• 제목/요약/키워드: health services research

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Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • 대한약침학회지
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    • 제22권4호
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    • pp.260-268
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    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

우리나라 원격의료산업의 글로벌 경쟁력 강화를 위한 정책 과제 (Enhance Issues of the global competitiveness of Telemedicine Industry in Korea)

  • 윤영한
    • 통상정보연구
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    • 제13권3호
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    • pp.325-351
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    • 2011
  • 전세계적으로 원격진료에 대한 관심은 매우 높은데, 선진국은 격오지 내지 도서지역의 자국민에 대한 양질의 의료서비스를 제공하려는 의도로 개도국은 한정된 의료인프라를 보다 적극적이고 효율적으로 활용함으로서 국민들의 삶의 질 제고를 위한 목적으로 추진되고 있다. 그리고 이들 시장은 급속한 노령화 추세와 정보통신기술의 진보 등이 어우러지면서 20201년경에는 폭발적 성장을 이룰 것으로 기대되고 있다. 우리나라의 경우에도 선진국이 50년 이상에 걸쳐 일어난 노령화가 겨우 20년만에 진행되면서 이들 문제에 대한 해결방안 강구가 절실한데 우리나라의 정보통신기술과 인프라는 이마 세계 최고 수준을 자랑하고 있다. 이에 중앙정부에서는 원격의료를 신성장통력으로 선정하고 육성하려는 노력이 다각도로 진행되고 있으나, 관련 볍제의 미비 등으로 인해 이들 산업 성장에 큰 걸림돌이 되고 있다. 이에 본 연구에서는 우리나라 원격의료 활성화를 위해서 요구되는 각종 법 정비제도를 중심으로 살펴보았는데 원격의료 관련 산업 육성을 위해서는 supply chain의 관점에서 당해 산업을 검토하는 한편, 비교적 글로벌 경쟁력을 확보하고 있다는 평가를 받고 있는 정보통신산업을 중심으로 패키지형의 산업 육성이 필요할 것으로 판단된다. 현재, 미국을 중심으로 전개되고 있는 당해 산업에서 글로벌 시장의 선점을 위해서는 우려와 뜻을 같이하는 기업 및 국가와 지역적 표준을 확립하는 것이 시급하다. 이와 함께 우리나라의 관련 산업 육성을 위해서는 원격진료의 구체적 개념과 범주 명시가 필요하며, 이외에도 현행 의료법에서 명시되고 있는 원격의료에 대한 문제점을 검토하여 보았다 이와 아울러 의료정보 활성화를 위한 매우 중요한 전제조건인 프라이버시에 대한 측면도 해결되어야 할 과제가 매우 많음을 알 수 있었다.

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Development of tailored nutrition information messages based on the transtheoretical model for smartphone application of an obesity prevention and management program for elementary-school students

  • Lee, Ji Eun;Lee, Da Eun;Kim, Kirang;Shim, Jae Eun;Sung, Eunju;Kang, Jae-Heon;Hwang, Ji-Yun
    • Nutrition Research and Practice
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    • 제11권3호
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    • pp.247-256
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    • 2017
  • BACKGROUND/OBJECTIVES: Easy access to intervention and support for certain behaviors is important for obesity prevention and management. The available technology such as smartphone applications can be used for intervention regarding healthy food choices for obesity prevention and management in elementary-school students. The transtheoretical model (TTM) is comprised of stages and processes of change and can be adopted to tailored education for behavioral change. This study aims to develop TTM-based nutrition contents for mobile applications intended to change eating behaviors related to weight gain in young children. SUBJECTS/METHODS: A synthesized algorithm for tailored nutrition messages was developed according to the intake status of six food groups (vegetables, fruits, sugar-sweetened beverages, fast food and instant food, snacks, and late-night snacks), decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. The messages in this study were developed from December 2014 to April 2015. After the validity evaluation of the contents through expert consultation, tailored nutrition information messages and educational contents were developed based on the TTM. RESULTS: Based on the TTM, stages of subjects are determined by their current intake status, decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. Three versions of tailored nutrition messages at each TTM stage were developed so as to not send the same messages for three weeks at most, and visual materials such as figures and tables were developed to provide additional nutritional information. Finally, 3,276 tailored nutrition messages and 60 nutrition contents for applications were developed. CONCLUSIONS: Smartphone applications may be an innovative medium to deliver interventions for eating behavior changes directly to individuals with favorable cost-effectiveness. In addition, using the TTM for tailored nutrition education for healthy eating is an effective approach.

