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Factors Influencing Stroke in Community-dwelling Adults : Focusing on Health-related Quality of Life

지역사회거주 성인의 뇌졸중 영향 요인 : 건강관련 삶의 질을 중심으로

  • Moon, Jong-Hoon (Dept. of Healthcare and Pubic Health Research, National Rehabilitation Research Institute, National Rehabilitation Center)
  • 문종훈 (국립재활원 재활연구소 건강보건연구과)
  • Received : 2018.11.29
  • Accepted : 2019.01.02
  • Published : 2019.04.30

Abstract

Objective : The purpose of this study was to investigate the factors influencing stroke in community-dwelling adults. Methods : This study used raw data from the community health survey in 2016. Among the 228,452 subjects who participated in the survey, 225,003 (98.5%) of them were included in the analysis of this study. The sociodemographic characteristics were selected as gender, age, region, income, marital status, and comorbidity was selected as osteoporosis, hypertension, diabetes, dyslipidemia, myocardial infarction and arthritis. Health-related quality of life was assessed by EuroQol-5 Dimension(EQ-5D) and the subcategory of EQ-5D (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) were included in the analysis. Dependent variables were stroke, and the independent variables were the 16 variables described above. Statistical analysis was performed using binomial logistic regression analysis. Results : In sociodemographic variables, stroke was predicted by men, aging, and lower income levels. In comorbidity variables, stroke was predicted by hypertension, diabetes mellitus, hyperlipidemia, and myocardial infarction. In sub-domains of health-related quality of life, stroke was predicted by self-care, usual activities, mobility, anxiety/depression, and pain/discomfort. Conclusion : These finding suggest that it is needed development of a customized health promotion program for the improvement of self-care and activities of daily living in community-dwelling stroke survivors.

목적 : 본 연구는 지역사회거주 성인에서 뇌졸중에 영향을 미치는 요인을 규명하고자 하였다. 연구방법 : 본 연구는 2016년 지역사회건강조사의 원시자료를 이용하였다. 이 조사에 참여한 대상자 228,452명 중 결측 값을 제거한 225,003명(98.5%)이 본 연구의 분석에 포함되었다. 사회인구학적 특성은 성별, 나이, 지역, 소득, 혼인상태로 설정하였고, 동반질환은 골다공증, 고혈압, 당뇨병, 이상고지혈증, 심근경색, 관절염이 선택되었다. 건강관련 삶의 질은 EuroQol-5 Dimension로 평가되었고 하위영역인 운동능력, 자기관리, 일상활동, 통증/불편, 불안/우울의 수준을 확인하였다. 종속변수는 뇌졸중 여부, 독립변수는 위에 서술한 16개 변수였다. 통계분석은 이분형 로지스틱 회귀분석을 이용하였다. 결과 : 인구사회학적 특성 변수에서는 남성일수록, 나이가 증가할수록, 소득수준이 낮을수록 뇌졸중을 높게 예측하였다. 동반질환 여부에서, 고혈압, 당뇨, 이상고지혈증, 심근경색이 있을수록 뇌졸중을 높게 예측하였다. 건강관련 삶의 질 하위영역에서 뇌졸중을 예측하는 영역은 자기관리, 일상활동, 운동능력, 불안/우울 순서로 나타났다. 결론 : 본 연구의 결과는 지역사회에 거주하는 뇌졸중 성인의 자조관리와 일상생활 능력 증진을 위한 맞춤형 건강증진 프로그램 개발이 필요함을 제안한다.

