patients who had been clinically diagnosed with mental disorder and visiting a mental rehabilitation center located in S City (17 in the experimental group, and 20 in the control group). The experimental group participated in the IHCP consisting of 24 sessions for eight weeks. Results: After the intervention, only the participants in the experimental group reported significant improvement in physical (body mass, triglyceride), psychosocial (mental symptoms, depression, self-esteem, ability of problem solving), and spiritual wellbeing when compared with those in the control group. Conclusion: These results indicate that IHCP is effective in improving the physical, psychosocial, and spiritual wellbeing of people with mental disorder. Therefore, IHCP developed in this study is considered a useful nursing intervention for raising the comprehensive health level of people with mental disorder in community.

Purpose: This research was conducted to evaluate the effects of asystemic follow-up care program on health promotion and risk reduction in 64 high-risk infants(HRI) including premature infants and their mothers. Method: The intervention consisted of systemic NICU education, tele-counseling and 3 home visits in 6 months. The subjects were divided into either the intervention group or the control group receiving the conventional NICU education without the tele-counseling and home visiting. Infant health promotion was measured using physical assessment, types of health problems, reflexes, OPD visiting history, DDST, immunization, feeding assessment, Infant death rate, etc. Maternal self-esteem, postpartum depression and family function were measured using the maternal self-report inventory(MRI), EPDS, and family apgar score(Fapgar), retrospectively. Result: All premature infants in the intervention group were in the normal range of growth and development, and the regular vaccination schedule. The health problems in the intervention group were addressed early so not to develop into adverse effects. The follow-up program for 6 months showed beneficial effects on MRI, EPDS, and Fapgar. Conclusion: A systemic follow-up health care program is beneficial on health promotion and risk reduction in 64 HRI including premature infants and their mothers.

Purpose: The purpose of this study was to investigate the effects of the maternal health care program on pregnant women's depression, maternal role self-confidence and delivery self-efficacy in a public health center. Methods: This study used a non-equivalent control group quasi-experiment design attempted to verify the effectiveness of maternal health care program. In the experimental group (39 participants), maternal health care program was applied for 120 minutes for 8 weeks, and the control group (40 participants) was provided with a booklet for maternal health care. Data collection was conducted from September 20, 2015 to November 30, 2015. Data were analyzed using ${\chi}^2-test$, Fisher's exact test and t-test. Results: The maternal health care program showed a significant effect on maternal role self-confidence and delivery self-efficacy compared to control group. Conclusion: The maternal health care program conducted at the public health center was found to be effective in improving maternal role self-confidence and delivery self-efficacy. Further development of a program to mediate the depression of the expectant mothers is needed.

Purpose: This study aimed to determine the effects of a 'Customized Integrated Health Care Program' for male living alone in a single region and assist health promotion of the participants. Methods: This study was one-group pretest-posttest design. Eleven participants in the 'Happy Cooking Class for Male Living Alone' who made 100% of attendance from February 18 to September 8, 2016 were analyzed. Nonparametric paired T-test was performed to determine the differences in Blood pressure(BP), Blood sugar(BS), Cholesterol, Hemoglobin(Hb), Dementia screening test, Depression screening test of the participants in the Customized Integrated Health Care Program. Results: After applying the 'Customized Integrated Health Care Program', Hb level(z=-2.724, p=.006) and Dementia screening test(z=-1.974, p=.048) increased statistically significantly. Conclusion: As the elderly living alone increase in number, it seems that social support networks and health care programs contribute to health promotion of the participants and positively affect the rest of their life.

Purpose: This study examined the operational status and challenges of a public health center-based home healthcare program in Seoul from the perspective of visiting nurses and explored the implications for integrated community care. Methods: A mixed-methods design was used with secondary data collected by the Seoul Metropolitan Government in 2018. Quantitative survey data from 324 visiting nurses were analyzed using descriptive statistics, and qualitative open-ended responses were analyzed using content analysis based on Patton's framework. The analysis was guided by the following five components of the national healthcare system: resource development, service delivery, economic support, management, and outcomes. Results: Visiting nurses were mainly middle-aged women working alone in community centers. The major challenges include insufficient field-oriented training, dual data entry across health and welfare information systems, limited collaboration with social workers, frequent visit refusals by older adults, and low wages with unstable employment conditions. Nevertheless, the nurses perceived the program as meaningful for the early identification of health and psychosocial needs. Conclusion: Structural barriers hinder IC effectiveness. Improving information system integration, workforce support, training, and compensation is essential for strengthening home-based nursing services and promoting the implementation of the Integrated Community Care Act in Korea.

-Key concept : Premature infants, Community based-nursing, Infant mortality rate, Home visiting nursing

Purpose: The purpose of the study is to develop a web-based program on child health care, and to identify the effect of the program on knowledge of, attitudes towards child health care, and health care practice in staff of daycare centers. Methods: The program was developed through the processes of needs analysis, contents construction, design, development, and evaluation. After the program was developed, it was revised through feedback from 30 experts. To identify the effect of developed program, onegroup pretest-posttest design study was conducted with 64 staff members from 12 daycare centers in Korea. Results: The program was developed based on users' needs and consisted of five parts: health promotion, disease and symptoms management, oral health, injury and safety, sheets and forms. This study showed that the total score of staff who used the program was significantly higher in terms of knowledge, attitudes, and their health care practice compared with pretest score (p<.05). Conclusion: These results suggest that this Web-based program can contribute to the child health promotion as well as can provide the staff with the insightful child health information. Therefore, it is expected that this program will be applied to staff of other child care settings for children's health.

