• 정신신체의학
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• 제11권2호
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• pp.137-148
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• 2003

연구목적: 비만클리닉에 내원한 여성들을 대상으로 식이제한 태도 및 우울증상, 스트레스 등 심리적인 문제들에 대한 특성을 파악하고 비만과의 상관관계를 조사하고자 본 연구를 시행하였다.방 법: 2001년 5월 한 달 동안 아주대학교병원과 서울 시내에 소재한 비만 클리닉에 내원한 여성 150명을 대상으로 사회인구학적 특성 및 신체적 특성, Three Factor Eating Questionnaire, Symptom Check List-90-R(SCL-90-R), 스트레스 인지척도 등을 설문 조사하였고 저자가 Hamilton Depression Rating Scale를 측정하였으며, 이 중 설문지의 답을 충실히 기입한 116명을 대상으로 하였다. 결 과: 연구대상 중 체질량지수 $25.0kg/m^2$ 이상인 비만군은 50.0%였으며, 연령이 증가함에 따라 체질량지수가 증가하였다(p<0.001). 정상이하 체중군에서 미혼인 경우가 48.8%로 비만군 13.8%에 비해 유의하게 높았으며(p<0.01), 흡연률 및 음주율과 체질량지수와는 유의한 관계가 없었다. Three Factor Eating Questionniare는 체질량지수와 체지방과 비교해 볼 때 유의한 차이를 보이지 않았으나, Factor 2(Disinhibition)와 Global Severity Index(r=0.27, p<0.01), Factor 3(Hunger)과 Global Severity Index(r=0.24, p<0.01)와는 각각 유의한 상관관계가 있었다. 체질량지수에 따른 Symptom Check List-90-R의 각 증상척도는 편집증 척도만이 과체중군과 비만군 간에 통계적으로 유의한 차이가 있었다(p<0.05). 대상군 모두 Symptom Check List-90-R의 전체 척도가 50점 이하였으나 각 증상척도는 정상이하 체중군과 비만군이 과체중군에 비해 높은 경향이 있었다. Global Severity Index와 Hamilton Depression Rating Scale(r=0.75, p<0.01), Global Severity Index와 스트레스 인지척도(r=0.32, p<0.01) 간에 각각 유의한 상관관계가 있었다. Hamilton Depression Rating Scale를 체지방 정도에 따라 정상군과 비만군 두 군으로 나누어 비교한 결과 비만군에서 우울증상이 유의하게 높았다(p<0.05). 스트레스의 정도는 체질량지수 및 체지방과 유의한 차이가 없었고 대상군 모두 높은 스트레스를 느끼고 있는 것으로 나타났으며, 스트레스 인지척도가 Factor 2(r=0.29, p<0.01) 및 Factor 3(r=0.37, p<0.01)과 유의한 상관관계가 있는 것으로 보아 스트레스가 식이제한 태도에 영향을 미치는 것으로 생각된다. 또한, 스트레스 인지척도가 Symptom Check List-90-R 중 우울척도, Global Severity Index 및 Hamilton Depression Rating Scale와도 유의한 상관관계가 있는 것으로 보아 스트레스가 심리적인 특성에 영향을 미치는 것으로 생각된다(r=0.33, r=0.32, r=0.34, p<0.01). 결 론: 비만한 사람들은 우울을 비롯한 심리적 고통을 더 많이 가지며 스트레스 점수가 높고, 이는 식이제한 태도와도 관계가 있을 것으로 생각된다. 향후 비만클리닉을 방문하는 사람들의 정신과적 문제에 대한 적극적인 평가 및 정신과적 개입이 필요할 것으로 생각된다.

• Journal of Nutrition and Health
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• 제48권3호
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• pp.228-235
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• 2015

