성과기반 지역사회간호학 세트

『성과기반 지역사회간호학 volume I』

제1장 지역사회간호와 건강
제1절 지역사회의 이해 ······································ 19
1. 지역사회의 정의 ············································· 19
2. 지역사회의 특성 ············································ 20
3. 지역사회의 유형 ············································ 20
1) 구조적 지역사회 _20
2) 기능적 지역사회 _21
3) 감정적 지역사회 _21
4. 지역사회의 기능 ············································ 22
1) 경제적 기능 _22
2) 사회화 기능 _22
3) 사회통제의 기능 _22
4) 사회통합 또는 참여의 기능 _22
5) 상부상조의 기능 _23
5. 지역사회의 중요성 ········································ 23
1) 건강문제의 유사성 _23
2) 경제적 공동체 _23
3) 가치와 문화의 공유 _23
4) 정치적 의사결정 기구 _23
제2절 지역사회간호의 이해 ······························ 24
1. 지역사회간호 ·················································· 24
1) 지역사회간호의 정의 _24
2) 지역사회간호의 특징과 속성 _26
2. 공중보건의 개념 ············································ 26
1) 공중보건 _26
2) 공중보건의 특성 _27
3) 공중보건의 핵심기능과 필수 보건서비스 _28
3. 지역사회보건의 개념 ····································· 29
4. 보건간호와 지역사회간호의 차이 이해 ········ 30
5. 지역사회 간호사의 역할과 기능 ··················· 30
1) 지역사회 간호사의 역할과 기능 _30
2) 지역사회 간호사의 주요 활동현장과 역할 _34
3) 지역사회 간호사의 역할 확대 _35
제3절 지역사회와 건강 ······································ 36
1. 건강의 개념 ···················································· 36
1) 세계보건기구의 건강 정의 _36
2) 의학적 관점 _36
3) 간호학적 관점 _37
4) 지역사회간호학에서의 건강의 정의 _38
2. 건강의 결정요인 ············································ 39
3. 건강의 연속선과 질병예방수준의 관계 ········ 41
4. 적정 기능수준의 영향요인 ···························· 42
1) 정치적인 영향 _42
2) 습관적인 영향 _42
3) 유전적인 영향 _42
4) 보건의료 전달체계의 영향 _43
5) 환경적인 영향 _43
6) 사회 · 경제적인 영향 _43
5. 건강형평성 ····················································· 43
1) 건강형평성의 개념 _43
2) 건강형평성의 중요성 _44
3) 우리나라의 건강형평성 현황 _45
4) 우리나라의 건강형평성 정책과 과제 _46
6. 건강권 보장 ··················································· 47
7. 건강한 지역사회 ············································ 48
1) 건강한 지역사회의 개념 _48
2) 건강한 지역사회의 특성 _49
8. 건강도시 ························································· 50
1) 건강도시의 개념 _50
2) 건강도시의 추진과정 _51
3) 우리나라의 건강도시 현황 _53
제4절 지역사회간호와 문화적 다양성 ··········· 55
1. 문화적 다양성과 간호사의 문화적 역량 ······ 55
2. 다문화간호를 위한 문화사정모델 ················· 56
1 ) Lei ni nger의 다양성과 보편성의 문화돌봄 이론 _56
2) Giger와 Davidhizar의 횡문화사정모델 _58
3. 국내 다문화 사회 배경과 현황 ···················· 60
제5절 지역사회간호의 역사 ······························ 62
1. 외국 공중보건의 역사 ··································· 62
1) 서양 근대 공중보건의 확립 _62
2) 서양 현대 공중보건의 발전 _62
2. 외국 지역사회간호의 역사 ···························· 64
1) 방문간호시대 : 1900년대 이전 _64
2) 보건간호시대 : 1900∼1960년대 _65
3) 지역사회간호시대 : 1960년∼현재 _66
3. 우리나라 지역사회간호의 역사 ···················· 66
1) 방문간호시대 : 1945년 이전 _66
2) 보건간호시대 : 1945∼1980년 _67
3) 지역사회간호시대 : 1980년∼현재 _67
제6절 지역사회간호이론 ···································· 70
1. 체계이론 ························································· 70
1) 주요 개념 _70
2) 지역사회간호에의 적용 _72
2. 기획이론 ························································· 72
1) 기획의 특성 _72
2) 기획과정 _73
3. 교환이론 ························································· 75
1) 주요 개념 _75
2) 지역사회간호에의 적용 _75
4. Neuman의 건강관리 체계이론 ················· 76
1) 주요 개념 _76
2) 뉴만모델의 장점과 단점 _78
3) 지역사회간호에의 적용 _79
5. Orem의 자가간호이론 ································· 80
1) 주요 개념 _80
2) 지역사회간호에의 적용 _82
6. Roy의 적응이론 ··········································· 83
1) 적응이론의 개요 _83
2) 주요 개념 _83
3) 지역사회간호에의 적응 _86
제2장 국내외 보건정책의 이해
제1절 보건의료체계의 이해 ······························ 89
1. 보건행정 ························································· 89
1) 보건행정의 정의 _89
2) 보건행정의 특성과 범위 _89
2. 국가보건의료체계 ·········································· 91
1) 보건의료체계의 개념 _91
2) 보건의료체계의 구성 요소 _92
3) 보건의료체계의 유형 _96
4) 주요 국가별 보건의료체계 _98
