• 농촌의학ㆍ지역보건
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• 제44권3호
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• pp.115-123
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• 2019

이 연구는 J시 일부 보건진료소에서 실시한 건강증진프로그램이 농촌여성노인 노쇠정도 확인을 위한 건강상태(지각된 건강상태, 노쇠 점수, 상 하체 유연성, 최대악력, 동적평형검사 Timed Up and Go)에 미치는 효과를 규명하기 위함으로 대한노인병학회에서 개발한 한국형 노쇠측정도구 8개 항목을 통해 보건진료소 관할지역 노인들의 노쇠수준을 파악하고, 농촌 여성노인들의 노쇠수준에 맞는 12주 건강증진프로그램을 적용하였다. 건강증진프로그램(프로그램명: ${\bigcirc}{\bigcirc}$보건진료소와 주민이 함께 만드는 하하호호 백세건강마을 만들기)은 J시 보건진료소 특성화 사업의 한 부분으로 연구자인 보건진료전담공무원이 전문가의 자문을 얻어 농촌여성 노인들에게 적합하도록 수정 보완하여 실시하였다. 연구 결과 노쇠측정도구 8개 항목을 통한 노쇠점수도 실험군이 대조군에 비해서 유의한 차이를 보였는데, 8개 항목 중 주관적인 현재 건강상태와 우울한 감정의 개선이 노쇠점수가 향상에 특히 도움이 되었다. 건강상태 변화로 왼쪽 상체유연성은 실험군이 약 2배(+17cm), 오른쪽 상체유연성은 +11cm, 하체유연성은 실험군이 +6cm 증가하였고, 대조군은 거의 변화가 없어 통계적으로 유의한 차이가 있었다. 노인의 근력평가로 최대악력은 실험군이 약+4kg 증가하였고, 동적 균형 검사(Timed Up and Go test)는 실험군이 3초 빨라지고 대조군은 거의 변화가 없어 통계적으로 유의한 차이가 있었다. 따라서 이 연구에서 실시한 건강증진프로그램이 상 하체 유연성 및 근력, 민첩성 등 운동능력을 향상하는 데 도움이 되었다고 볼 수 있다. 이상의 연구 결과를 바탕으로 의료취약지역 보건 진료소 관할 인구의 평균수명 연장과 고령화로 노쇠한 농촌 노인들의 특성을 반영한 근력강화 및 유연성 운동과 인지개선 활동 등 다양한 건강증진프로그램의 지속적인 개발과 프로그램의 표준화를 통한 확대 적용이 필요하다.

• 보건행정학회지
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• 제32권3호
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• Journal of Preventive Medicine and Public Health
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• 제56권3호
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• pp.221-230
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• 2023

Objectives: The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model. Methods: This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables. Results: A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes. Conclusions: Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.

• 한국환경보건학회지
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• 제45권1호
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• pp.30-41
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• 2019

Objectives: The effects of particulate matter and ozone on health are being reported in a number of studies. These effects are likely to be stronger on the elderly population, but studies in this regard are scarce. The purpose of this study was to examine the effects of particulate matter ${\leq}2.5{\mu}m$ and ozone on the acute health status of the elderly population. Methods: In order to analyze the health status of the elderly population, the NHIS-Senior Cohort data was used. In this study of people 60 years or older in Seoul, the number of outpatient visits and ER visits between 2002 and 2013 were calculated. Each disorder and the lag effect were analyzed separately. Particulate matter and ozone were analyzed using both the single exposure model and the adjusted multi-exposure model. Results: In the single exposure analysis with PM2.5 as the exposure variable, with each increase of $10{\mu}g/m^3$, the number of outpatient visits increased by 1.0081 times, vascular disease 1.0065 times, chronic pulmonary disease 1.0086 times, and diabetes 1.0055 times. In the multi-exposure model adjusting for ozone, the number of outpatient visits increased by 1.0066 times. There was a one-day lag effect and 1.0066 times increase between PM2.5 and ER visits in the multi-exposure model and 1.0057 times when adjusted for ozone (p value <0.10). There was a one-day lag effect in all multi-exposure models with ozone as the main variable, and when the particulate matter was adjusted, there was a one-day delay and 1.0143 times increase in ER visits. Conclusions: In our study, an increase in the number of outpatient and ER visits in the elderly population in accordance with the increase in PM2.5 and ozone was found. The association found in our study could also produce a socioeconomic burden. Future studies need to be performed in regards to younger populations and other air pollutants.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.283-287
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• 2012

Objective: To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Methods: Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. Results: The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94; colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). Conclusion: The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.109-116
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• 2000

