• Research in Community and Public Health Nursing
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• v.26 no.4
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• pp.405-414
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• 2015

Purpose: The purposes of this study were to examine the effects of home visit healthcare using a complex program on community-dwelling frail elders' physical strength, frailty, and depression and to compare the effects among three regions. Methods: This study was conducted as a quasi-experimental study using one-group pretest-posttest design. A total of 86 subjects were sampled from three regions (metropolis, small city, and rural area). The program was applied for 14 weeks. This program consisted of disease management by a visiting nurse, exercise with a visiting nurse, self exercise, telephone monitoring, health education, counseling, providing handbook, and incentive. Physical strength was measured by balance, upper-limb, and lower-limb muscle strength. Frailty was measured by the Korean Frail Scale and depression was measured by the Geriatric Depression Scale. Paired t-test and ANCOVA were used to analyze the effects. Results: Physical strength, frailty, and depression were significantly improved after applying the complex program. There were not differences among the regions. Conclusion: Home visit healthcare using a complex program was effective in improving frail elders' physical strength, frailty, and depression. There were not differences among the regions. Therefore, home visit healthcare using a complex program needs to be expanded to other regions.

• Journal of dental hygiene science
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• v.10 no.2
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• pp.109-116
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• 2010

Objective: The purpose of this study was oral health related quality of life among elderly population in some rural area, Korea. Methods: 546 participants (male 196, female 350) aged more than 65 years (mean $71.4{\pm}4.6\;years$) were surveyed cross-sectionally. All the subjects were examined short-form of Oral Health Impact Profile (OHIP-14) by face to face interview. Categorical responses of strata-adjusted Wilcoxon correlation and Kruskal-Willis test and multiple regression analysis after adjusting for socio-demographic variables were adapted for statistical analysis. Results: 1. As for sub-factors of the quality of living related to oral health, the drop in social ability was 4.61, the drop in mental ability 4.53, the drop in physical ability 3.99, mental inconvenience 3.98, social disadvantages 3.82, physical pains 3.77, and functional division 3.44, on the average. 2. As for the quality of living related to oral health, there were statistically significant differences in functional restrictions by gender, the educational level, and the presence of occupation, in physical pains by gender, the educational level, family members living together. mental inconvenience by gender, the educational level, the presence of occupation. and in the drop in physical ability by gender, the educational level, monthly incomes. There were statistically significant differences in the drop in physical ability by gender, the educational level. in the drop in social ability by the educational level, the presence of occupation, monthly income. and in social inconvenience by age, the presence of occupation, monthly income. 3. There were statistically significant differences in the general quality of living related to oral health by gender, the educational level, the presence of occupation.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.657-668
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• 1996

To investigate the factors which affecting the cognitive impairment of the 60 or more age group, the authors surveyed for the subjects in some area of Kyungnam Province. 201 studied subjects were tested for cognitive function with mini-mental state examination(MMSE). Information on demographic characteristics and life style has been collected through direct interview. The concentration of Ai and Ca of subject's drinking water, which might be related with cognition, was measured by Inductively Coupled Argon Plasma Spectrometer. The main results were summarized as follows. 1. The prevalence rate of cognitive impairment was 18.4% in male and 45.2% in female and this sexual difference was statistically significant(p=0.03). And the uneducated or illiterated showed significantly high prevalence rate of cognitive impairment(p=0.02). 2. In stratified analysis by sex md education year, we can not see significant trend indicating the neurotoxic effects of aluminum and protective effects of calcium to the cognitive function(p>0.05). 3. The correlation between the concentration of aluminum in drinking water and the MMSE score in whole subjects showed weak negative relationship(r=-0.066). But there was no statistical significance(p=0.434).