3. 진료비 지불보상제도 ··································· 100
1) 행위별수가제(FFS) _101
2) 포괄수가제 _101
3) 인두제 _102
4) 봉급제 _102
5) 총액계약제 _102
4. 사회보장제도와 의료보장제도 ···················· 103
1) 사회보장제도 _103
2) 의료보장제도 _105
제2절 지역사회간호와 보건정책 ··················· 113
1. 보건의료정책 ················································ 113
1) 정책의 개념 _113
2) 정책과정 _114
3) 정책결정 _114
4) 보건의료정책 _114
2. 일차보건의료 ················································ 116
1) 일차보건의료의 배경과 개념 _116
2) 일차보건의료의 전개 _117
3) 우리나라의 일차보건의료 _118
3. 지역보건 ······················································· 119
1) 우리나라의 보건기관 _119
2) 지역보건의료계획 _124
4. 우리나라 주요 보건정책 ····························· 127
1) 우리나라 보건의료정책의 변화 _127
2) 보건환경 및 보건정책 변화 _129
3) 보건의료 관련법과 지역사회 간호실무 _131
4) 국민건강증진종합계획 _134
5) 지역사회 통합건강증진사업 _141
제3절 국제보건의 이해 ···································· 151
1. 국제보건의 개념 ··········································· 151
2. 국제보건기구 ················································ 151
1) 세계보건기구(WHO) _151
2) 유엔아동기금(UNICEF) _152
3) 기타 국제기구 _153
4) 국내 기구 _154
3. 국제개발협력과 공적개발원조사업 ············· 154
4. 국제보건과 국제사회의 목표 ······················ 155
1) 새천년개발목표(MDGs) _155
2) 지속가능발전목표(SDGs) _157
5. 국제보건사업과 간호사의 역할 ·················· 159
제3장 보건사업 기획과 지역사회 간호과정
제1절 보건사업 기획의 이해 ························· 163
1. 보건사업 기획의 개념 ·································· 163
1) 보건사업 기획의 정의 _163
2) 보건사업 기획의 주요 요소 _163
3) 보건사업 기획의 필요성 _163
4) 보건사업 기획의 분류 _164
2. 보건사업 기획의 특성 ································· 165
1) 보건사업 기획의 특성 _165
2) 보건사업 기획의 원칙 _166
제2절 보건사업 기획의 모형 ························· 167
1. PATCH 모형 ·············································· 167
1) 1단계 : 지역사회 조직화 _168
2) 2단계 : 자료수집 및 분석 _168
3) 3단계 : 건강문제 우선순위 설정 _168
4) 4단계 : 포괄적인 중재계획 개발 _168
5) 5단계 : 평가 _168
2. MAPP 모형 ················································ 168
1) 1단계 : 지역사회 조직화와 협력체계 개발 _169
2) 2단계 : 비전 설정 _169
3) 3단계 : 지역사회 보건체계의 MAPP 사정 _169
4) 4단계 : 전략적 과제 확인 _170
5) 5단계 : 목표와 전략 수립 _170
6) 6단계 : 순환적 활동 _170
3. MATCH 모형 ············································· 170
1) 1단계 : 목표설정 _171
2) 2단계 : 중재 계획 _171
3) 3단계 : 보건사업 개발 _171
4) 4단계 : 실행 준비 _171
5) 5단계 : 평가 _171
4. 논리모형 ······················································· 173
1) 투입 _173
2) 과정 _173
3) 산출 _173
4) 성과 _174
제3절 보건사업 기획의 과정 ························· 175
1. 보건사업 기획팀의 조직 ······························ 175
1) 이해관계자의 참여 _176
2) 참여의 수준 _176
2. 현황분석 ······················································· 177
1) 자료수집 _177
2) 자료분석 _179
3. 우선순위 설정 ·············································· 182
1) BPRS(기초우선순위평정법) _182
4. 목표설정 ······················································· 186
1) 목적과 목표의 개념 _186
2) 목표설정의 분류 _187
3) 목표의 기술 _189
5. 전략 및 세부계획 수립 ······························· 189
1) 전략 수립 _189
2) 세부계획 수립 _190
3) 평가계획 _195
6. 보건사업 수행 ·············································· 197
7. 보건사업 평가 ·············································· 197
제4절 지역사회 간호과정 ································ 198
1. 지역사회 간호사정 ······································· 198
1) 사정유형 _198
2) 사정영역 및 내용 _199
3) 자료수집 방법 _201
4) 자료분석 _202
5) 법적 기준 및 지침 확인 _204
2. 지역사회 간호진단 ······································· 204
1) 지역사회 간호진단의 특성 _204
2) 간호진단 분류체계 _205
3) 우선순위설정 _212
3. 지역사회 간호계획 ······································ 213
1) 목표설정 _214
2) 방법 및 수단의 선택 _214
3) 수행계획 _214
4) 평가계획 _216
4. 지역사회 간호수행 ······································ 217
1) 간호수행 활동 _217
2) 사업수행을 위한 지역사회 접근방법 _218
3) 사업수행에 영향을 미치는 요소 _219
5. 지역사회 간호평가 ······································ 220
1) 평가의 목적 _220
2) 평가의 내용 _221
2) 평가의 유형 _221
3) 평가절차 _223
4) 평가결과의 활용 _224