Objectives : Routine vaccination against influenza is recommended for all people aged 65 years or more. Without active encouragement to receive the vaccine, the rate of compliance is generally low. A study was undertaken to assess and compare the effectiveness of two reminder systems in improving the influenza vaccination rate. Methods : A total of 2,017 patients aged 65 or over in a tertiary care hospital family practice center were randomly assigned to a control, a telephone reminder, or a postcard reminder group before the influenza season in 1998. The outcome measure, receipt of vaccination, was determined by telephone interview. Demographic and clinical characteristics were checked through the medical chart review. Results : Among the 1,312 patients who actually received reminders and interviewed, the vaccination rate was 46.7% in the control group, 56.3% in the postcard reminder group, and 63.3% in the telephone reminder group. Vaccination compliance was significantly higher in people reminded by telephone (Odds ratio [OR], 2.00; 95% confidence interval [CI], 1.52-2.64) and postcard (OR, 1.55; 95% CI, 1.18-2.02) compared to that in the control group. Of the characteristics investigated, number of high risk co-morbidity was positively associated with vaccination compliance while current smoking was negatively associated. Conclusions : This result suggests that telephone and postcard reminders can significantly improve compliance with influenza vaccination in this group of Korean elderly. However, additional strategies need to be developed to encourage vaccination among noncompliant.

• 지역사회간호학회지
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• 제14권2호
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• pp.287-298
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• 2003

The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.

• 한국건강관리협회지
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• 제2권2호
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• pp.160-166
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• 2004

The aging of population in Korea is proceeding in such a fast speed that other developed countries kaven't experienced. Korea already emerged in the aging society in 2000, and expected to become an aged society in 2019.There(ore, making effort to improve the quality of life of the aged people tv prolonging their social, economic activity, resulting in retrenchment of expenditure on health is very important. Developing nutrition and exercise programs to improve the quality of life of the elderly people, resulting in prolonged independent life is as important as medical care after onset of diseases. As a national preventive measure to save elderly people from becoming in need of assist, comprehensive program including teaching computer to prevent senile dementia, nutritional and exercise programs, along with programs of everyday life activity for the risk-group people should be carried out,

• 한국산학기술학회논문지
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• 제19권4호
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• pp.301-310
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• 2018

본 연구는 요양시설 노인의 신체적 기능(ADL, IADL) 및 정신적 기능(우울, 인지기능장애) 수준과 삶의 질과의 관련성을 규명하고자 시도하였다. 조사대상은 D광역시에 소재하고 있는 15개 요양시설에 입소하고 있는 65세 이상 노인 524명으로 하였으며, 자료 수집은 2015년 11월부터 2016년 1월까지의 기간 동안에 조사원이 조사대상 요양시설을 직접 방문하여 면접 조사하였다. 자료의 분석은 각 독립변수에 대한 삶의 질을 종속변수로 하여 평균점수를 비교하기 위해 t-test 및 ANOVA로 검정하였다. 또한, 삶의 질에 영향을 미치는 관련 독립변수들의 설명력을 파악하기 위하여 다중회귀분석을 실시하였다. 연구결과, 조사대상자의 삶의 질은 연령이 높을수록, 학력이 낮을수록, 가족과 함께 산다는 군보다 혼자 산다는 군, 자녀와의 관계가 좋다는 군보다 좋지 않다는 군, 주관적인 건강상태가 건강하다는 군보다 건강하지 않다는 군, 신체의 부자유가 없다는 군보다 있다는 군, 치아상태가 좋다는 군보다 좋지 않다는 군, 아침식사를 한다는 군보다 하지 않는다는 군, 규칙적인 운동을 한다는 군보다 하지 않는다는 군, 정기적인 건강검진을 한다는 군보다 하지 않는다는 군에서 유의하게 낮았다. 또한, 일상생활수행능력(ADL)과 도구적 일상생활수행능력(IADL)이 낮을수록, 우울수준이 높을수록, 인지기능장애점수가 낮을수록 삶의 질 수준이 유의하게 낮은 것으로 나타났다. 이 같은 연구결과는 요양시설 노인의 삶의 질은 인구사회학적특성, 건강상태 및 건강관련행위특성뿐만 아니라 신체적 기능 및 정신적 기능과도 유의한 관련성이 있음을 시사하고 있다.

• 한국노년학
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• 제31권3호
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• pp.673-689
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• 2011

본 연구는 농어촌 건강취약지역의 노인들이 경험하는 건강불평등 경험의 의미를 focus group으로 연구한 질적연구이다. 연구목적은 농어촌 건강취약지역의 노인건강불평등을 이해하고 건강증진을 위한 기초자료를 제공하고자 한다. 경상남도의 20개 시·군에서 2004년부터 2007년간 표준화 사망비가 지속적으로 높은 40개 취약지역으로 선정된 읍·면·동 중에서 15개 농어촌지역을 임의로 선정하여 각 지역별로 focus group 참여자를 구성하고 현상학적 분석방법에 근거하여 분석하였다. 연구결과로 농어촌 건강취역 지역 노인들이 경험하는 건강불평등은 생태학적 환경오염, 지역사회 서비스부족과 위해환경, 낮은 경제상태, 건강행태차원에서 건강관리 부족의 4개 범주로 나타났다. 이러한 결과를 바탕으로 건강취약지역의 노인건강 증진을 위한 몇 가지 제언을 제시하였다.