초록 ▼

IV. 연구결과
1. 기초조사연구
1) 지난 1년간의 각 학년의 평균시력 저하율은 39.7% 였으며 이러한 시력저하율은 각 학년별로 모두 유의한 차이를 나타내는 것이다(p<.01).
2) 0.7이하의 이상시력의 분포는 좌안시력은 4학년 26.84%, 5학년 31.30%, 6학년 38.39%로 각각 나타났다. 우안시력은 각 학년별로 29.31%, 30.37%, 37.92%로 역시 좌안과 동일하게 학년이 높아질수록 이상시력의 비율이 높아지는 경향을 보인다. 이러한 시력정도별 분포는 학년별로 유의한 차이를 보이는 것이었다

IV. 연구결과
1. 기초조사연구
1) 지난 1년간의 각 학년의 평균시력 저하율은 39.7% 였으며 이러한 시력저하율은 각 학년별로 모두 유의한 차이를 나타내는 것이다(p<.01).
2) 0.7이하의 이상시력의 분포는 좌안시력은 4학년 26.84%, 5학년 31.30%, 6학년 38.39%로 각각 나타났다. 우안시력은 각 학년별로 29.31%, 30.37%, 37.92%로 역시 좌안과 동일하게 학년이 높아질수록 이상시력의 비율이 높아지는 경향을 보인다. 이러한 시력정도별 분포는 학년별로 유의한 차이를 보이는 것이었다(p<.01).
3) 시력저하에 영향을 미친 요인
시력저하에 유의한 영향 요인은 학년의 증가(O.R=1.06)였으며, 성별에서는 여학생에서 더 시력저하가 되는 것으로 나타났다(O.R=2.29). 또한 부의 시력이 좋을수록 (O.R=1.26), 모의 시력이 좋을수록(O.R=1.25) 자녀의 시력은 양호하였다. 한편 형제가 안경을 낀 확률이 높을 수록 더 시력이 저하된 것으로 나타났다(O.R=2.31).
공부시의 자세는 앉아서 하는 경우가 자세가 불량한 경우보다(O.R=.90) 시력저하가 적었으며, TV가 눈높이보다 낮은 경우(O.R=.48) 시력저하율이 낮았다. 자기의 시력을 아는 경우에서(OR=.77) 시력저하율이 낮았다.
이중 교차비가 통계적으로 유의한 변수는 성(p<.01), 형제의 안경낄 확률(p<.01), 시력인지여부(p<.01) 였다.
2. 시력증진프로그램 중재효과 - 학생
시력증진프로그램의 중재효과를 파악하기 위한 2차 연구는 실험군 비동등성 대조군전후 실험설계(nonequivalent control group pretest-posttest design)이다. 실험군은 398명, 대조군은 344명, 총 742명으로 구성되었다. 시력증진프로그램은 보건교육과 눈운동으로 구성되었으며, 보건교육은 총 5회 실시되었다. 그 외 비정규 교육으로서 학교내에 각종 게시물을 게재하고, 총5회의 가정통신문을 배포하였다. 눈운동은 본연구진이 자체 제작한 비디오를 통해 각 반별로 시행토록 하였으며, 하루 2회, 총 20분간 10주동안 실시되었다. 프로그램의 효과는 학생 및 학부모를 대상으로 조사되었으며, 시력과 굴절력조사, 설문조사를 통해 자료를 수집하였다. 연구 결과는 다음과같다.