제5절 보건정보 및 기술활용 ························· 225
1. 지역보건의료정보시스템 ······························ 225
1) 지역보건의료정보시스템 개요(PHIS) _225
2) 보건소 통합정보시스템 _230
3) 보건진료소 통합정보시스템 _230
4) 포털서비스 _231
5) 개인정보 보호지침 _233
2. 보건의료 정보화 ·········································· 236
1) USN기반 원격건강모니터링시스템 _236
2) 원격건강도우미서비스 _237
3) 질병관리청 질병보건통합관리시스템 _237
4) 예방접종등록관리 정보시스템 _238
5) 응급환자진료정보망 _238
3. 지리정보시스템(GIS) ································· 238
1) GIS의 개요 _238
2) GIS의 활용범위 _239
4. 보건소 모바일 헬스케어 ····························· 239
1) 보건소 모바일 헬스케어 개요 _239
2) 보건소 모바일 헬스케어 서비스 프로세스 _243
3) 모바일 헬스케어 연동디바이스 _243
4) 보건소 모바일 헬스케어 서비스사업 특징 _244
5) 모바일 헬스케어 사례 _247
제6절 보건간호사업의 질 관리 ····················· 249
1. 질 관리의 이해 ············································ 249
2. 질 관리를 위한 전략 ··································· 250
1) QA/QI _250
2) TQM/CQI _250
3. 질 관리 수행절차 ········································ 251
1) 발견 _251
2) 조직 _251
3) 명확화 _251
4) 이해 _251
5) 선택 _251
6) 계획 _251
7) 실행 _251
8) 평가 _251
9) 유지 _252
4. 질 관리의 평가방법 ····································· 252
1) 투입?산출 모형에 따른 평가 _252
2) 성과관리에 의한 평가 _252
제4장 지역사회 간호활동 및 자원활용
제1절 지역사회 간호활동 ································ 255
1. 방문활동 ······················································· 255
1) 방문활동의 목적 _255
2) 방문활동의 원리 및 원칙 _256
3) 방문활동 단계 _257
4) 방문가방 _258
5) 방문활동의 장 · 단점 _258
6) 방문활동 시 안전을 위한 주의사항 _259
2. 건강관리실 활동 ·········································· 259
1) 건강관리실의 유형 _259
2) 건강관리실의 설치 장소 _259
3) 건강관리실의 운영 _260
4) 건강관리실 활동의 장 · 단점 _260
3. 자원활용 ······················································· 261
1) 자원의 종류 _261
2) 자원의 활용 _262
3) 자원연계 및 의뢰 _263
4) 자원활용의 효과 _264
4. 상담 ······························································ 264
1) 상담의 원리 _264
2) 상담의 과정 _265
3) 상담의 기법 _265
4) 상담 시 주의사항 _266
5) 상담의 장 · 단점 _266
5. 매체 활용 ····················································· 266
1) 인쇄매체 _267
2) 전자매체 _267
6. 지역사회조직 활용 ······································ 268
1) 기존 조직의 활용 _268
2) 새로운 조직의 개발 _269
3) 지역사회조직화 단계 _269
7. 지역주민 참여 ·············································· 270
1) 지역주민 참여의 형태 _270
2) 지역주민 참여의 유형 _270
3) 지역주민 참여의 단계 _271
4) 지역주민 참여 활성화 _272
5) 지역주민 참여의 문제점 및 장애요인 _273
제2절 사례관리 ··················································· 274
1. 사례관리의 이해 ··········································· 274
1) 사례관리의 정의 _274
2) 사례관리의 필요성 및 도입 배경 _275
3) 사례관리의 목적 _276
4) 사례관리의 원칙 및 특징 _276
5) 사례관리 대상자 _277
6) 사례관리자의 역할 및 기능 _278
7) 사례관리 모형 _279
2. 사례관리 흐름 및 절차 ······························· 279
3. 우리나라의 지역사회중심 공적 사례관리 · · 281
1) 국민건강보험공단의 사례관리사업 _281
2) 의료급여 사례관리사업 _283
3) 방문건강관리사업의 사례관리 _285
4) 치매환자 맞춤형사례관리사업 _286
5) 통합사례관리 _290
6) 공공부문 사례관리 연계 · 협력 _291
제3절 방문보건사업 ·········································· 292
1. 방문보건의 개념 ··········································· 292
2. 방문건강관리사업 ········································ 292
1) 방문건강관리사업의 정의 _292
2) 방문건강관리사업의 목적과 목표 _294
3) 방문건강관리 사업대상 _294
4) 방문건강관리서비스 제공과정 _294
5) 방문건강관리서비스 세부사업 내용 _295
3. 가정간호사업 ················································ 302
1) 가정간호의 개념 _302
2) 가정간호사업의 도입배경 _303
3) 가정간호사업의 목적 _303
4) 가정간호사업의 대상자 _303
5) 가정간호서비스의 내용 _304
6) 가정전문간호사 _304
7) 가정간호 비용 _305
4. 노인장기요양에서의 방문간호사업 ············· 306
1) 노인장기요양 방문간호 개념 _306
2) 노인장기요양보험의 방문간호 목적 _306
3) 노인장기요양의 방문간호 대상 및 내용 _306
4) 노인장기요양 방문간호 이용절차 _307
5) 노인장기요양 방문간호 인력 _308
6) 방문건강관리사업과 가정간호 및 노인장기요양
방문간호사업의 차이 _309
5. 지역사회 통합돌봄(커뮤니티케어) ············· 309
1) 개념 _309
2) 비전과 과제 _309
3) 통합돌봄 주요 서비스 _311
4) 통합돌봄 모형 _311
제5장 건강증진사업 운영
제1절 건강증진 개념의 이해 ························· 315
1. 건강증진의 개념 ··········································· 315
