• Journal of Preventive Medicine and Public Health
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• 제38권3호
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• pp.276-282
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• 2005

Objectives : To evaluate the predictive validity of three scoring systems; the acute physiology and chronic health evaluation(APACHE) III, simplified acute physiology score(SAPS) II, and mortality probability model(MPM) II systems in critically ill patients. Methods : A concurrent and retrospective study conducted by collecting data on consecutive patients admitted to the intensive care unit(ICU) including surgical, medical and coronary care unit between January 1, 2004, and March 31, 2004. Data were collected on 348 patients consecutively admitted to the ICU(aged 16 years or older, no transfer, ICU stay at least 8 hours). Three models were analyzed using logistic regression. Discrimination was assessed using receiver operating characteristic(ROC) curves, sensitivity, specificity, and correct classification rate. Calibration was assessed using the Lemeshow-Hosmer goodness of fit H-statistic. Results : For the APACHE III, SAPS II and MPM II systems, the area under the receiver operating characterist ic(ROC) curves were 0.981, 0.978, and 0.941 respectively. With a predicted risk of 0.5, the sensitivities for the APACHE III, SAPS II, and MPM II systems were 81.1, 79.2 and 71.7%, the specificities 98.3, 98.6, and 98.3%, and the correct classification rates 95.7, 95.7, and 94.3%, respectively. The SAPS II and APACHE III systems showed good calibrations(chi-squared H=2.5838 p=0.9577 for SAPS II, and chi-squared H=4.3761 p=0.8217 for APACHE III). Conclusions : The APACHE III and SAPS II systems have excellent powers of mortality prediction, and calibration, and can be useful tools for the quality assessment of intensive care units(ICUs).

• Safety and Health at Work
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• 제6권3호
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• pp.256-262
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• 2015

Background: Heart attack is the most common cause of line-of-duty death in the fire service. Daily aspirin therapy is a preventative measure used to reduce the morbidity of heart attacks but may decrease the ability to dissipate heat by reducing skin blood flow. Methods: In this double-blind, placebo-controlled, crossover study, firefighters were randomized to receive 14 days of therapy (81-mg aspirin or placebo) before performing treadmill exercise in thermal-protective clothing in a hot room [$38.8{\pm}2.1^{\circ}C$, $24.9{\pm}9.1%$ relative humidity (RH)]. Three weeks without therapy was provided before crossing to the other arm. Firefighters completed a baseline skin blood-flow assessment via laser Doppler flowmetry; skin was heated to $44^{\circ}C$ to achieve maximal cutaneous vasodilation. Skin blood flow was measured before and after exercise in a hot room, and at 0 minutes, 10 minutes, 20 minutes, and 30 minutes of recovery under temperature conditions ($25.3{\pm}1.2^{\circ}C$, $40.3{\pm}13.7%\;RH$). Platelet clotting time was assessed before drug administration, and before and after exercise. Results: Fifteen firefighters completed the study. Aspirin increased clotting time before and after exercise compared with placebo (p = 0.003). There were no differences in absolute skin blood flow between groups (p = 0.35). Following exercise, cutaneous vascular conductance (CVC) was $85{\pm}42%$ of maximum in the aspirin and $76{\pm}37%$ in the placebo groups. The percentage of maximal CVC did not differ by treatment before or after recovery. Neither maximal core body temperature nor heart rate responses to exercise differed between trials. Conclusion: There were no differences in skin blood flow during uncompensable heat stress following exercise after aspirin or placebo therapy.

• 한국산학기술학회논문지
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• 제16권10호
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• pp.6495-6503
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• 2015

본 연구는 혈액투석환자의 이행 수준을 파악하고 이행과 생리적 지표, 건강관련 삶의 질 간의 관계를 조사하였다. 지역 투석의원 27곳에서 220명의 혈액투석환자로부터 자료를 수집하였다. 이행은 투석 간 체중증가, 혈중 칼륨과 인과 함께 환자역할행위이행 도구로 측정하였고 건강관련 삶의 질은 MOS-SF 12로 측정하였다. 자료는 서술통계, t-test, ANOVA, 피어슨 상관계수로 분석하였다. 이행의 평균 점수는 4점을 기준으로 2.92점이었고, 전체 15개 이행 항목 중 투석스케줄 지키기에서 가장 높은 점수를 보였다. 이행 수준은 연령, 결혼상태, 투석기간에 따라 유의한 차이가 있었으며, 이행 항목 중에서 복약, 감염관리, 수면, 야채와 과일섭취가 건강관련 삶의 질과 유의한 상관관계를 보였다. 본 연구결과는 혈액투석환자의 삶의 질을 향상시키기 위해 환자중심 접근이 도움이 될 것임을 시사한다. 건강돌봄제공자들은 환자에게 중요한 이행을 확인하고 환자의 가치와 우선순위를 고려함으로써 환자들의 입장을 이해할 필요가 있다.