1) 시력변화
평균시력은 중재전 실험군 .87, 대조군 .91, 중재 후 실험군 .95, 대조군은 .90으로 중재군에서 상당한 정도의 시력증가가 나타났으나, 대조군과 유의한 통계적 차이는 없었다. 4학년, 5학년, 6학년 각 학년별로 실험군, 대조군간의 중재전후 차이의 검증 역시 통계적으로 유의한 차이를 보이지 않았다.
2) 굴절력 변화
굴절력에 대해서는 실험군(398명, 총 796안)에 대해서만 조사가 이루어졌다. 정시안은 327안(41.08%), 굴절이상안은 469안(58.92%)로서 굴절이상안이 정시안보다 많았다. 굴절이상안으로는 근시가 가장 많아 총안구의 38.82%를 점하였다. 시력증진프로그램적용 후의 근시의 굴절력 값의 변화는 약간 악화되었으나 유의한 차이가 없었다.
3) 시력인지도 및 시력건강 관련 지식, 행위, 태도 변화
(1) 시력인지도: 자기시력을 아는 비율이 실험군 70.10%, 대조군 50.97%(p<.01)로 증가하였다.
(2) 시력관련 지식: 실험군에서 유의한 증가(p<.01)를 하였다.
(3) 시력보호행위는 유의한 차이가 없어 프로그램의 효과가 없는 것으로 나타났다/
(4) 시력건강에 대한 태도 : 실험군에서 유의한 증가(p<.05)를 하여 시력건강에 대한 긍정적인 태도가 형성되었다.
(5) 변화단계 : 실험군에서 유의한 증가(p<.01)를 보여 앞으로 긍정적 행위변화가 가능할 것으로 예측되었다.
4) 시력건강 관련 증상
주관적 불편감은 실험군에서 호전되었으며(p<.05), 객관적 증상 역시 실험군에서 증가하였으나 유의한 차이는 아니었다.
5) 눈건강행위 관련 이익인지 및 인식된 장애요인
실험군에서 이익에 대한 인식이 높아졌으나(p<.05), 장애요인의 감소효과는 없었다.
3. 학부모 시력증진프로그램 중재효과
조사대상자는 실험군 349명, 대조군 263명으로 총 612명이었으며 양집단간 응답자의 성별, 교육수준의 차이는 없었다. 학부모의 평균 연령은 실험군 38.89세, 대조군 38.03세로 역시 양 집단간 유의한 차이가 없었다. 중재효과로서 지식수준은 유의하게 증가하였다(p<.01). 또한 시력건강에 대한 태도에서도 유의하게 긍정적인 변화를 보였다(p<.05). 그러나 행위실천정도나, 변화단계는 변화가 없었다.