1) 건강증진의 정의 _315
2) 건강증진개념 대두 배경 및 국외발전과정 _316
3) 우리나라 건강증진 발전과정 _323
2. 건강행위이론과 건강증진모형 ···················· 325
1) 개인 수준의 건강행위이론 _325
2) 개인 간 수준의 건강행위이론 _340
3) 집단 및 지역사회 수준의 건강행위이론 _346
제2절 건강증진프로그램의 개발 ··················· 362
1. 건강증진의 대상 ··········································· 362
2. 건강증진사업과 프로그램의 필요성 ··········· 363
3. 건강증진사업과 프로그램 접근전략 ··········· 363
1) 생활터 접근 _364
2) 생애주기별 접근 _366
4. 건강증진프로그램 개발과정 ························ 367
5. 건강증진프로그램 ········································ 367
1) 금연 프로그램 _367
2) 절주 프로그램 _372
3) 신체활동프로그램 _376
4) 영양 프로그램 _380
제3절 보건교육의 이해 ···································· 394
1. 보건교육의 개념 ··········································· 394
1) 보건교육의 정의 _394
2) 보건교육의 필요성과 중요성 _395
3) 보건교육의 목적과 목표 _396
2. 보건교육자의 역할 ······································· 398
3. 보건교육의 대상 및 범위 ···························· 400
1) 대상자의 수에 따른 분류 _400
2) 대상자집단의 특성에 따른 분류 _400
3) 대상자의 생애주기에 따른 분류 _401
4) 실무현장에 따른 분류 _401
4. 보건교육의 내용 ·········································· 403
1) 예방수준별 보건교육 내용 _403
2) 국민건강증진법의 보건교육 내용 _404
5. 학습이론과 보건교육 ··································· 404
1) 행동주의 학습이론 _404
2) 인지주의 학습이론 _406
3) 인본주의 학습이론 _408
4) 구성주의 학습이론 _409
5) 학습이론 간의 특성 비교 _411
제4절 보건교육 프로그램의 개발 ················· 413
1. 보건교육 요구조사 및 분석 ························ 415
1) 자료수집 _416
2) 자료분석 _418
3) 교육주제 도출 _419
4) 우선순위설정 _419
2. 보건교육 계획 ·············································· 420
1) 학습목표 설정 _420
2) 학습내용 선정과 구성 _430
3) 교수?학습방법 선정 _431
4) 교육매체 선정 _432
5) 교육수행 계획 _432
6) 교육평가 계획 _433
7) 보건교육 계획서 작성 _433
제5절 보건교육의 수행 ···································· 437
1. 보건교육 수행단계 ······································· 437
1) 도입활동 _437
2) 전개활동 _437
3) 정리활동 _438
2. 보건교육시 활용하는 교수?학습 방법 ······ 438
1) 교수?학습방법 선정의 원리 _438
2 ) 보건교육시 활용하는 교수?학습방법의 종류 _441
3. 보건교육 매체 ·············································· 458
1) 보건교육 매체의 선정의 원리 _458
2) 보건교육 매체의 종류 _461
제6절 보건교육의 평가 ···································· 476
1. 보건교육 평가의 목적과 기능 ····················· 476
2. 보건교육 평가의 단계 ································· 477
1) 보건교육 관계자 참여 _477
2) 보건교육의 기술 _477
3) 평가단계 _478
3. 보건교육 평가의 분류 및 방법 ·················· 480
부 록
1) 보건교육 평가의 분류 _480
2) 보건교육 평가방법 _482
3) 평가도구의 조건 _482
1. 다문화 대상자의 문화 사정도구 ················· 487
2. Omaha체계 ··············································· 490
3. 간호과정 보고서 양식 ································· 497
4. 보건진료소 주요 업무 ································· 503
5. 사례관리 프로그램의 실제 ·························· 506
6. Green의 PRECEDE-PROCEED
모형 변화 ····················································· 518
7. 제1·2차 국민영양관리기본계획 비교 ·········· 520
참고문헌 ························································· 523
Index ···························································· 533


『성과기반 지역사회간호학 volume II』

제6장 생활터별 일차보건의료 제공
Ⅰ 가족간호
제1절 가족의 이해 ·············································· 21
1. 가족의 개념 ···················································· 21
1) 가족의 정의 _21
2) 가족의 특성 _22
3) 가족의 기능 _23
2. 가족의 유형 ··················································· 24
1) 핵가족 _24
2) 확대가족 _25
3) 기타 가족형태 _25
3. 가족생활주기와 발달과업 ····························· 25
1) 가족생활주기 _25
2) 가족발달과업 _26
4. 가족간호의 개념 ············································ 29
1) 가족간호의 정의 _29
2) 가족간호의 개념틀 _30
5. 가족간호사의 역할 ········································ 31
제2절 가족간호 관련 이론 ······························· 34
1. 체계이론 ························································· 35
2. 구조기능주의 이론 ········································ 37
3. 상징적 상호주의 이론 ··································· 37
4. 발달이론 ························································· 38
