Objectives: The purpose of this study is to examine change in adolescent depression across time and to determine the relation between individual and neighborhood socioeconomic status (SES) and depression. Methods: This study employed multilevel latent growth analysis using longitudinal data from Korea Children and Youth Panel Survey. A sample of this study consists of 2,351 adolescents who were in first grade of middle school in 2010. Results: Results showed that both initial level and downward trajectory of depression varied significantly across individuals as well as across neighborhoods. On the individual level, self-rated economic condition(b=-0.203, p<.001) was related to the initial level of depression. Adolescents whose father had a high educational level(b=0.028, p<.001) or whose mother had a low educational level(b=-0.022, p=.011) had lower rates of decline in adolescent depression. On the neighborhood level, neighborhood deprivation index (b=0.003, p=.019) and gini coefficient(b=0.124, p=.040) were associated with lower rates of decline in depression. Conclusions: Low SES in adolescence is correlated with worse mental health, especially depression. Social disparities in depression likely originate before adulthood. The findings argue for the importance of understanding depression in adolescence from a multilevel or ecological framework.
Bae, Sung-Heui;Choi, Eun-Ok;Lee, In sook;Lee, In Young;Chun, Chae min
Journal of Korean Biological Nursing Science
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제18권3호
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pp.144-152
/
2016
Purpose: This study compares beneficiaries of Korean Medicaid with those under the National Health Insurance program, seeking to understand how each group utilizes their healthcare. Methods: Data were obtained from a Health Promotion Survey in 2005. Health status was measured by the respondents' perception of health. Health service utilization included the availability of healthcare services, the type of healthcare institution, and intent to revisit. Predisposing and enabling factors, as well as health care needs were used for this study. Results: Compared to National Health Insurance beneficiaries, Medicaid beneficiaries reported lower levels of health status and fewer enabling factors. They had more chronic diseases and disabilities. Education level, existence of chronic diseases, exercise patterns, and disabilities were associated with health status. Conclusion: We found that Medicaid beneficiaries had fewer resources and higher levels of health needs. As Medicaid is reformed, policy makers and administrators should understand healthcare utilization behaviors of Medicaid beneficiaries and the factors hindering access to care.
Purpose: This study assessed the impact of self-reported periodontal health on the oral health-related quality of life among elderly Koreans. Methods: Four hundred twenty one elderly Koreans in Seoul and suburban areas were selected with a cluster (institution) sampling method, and were requested to take oral examinations and finish questionnaires on the Oral Health Impact Profile-14(OHIP-14). and self-reported periodontal health status, such as periodontal symptoms, self-rated periodontal health and periodontal treatment need. As the dependent variable, OHIP-14 showed a positive skewed distribution (skewness: 1.17), we transformed to square-root form to apply parametric analyses. Bivariate analysis by t-test and ANOVA, and multivariate analysis with the two-level regression model accounting clusters were implemented. Results: Mean age of the subjects was 74.6 years and 66.5% were women. Fourteen items of OHIP-14 were summarized to one factor explaining 78.6% of total variance and produced the Chronbach alpha coefficient of 0.92. Results from the multivariate model, adjusting for age, sex, type of institutions, ability to pay, and number of teeth present, showed significantly lower OHIP-14 with reporting less than 3 periodontal symptoms (p(O.OOO1), rating their own periodontal health as above average level (p=O.0144), and thinking they don't need any periodontal treatments in the near future (p=O.0148), than their counterparts. The intraclass-corrrelation estimated by the final model was 0.028. Conclusion: This study demonstrates a significant association between self-reported periodontal health status and the oral health-related quality of life.
Purpose: The purpose of this study was to identify the assertive behavior of asking smokers not to smoke and investigate the factors related to assertive behavior in patients with vascular diseases. Methods: Participants were 203 adult Korean patients with vascular diseases such as cerebral infarction and myocardial infarction. Data were collected using questionnaires that included the characteristics of secondhand smoke (SHS), secondhand smoke-related variables (Health belief model factors, health promotion model factors) and level of assertive behavior. Descriptive statistics, t-test, ANOVA and multiple regression using SPSS/WIN 18.0 were performed. Results: Participants who never ask smokers not to smoke was 39.9%, whereas participants who always ask was 7.4%. There was a weak positive relationship between assertive behavior and susceptibility to disease (r=.18), severity of disease (r=.19), benefit of assertive behavior to SHS exposure (r=.10), barrier of assertive behavior to SHS exposure (r=.24), and self-rated health (r=.21) respectively. There was a moderate positive relationship between assertive behavior and self-efficacy of assertive behavior to SHS exposure (r=.49). Health belief model factors explained 15.7% variance and health promotion model factors explained 27.0% of assertive behavior. Conclusion: The findings of this study suggest that self-efficacy of assertive behavior to SHS exposure is a very important factor. Therefore the development of a program to foster self-efficacy of assertive behavior regarding SHS exposure in patients with vascular diseases is needed.