본 연구는 만 15~19세 남자 고등학생 902명을 대상으로 식행동, 간식 섭취, 식환경, 생활 습관에 대해 설문 조사를 실시하였고, 비만 판정을 위해 신장과 체중을 측정하여 식행동 패턴에 따른 간식 섭취 및 기타 요인과 비만과의 연관성을 분석하였다. 1) 청소년 식생활 지침의 항목을 이용하여 식행동을 평가한 결과 대상자들은 3가지 패턴으로 분류되었다. 식생활과 생활 습관 모두 건강한 패턴과 식생활과 생활 습관 면에서 건강한 요소와 비건강한 요소가 혼재되어있는 혼합 패턴, 그리고 마지막으로 식생활과 생활 습관이 전반적으로 바람직하지 않은 비건강 패턴이었다. 2) 각 패턴 별로 간식 섭취가 차이를 보였는데, 건강한 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 높았고, 혼합 패턴은 과일이나 호상요구르트 섭취 빈도가 높은 반면 라면, 아이스크림, 탄산음료, 사탕 섭취 빈도도 같이 높았으며, 비건강 패턴은 과일, 우유, 호상요구르트의 섭취 빈도가 다른 두 패턴에 비해 가장 낮은 반면 라면, 단 간식, 탄산음료 등의 간식 섭취 빈도는 가장 높았다. 3) 식환경을 포함한 생활 습관 요인도 패턴마다 상이했는데, 가정 내 식품 비치율은 각 식품 섭취 빈도와 유사하게 건강한 패턴과 혼합 패턴의 가정 내 과일 비치율이 비건강 패턴에 비해 높았다. 또한 혼합 패턴이 건강기능성 식품이나 식이 보충제 복용 비율이 가장 높았고, 비건강 패턴은 식사 속도, 수면 시간은 짧고 스크린 시간이 하루 2시간 이상인 비율이 가장 높았다. 4) 패턴 별 비만과의 연관성은 건강한 패턴을 기준으로 하였을 때, 혼합 패턴의 교차비는 1.11이었으나 유의하지 않았고, 비건강 패턴의 교차비는 1.88로 유의적이었다. 이상의 결과로부터 청소년의 식행동 패턴에 따라 간식 섭취 뿐 아니라 식습관, 생활 습관 요인이 차이를 보였으며 이러한 요인들이 비만과의 연관성에도 영향을 주었다. 식행동은 식품 섭취나 생활 습관 요인들과 서로 상호작용을 하므로 앞으로 청소년 비만 예방 및 관리를 위한 전략으로 적절한 영양 교육과 함께 식행동과 생활 습관을 함께 개선해 나갈 수 있는 방안을 모색하는 것이 필요하다.

• 농촌의학ㆍ지역보건
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• 제37권3호
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• pp.167-180
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• 2012

본 연구는 대구광역시 심뇌혈관질환 고위험군 등록관리 시범사업단 고혈압 당뇨병 교육정보센터를 방문한 고위험군환자와 교육자의 교육요구도를 반영하여 질환, 영양, 운동 3영역의 기본, 심화, 개별 3단계로 단계별 교육프로그램을 개발하였다. 이 프로그램의 효과평가를 위하여 교육정보센터에 방문한 기본교육군 32명, 단계교육군 37명을 대상으로 교육 전후 임상적 지표, 행동변화단계, 자아효능감을 측정하였고 주요 연구결과는 다음과 같다. 교육요구도조사결과 고위험군과 교육자의 요구도가 높은 소그룹형태, 30분-1시간이내 수업 및 이론 50%와 실습 50%의 구성과 형태로 이루어지며 3개월의 교육과정인 질환, 영양, 운동영역의 단계 교육프로그램을 개발하였다. 교육요구도조사 결과 교육영역별 교육내용은 고위험군과 교육자의 필요도와 지식정도의 통계적으로 유의한 차이에 따라 5가지 범주로 분류하여 프로그램 구성에 적용할 수 있었다. 첫째, 고위험군과 교육자간의 요구도에 유의한 차이가 없는 항목은 기본과정내용으로 반복하게 하였고 둘째, 고위험군의 인지도가 평균점수 이하인 항목은 기본교육과정내용을 조정하여 효과적인 실습방법으로 모든 단계에서 반복할 수 있도록 하였다. 셋째, 고위험군의 지식정도 평균 편차가 큰 항목은 개별교육과정에 포함시켜 문제를 해결할 수 있는 기술습득을 목표로 이루어지도록 하였다. 넷째, 고위험군과 교육자간 지식정도의 유의한 차이가 있는 항목과 다섯째, 고위험군과 교육자간 요구도에서 유의한 차이가 있는 항목은 고위험군의 참여도가 높은 실습 중심의 심화교육으로 구성하며 교육자도 표준 매뉴얼에 따라 교육방법, 교육환경을 일관성 있게 유지하도록 교육훈련을 강화하여 교육자 간 격차를 줄이도록 하였다. 교육자와 고위험군과의 격차를 줄이기 위하여 자가관리 목표, 단기 계획 설정을 고위험군과 교육자 상호약속에 의해서 계획하여 실천동기와 문제해결능력을 향상시키도록 하는 과정을 단계마다 필수적으로 포함시켰다. 교육프로그램의 평가는 기본교육군, 단계교육군을 대상으로 임상적 지표, 행동변화단계 자기 효능감을 측정하여 비교하였다. 임상지표 중 허리둘레, 수축기혈압, 이완기혈압(p<0.05), 자기효능감 중 혈압/혈당조절 불량시 병원방문, 의사의 지시에 따라 약 복용, 식사량 일정유지(p<0.05), 정기적으로 합병증 검사, 정상적인 혈압/혈당을 유지, 허리둘레 유지, 체중 유지(p<0.01), 행동변화단계에서는 싱겁게 먹기(p<0.05)에서 유의적인 차이가 있었다. 환자와 교육자의 교육요구도를 반영하여 개발된 실습 중심의 단계별 교육프로그램은 이론중심의 기본교육프로그램과 비교한 결과 임상지표, 자기효능감, 행동변화단계에서 유의한 차이가 있었다. 대상자 수가 적고 추구관리기간이 짧았으며 임상지표측정이 부족했던 한계점은 있으나 환자가 노인이며 만성질환환자로서 유병기간이 긴 점을 감안하면 이 프로그램을 지속적으로 시행한다면 환자의 심뇌혈관질환 예방에 기여할 수 있을 것이다.