Keywords

References

  1. Bae, S. G., Lee, S. K., & Han, C. H. (2015). Influencing and mediating factors in stroke: based on 2007-2012 Korea national health and nutrition examination survey. Journal of the Korea Academia-Industrial Cooperation Society, 16(1), 418-428. https://doi.org/10.5762/KAIS.2015.16.1.418
  2. Feibel, J. H., & Springer, C. J. (1982). Depression and failure to resume social activities after stroke. Archives of Physical Medicine and Rehabilitation, 63(6), 276-277.
  3. Ferrans, C. E., & Powers, M. J. (1992). Psychometric assessment of the quality of life index. Research in Nursing & Health, 15(1), 29-38. https://doi.org/10.1002/nur.4770150106
  4. Hyndman, D., & Ashburn, A. (2003). People with stroke living in the community: Attention deficits, balance, ADL ability and falls. Disability and Rehabilitation, 25(15), 817-822. https://doi.org/10.1080/0963828031000122221
  5. Kang, E. J., Shin, H. S., Park, H. J., Cho, M. W., & Kim, N. Y. (2006). A valuation of health status using EQ-5D. The Korean Journal of Health Economics and Policy, 12(2), 19-43.
  6. Kim, S. H. (2007). The association between expectations regarding aging and health-promoting behaviors among Korean older adults. Journal of Korean Academy of Nursing, 37(6), 932-940. https://doi.org/10.4040/jkan.2007.37.6.932
  7. Korea, Statistics. (2018). Korean statistical information service (KOSIS). Statistical Annual Report.
  8. Lee, C. D., Folsom, A. R., & Blair, S. N. (2003). Physical activity and stroke risk: a meta-analysis. Stroke, 34(10), 2475-2481. https://doi.org/10.1161/01.STR.0000091843.02517.9D
  9. Lip, G. Y., Nieuwlaat, R., Pisters, R., Lane, D. A., & Crijns, H. J. (2010). Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest, 137(2), 263-272. https://doi.org/10.1378/chest.09-1584
  10. Merie, C., Kober, L., Olsen, P. S., Andersson, C., Jensen, J. S., & Torp-Pedersen, C. (2012). Risk of stroke after coronary artery bypass grafting: effect of age and comorbidities. Stroke, 43(1), 38-43. https://doi.org/10.1161/STROKEAHA.111.620880
  11. Ministry of Health & Welfare. (2005). Disability registration status. Korea Institute for Health and Social Affairs.
  12. Ministry of Health & Welfare. (2014). Disability registration status. Korea Institute for Health and Social Affairs.
  13. Ministry of Health & Welfare. (2017). Disability registration status. Korea Institute for Health and Social Affairs.
  14. Oh, I. H., Yoon, S. J., & Kim, E. J. (2011). The burden of disease in Korea. Journal of the Korean Medical Association/Taehan Uisa Hyophoe Chi, 54(6), 646-652. https://doi.org/10.5124/jkma.2011.54.6.646
  15. Reynolds, K., Lewis, B., Nolen, J. D. L., Kinney, G. L., Sathya, B., & He, J. (2003). Alcohol consumption and risk of stroke: a meta-analysis. Jama, 289(5), 579-588. https://doi.org/10.1001/jama.289.5.579
  16. Robinson-Smith, G., Johnston, M. V., & Allen, J. (2000). Self-care self-efficacy, quality of life, and depression after stroke. Archives of Physical Medicine and Rehabilitation, 81(4), 460-464. https://doi.org/10.1053/mr.2000.3863
  17. Seok, S., & Lee, J. (2017). Comparison of stroke risk factors between middle-aged and elderly patients. Journal of Korean Gerontological Nursing, 19(1), 13-27. https://doi.org/10.17079/jkgn.2017.19.1.13
  18. Shin, S. O., & Roh, E. K. (2013). A influencing factors in Korea adults stroke. Journal of the Korea Academia-Industrial Cooperation Society, 14(12), 6227-6236. https://doi.org/10.5762/KAIS.2013.14.12.6227
  19. Song, Y. J., & Cha, Y. J. (2015). Occupational therapy medical insurance review of issues and improvement of the system in Korea. Journal of Korean Society of Occupational Therapy, 23(1), 123-135. https://doi.org/10.14519/jksot.2015.23.1.10
  20. Stamm, T. A., Cieza, A., Machold, K., Smolen, J. S., & Stucki, G. (2006). Exploration of the link between conceptual occupational therapy models and the international classification of functioning, disability and health. Australian Occupational Therapy Journal, 53(1), 9-17. https://doi.org/10.1111/j.1440-1630.2005.00513.x
  21. Turner-Stokes, L., & Jackson, D. (2002). Shoulder pain after stroke: a review of the evidence base to inform the development of an integrated care pathway. Clinical Rehabilitation, 16(3), 276-298. https://doi.org/10.1191/0269215502cr491oa
  22. Tyson, S. F., Hanley, M., Chillala, J., Selley, A. B., & Tallis, R. C. (2008). Sensory loss in hospital-admitted people with stroke: characteristics, associated factors, and relationship with function. Neurorehabilitation and Neural Repair, 22(2), 166-172. https://doi.org/10.1177/1545968307305523
  23. von Sarnowski, B., Putaala, J., Grittner, U., Gaertner, B., Schminke, U., Curtze, S., ... Basic-Kes, V. (2013). Lifestyle risk factors for ischemic stroke and transient ischemic attack in young adults in the stroke in young fabry patients study. Stroke, 44(1), 119-125. https://doi.org/10.1161/STROKEAHA.112.665190
  24. Yang, J. B. (2010). A study on the major factors affecting health-related quality of life of elderly stroke survivors. Journal of the Korea Gerontological Society, 30(4), 1239-1261.
  25. Youngstrom, M. J., Brayman, S. J., Anthony, P., Brinson, M., Brownrigg, S., Clark, G. F., ... Desmarais, S. M. (2002). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56(6), 609-639. https://doi.org/10.5014/ajot.56.6.609