• Journal of Korean Neurosurgical Society
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• 제62권1호
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• pp.71-82
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• 2019

Objective : To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson's disease (PD) in Korea and its association with socioeconomic status. Methods : Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest. Results : The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries. Conclusion : The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.81-93
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• 2022

Objectives: The purpose of this study was to develop a model for comprehensively evaluating the risk of sarcopenia in Korean adults and to generate the sarcopenia risk scorecard model based on the results. Methods: The participants of the study were 7,118 adults without sarcopenia in the first basic survey, and a longitudinal analysis was conducted using data from the 1st to 8th survey (2006-2020) of the Korean Longitudinal Study of Aging (KLoSA). The data were analyzed using Rao-Scott chi-square test and weighted Cox proportional hazards regression of complex sampling design. The sarcopenia risk scorecard model was developed by Cox proportional hazards regression using points to double the odds (PDO) method. Results: The findings show that the risk factors for sarcopenia in Korean adults were gender, age, marital status, socioeconomic status, body mass index (BMI), regular exercise, diabetes and arthritis diagnosis. In the scorecard results, the case of exposure to the highest risk level was 100 points. The highest score range were given in the order of age over 65, low BMI, and low socioeconomic status. Conclusions: The significance of this study is that the causal relationship between various factors and the occurrence of sarcopenia in Korean adults was identified. Also, the model developed in this study is expected to be useful in detecting participants with risk of sarcopenia in the community early and preventing and managing sarcopenia through appropriate health education.

• 대한간호학회지
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• 제21권1호
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• pp.89-116
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• 1991

The purpose of this study was to describe mother -infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breast feed were comprised as the subjects of this study. All subjects were interviewed and observed individuaily at 1 to 5 days after the delivery at the hospital, mid -wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city, The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were taperecorded and then recorded in narrative form. Mother - infant interaction behaviors in early feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother -infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother - infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother - infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother - infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi -square test, there were statistically significant relationships in the activity of psychological readiness in preparation behavior and the movement of extremities for the position of instrumental behavior in both groups. However, interaction inducing behaviors were not related with statistical significance in any set of groups. Accomplishment of marriage, bonding and emotional mediation of family members were the categories related to mother's cultural belief about the infant in aspect of functional values. Infant at birth is considered little more than a biological organism without social capabilities. Although the newborn infant is still be attached to his mother, he makes his mother extend her territoriality. The mother's interacting behavior toward her infant based on those beliefs appeared task oriented, separative behavioral series. On the other hand, it was seen that infant reacted independently to his mother's behavior by the in-nate perceptual abilities. Those independent behavioral series of mother and infant on the feeding situation were synchronized at any moment. Nurses are In a unique position to teach mothers about their infant's capabilities and help reducing some of uncertainty about infant's behaviors. Study results indicated that the informations infant's social capabilities and breast feeding should be given to the mothers. The results of this study have several implications for nursing. First, the study results will be used as fundamental resources for the development of the assessment tool about the early mother - infant interaction. Second, the results could be a relevant information in the fied. I of maternal child nursing education as real and useful data. Third, the behavioral patterns of early mother - infant interaction which were classified based on the qualitative analysis could be used for nursing theory development as very fundamental data.

• 재활치료과학
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• 제12권3호
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• pp.79-88
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• 2023

목적 : 본 연구는 감각활동기반 인지재활 그룹 프로그램이 시설거주 치매노인의 인지기능과 우울감, 삶의 질에 미치는 영향에 대해 알아보고자 실시하였다. 연구방법 : 강원도 H군에 위치한 노인 요양시설에 거주하는 65세 이상 치매노인 8명을 대상으로 감각기반 인지재활 그룹 프로그램 총 20회기(사전/사후평가 포함)를 실시하였다. 대상자들의 인지기능, 우울수준과 삶의 질 수준을 프로그램 전과 후에 측정하였다. 결과 : 인지기능 평가에 사용한 한국어판 간이 정신상태 검사(Mini-Mental State Examination-Dementia Screening)의 평균점수는 증가하였지만 통계적으로 유의미한 차이는 없었다. 주관적 기억감퇴 설문지(Subjective Memory Complaints Questionnaire) 결과 통계적으로 유의한 향상이 있었다(p < .05). 우울정도 변화를 확인하기 위해 측정한 한국형 단축형 노인우울 척도(Short Geriatric Depression Scale, SGDS-K)의 사후평가 평균점수는 사전평가보다 향상을 보였으나 통계적으로 유의미한 차이는 없었다. 마지막으로 삶의 질의 변화를 확인하기 위해 측정한 세계보건기구 삶의 질 간편형 척도(World Health Organization Quality of Life assessment instrument-Brief) 결과에서 통계적으로 유의미한 향상이 있었다(p < .001). 결론 : 본 연구 결과를 통해서 시설에 거주하는 치매노인을 위한 감각활동기반 인지재활 그룹 프로그램 개발의 필요성과 유용성을 제시하는 데 기초적 근거를 마련할 수 있을 것이다.