• 환경영향평가
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• 제27권6호
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• pp.695-703
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• 2018

북한의 텃밭에서는 비료사용이 매우 제한적이므로 남북한 농업분야 협력사업의 하나로 텃밭 부산물을 이용한 퇴비 제조방법의 제안은 실용적 가치가 있다. 본 연구는 북한의 실정을 고려하여 토끼 분변과 옥수수 부산물이 가장 얻기 쉬운 원재료 물질로 판단하고 이를 이용한 퇴비 제조 방법을 제안하고자 하였다. 북한의 시료를 구하기는 불가능한 일이기 때문에 남한의 여러 지역에서 옥수수 부산물 시료를 구하여 이들의 이화학적 성질을 분석하였다. 분석 결과, 주요 비료 성분인 질소의 경우 남한 정도의 공간 규모에서 유의한 차이가 없었으므로 경기도 지역의 옥수수 부산물을 퇴비화 재료로 활용하였다. 토끼 분변도 여러 지역에서 수집 분석하였는데 이를 풀만을 급이한 중국 단동의 분변 시료와 비교하였다. 이 결과 사료를 먹은 토끼 분변의 질소 함량은 풀을 먹인 토끼 분변에 비해 유의하게 낮았다. 북한 상황을 고려할 때 텃밭에서 키우는 토끼는 사료가 아닌 풀을 급이할 확률이 크지만 재료의 가용성으로 인해 경기도 연천에서 토끼의 분변을 확보하여 퇴비화 재료로 활용하였다. 퇴비화 과정은 토끼 분변과 옥수수 부산물의 혼합비를 1:1, 1:2, 1:3 로 각각 처리하여 60일 동안 진행하였다. 그 결과 1:1 혼합비를 통해 제조된 퇴비는 부숙 완료 후 총 질소 함량은 1.98%이었고 유기물/질소 비도 31.7에 달하여 시판되고 있는 상업용 퇴비와 질적으로 차이가 없음을 확인하였다.

• 한국학교ㆍ지역보건교육학회지
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• 제9권1호
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• pp.47-61
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• 2008

Objectives: This study examined to explain the practical health behaviour and health-related quality of life, and their influencing factors in high school students. Methods: Total of 718 high school students from 1 school in Seoul were assessed with a self-administered questionnaire regarding general characteristics, health related characteristics, obesity index(Height and weight calculated by using the relative weight law: obesity group>20%, overweight group $10{\sim}20%$, normal weight group $-10{\sim}10%$, under weight group <-10%), health behaviour in school-aged children(eating, exercise and weight control) and health-related quality of life(PedsQLTM4.0 Generic Core Scale: physical health, emotional functioning, social functioning, school functioning). Results: Major results were as follows. 1. The rate of obesity by obesity index was 5.3% of high school students. Obesity incidence in adolescents was mainly associated with gender and parents whether obesity. 2. Perceived health status was lower in obese adolescents than in normal adolescents. 3. The rate of miss a breakfast was 37.9%, and obesity group than normal weight group were fruits, vegetables and milk intake at least, a lot of fastfood intake. During the past week, followed by intense physical activity, and overweight consumed a lot of time for TV and the Internet. Overall, under weight group and normal weight group belong to the students evaluated fatter than themselves. Weight control for weight loss, gain and maintain was grater in obesity group than in normal weight group. Weight loss showed highest scores in overweight group which appeared significant difference. 4. Obese adolescents compared with other groups, reported lower total QOL score and all QOL in domain, and especially social functioning showed significant differences. 5. Factors influencing the adolescents's QOL were found to be gender, perceived health status and exercise. Conclusions: High school girls were aware of their bad health status and likely to improve the QOL by practicing health behaviour. But obese adolescents were likely to degrade the quality of life by reducing the practice of health behaviors. So further school-based education about proper practical health behaviors and obesity prevention is necessary.