피부미용사의 전문직업성 연구 (A Study on the Professionalism of Estheticians)

  • 양현옥;곽희영
    • 한국산학기술학회논문지
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    • 제10권6호
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    • pp.1380-1388
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    • 2009
  • 피부미용사들의 전문직업성에 대한 인식을 밝혀보고자 2009년 4월 1일부터 4월 20일까지 전라북도 군산시와 전주시의 피부미용사 290명을 대상으로 설문조사한 결과는 다음과 같다. 첫째, 변인별 전문직업성은 연령, 학력, 현 근무지 근무 연수에 따른 전문직업성은 통계적으로는 유의미한 차이를 보이지 않았지만, 삶의 만족도, 직무만족도별 전문직업성은 통계적으로 유의미한 차이를 보였다. 삶의 만족도에 따른 전문직업성은 삶에 대해 만족하는 피부미용사가 그렇지 않은 피부미용사보다 높았고(t =2.77, p<.01), 직무만족도에 따른 전문직업성은 직무에 대해 만족하는 피부미용사가 가장 긍정적이었고, 보통인 피부미용사가 불만족하는 피부미용사보다 높지 않았다(F= 6.06, p<.01). 둘째, 전문 직업성의 하위요인간의 상관관계 분석 결과, 자율성 (r=.595, p<.001), 전문조직의 활용(r=.428, p<.001), 직업에 대한 소명의식(r=.492, p<.001)과는 통계적으로 유의미한 정적 상관관계를 보였으며, 서비스에 대한 신념 (r=-.634, p<.001), 자기규제에 대한 신념 (r=-.485, p<.001)과는 통계적으로 유의미한 부적 상관관계를 보였다.

해외병원 입찰분석을 통한 디지털병원 수출사업 성공요인 (Digital-hospital Research on the Factors that Lead to the Success of the Overseas-hospital Export Business through an Analysis of the Bidding Documents)

  • 차맹규;김정옥;유기윤
    • 정보과학회 컴퓨팅의 실제 논문지
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    • 제23권6호
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    • pp.359-370
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    • 2017
  • 해외병원 프로젝트는 정보통신기술과 첨단의료기기의 발전으로 원격진료, Smart-health, City Like Hospital 개념 확산과 IT 비중이 증가하는 디지털병원으로 변화하는 추세이다. 디지털병원에서 IT역할은 첨단화 되어가는 시공, 기계, 전기, 시스템, 의료장비를 연계하여 통합함으로써 병원운영의 효율성을 극대화 시키는 것이 핵심 요소이다. 본 연구에서는 해외에서 발주되었던 5개의 디지털병원 프로젝트를 대상으로 입찰요구서를 IT 관점에서 분석하고 디지털병원 성공요인을 제안한다. 연구방법은 문헌조사를 통해서 디지털병원 개념과 발전과정을 분석하며, 디지털병원 시스템은 입찰요구서를 분석해서 디지털병원에 적용된 시스템과 기술수준을 분석하고, 최종적으로 디지털병원 성공요인은 프로젝트 성공관리기법에서 제안하는 원가, 공기, 품질 측면에서 분석한다. 연구 성과는 원가측면에서는 IT 및 병원 인프라 운영관점에서 가치를 증대하는 가치공학(Value Engineering) 전략 수립이 필요하고, 공기측면에서는 병원 내 시스템을 통합 테스트하는 Integrated Test & Commissioning 단계에서의 공사기간 준수가 필요하며, 품질측면에서는 사용자 요구사항이 반영된 System Integration을 통해 디지털병원이 지향하는 서비스 성능을 보장하는 것이 디지털병원 수출사업의 성공요인이라고 제시한다.