제3절 가족간호과정 ············································ 39
1. 가족간호사정 ·················································· 40
1) 가족건강 사정도구 _40
2) 자료수집 _45
3) 자료분석 _47
2. 가족간호진단 ·················································· 47
1) 가족간호 진단체계 _48
2) 우선순위설정 _48
3. 가족간호계획 ·················································· 48
1) 가족간호 목표설정 _48
2) 방법 및 수단의 선택 _49
3) 수행계획 _50
4) 평가계획 _51
4. 가족간호중재 ·················································· 51
1) 예측적 안내 _52
2) 건강상담 _52
3) 가족건강교육 _53
4) 직접 간호제공 _55
5) 의뢰 _55
6) 가족의 자원 강화 _55
7) 스트레스 관리 _56
5. 가족간호평가 ·················································· 56
1) 평가의 방법과 시기 _56
2) 평가내용 _57
제4절 우리나라의 가족 ······································ 58
1. 우리나라 가족의 변화 ··································· 58
1) 우리나라 가족의 발달과 특성 _58
2) 우리나라 가족의 변화 _59
2. 우리나라의 가족정책 ····································· 61
1) 가족정책의 개념 _61
2) 우리나라 가족관련법 _62
3) 가족정책 전달체계 _63
4) 가족정책의 과제 _64
3. 다문화가족 ····················································· 65
1) 다문화가족의 개념과 현황 _65
2) 다문화가족의 문제와 과제 _65
제5절 취약가족과 간호 ······································ 68
1. 취약가족 간호의 중요성과 특성 ··················· 68
1) 취약가족 간호의 중요성 _68
2) 취약가족의 특성 _68
2. 취약가족의 사정 및 간호중재 ······················ 69
1) 가족사정도구 _69
2) 취약가족의 간호중재 _73
3) 취약가족을 위한 지역사회 자원 _74
Ⅱ
3. 취약가족별 간호 ············································ 74
1) 만성질환자 가족 _74
2) 장애인 가족 _76
3) 한부모가족 _76
4) 빈곤가족 _77
5) 폭력가족 _78
학교보건
제1절 학교보건의 이해 ······································ 80
1. 학교보건의 개념 ············································· 80
1) 학교보건의 정의 _80
2) 학교보건의 목적 _82
3) 학교보건의 필요성 _82
2. 학교보건의 역사 ············································ 83
1) 외국의 학교보건 _83
2) 우리나라의 학교보건 _84
3. 학교보건인력 ·················································· 87
1) 보건교사 _87
2) 학교의사와 학교약사 _88
3) 영양교사 _89
4) 기타(행정 관련) _89
5) 의료인, 약사 및 보건교사 배치기준 _89
4. 학교보건 관련법 ············································ 89
1) 학교보건법 _89
2) 기타 학교보건 관련법 _91
5. 학교간호과정 ·················································· 92
1) 학교간호의 개념 _92
2) 학교간호과정 _93
6. 학교건강증진 ················································· 97
1) 성교육 _97
2) 약물 오 · 남용 관리 _97
3) 인터넷 중독 및 스마트미디어 중독 _98
4) 정신건강 _99
제2절 학생건강관리 ·········································· 100
1. 학교건강검사 ················································ 100
1) 학교건강검사의 목적 _100
2) 학교건강검사의 내용 _100
3) 건강검사 결과 기록 및 관리 _101
2. 학교감염병 ··················································· 103
1) 감염병 관리 _103
3. 학교 응급환자 관리 ····································· 110
1) 안전사고와 응급환자 관리 _110
2) 심폐소생술 _112
4. 학교환경관리 ················································ 113
1) 교내환경관리 _114
2) 교육환경보호구역 _120
제3절 학교보건실 운영 ···································· 121
1. 학교보건조직 운영 ······································· 121
1) 학교보건실 _121
2) 조직 관리 _122
3) 보건실 현대화 기준 _122
2. 보건실의 시설 및 설비 ······························· 123
3. 물품관리 ······················································· 123
1) 물품구입 절차 _124
2) 물품의 보관 및 유지관리 _124
4. 약품관리 ······················································· 124
1) 구급약품과 치료용 재료의 준비 _124
2) 약품관리방법 _125
3) 올바른 약물 복용법 _126
4) 의약품 투약 시 주의사항 _126
5. 보건예산관리 ················································ 126
1) 예산 설정의 이점 _126
2) 예산의 원칙 _126
6. 보건실 문서관리 ·········································· 127
1) 기록의 종류 _127
2) 보건일지 _127
3) 학생건강기록부 _127
4) 가정통신문 _127
5) 보고 공문 작성요령 _128
6) 기안 및 공문서 관리 _128
Ⅲ 산업간호
제1절 산업간호의 이해 ···································· 130
1. 산업보건과 산업간호 ··································· 130
1) 산업보건과 산업간호의 개념 _130
2) 산업보건의 발전과정 _131
3) 산업보건 인력 및 조직 _134
4) 보건관리자의 업무 _137
5) 보건관리업무위탁(보건관리대행) _140