• 호스피스학술지
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• 제3권2호
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• pp.19-33
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• 2003

Cancer causes many crises to cancer patients imcluding physical dysfunction and emotional changes such as anxiety, depression as well as a threat of life, fear of death. As it develops, cancer makes people feel powerlessness due to the losses of their own positions, roles and independence. Although occupying a little proportion among all types of cancer, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking, provoke anxiety and depression after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. This study is a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research design to determine, how nursing intervention has effects on anxiety, depressing of head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher with reference to a literal review and esperts' advice. The measurement tool of anxiety was consisting of totaled 20 question items which was prepared by Spielberger and translated by Kim et al., the device of depression measurement consisting of total 20 question items which was the output of Song's translation the device of depression self-evaluation from Zung. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using x2-test and t-test. 5 hypoteses were tested using t-test. The results of the study can be summarized as follows. 1.The first hypothesis that the experimental group receiving supportive nursing intervention shows a little anxiety than the control group not receiving supportive nursing intervention was supported(t=3.817, P=.000). 2.The second hypothesis that the experimental group receiving supportive nursing intervention shows a little depression than the control group not receiving supportive nursing intervention was supported(t=8.089, P=.000). Consequently, supportive nursing intervention was found an effective nursing intervention strategy to reduce anxiety and depression of head and neck cancer patients. Providing supportive nursing intervention in nursing practice can enhance the quality of life of those cancer patients.

• 대한지역사회영양학회지
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• 제21권1호
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• pp.65-74
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• 2016

Objectives: This study was performed to investigate the nutritional status, health conditions, eating habits and experience and demand for nutrition dietary management of senior citizens. And these data are formed foundation of development of nutrition dietary management education program and contents in welfare facilities for the aged. Methods: We visited 3 public health centers, 3 senior citizens centers, and 4 welfare centers in Seoul, Gyeonggi-do, Chungnam province, and Daejeon area and carried out interview by semi-structured questionnaire for senior citizens older than 65 years who use those facilities. Results: The study included 17%, 30.7% and 52.3% of senior citizens from public health centers, seniorcitizen centers and and welfare centers, respectively. The age range of 43.9% of the population was 65-74 years and and 56.1% were older than 75 years. We observed that 83.2% of subjects took some medicines due to diseases that they have and 58.0% took prescription medicines for hypertension. The thing that they considered the most when selecting food was 'the taste'(p<0.05). Regarding the level of practice to keep the dietary life, they answered more than 'average' for most of items but answered less than 'average' for lot of salt intake, drinking, exercise. For the experience of nutrition dietary life education, only 19.8% answered 'Yes' and the service for nutrition dietary life management showed the highest score in the demand for 'provide nutritious food'. For the size of consulting group for nutrition/dietary life education, the public health center and welfare center preferred a larger group size but the senior citizens center preferred a smaller group. With regard to who will carry out the consulting, the demand for dietitian was the highest and the operation type showed the high demand in the order of consulting, education. The contents that they want to have consultation in nutrition dietary life education were diet therapy for diseases and the ordinary diet therapy for health. Conclusions: This study suggested the management of nutrition dietry life necessitates qualitative measures according to the different types of welfare facilities. For these, it is in need of development of counseling and education program included therapy for disease. Above all, the policy to secure dietitian of welfare facilities for the aged to perform these should be achived.

• 대한지역사회영양학회지
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• 제13권5호
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• pp.682-692
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• 2008