For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5％ 10％ 20％ 30％ 40％ 50％ 60％ Diagnosability : 12% 23% 40% 5

Purpose: The purpose of this study was to develop a parents education program for early childhood health care and to measure its effects. Methods: This study was a quasi experimental study following a pretest-posttest design model. The subjects were 264 parents who had children aged 0-5 years in 7 rural districts or in the city. The content of this program was child development and management, and the management for health and disease for and emergency care. Parent education was performed by 7 nursing professors in each area, including 2 education sessions. Data were twice collected using a questionnaire,i.e. before the first session and after the second session. Data were analyzed by using the SAS software version 9.1. Result: The hypothesis of this study was that “the parents' score will improve after education”. Our hypothesis was supported (t=7.30, p=<.0001). We found corelation in occupation and past experience of similar education. The contentment of education was higher than 90%. Conclusion: The systematic parents education program was very useful and effective, in raising the level of contentment of subjects. There is the needed for the social opportunity of parents' education program to be extended and emphasised by public support.

=Program ⅡHan, Kyung-Ja1)Kim, Ji-Soo2)Choi, Mi-Young3)1) Professor, College of Nursing, Seoul National University2) Lecturer, College of Nursing, Seoul National University3) Doctorial Candidate, College of Nursing, Seoul National UniversityPurpose:management of sick children by day-care staff. Methods: A cross-sectional descriptive study. Day-care staf (N=206) from 3 day care centers in Seoul, completed a structured questionnaire. Results: Almost half of the day-care staf (53.4%) experienced sick events in their child at least once a month. The most frequently reported (99.5%) had asked parents not to bring a sick child to the day care center. The biggest reason of exclusion was due to infectious disease including measles, chicken pox, mumps, diarrheavomiting, and pink eye. The majority of day-care staff (97.6%) agreed that there is a ned for Center-based Child Care Health Program (CHP), and Conclusion:These results showed a high incidence of sicknes in children in day care centers, and there were great demands for a Center-based Child Care Health Program for day-care staff. Also the results of this study can be utilized as a basis for the establishment of child care policy in Korea.

Purpose: The purpose of this study was to examine the effects of a health care empowerment program on health care empowerment, self-management, symptom management and symptom severity for patients undergoing hematopoietic stem cell transplantation. Methods: The study design consisted of a non-equivalent control group with a non-synchronized design. The samples consisted of 43 patients who were scheduled to discharge after hematopoietic stem cell transplantation. The patients in the experimental group were enrolled in a health care empowerment program for 6 weeks. The efficacy of the program was evaluated by measuring pre- and post-health care empowerment, self-management, symptom management, and symptom severity. Results: There were statistically significant changes detected in the level of health care empowerment, self-management, symptom management, and symptom severity in both groups after the health care empowerment program. Conclusion: The health care empowerment program was effective in improving health care empowerment, self-management, and symptom management, in addition to decreasing symptom severity for patients undergoing hematopoietic stem cell transplantation. This program is differentiated from those in other studies in that it involves being engaged, informed, collaborative, committed, and tolerant of uncertainties regarding health care. This suggests that a hospital-based, nurse-led intervention program can enhance patients’ self-management.

To investigate the actual conditions of health care management in child day care centers and parents needs for a Center-based Child Care Health Program. Methods: Study design was cross-sectional descriptive study. 937 parents from 33 day care centers in Seoul completed a structured questionnaire. Results: 73.0% of the parents experienced sick events with their child at least once or more every 1-3months. These events resulted in 35.2% of the parents having to leave work early or to be absent from their jobs. 30.4% were asked to drive a sick child from the child day care centers to their home. Most parents (76.7%) agreed on the need for a Center-based Child Care Health Program (CCCHP), and expected general health & illness management, and growth & development evaluation from the CCCHP. Conclusion: These results show that there is a great demand for Center-based Child Care Health Program. They suggest that there is an urgent need to develop CCCHPs to promote children's health and to support parents. Also the results of this study can be utilized as a basis for the establishment of a childcare policy in Korea.

Purpose: This study was conducted to develop a mobile web-based pregnancy health care educational program for mothers who were at an advanced maternal age (AMA) and to verify the effects of the program on pregnancy health care. Methods: This program was developed using a web-based teaching-learning system design model and composed of 10 subject areas. This research was a quasi-experimental study using a non-equivalent control group pretest-posttest time serial design and data were collected from April 2 to May 3, 2014. To verify the effects of the program, it was used for 2 weeks with 30 AMA mothers (experimental group). For the control group, a classroom education booklet for pregnant women used with 31 AMA mothers. Results: The experimental group having participated in program had statistically significantly higher scores for knowledge (t=3.76, p <.001), self-efficacy (t=8.54, p <.001), and practice behavior (t=4.88, p <.001) of pregnancy health care, compared to the control group. Conclusion: The results of the program indicate that a Mobile web-based pregnancy health care educational program is effective in meeting the needs of AMA mothers and can be used as the prenatal educational program for AMA mothers and is appropriate as an educational media for theses mothers.

Purpose: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessationweb-based, multimedia, educational program for a range of medical professionals. Methods: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1)analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. Results: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. Conclusion: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.