Korean Journal of Health Education and Promotion (보건교육건강증진학회지)

Korean Society for Health Education and Promotion (한국보건교육건강증진학회)
권호 표지

Evaluation of Hypertension Prevention and Management Programs Conducted by Community Health Nurse Practitioners in Rural Areas of Korea

농촌지역 보건진료소의 고혈압 예방 및 관리사업 평가

  • Kwon, Myung-Soon (Division of Nursing, Hallym University) ;
  • Cho, Won-Jung (Department of Nursing Environment Systems College of Nursing, Yonsei University) ;
  • Kim, Mi-Ja (Department of Medical-Surgical Nursing, College of Nursing, University of Illinois at Chicago) ;
  • Lee, Hyeon-Kyeong (Department of Nursing Environment Systems College of Nursing, Yonsei University)
  • Received : 2010.11.05
  • Accepted : 2010.12.11
  • Published : 2010.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study aims to evaluate effectiveness of hypertension prevention and management programs (HPMPs) in rural Korea. Methods: A questionnaire survey was conducted with 700 community health practitioners working at primary health care posts (PHCPs). The questionnaire had four domains, which were hypertension management, hypertension prevention, the PHCP environment, and evaluation system, each with different maximum weighted values (WVs). Weighted values of 100 indicate the best effectiveness for the HPMP in all four domains. Results: The average WVs and percent effectiveness of all four domains combined was 61.65 (62%); the hypertension management domain was 28.81 (72%); the hypertension prevention domain was 23.44 (67%); the PHCP environment was4.29(43%); and the evaluation system was5.10(34%). Conclusion: The HPMPs were generally effective, and hypertension management was the most effective. The environment of PHCPs and the evaluation system of HPMPs should be improved to increase the effectiveness of the HPMPs.

목적: 한국 농촌지역에 있는 보건진료소에서 수행하고 있는 고혈압 예방 및 관리 사업 평가도구를 개발하고, 이를 활용하여 현장에서 수행되고 있는 프로그램을 평가하고자 한다. 방법: 문헌고찰, 현장방문과 보건진료소에서 근무하는 보건진료원과의 심층면담을 통해 예비문항을 작성하고, 전문가(중앙기관의 업무행정담당자 5인, 보건진료원 6인, 이론과 연구전문가 5인)집단을 통해 2회 내용타당도 검정을 실시하였다. 전문가들에 의해 80%이상 동의한 항목만을 선정한 결과, 4개 영역, 12개 항목, 41개 세부평가 항목으로 구성된 평가도구가 완성되었다. 4개 영역은 고혈압 예방사업, 고혈압 관리사업, 사업여건조성, 자체평가로 분류되었고. 고혈압 예방사업 영역은 보건교육, 고혈압환자 조기발견 항목이 포함되었고, 고혈압 관리사업 영역은 고혈압환자 등록 및 관리사업, 교육 및 상담, 고혈압환자 치료 및 추구관리 항목이 포함되었다. 사업여건조성 영역은 지역주민의 접근성, 보건교육자료의 비치, 홍보 항목이 있고, 자체평가는 사업계획서 수립, 중간평가, 결과평가 항목으로 구성하였다. 영역별 가중치는 전문가타당도 검정을 통해 각기 다르게 설정하였으며, 연구대상은 전국 보건진료소를 모집단으로 비례층화추출법에 의해 700개소를 선정하였다. 연구의 윤리적인 측면을 고려하여 설문지 표지에 연구에 대한 구체적인 소개, 익명성보장과 자발성을 제시하고 자가 보고식의 우편설문조사를 실시하였다. 최종적으로 215개의 설문지를 자료 분석에 활용하였다. 결과: 영역별 평가결과에 의하면 고혈압 관리 사업이 평균 28.81점(72%), 고혈압 예방사업은 평균 23.44점(67%), 사업여건조성이 평균 4.29점(43%), 자체평가 5.10점(34%) 순으로 나타났다. 항목별 평가에서 가장 낮은 결과를 보인 것은 보건교육을 위한 교육매체 보유, 공식적인 연계망, 고혈압사업의 여건조성을 위한 물리적 환경조성과 사업결과로 나타났다. 결론: 보건진료소에서 실시하고 있는 고혈압 예방 및 관리 사업을 좀 더 효과적으로 수행하기 위해서는 사업여건 조성과 자체평가 영역을 향상시켜야 할 것으로 사료된다.