6) 산업전문간호사의 자격 및 역할 _141
2. 산업간호과정 ················································ 142
1) 산업간호사정 _142
2) 산업간호진단 _144
3) 산업간호계획 _145
4) 산업간호수행 _146
5) 산업간호평가 _146
제2절 산업재해 ··················································· 147
1. 산업재해의 개념 ··········································· 147
2. 산업재해의 원인과 분류 ····························· 147
1) 산업재해의 원인 _147
2) 산업재해의 분류 _149
3. 산업재해 통계지수 ······································ 151
1) 재해통계 _151
2) 작업동태통계 _151
3) 질병통계 _152
4) 산업재해 관련 용어 정의 _152
4. 산업재해 현황 ·············································· 153
1) 산업재해 발생현황 개요 _153
2) 산업별 재해현황 _153
3) 재해유형별 재해현황 _153
4) 사망재해 현황 _153
5) 업무상질병 현황 _155
5. 산업재해 예방대책 ······································ 157
1) 산업재해 예방대책 개요 _157
2) 하인리히 예방대책 _157
3) 산업재해 예방방법 _157
4) 산업재해 발생 시 조치사항 _158
6. 업무상 상병과 재해보상 ····························· 159
1) 업무와 상병의 인과관계 _159
2) 재해보상 _160
제3절 작업환경관리 ·········································· 163
1. 작업환경관리 ················································ 163
1) 작업환경 유해인자 _163
2) 작업환경관리 기본원칙 _165
3) 유해인자별 작업환경관리 방법 _168
4) 유해물질 허용기준 _168
2. MSDS/GHS 제도 ····································· 170
1) MSDS/GHS 개요 _170
2) MSDS/GHS 작성 _171
3. 작업환경측정 ················································ 174
1) 작업환경측정 개요 _174
4. 작업환경 개선방안 ······································ 177
1) 작업환경 개선의 기본방향 _177
2) 작업환경 개선의 실제 _178
제4절 근로자 건강관리 ···································· 183
1. 근로자 건강진단 ··········································· 183
1) 건강진단의 종류와 내용 _183
2) 건강진단 사후관리 _185
2. 유해환경과 직업병 관리 ····························· 187
1) 물리적 유해인자와 건강문제 _187
2) 유해화학물질과 건강문제 _194
3) 중금속과 건강문제 _195
3. 유해인자별 작업관련성 질환관리 ··············· 198
1) 근골격계 질환 _198
2) 심뇌혈관질환 _200
3) 직무스트레스 _200
4) 감정노동 _201
4. 건강관리실 운영 ·········································· 202
1) 시설과 물품관리 _202
2) 예산관리 _203
3) 기록과 보고 _203
제7장 생애주기별 일차보건의료 제공
제1절 영유아 건강관리 ···································· 209
1. 건강관리 ······················································· 209
1) 건강진단 _210
2) 치아관리 _210
3) 시력관리 _210
4) 장애예방을 위한 선별검사 _210
2. 예방접종 ······················································· 210
1) 예방접종 전 · 후의 주의사항 _210
2) 예방접종 금기사항 _211
3. 선천성대사이상검사 및 환아 관리 ············· 211
1) 선천성대사이상검사 _211
2) 환아 관리 _212
4. 미숙아 및 선천성이상아 등록관리 ············· 213
1) 미숙아 및 선천성이상아 관리 목적 _213
2) 미숙아 및 선천성이상아 관리 내용 _213
제2절 모자보건사업 ·········································· 215
1. 모자보건사업의 이해 ··································· 215
1) 모자보건의 개념 _215
2) 모자보건사업의 중요성 _216
3) 모자보건사업 대상 _216
4) 모자보건사업 주요지표 _217
5) 우리나라의 모자보건사업 _219
6) 지역사회 모자보건서비스 _221
2. 모자보건사업 간호과정 ······························· 230
1) 모자보건사업 간호사정 _230
2) 모자보건사업 계획 _232
3) 모자보건사업 수행 _233
4) 모자보건사업 평가 _233
3. 모성건강관리 ················································ 234
1) 임신 전 관리 _234
2) 산전관리 _235
3) 분만관리 _237
4) 산후관리 _237
제3절 노인보건사업 ·········································· 240
1. 노인인구의 특성 ··········································· 240
1) 노인인구의 구성 및 변화추세 _240
2) 노인인구의 특성 _242
2. 노인건강 ······················································· 245
1) 노화와 건강 _245
2) 노인인구의 보건의료 요구 _246
3. 노인보건복지정책과 사업 ···························· 248
1) 노인요양 및 건강보장 _248
2) 노인복지정책과 사업 _259
4. 노인장기요양보험제도 ································· 267
1) 노인장기요양보험제도의 개념 _267
2) 노인장기요양보험제도의 운영체계 _268
3) 장기요양기관 및 인력 _270
제8장 역학지식 및 통계기술 실무적용
제1절 역학의 이해 ············································ 275
1. 역학의 정의와 목적 ····································· 275
1) 역학의 정의 _275
2) 역학의 목적과 활용 _276
2. 역학의 역사적 배경 ····································· 277
제2절 질병의 자연사와 예방수준 ················· 279