• Korean Journal of Rural Living Science
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• v.5 no.2
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• pp.135-144
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• 1994

This study was carried out to investigate health status and nutritional status based on dietary intake and food habit of elderly women in rural area of Keyonggi Province. The subject of this study were 133 elderly women aged 60 and over and interviewed with a questionaire. Main result was as follows : 1) Health score based on modified Cornell Medical Index, CMI(45 out of 195 items) was the average $29.1\pm6.8$ and was not significantly different with family size educational level and farmwork participation. In age, 44.0% of the subject in 60~65 years old was low score of CMI(11~25), but 50% of the subject in older than 80 years old was high score(33~44). The subject with disease was 82% and disease of musculoskeletal system was main type. 2) Dietary intake data obtained by a semiquantitative food frequency questionaire showed the average daily intake of energy, protein, Ca, retinol and riboflavin was lower than RDA Daily energy, protein and Ca intake was individually 84%, 67% and 55.1%. It was retinol that was the least sufficient as 49.1% of RDA. 3) The relation between CMI score(divided into three level : low, middle and high) showed low level was significantly different with others according to daily intake of energy, protein, retinol, thiamin, riboflavin and ascorbic acid. The correlation between CMI score and all nutrient intake were highly significant (p＜0.001), thus we knew that health status was affected importantly by nutrient intake. 4) Family size, educational level and age showed not significant correlation with all nutrient intake. 5) In food habit, 84.8% of the subject had regular mealtime and 14.4% were skip meal sometimes. The main reason of skip meal was a poor appetite. Preference for salty taste of subject was insufficiently salty of somewhat salty. Preference for fishes and meats showed the subject consumed fishes more than meats, but 23.5% of the subject didn't consume both. The subject eaten supplement was 38.3%.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.4
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• pp.511-517
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• 2010

This study was performed to estimate the prevalence and the risk factors of metabolic syndrome in Andong rural area. A total of 1,431 people (533 males, 898 females) aged over 45 years participated in this study in 2003. The prevalence of metabolic syndrome was 38.2% (male 23.5%, female 46.9%, p<0.001). As age increased, the prevalence of the metabolic syndrome increased in female, but not in male. The major underlying components of metabolic syndrome were high blood pressure (67.1%), low HDL-cholesterol (60.6%), and abdominal obesity (39.9%). The distinctive component for male was high blood pressure (70.1%), and for female, low HDL-cholesterol (73.6%), high blood pressure (65.3%), and abdominal obesity (54.5%). Subjects having more than one component were 94.7%. The risk factors for metabolic syndrome were analyzed using the multiple logistic regression method according to gender and expressed as age-adjusted odds ratio (OR). The results of comparing female to male (OR=2.953), and of comparing obese by % body fat (M: OR=5.786, F: OR=13.498) or BMI (M: OR=3.782, F: OR=13.301) to normal body weight showed significantly higher risk for metabolic syndrome (p<0.001). Health related habits, such as smoking, alcohol drinking, and exercise, didn't show any effect on metabolic syndrome. This study revealed that the prevalence of metabolic syndrome was significantly higher in female subjects compared to both male and female, and high blood pressure was the main cause of metabolic syndrome. We suggest that the strategy for prevention or reducing the prevalence of metabolic syndrome in this area should be concentrated on reducing high blood pressure through lowering obesity and abdominal obesity.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.91-95
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• 2004

This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

• Journal of Preventive Medicine and Public Health
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• v.57 no.1
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• pp.65-72
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• 2024

