• Title/Summary/Keyword: 만성질환노인

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The Patterns of Medical Utilization on Dermatoses among Rural Inhabitants (농촌지역 주민들의 피부 질환에 대한 치료 행태)

  • Kim, Chang-Yoon;Joo, Ree;SaKong, Joon;Chung, Jong-Hak;Kwak, Tae-Hun
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.103-113
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    • 1999
  • The authors surveyed the inhabitants of a rural area to assess the patterns of medical utilization on dermatoses. Seven hundred and sixty new outpatients of dermatoses were examined and surveyed with formed questionnaire from March 1997 to February 1999. The results are as follows; 1. Among 760 new outpatients, the number of male patients was 283(37.2%) and that of female patients was 477(67.3%). 2. The most common dermatoses was Tinea pedis(34.9%), and follows senile pruritus, contact dermatitis, housewife eczema, seborrheic dermatitis, numular dermatitis, atopic dermatitis, Tinea corporis, Tinea ungium, acne vulgaris, impetigo, keratolysis exfoliativa, chronic urticaria, Tinea cruris and Molluscum contagiosum in orders. 3. Drug store was the most frequent places where patients initially visited for their skin diseases(39.6%) and followed by non dermatologic clinic, dermatologic clinic and general hospital in orders. 4. One hundred and twenty one(15.9%) patients have been experienced folk treatment. It was founded that the topical vinegar application or soaking was the most common method. Many patients felt no symptom improvement after the folk treatment(48.8%). Seventeen point four percent of patient felt symptom worsened. The results of this study suggest that many of the rural inhabitants are lack of understanding on their dermatoses. So many physician who are in charge of the primary care in rural area have to pay attention to the common dermatoses and educate patients on their medical utilization.

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Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

A Survey on Utilization of Health Center and Health Service Demand of Residents in a Urban and Rural Unified Community (일개 도시·농촌 통합지역 주민의 보건기관 이용경험과 보건서비스 요구도 조사)

  • Lim, Bu-Doll;Lee, Ju-Young
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.99-112
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    • 2000
  • This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

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The Effect of Elastic Band Exercise Training and Detraining on Body Composition and Fitness in the Elder (탄력밴드 운동이 노인의 신체조성과 체력에 미치는 지속적 효과)

  • So, Wi-Young;Song, Misoon;Cho, Be-Long;Park, Yeon-Hwan;Kim, Yeon-Soo;Lim, Jae-Young;Kim, Seon-Ho;Song, Wook
    • 한국노년학
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    • v.29 no.4
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    • pp.1247-1259
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    • 2009
  • Muscle mass is reduced by aging. There seems to be no direct relationship between sarcopenia(muscle loss) and medical cost in the elderly, but lowering muscle mass results in increase risk of fall and decrease of strength, fitness, physical activity, and independent life. This is coupled with physical trouble and chronic degenerative disease such as diabetes, obesity, hyperlipidemia, and hypertension. Thus, sarcopenia is potential risk factor increasing mortality. The purpose of this study was to investigate the effects of elastic band exercise and detraining on sarcopenia prevention related variables, body composition and fitness. The subject of this study was 60~70 aged 14 seniors who participated in exercise program in J-welfare senior center at J-gu in S-city. Elastic band exercise was performed twice per week for 12 weeks. The body composition and fitness variables were measured before 12 weeks of control, after control(before exercise), after 12 weeks of exercise(before detraining), and after 12 weeks of detraining. There was no significant difference in body composition and fitness variables before and after 12 weeks of control, but elastic band exercise before and after 12 weeks has effect on body composition variables such as weight (t=2.978, p=0.001), body mass index (t=3.502, p=0.004), percent body fat (t=2.216, p=0.045), muscle mass (t=-3.837, p=0.002), visceral fat area (t=5.186, p<0.001), and waist-hip ratio (t=3.045, p=0.009) and on fitness variables such as 2-minutes step (t=-6.891 p<0.001), arm curl (t=-4.702, p<0.001), chair stand (t=-4.860, p<0.001), chair sit and reach (t=-5.910, p<0.001), back scratch (t=-3.835, p=0.002), and 8-ft up and go (t=7.560, p<0.001). This exercise effect was continued after 12 weeks of detraining on body composition variables such as weight (t=2.323, p=0.037), body mass index (t=2.503, p=0.026), muscle mass (t=-3.137, p=0.008) and on fitness variables such as 2-minutes step (t=-6.489 p<0.001), chair stand (t=-4.694, p<0.001), chair sit and reach (t=-3.690, p=0.003), and 8-ft up and go (t=7.539, p<0.001). It was found that the elastic band exercise has positive effect on body composition and fitness in the elderly and the effect was maintained over 12 weeks of detraining.

