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J Korean Community Nurs. 1998 Dec;9(2):502-517. Korean. Original Article.
Bae YS , Park KM .
Abstract

This research intends to survey family environment, health behavior and health status of the students in urban-rural elementary schools and analyze those factors comparatively, and use the result as basic material for school health teacher to teach health education in connection with family and regional areas. It also intends to improve a pupil's self-abilitiy in health care. The subjects involve 2,774 students of urban elementary schools and 583 student in rural ones, who were selected by means of a multi-stage probability sampling. Using the questionnaire and school documents, we collected data on family environment, health behavior and health status for 19 days. Feb. 2nd 1998 through Feb. 20th 1998. The R-form of Family Environment Scale (Moos, 1974) was used in the analysis of family environment(Cronbach's Alpha=0.80). Questionnaires of Health Behavior in School-aged children used by the WHO in Europe(Aaro et al., 1986) and the ones developed by the Health Promotion Committee of the Western Pacific(WHO, 1995)(adapted by long Young-suk and Moon Young-hee(1996)) were used in the analysis of health behavior, as well documents on absences due to sickness, school health room-visits, levels of physical strength, height, weight and degree of obesity were used to determine health status. In next step, We used them with an chi2-test, t-test, Odds Ratio, and a 95% Confidence Interval. 1. In two dimensions of three, family-relationship (t=3.41, p=0.001) and system-maintenances(t=2.41, p=0.0l6) the mean score of urban children were significantly higher than those of rural ones. In the personal development dimension however, there was little significant difference. Assorting family environment into 10 sub-fields and analyzing them, we recognized that urban children were superior to rural children in the sub-fields of expressiveness (t=3.47, p=0.001), conflict (t=0.48, p=0.001), active-recreational orientation (t=1.97, p=0.049) and organization (t=4.33, p=0.000). 2. Referring to the Odds Ratios of urban-rural children's health behaviors, urban children set up more desirable behavior than rural children wear ing safety belts (Odds Ratio=0.32, p=0.000), washing hands after meals(Odds Ratio=0.43, p=0.000), washing hands after excreting (Odds Ratio=0.39, p=O.OOO), washing hands after coming-home ( Odds Ratio=0.75, p=0.003), brushing teeth before sleeping(Odds Ratio=0.45, p=0.000), brushing teeth more than once a day (Odds Ratio=0.73, p=0.0l2), drinking boiled water (Odds Ratio=0.49, p=0.000), collecting garbage at home(Odds Ratio=0.31, p=0.000) and in the school(Odds Ratio=0. 67, p=0.000). All these led to significant differences. As to taking milk(Odds Ratio=1.50, p=0.000), taking care of eyesight(Odds Ratio=1.41, p=0.001) and getting physical exercise in(Odds Ratio=1.33, p=0.0l9) and outside the school(Odds Ratio=1.32, p=0.005), rural children had more desirable behavior which also revealed a significant difference. There was little significant difference in smoking, but the smoking rate of rural children(5.5%) was larger than that of urban children(3.9%). 3. Health status was analyzed in terms of absences, school health room-visits, levels of physical strength, and the degree of obesity, height and weight. Considering Odds Ratios of the health status of urban-rural children, the health status of rural children was significantly better than that of the urban ones in the level of physical strength(t=1.51, p=0.000) and the degree of obesity(t=1.84, p=0.000). The mean height of urban children (150.4+/-7.5cm) is taller than that of their counterparts(149.5+/-7.9), which revealed a significant difference (t=2.47, p=0.0l4). The mean weight of urban children(42.9+/-8.6kg) is larger than that of their counterparts(41.8+/-9.0kg), which was also a significant difference(t=2.81, p=0.005). Considering the results above, we can recognize that there are significant differences in family environment, health behavior, and health status in urban-rural children. These results also suggestion ideas for health education. What we would suggest for the health program of elementary schools is that school health teachers should play an active role in promoting the need and importance of health education, develop the appropriate programs which correspond to the regional characteristics, and incorporate them into schools to improve children's ability to manage their own health management.

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