• 사상체질의학회지
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• 제4권1호
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• pp.81-106
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• 1992

The purpose of this study was to find out the causal relationship between perceptual level of stress and health state according to Korean constitutions and to analyze that effect on the Korean constitution's health state. Subjects of this study were 87 out patient department of constitution at Kyung-Hee Oriental Medicine Hospital. Data were collected by using interview with Questionaire during 6 months from Feb. 2 to June 31, 1991. The Measurement tools used by this researcher were Go's The Questionaire of Identify about constitution, Lee's stress scale and Go's modified Cornell Medical Index which were approved it's reliability and validity. All of the questionaires of were used after pre- test. For the purposes of the study, the collected data were analyzed by frequency, t-test, ANOVA and Pearson correlation. And then this research's issue was tested by SAS program's ANCOVA. The findings of this study was summarized as follow. 1. There was significantly differences in stress perceptual level in Korean constitution. (F=9.68, P=.000). The So Em In (小陰人) were higher than the other constitution on stress perceptional level. 2. In health state, there was significantly difference among Korean constitution. (F=6.654, P=.002). Also the So Em In (小陰人) was lower than the other constitution at health state. Therefore, it was considerate that So Em In (小陰人) was higher perceptual level of stress than the other constitution and the resulting poor health state. 3. Stressful perception was effected on the health state, as a result inverted correlation was constructed between stress perception and health state. (r=-.6034, P=.0001) 4. After exclusion of stress perceptual level, each of the Korean Constitution's health state was not difference (F=1.01, P=.37). It was mean that differences of the Korean Constitution's perceptual level of stress effected on the health state. Bacause So Em In (小陰人) had higher perceptual level of stress than other constitution (F=9.687, P=.000), in proportion to that one's health state was poor. From the results of this study, it could be concluded that the higher stress perceptual level according to Korean constitution, the poorer health state. Further study in this area needs to be consideration that in order to coping with stress, researcher grope for quality nursing intervention with more accurative assessment about Korean constitution.

• 근관절건강학회지
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• 제7권2호
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• pp.269-280
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• 2000

This study was conducted to clarify the effect of physical ability, pain, fatigue, depression, sexual satisfaction, and spouse criticism on the sexual intrusiveness of rheumatoid arthritis(RA)women. The subjects of the study were 89 RA outpatients who visited the department of rheumatology of Dong-A University Hospital in Pusan from March 2000 to April, 2000. Pain & Fatigue via graphic rating scale, depression via CES-D(Center for Epidemiologic Studies -Depression) scale and physical ability via the Health Assessment questionnaire(HAQ) were assessed. Also we used both Sexual satisfaction scale(Kim, et al, 1997) to measure sexual satisfaction and Spouse criticism scale(Kraaimaat et al. 1996) to measure spouse criticism. The Intrusiveness rating scale which was derived from Arthritis Impact Measurement Scale(AIMS) was used to measure illness intrusiveness in sexuality. The relationships between the variables such as pain, depression, fatigue, physical ability, spouse criticism, sexual satisfaction and illness intrusiveness on sexuality were analyzed by Pearson correlation. As a result, pain & depression were significantly positively related to illness intrusiveness and physical ability & sexual satisfaction was significantly negatively related to illness intrusiveness. But these variables were interrelated. So hierarchical regression was performed to examine the relative contribution of pain, depression, physical ability, and sexual satisfaction with regard to intrusiveness of RA on sexuality. It revealed that pain, depression & sexual satisfaction predicted significantly illness intrusiveness on sexuality. Therefore it is very important to reduce pain and depression and to increase sexual satisfaction for reducing illness intrusiveness.

• 한국융합학회논문지
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• 제10권7호
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• pp.391-397
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• 2019

우리나라의 인구 10만명 당 자살자 수는 24.6명으로 OECD국가 중 가장 높은 수준이다. 연령이 증가함에 따라 자살사망은 증가하고 있어 노인인구는 자살사망의 위험이 다른 인구집단에 비하여 매우 높다. 본 연구는 한국노인의 자살을 예측하는 요인을 확인하기 위하여 시도되었다. 노인을 대상으로 한 자살예방교육의 기초자료로 활용하고자 한국 복지패널의 2016년도에 구축된 11차 년도 복지패널 자료 중 만 65세 이상 노인 가구원 자료를 추출하여 분석하였다. 연구 대상자의 평균연령은 75.55세(표준편차 6.34)이며, 남성은 37%, 여성은 63%였으며, 지난 일 년간 자살생각을 한 적이 있는 대상자는 165명으로 전체의 3.4%였다. 주관적 건강상태와 우울, 자아존중감, 기초생활수급, 의료급여, 노인장기요양급여 등 사회서비스 수급여부의 관련요인을 포함하여 단계적 로지스틱 회귀분석 결과 우울(Exp(B)=1.113), 주관적 건강상태(Exp(B)=.767)가 자살생각을 예측하는 것으로 나타났다(Nagelkerke $R^2=.248$). 따라서 노인을 대상으로 한 자살예방프로그램의 효과적 적용을 위하여 주관적 건강상태의 사정과 우울증 선별검사를 통한 고위험군의 파악이 요구된다.