Purpose: The present study was conducted to examine the effects of a health counseling program by occupational health nurses on the unemployed visiting the Employment Welfare Plus Center. Methods: The one-group pretest-posttest design was used. The study presented a secondary analysis of the data collected in a health counseling program run by occupational health nurses for the unemployed visiting the Employment Welfare Plus Center. Kolmogorov-Smirnov, Shapiro-Wilk test, ${\chi}^2$ test and Wilcoxon signed rank test were used to analyze 158 data collected between October 5, 2015 and January 5, 2016. Results: After the intervention, the participants showed a significant decrease in the level of stress index (uBioMacpa), stress (discomfort), musculoskeletal pain and depression. In addition, the participants showed a significant increase in self-rated general health, exercise and regular eating behavior. Conclusion: The health counseling program offered by occupational health nurses is an effective intervention to improve the physical and mental health of the unemployed individuals visiting the Employment Welfare Plus Center.
Objectives: The purpose of this study was to investigate effective predictive factors of the persistence of unmet dental care needs. Methods: Data were obtained from the Korea Health Panel studies of 2011 and 2015, and 4,406 subjects, aged 18 years or older, were included in this study. Of these subjects, those who persistently experienced unmet dental care needs over the three-year period were identified. Panel logistic regression analyses were conducted to identify socio-demographic and health-related factors associated with the persistence of unmet dental care needs in two groups, those aged between 18-64 years and over 65 years. Results: Approximately 12% of subjects showed a persistence in unmet dental care needs. Marital status, education level, household income, type of health insurance, and self-rated health status all significantly correlated with the persistence of unmet dental care needs in both age groups. Conclusions: Efforts should be made to identify factors related to the persistence of unmet dental care needs in order to improve patient accessibility to dental care services.
Purpose: This paper presents the development process and the final contents of the sellf- management education program integrated with exercise training (Healthy Aging Happy Aging, HAHA program) for community residing older adults with chronic diseases. Methods: The program evaluation methodology was applied which is an interactive program development process based on needs assessment, formative evaluation, process evaluation and outcome evaluation. The program was developed and revised while the program was implementing to 22 hypertension (HT) and 32 diabetic (DM) participants. Results: The final program has two sub-programs for HT and DM participants utilizing self-efficacy resources. They share four common components; 1) health screening of exercise risks, 2) weekly 1-hour group self-management education classes, 3) biweekly 1-hour group exercise training and 4) a mid-term individual counseling. Both sub-programs were 12-weeks long but have different education and exercise contents. Participants-rated mean satisfaction scores were 3.47/4 and 3.61/4 for HT and DM program respectively. Attendance rate were 83.1% ~ 92.3% for the classes. Conclusion: The HAHA program developed by multidisciplinary team which reflected participants needs was accepted well by participants evidenced by high attendance rate and perceived satisfaction level.
The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease. Method: Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn. Results: 9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia. Conclusion: The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.
Objectives: This study was performed to determine the relationships among health concern, health practice and health status of the disabled. Methods: A self-administered questionnaire survey was carried out for 1,662 disabled persons in Taegu city from April to July, 1997. Results: Health concern had a significant and positive relationship with health practice(p<0.05) and health practice also had a significant and positive relationship with self-rated health status(p<0.05) in men and women. To determine the structural model of the Health concern, health practice, health status and sociodemographic variables, the covariance structural analysis was used. In men, age, economic status, medical security type, educational level and type of disability had significant direct effects on Health concern(T>2.0). Educational level and type of disability had significant direct effects on health practice(T>2.0). And Economic status, medical security type and job status had significant direct effects on health status(T>2.0). In women, economic status and educational level had significant direct effects on Health concern(T>2.0). However there was no variable which had a significant direct effect on health practice. Job status had a significant direct effect or health status(T>2.0). In men and women, health practice was significantly increased with increasing health concern and the more health practice, the higher health status(T>2.0). Conclusions: It is recommended that the institutional approach which improve the economic status of the disabled with understanding their behavior and attitude should be established to increase health status, in addition, the health policy for encouraging the disabled, such as health education, consulting and health promotion program, should be done.
Park, Jinju;Lim, Min Kyung;Yun, E Hwa;Oh, Jin-Kyoung;Jeong, Bo Yoon;Cheon, Yejin;Lim, Sujin
Journal of Korean Medical Science
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제33권47호
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pp.302.1-303.10
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2018
Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ${\geq}9$ correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ${\leq}4$ correct answers). Interestingly, among current smokers, only those who correctly responded to ${\geq}9$ of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.
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