The purpose of this study was to investigate the status of children's breakfast skipping and their mothers' needs for breakfast service at child care centers. A survey was conducted with mothers of children aged 3 to 5 years and attending child care centers in Gwanak-gu, Seoul. Out of 960 questionnaires distributed to the caregivers at 32 child care centers, 633 were returned (66% response rate), and 449 were analyzed (47% analysis rate) after excluding data from the respondents not meeting the selection criteria for this study: mothers of children aged 3 to 5 years. Over 2/3 (69%) of children ate breakfast every weekday (Breakfast Eaters) and almost 1/3 (31%) of children skipped breakfast one time or more often on weekdays (Breakfast Skippers). The collected data were compared between Breakfast Eaters and Breakfast Skippers. The average Good Dietary Practice Score of Breakfast Skippers was significantly lower than that of Breakfast Eaters, implying poorer dietary habits. A higher percentage of mothers of Breakfast Skippers (62%) responded that breakfast service was 'necessary' or 'very necessary' at child care centers than those of Breakfast Eaters (27%). A multiple logistic regression analysis was conducted to determine factors affecting mothers' needs for breakfast service at child care centers. The result showed that the children's ages, mothers' occupational status, household monthly income, frequencies of eating breakfast on weekdays and satisfaction level with morning snack provided at child care centers affected mothers' needs for breakfast service at child care centers. In particular, mothers who had a full-time job (OR = 2.06) than housewives, mothers whose children did not eat breakfast at al (OR = 3.54), ate $1{\sim}2$ times (OR = 5.50) or ate $3{\sim}4$ times (OR = 3.80) on weekdays than those whose children ate breakfast every weekday were more likely to have needs for breakfast service at child care centers than housewives. In conclusion, Breakfast Skippers tended to have poorer dietary habits than Breakfast Eaters and Full-time working mothers had higher needs for breakfast service at child care centers. This study results suggest that child care centers consider serving breakfast to children as the number of working mothers increases.

• Nutrition Research and Practice
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• 제9권2호
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• pp.207-212
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• 2015

BACKGROUND/OBJECTIVES: The Recaller app was developed to help individuals record their food intakes. This pilot study evaluated the usability of this new food picture application (app), which operates on a smartphone with an embedded camera and Internet capability. SUBJECTS/METHODS: Adults aged 19 to 28 years (23 males and 22 females) were assigned to use the Recaller app on six designated, nonconsecutive days in order to capture an image of each meal and snack before and after eating. The images were automatically time-stamped and uploaded by the app to the Recaller website. A trained nutritionist administered a 24-hour dietary recall interview 1 day after food images were taken. Participants' opinions of the Recaller app and its usability were determined by a follow-up survey. As an evaluation indicator of usability, the number of images taken was analyzed and multivariate Poisson regression used to model the factors determining the number of images sent. RESULTS: A total of 3,315 food images were uploaded throughout the study period. The median number of images taken per day was nine for males and 13 for females. The survey showed that the Recaller app was easy to use, and 50% of the participants would consider using the app daily. Predictors of a higher number of images were as follows: greater interval (hours) between the first and last food images sent, weekend, and female. CONCLUSIONS: The results of this pilot study provide valuable information for understanding the usability of the Recaller smartphone food picture app as well as other similarly designed apps. This study provides a model for assisting nutrition educators in their collection of food intake information by using tools available on smartphones. This innovative approach has the potential to improve recall of foods eaten and monitoring of dietary intake in nutritional studies.

• Nutrition Research and Practice
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• 제5권5호
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• pp.455-463
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• 2011

The aim of the present study was to assess the effects of skipping breakfast on diet quality and metabolic disease risk factors in healthy Korean adults. Subjects included 415 employees (118 men, 297 women; 30-50 years old) of Jaesang Hospital in Korea and their acquaintances. Data collected from each subject included anthropometric measurements, 3-day dietary intake, blood pressure, and blood analyses. The subjects were classified into three groups based on the number of days they skipped breakfast: 'Regular breakfast eater', 'Often breakfast eater', or 'Rare breakfast eater'. Participants in the 'Rare breakfast eater' group consumed less rice, potatoes, kimchi, vegetables, fish and shellfish, milk and dairy products, and sweets than did participants in the other two groups (P for trend <0.05) and ate more cookies, cakes, and meat for dinner (P for trend <0.05). Participants in the 'Rare breakfast eater' group consumed less daily energy, fat, dietary fiber, calcium, and potassium than did participants in the other groups (P for trend <0.05). The percent energy from carbohydrates was lower and fat intake was higher in the 'Rare breakfast eater' group than in the other groups (P for trend <0.01). When diets were compared using the Acceptable Macronutrient Distribution Range for Koreans, 59.1% of subjects in the 'Rare breakfast eater' group consumed more energy from fat compared with the other two groups (P <0.005). According to the Estimated Average Requirements for Koreans, intake of selected nutrients was lower in the 'Rare breakfast eater' group than in the other two groups (P <0.05). The risk of elevated serum triglycerides was decreased in the 'Rare breakfast eater' group (OR, 0.3 [0.1-1.0], P for trend=0.0232). We conclude that eating breakfast regularly enhances diet quality, but may increase the risk of elevated serum triglycerides.