No Association of the TGF-β1 29T/C Polymorphism with Breast Cancer Risk in Caucasian and Asian Populations: Evidence from a Meta-Analysis Involving 55, 841 Subjects

  • Alqumber, Mohammed A.A.;Dar, Sajad Ahmad;Haque, Shafiul;Wahid, Mohd;Singh, Rohit;Akhter, Naseem
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권20호
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    • pp.8725-8734
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    • 2014
  • The transforming growth factor-${\beta}1$ (TGF-${\beta}1$) gene 29 T/C polymorphism is thought to be associated with breast cancer risk. However, reports are largely conflicting and underpowered. We therefore conducted a meta-analysis of all available case-control studies relating the TGF-${\beta}1$ 29T/C polymorphism to the risk of developing breast cancer by including a total of 31 articles involving 24,021 cases and 31,820 controls. Pooled ORs were generated for the allele contrasts, with additive genetic, dominant genetic and recessive genetic models. Subgroup analysis was also performed by ethnicity for the TGF-${\beta}1$ 29T/C polymorphism. No association was found in the overall analysis (C vs T: OR=1.028, 95% CI=0.949-1.114, p-value 0.500; CC vs TC: OR= 1.022, 95% CI=0.963-1.085, p-value 0.478; CC vs TT: OR= 1.054, 95% CI=0.898-1.236, p-value 0.522; CC vs TT+ TC: OR= 1.031, 95% CI=0.946-1.124, p-value 0.482; TT vs CC+TC: OR= 0.945, 95% CI=0.827-1.080, p-value 0.403). Similarly, in the subgroup analysis by ethnicity, no association was found in Caucasian (C vs T: OR= 1.041, 95% CI=0.932-1.162, p-value 0.475; CC vs TC: OR= 1.031, 95% CI=0.951-1.118, p-value 0.464; CC vs TT: OR= 1.081, 95% CI=0.865-1.351, p-value 0.493; CC vs TT+TC: OR= 1.047, 95% CI=0.929-1.180, p-value 0.453; TT vs CC+TC: OR= 0.929, 95% CI=0.775-1.114, p-value 0.429;) and Asian populations (C vs T: OR= 1.004, 95% CI=0.908-1.111, p-value 0.931; CC vs TC: OR= 0.991, 95% CI=0.896-1.097, p-value 0.865; CC vs TT: OR= 1.015, 95% CI=0.848-1.214, p-value 0.871; CC vs TT+TC: OR= 1.000, 95% CI=0.909-1.101, p-value 0.994; TT vs CC+TC: OR= 0.967, 95% CI=0.808-1.159, p-value 0.720;). No evidence of publication bias was detected during the analysis. No significant association with breast cancer risk was demonstrated overall or on subgroup (Caucasian and Asian) analysis. It can be concluded that TGF-${\beta}1$ 29T/C polymorphism does not play a role in breast cancer susceptibility in overall or ethnicity-specific manner.

치과의료서비스 제공자의 의료서비스 정도와 치과공포의 관련성 (Relation between the degree of dental service on dental service provider and dental fear)