The Effect of Physical Health Status and Social Support on Depression and Quality of Life among the Elderly in G City (거제시 노인의 신체적 건강상태와 사회적 지지가 우울과 삶의 질에 미치는 영향)

  • Kim, Min-Ja;Oh, Mi-Jung;Lim, Jung-Hye;Chang, Koung-Oh
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.246-257
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    • 2018
  • The purpose of this study was to investigate the effects of physical health status and social support on depression and quality of life among the elderly in G City. This is a descriptive research study of 497 elderly residents in 45 senior citizen centers in G city; the data were collected from March 5 to 30, 2018. Data were analyzed using the IBM SPSS/win 24.0 program by t-test, ANOVA and multiple regression analysis. In physical health status, the chronic disease score was $1.35{\pm}0.91$, the functional status score was $1.80{\pm}4.45$, and the subjective health score was $3.14{\pm}1.13$. The average score for social support in the emotional network was $5.71{\pm}1.13$. In the sub-region of the social network, the score for frequency of contact with relatives was $2.92{\pm}1.31$, that for contact with friends was $3.18{\pm}0.98$, and that for social participation was $0.68{\pm}0.82$. In the multiple regression analysis of factors affecting depression and quality of life, the explanatory power of physical health status and quality of life was 45.5% and 21.1%, respectively. The explanatory power of depression based on social support and quality of life was 46.7% and 27.5%, respectively. This study indicates that physical health status and social support affect depression and quality of life. Therefore, programs should be developed to increase the physical health status and social support and thus improve the quality of life of the elderly in the community.

The intake of food and nutrient by the elderly with chronic disease in the Seoul area (서울지역 거주 노인들의 만성질환에 따른 식품 및 영양소 섭취 실태 조사)

  • Park, Yoo Kyung;Lee, Yeon Joo;Lee, Sang Sun
    • Journal of Nutrition and Health
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    • v.45 no.6
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    • pp.531-540
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    • 2012
  • This study was carried out in order to investigate the status of food and nutrient intakes depending on the types of chronic disease of the elderly at welfare centers in Seoul. The total number of subjects was 299 elderly over the age of 60 (82 men and 217 women); they were grouped by the disease status: normal, cardiovascular disease (CVD), diabetes mellitus (DM) and arthritis patients groups. The dietary intakes were obtained by a 24-hour recall and analyzed by CAN-Pro 4.0; they were then compared with the dietary reference intakes for the Korean (KDRIs). In the results of anthropometric data according to chronic disease, the waist circumference of the normal group in males and females was lower than the other groups; in particular, the normal female group showed a lower level of waist-hip ratio, body mass index (BMI) and body fat % than those of the other groups. The arthritis group showed a higher intake of milk products than the other groups (p < 0.05); consequently, calcium intake was significantly higher than that of the other groups (p < 0.001). Vitamin A intake in the arthritis group was significantly higher than the intake in the normal and DM groups (p < 0.01). Normal and arthritis groups showed significantly higher intake of zinc and copper than the CVD group (p < 0.01). In general, about 80% of the subjects in this study revealed insufficient intakes of riboflavin, vitamin C, calcium, dietary fiber, vitamin D, biotin and potassium, compared with the estimated average requirement (EAR) or adequate intake (AI). However, sodium intake of all groups was higher than the AI of KDRIs. In conclusion, nutrient intake, according to the chronic disease, showed significant difference in some of the micronutrients, vitamin A, Ca, Zn and Cu. Therefore, we suggest that dietary guidelines, such as reducing the intake of salty foods and sweet drinks and increasing the intake of foods with sufficient calcium, vitamin D and vitamin C, are necessary to the improvement of eating habits for the elderly.

Inflammatory Cytokines and Dietary Factors in Korean Elderly with Chronic Disease (만성 질환 노인에서의 면역 성분 양상과 식이예방인자)

  • Park Hee-Jung;Hwang Yu-Jin;Kim Wha-Young
    • Journal of Nutrition and Health
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    • v.39 no.4
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    • pp.372-380
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    • 2006
  • The purpose of this study was to investigate the association between inflammatory cytokines and chronic disease status in Korean elderly. The subjects were 248 elderly people aged over 65 years recruited from Health Center in Seoul. The subjects were classified into 3 groups based on their disease (diabetes, hypertension, and hyperlipidemia) status: subjects with one diagnosed disease of diabetes, hypertension, and hyperlipidemia fall into singular group (n=89), subjects with more than 2 disease into multiple group (n=39), and those with free of the diseases into normal (n=122). Anthropometric and biochemical characteristics, and dietary intakes were assessed. Dietary intakes were surveyed by 24-recall method. The means of IL-2, IL-6, MCP-1 and C3 were not differ among 3 groups. However, when subjects classified into tertiles of IL-6, MCP-1, TNF-$\alpha$ and C3 and frequencies of each fertile were compared, the multiple group showed significantly lower frequencies in lowest fertile than normal group (p<0.05), suggesting higher tendency of inflammatory responses. For hematological values, blood pressure, triglycerides, fasting blood glucose levels were highest in multiple group (p<0.05) compared to other 2 groups. BMI, body fat(kg), and triceps skinfold thickness were also significantly higher in multiple group than in 2 other groups(p<0.05). Moreover, the concentrations of IL-2, IL-6 and C3 were significantly correlated with hematologic values of fasting blood glucose, total cholesterol, LDL-cholesterol, and triglycerides or obesity factors such as triceps skinfold thickness, BMI, and body fat(%). Among singular and multiple group, the subjects with higher intakes for vitamins A, C, and E showed the higher level of IL-2 and the lower level of MCP-1, and C3. In conclusion, blood concentrations of triglycerides and proinflammatory cytokines, blood pressure, obesity parameters (BMI, body fat, triceps skinfold thickness) were higher in multiple group than in normal, but this result strongly suggest that the increasement of the vitamin A, C, and E intakes would modify the cytokine levels to reduce the inflammatory response in the elderly people with chronic diseases.