1. 질병의 자연사 ·············································· 279
2. 역학 모형 ····················································· 280
1) 생태학적 모형 _280
2) 수레바퀴 모형 _281
3) 거미줄 모형 _281
3. 감염성질환의 발생 ······································ 282
1) 병원체 _283
2) 병원소 _283
3) 병원소에서 병원체의 탈출 _284
4) 전파방법 _285
5) 새로운 숙주로의 침입 _285
6) 새로운 숙주의 감수성과 면역 _285
4. 감염성질환의 자연사 ··································· 286
1) 병원체 발현 중심의 변화과정 _286
2) 임상증상 발현 중심의 변화과정 _287
5. 감염성 지표 ················································· 287
1) 감염력 _287
2) 병원성 _288
3) 독력 _288
6. 감염성질환의 관리 ······································ 288
1) 병원체와 병원소 관리 _288
2) 전파방지를 위한 관리 _289
3) 숙주 관리 _289
제3절 역학적 측정지표 ···································· 290
1. 측정의 의의와 기본단위 ······························ 290
1) 구성비율 _290
2) 비율 _291
3) 비 _291
4) 조율 _291
5) 특수율 _291
6) 보정률/표준화율 _292
2. 측정지표 ······················································· 293
1) 발생률 _293
2) 발병률 _294
3) 유병률 _294
4) 발생률과 유병률의 관계 _295
제4절 건강검진의 진단검사 ···························· 296
1. 집단검진 ······················································· 296
2. 검사방법의 타당도와 신뢰도 ······················ 296
1) 타당도(정확도) _297
2) 신뢰도 _297
제5절 역학연구 ··················································· 298
1. 역학연구 개념 ·············································· 298
1) 연관성과 원인 _298
2) 원인적 연관성의 확정조건 _299
2. 역학연구 방법 ·············································· 300
1) 기술역학연구 _300
2) 분석역학연구 _300
3) 실험역학연구 _303
제6절 보건통계 활용 ········································ 305
1. 보건통계 ······················································· 305
1) 서술통계 _305
2) 추론통계 _308
제7절 인구현상의 이해 ···································· 311
1. 인구의 종류 ·················································· 311
1) 이론적 인구 _311
2) 실제적 인구 _312
2. 인구이론 ······················································· 312
1) 맬서스주의 _313
2) 신맬서스주의 _313
3) 인구변천이론 _313
3. 인구통계 ······················································· 315
1) 인구통계 자료 _315
2) 생정통계의 기본 지표 _316
4. 인구구조 ······················································· 319
1) 성 구조 _319
2) 연령 구조 _320
3) 인구 피라미드 유형 _321
5. 우리나라 인구변동 ······································ 322
1) 우리나라의 인구현황 _322
2) 인구구조의 변화 _323
6. 우리나라 인구정책 ······································ 324
1) 인구정책의 개념 _324
2) 우리나라 인구정책의 변화 _324
제9장 감염성질환과 만성질환 관리
제1절 감염성질환의 관리사업 ······················· 329
1. 감염성질환 ···················································· 329
2. 법정감염병 ··················································· 331
1) 법정감염병의 종류 _331
2) 용어의 정의 _333
3) 감시체계 _333
3. 감염병 관리 ················································· 335
1) 감염병 관리방법 _335
2) 주요 감염병 관리 _336
3) 예방접종 및 방역체계 _344
제2절 만성질환의 관리사업 ···························· 348
1. 만성질환 ······················································· 348
1) 만성질환의 정의 및 특성 _348
2) 만성질환의 관리 _349
2. 만성질환관리사업 ········································ 351
1) 실시배경 _351
2) 주요 사업내용 _351
3) 만성질환 감시체계 _361
제3절 재활간호사업 ·········································· 362
1. 재활간호사업의 개념 ··································· 362
1) 장애의 정의와 분류 _362
2) 재활간호사업의 정의 _363
3) 재활간호사업의 필요성 _365
2. 지역사회중심 재활사업의 개념 ·················· 366
1) 지역사회중심 재활사업의 개요 _366
2) 지역사회중심 재활사업의 목적 및 목표 _366
3) 지역사회중심 재활사업의 추진배경 _367
4) 지역사회중심 재활사업의 운영 방향 _367
5) 지역사회중심 재활사업 운영 _367
3. 재활간호사업팀의 역할 ······························· 375
제10 장 환경보건 관리
제1절 환경과 건강의 이해 ······························ 379
1. 환경의 개념 ·················································· 379
1) 환경보건의 개념 _380
2) 환경보건정책 _380
2. 환경영향평가와 건강영향평가 ···················· 382
1) 환경영향평가(EIA) _383
2) 건강영향평가(HIA) _386
3. 환경보건 관련기관의 역할 및 법적규제 ···· 389
1) 환경보건 관련기관의 역할 _389
2) 환경보건 관련 법적규제 _390