  • 전성희;정명희
    • 한국치위생학회지
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    • 제7권4호
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    • pp.535-551
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    • 2007
  • Objectives: This study was conducted to know dental service and fear after research on reliability on dentists and satisfaction on dental hygienists. Methods: This study was conducted by the 325 persons who had the experience of visiting dental medical institution. Statistical analysis was conducted using the SPSS 12.0 with T-test, ANOVA and correlation. The obtained results were as follows: Results: 1. Internal consistency of Dental Beliefs Survey(DBS) and dental hygienists satisfaction questionnaire factors were 0.758~0.908(Cronbach' alpha). And the Cronbach' alpha's coefficients of the all subscales were more than 0.6. So high reliability and validity were identified. 2. As result of analysing fear from general feature, the men feel more fear than women and more fear was felt in the case of having worse teeth status. Fear was higher in case of visiting to dental clinic than in case of visiting dental clinic for precaution. And that was statistically related. 3. Dental fear was higher in the case of having the past pain experience, insufficient anesthesia experience, experience of seeing other persons pain and this was statistically related(P<0.01)(P<0.05). 4. Average of reliability on dentists was 37.9, person who has high reliability was 81.8%, person who has low reliability was 18.2%, average of satisfaction on dental hygienists was 31.5%(Satisfaction on dental hygienists was 51.1% and dissatisfaction on dental hygienists was 48.9%). 5. Higher dentists reliability and satisfaction on dental hygienists has lower fear considering general feature and dental clinic use behavior but person who has the dental clinic to go regularly has higher dentists reliability and satisfaction on dental hygienists where, however, fear was not low. 6. As result of analyzing correlation between dental service and dental clinic use behavior, satisfaction on dental hygienists was negatively related to reliability on dentists and fear. And, reliability on dentists was positively related to fear, pain experience in dental clinic, incomplete anesthesia experience, near person pain experience(experience on seeing person in pain), which were statistically related(p<0.01). Conclusions: In relation to general features and reliability on dentists and satisfaction on dental hygienists caused by dental clinic use behavior, dental fear was decreased when reliability and satisfaction are higher. Group with low dental fear had higher reliability on dentists and satisfaction on dental hygienists than group with high dental fear but only reliability on dentists was statistically related(p<0.05).

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Lycopene Content and Fruit Morphology of Red, Pink, Orange, and Yellow Fleshed Watermelon (Citrullus lanatus) Germplasm Collections

  • Noh, Jae-Jong;Hur, On-Sook;Ro, Na-Young;Lee, Jae-Eun;Hwang, Ae-Jin;Kim, Bit-Sam;Rhee, Ju-hee;Yi, Jung Yoon;Kim, Ji Hyun;Lee, Ho-Sun;Sung, Jung-Sook;Kim, Myung-Kon;Assefa, Awraris Derbie
    • 한국자원식물학회지
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    • 제33권6호
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    • pp.624-637
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    • 2020
  • High-quality and high-phytonutrient watermelon fruits have strong market opportunities besides their health related benefits. Hence, investigating quality and nutritional related traits of watermelon genetic resources could provide important baseline data in breeding for increased lycopene content thereby increasing the marketability of watermelon. To this end, we have examined some fruit morphological traits and lycopene content of 105 genetic resources. Seeds, originally obtained from 22+ countries, were obtained from the National Agrobiodiversity Center, Jeonju, South Korea, grown in an experimental field and harvested at a fully mature stage. The size of pistil scar (SPS), the width of stripes (WS), weight of fruit (WF), length of fruit (LF), width of fruit (WIF), the thickness of pericarp (TP), soluble solids content (SSC), fruit shape in longitudinal section, ground color of skin, the intensity of the green color of skin, fruit shape at the apical part, grooving distribution, conspicuousness of stripes, and main color of the flesh were recorded on the field and inside laboratory and the lycopene was measured using spectrophotometric and HPLC methods. Watermelon fruits have shown a diverse morphological characters. Red and pink fleshed fruits dominated in the entire collections. Fruits with higher thickness of rind were found to exhibit less soluble solid content (SSC). Korean origin fruits were characterized by intermediate SSC while the United States of America (USA), Russia (RUS), Tajikistan (TJK), Turkmenistan (TKM), Taiwan (TWN), and Uruguay (URY) originated fruits had the highest SSC. The lycopene content varied between 41.37 and 182.82 ㎍/g, 2.81 and 163.72 ㎍/g, and 3.54 and 255.47 ㎍/g using HPLC, UV-Vis spectrophotometer, and microplate reader spectrophotometer, respectively. Red- and pink-fleshed fruits had the highest levels of lycopene content compared to the yellow- and orange-fleshed. Lycopene content had a significant positive correlation with SSC, however, no correlations were detected between lycopene and other quantitative fruit morphological characters. Our study demonstrated high diversity exists in fruit morphological traits and lycopene content of the germplasm collections which provide beneficial baseline data for a future breeding program and utilization of watermelon germplasm collections in gene banks for the maintenance and improvement of the current levels of production, marketability, and health-related benefit of watermelon fruits.