Associations between Chronic Diseases and Depression in the Korean Elderly: A Gender-Specific Analysis (우리나라 노인의 만성질환과 우울과의 관련성: 성별 분석)

  • Jin, Young;Lee, Yongjae;Kim, Tae Hyun;Lim, Seungji;Chung, Woojin
    • Health Policy and Management
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    • v.30 no.2
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    • pp.231-244
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    • 2020
  • Background: As the population is aging, chronic diseases and depression are becoming the main problems in a country's healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. Methods: We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. Results: A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10-2.22) in the stroke patients group and 1.82 (95% CI, 1.01-3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28-3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03-1.64) in the group of patients with other diseases. Conclusion: Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.

An Evaluation of Chronic Disease Risk Based on the Percentage of Energy from Carbohydrates and the Frequency of Vegetable Intake in the Korean Elderly: Using the 2007-2009 Korea National Health and Nutrition Examination Survey (한국 노인 식사의 탄수화물 에너지비와 채소섭취 빈도에 기초한 만성질환 위험성 평가: 2007-2009년 국민건강영양조사 자료 이용)

  • Suh, Yoon Suk;Park, Min Seon;Chung, Young-Jin
    • Korean Journal of Community Nutrition
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    • v.20 no.1
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    • pp.41-52
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    • 2015
  • Objectives: Korean elderly people are known to consume diets high in carbohydrates low in vegetables compared to other age groups. This study evaluated the chronic disease risks and nutritional status in this group based on the percentage of energy from carbohydrates and the frequency of vegetable intake. Methods: Using the 2007~2009 Korean National Health Nutrition Examination Survey data, except those who were undergoing treatment for chronic disease, final 1,487 subjects aged 65 and older were divided into 4 groups: moderate carbohydrate energy ratio of 55~70% and low frequency of vegetable intake defined as less than 5 times per day (MCLV), moderate carbohydrate ratio and high frequency of vegetable intake more than 5 times (MCHV), high carbohydrate energy ratio above 70% and low frequency of vegetable intake less than 5 times (HCLV), and high carbohydrate ratio and high frequency of vegetable intake more than 5 times (HCHV). All data were analyzed after the application of weighted value, using a general linear model or logistic regression. Results: More than half of Korean elderly consumed diets with HCLV, and this group showed poor nutritional status and lower frequency of intake of most food items, but with no risk of chronic disease such as diabetes, obesity, hypertension, cardiovascular disease or anemia probably due to low intake of energy. On the contrary, MCHV group with a high percentage of energy from fat and protein showed the highest intake of energy and most nutrients, the highest frequency of intake of most of food items and a tendency of high risk of abdominal obesity, being followed by the MCLV group. Meanwhile, HCHV group showed a tendency of high risk of hypertension, followed by HCLV group with low frequency of intake of vegetables compared with the two moderate carbohydrate groups. Conclusions: The results suggested that the percentage of energy from carbohydrate and the frequency of vegetable intake affected the nutritional status, but not significantly affected the risk of chronic disease in Korean elderly. Further studies using more detailed category of % energy from carbohydrates and of type and amount of vegetables with consideration of individual energy intake level, excessive or deficient, are needed to confirm the results.

A Comparison between Asia-Pacific Region Criteria and Entropy Model Criteria about Body Mass Index of Elderly Females Using Morbidity of Chronic Disease (만성질환 이환율을 이용한 여자노인의 체질량지수에 대한 아시아-태평양지역 기준과 Entropy모델 기준 비교)

  • Jeong, Gu-Beom;Park, Jin-Yong;Kwon, Se-Young;Park, Kyung-Ok;Park, Pil-Sook;Park, Mi-Yeon
    • Korean Journal of Community Nutrition
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    • v.19 no.5
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    • pp.490-498
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    • 2014
  • Objectives: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). Methods: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. Results: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p < 0.001). Conclusions: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was $24kg/m^2$ (ENT-C) rather than $23kg/m^2$ (APR-C).