Abstract ▼

Vision disturbances in the elementary school-age children and the effect of visual health promotion program
The vision disturbances of school- age children has been recognized as and important school health problem. These days, more people are engaged in close work in polluted surroundings for a

Vision disturbances in the elementary school-age children and the effect of visual health promotion program
The vision disturbances of school- age children has been recognized as and important school health problem. These days, more people are engaged in close work in polluted surroundings for a long time. Also, increased hours of the TV watching and computer work as well as heavy studies for college entrance examination are considered as factors for visual disturbances. As the visual disturbances of the school-age children is recognized as the nation's health problem, the importance of the development of educational program for visual health should be emphasized.
The most of the student's visual disturbance is myopia. The cause of myopia is unknown. But, genetic factor, nutritional deficiency, environmental factor, mental illness and their interaction are considered as possible causes.
Recently, eyeball movement and other visual health management method has been introduced for prevention or recovery of decrease in visual acuity. But, the effect of eyeball movement was not confirmed yet. And, the controversy around the treatment effect is continued.
The decrease of visual acuity is one of the important school health problem as well as it causes discomfort in daily life of the students. So, it should be considered as an important subject for school health and there is a need to develop an effective intervention program for visual health.
The purpose of this study is to develop and evaluate the program with the recognition of the need of the intervention for visual health.
The visual health promotion program was developed by the researcher and the program was initiated by the school. Students, parents and teachers participated in the program.
This study, first, described the status of the visual health in the elementary school age children. Secondly, the effect of the visual health promotion program was analyzed.
1. The status of vision disturbances
To explore the current status of visual health and the related factors for the decrease in the visual acuity, two elementary school was selected. The study subjects were 697 children (Boys: 338, Girls: 359) of 4rth to 6th grade.
The visual acuity data of the school health examination in 1999 and 2000 were utilized for analysis. The questionnaire for children and parents was used for survey. The findings were as follows.
1) The rate of visual acuity decrease was 39.7%. The rate was significantly different by grade ( p<.01)
2) The prevalance rate of the children with the visual acuity less than 0.7 on the left eye were 26.84% ( Grade 4), 31.30% (Grade 5), and 38.39% (Grade 6). The rate on the right eye were 29.30% (Grade4), 30.37% (Grade 5), and 37.92% (Grade 6). There was a significant difference in the rate of the visual acuity less than 0.7 according to grade ( p<.01).
3) The factors related to the decrease in the visual acuity were grade, sex, genetic factor, posture, and the awareness of the visual acuity.
There was more decrease in the visual acuity when the children were in higher grade (O.R= 1.06), girls (O.R=2.29). Children having parents with better vision (Father: O.R=1.26; Mother O.R= 1.25) showed better vision. On the other hand, when the children have siblings with glasses, there was more decrease in the visual acuity (O.R=2.31).
Students with good posture during study (sitting on the chair) and watching TV to the lower direction showed less decrease in the visual acuity. Also, when the students know their visual acuity, the rate of decrease were lower. The variables which odds ratio were statistically significant were sex (p<.01), siblings with glasses (p <.01), and awareness of visual acuity (p<.01).
2. The effect of visual health promotion program-students
Nonequivalent control group pretest-posttest design was applied for the second study which examined the effect of the visual health promotion program.
The subjects were 742 children (experimental group: 398; control group: 344).
The experiment was composed of health education and eyeball movement.
Health education was provided 5 times to the children in the class room.
Also, exhibition related to visual health was done in the school. Letters were sent to home 5 times for visual health education for parents. Children of experimental group exercised eyeball movement in the class, watching video for 10 minutes two times a day. The exercise was continued for 10 weeks.
The effect of the program was examined by the measure of visual acuity, refraction, and the factors related to visual health.
The result of the study were as follows.
1) change of visual acuity
Before the intervention, mean of the visual acuity was .86 for the experimental group and .91 for control group. After the intervention, mean of visual acuity was .95 for the experimental group and .90 for the control group. There was no significant difference in the change of visual acuity between experimental and control group.
2) change of refraction.
In the experimental group, 327 eyes (41.08%) were normal vision and 469 eyes (58.98%) were eyes of refraction errors. 38.82 % of the total eyes were myopia. There was no significant change in the refraction in the children with myopia after the intervention.
3) Awareness of visual acuity, change of knowledge, behavior, and attitude
(1) After the intervention, there was a significant difference in the awareness of visual acuity (experimental group: 70.10%, control group: 50.97%, p<.01).
(2) After the intervention, there was a significant knowledge increase in the experimental group (p<.01).
(3) There was no significant difference in the visual health behavior after the intervention.
(4) There was a significant positive change in the attitude related to visual health in the experimental group ( p<.05).
(5) There was a significant increase in the Prochaska's stage of change in the experimental group (p<.01).
4) There was a significant positive change in the subjective discomfort of the students. But, there was no significant change in the objective eye symptom after the intervention.
5) There was a significant increase in the perceived benefit of the eyeball movement in the experimental group( p<.05). But, there was no difference in the perceived barriers between two groups.
3. The effects of visual health promotion program-parents
612 parents (experimental group: 349, control group: 263) participated in the study. There was no difference in the sex and educational level between groups.
The mean age of parents were 38.89 in the experimental group and 38.03 in the control group. There was a significant increase in the knowledge of visual health after the intervention (p<.01). Also, there was a significant positive change in the attitude toward visual health (p<.05). But, there was no significant change in the health practices and the Prochaska's stage of change.
The result of this study provide the current status of visual disturbance of the elementary school age children. And, the study explored the factors related to the decrease in the visual acuity. Also, after the development of the intervention program, the effect of the program was examined.
Even though there was no effect in the visual acuity and the change of the refraction, subjective visual health as well as the attitude and knowledge of the children and parents toward visual health was improved significantly. Also, there was an increase in the intention of change and the awareness for the visual health management. It is suggested that various educational strategies for visual health promotion should be developed and examined for the visual health promotion of the students.