TMA 분석을 위한 지능적 의학 전문가 시스템의 설계 및 구현 (Design and Implementation of an Intelligent Medical Expert System for TMA(Tissue Mineral Analysis))

  • 조영임;한근식
    • 한국정보과학회논문지:소프트웨어및응용
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    • 제31권2호
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    • pp.137-152
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    • 2004
  • 모발분석(TMA: Tissue Mineral Analysis)은 머리카락 속에 있는 30여 가지의 미네랄과 8가지의 중금속의 양과 중요 미네랄 비율을 분석하여 체내에 과잉, 결핍 및 불균형 상태를 평가하고, 그 결과가 현재 인체에 미치는 영향을 예측하여, 건강을 유지하는 방향을 제시하는 임상 영양학 및 독성학 모발조직 검사방법을 말한다. 그러나 국내 TMA 분석방법은 몇 가지 문제점이 있다. 첫째, TMA 분석기기는 있으나 분석결과를 해석할 수 있는 한국형 의학 정보 데이타베이스가 없다. 둘째, 미국에서 보내오는 TMA 검사결과 자료가 영문이며 철저한 보안에 바탕을 둔 그래픽 파일 형태이므로 활용성이 적다. 셋째, TMA 관련 데이터베이스가 있어도 의료기관에서 사용하기 어려운 매우 낮은 수준이므로 TMA 분석 및 의료서비스를 위해 매번 미국에 의뢰해야 하므로 심각한 외화낭비를 초래한다. 넷째, TMA 결과가 서구식 생활패턴에서 비롯된 데이터 베이스로부터 구축된 것이므로 검사결과의 신뢰성 문제가 발생한다. 따라서 본 논문에서는 이러한 문제점을 해결하기 위해 국내 전문 기관으로부터 자료를 제공받아 TMA 관련 국내 최초 지능적 의학 전문가 시스템(IMES: Intelligent Medical Expert System)을 개발하였다. IMES는 TMA 자료를 다단계 통계분석 방법에 의한 결정 트리 분류기를 이용하여 분류하고 다중 퍼지 규칙베이스를 구축하여, 지능적 퍼지추론 방법에 의해 한글화된 데이터베이스로부터 복잡한 자료를 추론하도록 구축하였다. 본 IMES 시스템을 실제 적용한 결과 업무능률과 만족도가 각각 86%, 92% 증가함을 알 수 있었다.

고령장애인의 만성질환과 다차원적 장애 : 국제기능장애건강분류틀(ICF)을 적용하여 (Chronic Illnesses and Multidimensional Disability among Older Adults with Disabilities: Applying the ICF Framework)

  • 조상은
    • 사회복지연구
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    • 제48권4호
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    • pp.91-120
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    • 2017
  • 본 연구에서는 WHO의 국제기능장애건강분류틀(ICF)을 기반으로 고령장애인의 만성질환과 다차원적 장애 간의 관계, 공식 비공식 지지와 다차원적 장애 간의 관계를 살펴보고 공식 비공식 지지의 조절효과를 확인하고자 하였다. 이를 위해 만 50세 이상 고령장애인 450명을 대상으로 2014년도 9차 한국복지패널자료를 사용하여 구조방정식모델(structural equation modeling)로 분석하였다. ICF에 근거하여 건강조건은 고령장애인의 만성질환 수준으로 측정하였고 다차원적 장애는 심리 정서적 기능, 일상활동 수행능력, 사회활동 참여로 측정하였으며 환경요인인 공식 지지와 비공식 지지는 각각 공적서비스 이용 총 수와 지각된 사적 사회적 지지 수준으로 측정하였다. 분석 결과, 만성질환은 심리 정서적 기능에 부정적인 영향을 미쳤고 비공식 지지는 심리 정서적 기능과 일상활동 수행능력에 긍정적인 영향을 미쳤다. 반면 공식 지지의 경우, 일상활동 수행능력과 부적 관계를 나타냈고 만성질환과 심리 정서적 기능의 부적 관계에 부정적 영향을 미치는 것으로 나타났다. 연구결과를 바탕으로 고령장애인의 기능수행(functioning) 제고를 위한 실천적 정책적 제언을 제시하고자 하였다.