Keywords

References

  1. Cho, H., & Kashka, M. 2004. The evolution of the Community Health Nurse Practitioner in Korea. Public Health Nursing 21(3):287-294. https://doi.org/10.1111/j.0737-1209.2004.021311.x
  2. Han, M. S. 1999. Empowerment in the practice of Community Health Nurse Practitioners(CHPs). Ph.D. dissertation, Department of Nursing, University of Yonsei, Seoul, Korea.
  3. Jeon, M. Y., & Community Health Nurse Practitioners' research team in Chungchungbook-do. 2003. The prevalence, health behaviors, and control of hypertension in rural areas in Korea. Journal of Korean Community Nursing 14(3):507-518.
  4. Kearney, P. M., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. K., & He, J. 2005. Global burden of hypertension; analysis of worldwide data. The Lancet 365(9455): 217-223. https://doi.org/10.1016/S0140-6736(05)70151-3
  5. Kim, J. L., Moon, H. G., Kang, G. H., Lee, M. S., & Hong, D. Y. 1997. Community-based follow-up study of the compliance and its determinants in hypertension. Korean Journal of Public Health 23(1):79-100.
  6. Kim, J. S. 1984. Analytical study on performance of the community health practitioner in primary health care in Korea. Ph.D. dissertation, Department of Nursing, University of Yonsei, Seoul, Korea.
  7. Korean Center for Disease Control and Prevention. 2006. Health behavior and chronic diseases statistics. Seoul, Korea: Korean Center for Disease Control and Prevention.
  8. Korean Ministry of Health and Welfare. 2005. National health promotion plan 2010. Seoul, Korea:Korean Ministry of Health and Welfare.
  9. Lee, E. S., & Jin, Y. R. 2002. Status of hypertension management in public health centers-aspect of administration, skill and education-. Spring scholarship competition monument of day of science National Korean Nursing Association. 187-188.
  10. Lim, K. S. 2002. Practice of Hypertension and Diabetic management (based on community). community health practitioners association.
  11. Martin, M. J., S. B. Hulley, et al. 1986. Serum cholesterol, blood pressure, and mortality: implications from a cohort of 361,662 men. The Lancet 2(8513):933-936.
  12. Ministry of Health and Welfare, Health promotion stressed public health centers, Evaluation team with support for Specialty. 2001. Comprehensive report of program.
  13. Ministry of Health and Welfare. 2001. The guideline of the management of disease.
  14. Miura, K., Daviglus, M. L., Dyer, A. R., Liu, K., Garside, D. B., & Stamler, J., et al. 2001. Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men: The Chicago Heart Association Detection Project in Industry. Archives of Internal Medicine 161(12):1501-1508. https://doi.org/10.1001/archinte.161.12.1501
  15. National Heart, Lung, & Blood Institute. (2003). Your guide to lowering blood pressure. from http://www.nhlbi.nih.gov/hbp/index.html.
  16. Nursing College in National University, Ministry of Health and Welfare. 2000. The study on National public health center network through prevention management system of national chronic-regression disease. Seoul.
  17. Ong, K. L., Cheung, B., Man, Y. B., Lau, C. P., & Lam, K. 2007. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999–2004. Hypertension 49:69-75 https://doi.org/10.1161/01.HYP.0000252676.46043.18
  18. Park, I., Ju, A., & Kim, Y. 2008. The relation between farmers' syndrome and quality of life of residents in suburban area. Journal of Korean Community Nursing 19(3): 495-505.
  19. Vasan, R. S., M. G. Larson, Leip, E. P., Evans, J. C., O'Donnell, C. J., Kannel, W. B., et al. 2001. Impact of high-normal blood pressure on the risk of cardiovascular disease. The England Journal of Medicine 345(18):1291-1297. https://doi.org/10.1056/NEJMoa003417