Objectives: Protecting people against financial hardship caused by illness stands as a fundamental obligation within healthcare systems and constitutes a pivotal component in achieving universal health coverage. The objective of this study was to analyze the prevalence and determinants of catastrophic health expenditures (CHE) in Iran, over the period of 2013 to 2019. Methods: Data were obtained from 7 annual national surveys conducted between 2013 and 2019 on the income and expenditures of Iranian households. The prevalence of CHE was determined using a threshold of 40% of household capacity to pay for healthcare. A binary logistic regression model was used to identify the determinants influencing CHE. Results: The prevalence of CHE increased from 3.60% in 2013 to 3.95% in 2019. In all the years analyzed, the extent of CHE occurrence among rural populations exceeded that of urban populations. Living in an urban area, having a higher wealth index, possessing health insurance coverage, and having employed family members, an employed household head, and a literate household head are all associated with a reduced likelihood of CHE (p<0.05). Conversely, the use of dental, outpatient, and inpatient care, and the presence of elderly members in the household, are associated with an increased probability of facing CHE (p<0.05). Conclusions: Throughout the study period, CHE consistently exceeded the 1% threshold designated in the national development plan. Continuous monitoring of CHE and its determinants at both household and health system levels is essential for the implementation of effective strategies aimed at enhancing financial protection.

• Journal of Preventive Medicine and Public Health
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• v.47 no.6
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5053-5056
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• 2012

Background: Bladder cancer is one the most common malignancies of the genitourinary tract. The present study aimed to assess the epidemiology, of bladder cancer in Mazandaran, a large province in northern Iran as high-incidence cancer area, during a 2-year period. Methods: The data for this study were obtained from the population-based cancer registry of the Vice-Chancellory for Health Affairs of Mazandaran University of Medical Sciences and Mazandaran hospitals between March 1, 2010 and March 1, 2011. Demographic data, including sex, age, residency and symptoms were investigated through careful review of medical records. Using a questionnaire protocol, several variables were assessed for these cases such as smoking, history of opium, vegetable consumption habits, and history of other cancers. Results: A total of 112 cases were analyzed, 98 (87.5%) in men and 14 (12.5%) in women (mean age of $68.0{\pm}14.6$ years). Urban and rural residence were 60.7% and 39.3%. Tobacco and opium use were found in 45.5% and 21.4% of patients, respectively. Approximately 60% consumed vegetables an average of fewer than one time per day. Hematuria was the first symptom in these cases which were mainly diagnosed as having bladder cancer by ultrasonography. Conclusion: The results showed that bladder cancer tends to be found in the elderly and the male to female ratio is high. Macroscopic hematuria is a very important symptom for indicating probably urothelial tumor that should be followed up patients with transabdominal ultrasonography as a routine modality.

• Journal of the Korean Society of Food Science and Nutrition
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• v.39 no.10
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• pp.1459-1466
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• 2010

This study was performed to identify the association between the metabolic syndrome and the biochemical measurements and nutrient intakes. A total of 1,431 people (533 males, 898 females) aged over 45 years living in Andong rural area participated in this study in 2003. Plasma aspartate aminotransferase (AST), alanine aminotransferase (ALT), $\gamma$-glutamyl transferase ($\gamma$-GT) and thiobarbituric acid reactive substances (TBARS) levels in metabolic syndrome were significantly higher than those in normal group. In multiple logistic regression, those biochemical measurements were found to be positively associated with the metabolic syndrome as the adjusted odds ratios (OR) 1.839 (p<0.001) by AST, 2.302 (p<0.01) by ALT, 2.143 (p<0.001) by $\gamma$-GT, and 1.874 (p<0.001) by TBARS. We also found that the increased level of those measurements tended to be strongly associated with high triglyceride among the metabolic syndrome components. However, the nutrient intakes between the metabolic syndrome and the normal group were not significantly different. Also, we could not find any nutrient intakes significantly associated with the metabolic syndrome, except high carbohydrate intake (>70% of kcal) compared to normal intake (55~70% of kcal) showed OR 0.781 (p<0.05). In analyzing the association of nutrient intakes with metabolic syndrome components, we found that the calorie intake was negatively associated with abdominal obesity (OR 0.696, p<0.05) and high fat intake (>25% of kcal) was positively associated with low HDL-cholesterol (OR 1.864, p<0.05). This study revealed that the biochemical measurements, such as plasma AST, ALT, $\gamma$-GT, and TBARS, are associated with metabolic syndrome, but considering the nutrient intakes, we suggest that further studies are needed to identify the associations.