제2절 환경이 건강에 미치는 영향 ··············· 392
1. 대기와 건강 ·················································· 392
1) 대기 _392
2) 대기오염 _396
3) 대기오염이 건강에 미치는 영향 _397
4) 대기오염 피해사례 _401
5) 대기오염으로 인한 영향 _402
6) 기후변화 현황 및 전망 _404
2. 물과 건강 ····················································· 406
1) 물의 개요 _406
2) 물의 자정작용 _406
3) 상수 _407
4) 수질오염이 건강에 미치는 영향 _416
5) 수질오염의 현상 _417
6) 수질환경기준 _417
7) 하수 _419
3. 식품과 건강 ················································· 421
1) 식품위생의 정의 _421
2) 식품위해요소 중점관리기준(HACCP) _422
3) 식품의 보존법 _423
4) 식품이 건강에 미치는 영향 _425
4. 주거환경과 건강 ·········································· 430
1) 주택의 기본조건 _431
2) 주거환경이 건강에 미치는 영향 _431
3) 생활환경이 건강에 미치는 영향 _432
4) 생활공감 환경보건기술개발(R&D) 사업 _435
5. 폐기물 처리와 건강 ····································· 436
1) 폐기물의 정의 _436
2) 폐기물 처리방법 및 관리정책 _438
3) 폐기물이 건강에 미치는 영향 _440
6. 토양과 건강 ················································· 441
1) 토양오염물질과 토양오염기준 _441
2) 토양오염의 원인과 대책 _441
3) 토양오염이 건강에 미치는 영향 _442
7. 방사능과 건강 ·············································· 443
1) 방사능의 개요 _443
2) 방사능이 건강에 미치는 영향 _443
제3절 환경보건과 간호사의 역할 ················· 444
1. 환경정의 실현 ·············································· 444
1) 환경정의의 개념 _444
2) 환경오염 피해 _445
2. 화학물질관리 ················································ 446
1) 화학물질관리의 중요성 _446
2) 우리나라의 화학물질 안전관리 현황 _447
3) 유해화학물질 대표적 사례 _448
3. 위험 의사소통 ·············································· 449
1) 위험 의사소통의 정의와 절차 _450
2) 위험 의사소통의 필요성과 원칙 _451
제11장
재난관리
제1절 재난의 개요 ············································ 455
1. 재난의 개념 ·················································· 455
2. 재난의 유형과 대응체계 ····························· 456
1) 재난의 유형 _456
2) 재난유형별 건강요구 _457
3) 국가재난관리체계 _458
4) 국가 재난 · 안전관리 단계별 대응방법 _461
5) 응급의료체계 _461
3. 재난과 공중보건 ·········································· 465
1) 공중보건의 역할 _465
2) 재난관리 기능모형 _466
3) 재난역학과 질병감시 _468
4) 재난과 관련된 감염성질환의 유행요인 _469
5) 인구집단 건강요구 _470
4. 취약인구집단의 재난 ··································· 471
1) 아동과 여성의 재난 _471
2) 노인과 만성질환자의 재난 _474
3) 장애인과 재난 _475
제2절 재난예방과 대비 ···································· 477
1. 재난예방 ······················································· 477
1) 일차예방(재난 발생 전) _477
2) 이차예방(재난대응) _477
3) 삼차예방(재난 후 복구) _478
2. 재난대비 ······················································· 478
1) 지역사회의 재난대비 _478
2) 병원의 재난대비 _479
3) 개인과 가족의 재난대비 _481
제3절 재난대응 및 복구 ·································· 483
1. 재난과 법적 · 윤리적 문제 ··························· 483
1) 간호사의 법적 의무 _483
2) 간호사의 윤리원칙 _484
3) 재난간호의 법적 · 윤리적 쟁점 _484
2. 재난의 심리 · 사회적 영향 ··························· 486
1) 재난 국면에 따른 심리적 현상 _486
2) 재난에 대한 인간의 반응과 정신장애 _487
3. 위험 의사소통 ·············································· 488
1) 위험 의사소통과 대상자의 심리 _488
2) 위험 의사소통의 원칙 _489
4. 수용시설 관리 ·············································· 496
1) 수용시설 관리 개요 _496
2) 이재민 건강관리 _497
5. 재난간호 ······················································· 498
제4절 국제 재난구호 활동 ······························ 500
1. 해외긴급구호 활동 ······································· 500
1) 해외재난복구의 주체 _500
2) 해외긴급구호기관 간 관계 _500
3) 이념적 기반 _501
2. 해외긴급구호기구 ········································ 501
1) 국제연합기구 _501
2) 비정부기구 _503
3. 우리나라의 해외긴급구호 ···························· 506
1) 해외긴급구호대 구성 _506
2) 한국국제협력단 _506
3) 한국국제보건의료재단 _507
4. 국제 재난구호 활동 시 간호사의 역할 ······ 507
부 록
1. 한국형 가족 간호진단 ·································· 513
2. 보건실 기록 양식 ········································ 518
3. 유해환경과 직업병 관리 ····························· 522
참고문헌 ························································· 525
Index ···························································· 534