• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.35-47
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• 1999

Medication non-compliance among the elderly results in medical problems and substantial cost to the health care system. This study investigate predicted variable related to the medication task ability among elderly. This study was done in the selected 4 villages in Kimchun County of Kyungbuk Province from July to August, 1996. The subject was the resident that 202 adults above 60 years of age. The questionnaire of interview included medication task ability, socio-demographic data, COOP/WONCA chart, family ABGAR score. BDI(Beck depression inventory), ADL(activities of daily living), IADL(instrumental activities of daily living), and MMSE-K(minimental state examination-Korean version). The results were as followed : 1. Approximately 49% of study population was taking drug medication currently. We found that 93% of study population was successful at the medication task all alone, 6% was failure at the medication task all alone, so need help partly or completely. 2. Significant variables between group of medication task ability were age, educational attainment, IADL, and MMSE-K in univariate analysis. And significant correlated variables with medication task ability were ADL, IADL, MMSE-K, and BDI in correlation analysis. 3. Major predictors to medication task ability on multiple logistic regression were IADL and sex finally. Findings suggest that IADL is related to medication task ability than other test battery of health status, so IADL could be used to necessary for medication management and add information to conventional methods of assessing mental status.

• Korean Journal of Biological Psychiatry
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• v.16 no.1
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• pp.25-36
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• 2009

Objectives : The aim of this study was to investigate the association between Korean ADHD patients and the l/s polymorphism of serotonin transporter(5-HTTLPR). Methods : The study sample consisted of 189 Korean ADHD children diagnosed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version(K-SADS-PL), both parents of ADHD children, and 150 normal children. DNA were extracted from the blood of all samples, and genotyping was done. Based on the allele and genotype information, not only the case-control analysis between ADHD and normal children but also the family-based association test among ADHD children and their parents. Transmission disequilibrium test(TDT) were performed for family-based associated test(number of trio=113). The results of the clinical rating and neuropsychological tests were compared according to the l/s genotype of ADHD children. Results : In case-control analysis, there were no statistically significant difference of l/s gene polymorphism between ADHD and normal children in various kinds of analysis condition. In family-based association study, TDT failed to detect linkage disequilibrium between l/s gene polymorphism and ADHD in whole ADHD families. However, in the families of ADHD inattentive type only(number of trio=23), I allele was transmitted more preferentially in the proband with ADHD even if the number of families was small(${\chi}^2$=4.57, p=.032). In the analysis of the results from the clinical scales and neuropsychological tests in ADHD children, the score of the Novelty- Seeking of ADHD children with l/l genotype was significantly lower than with the other genotypes(F=3.15, p=.047), and that of Self Transcendence was significantly higher(F=4.25, p=.017). Conclusion : The results of this study suggest there were no significant genetic association between the 5- HTTLPR gene polymorphism and Korean ADHD.

• 대한예방의학회:학술대회논문집
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• 2002.05a
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• pp.73-83
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• 2002

우리 사회에서 일정 정도 이상의 사회와 가정에서의 기능상의 부적응을 초래하는 정신적 문제는 경제활동인구에 있어 가장 흔한 보건의료상의 문제일 것으로 추측되고 있으나, 현재까지는 정신보건제도 마련에 있어 가장 극심한 부적응을 보이는 정신적 장애를 지닌 환자를 위주로 수용시설과 지역사회에서의 재활과 관리에 그 초점을 두어 왔다. 즉 직업스트레스와 같은 일시적인 사회심리적 갈등으로 인한 신체증상의 호소나 알을 및 약물중독으로 인한 사고의 발생으로부터 일생동안 관리되어야 하는 지능저하나 학습장애와 같은 만성적인 문제에 이르기까지 다양한 스펙트럼을 보이는 사업장과 지역사회에서의 정신적 문제들 중 그 일부만이 제도적으로 관리되어 왔다. 실제 그 동안 직장 내 정신보건문제에 대한 행정적 관심은 일부 장애인의 취업 문제를 제외하고는 없었다고 하여야 할 것이다. 그러나 한편으로 우리 사회의 산업구조와 경제사회적 조건의 변화에 따른 노동내용과 조건상 유연화의 증대가 많은 직장에서 노동강화로 이어진다는 점, 그리고 가족 및 교류집단을 비롯한 전통적인 사회적 지지구조가 와해되고 있다는 점과 정신적 문제로 인한 기능상 부적응의 척도가 한편으로 사회적 가치관의 변화에 따라 계속 그 영역이 넓어지는 방향으로 변화하고 있다는 점등에서 직장 내 정신보건 문제는 앞으로 더욱 그 비중이 커질 것으로 판단되고 있다. 문제의 심각성에 대한 관심이 요구되는 현재의 시점에서 제도적 접근에 대한 검토 또한 시작되어야 할 것으로 판단되고 있다. 현재까지 기업 내에서 이루어지고 있는 정신보건관리의 현황을 단편적으로 파악해 보았을 때, 단지 일부 기업에서 취업시 내지는 부서 배치시 성격검사를 비롯하여 적성검사를 실시하고 있으며, 기업윤리확보 차원에서 비정규적으로 사기앙양을 주목적으로 하는 집단적인 교육이나 단체훈련이 이루어지고 있으나, 정신심리적 문제를 개인적 차원에서 그리고 또한 조직적 차원에서 체계화된 프로그램으로 관리하고 있는 사례는 아직 없다. 앞으로 직장 내 정신보건문제에 대하여 제도적인 접근을 하기 위하여서는 다음과 같은 세가지 조건들이 구비되어야 할 것으로 판단된다. 첫 번째로 문제점 그 자체의 내용과 그 규모에 대한 정확한 파악과 예측이 가능하여야 한다. 즉 제도 전체의 운영을 객관적으로 평가하고 개선할 수 있는 기제가 함께 있어야 제도가 실제적인 기능을 할 수 있다는 최소한의 목적이 달성될 수 있다. 두 번째로 문제점의 관리를 위한 효과적인 개입내용 및 개입지점의 확보가 가능하여야 한다. 특히 직장 내에서 수행할 수 있는 프로그램이 개발되어야 하며, 이는 시범사업과 시장을 통한 소비자, 즉 사업주들의 자발적인 선택을 통하여 검토되고 걸려져야만 한다. 마지막으로 제도 운영의 대상, 특히 정신보건문제를 안고 있는 노동자들의 자발적인 동의가 확보될 수 있어야 한다. 이는 정신적 문제가 안고 있는 편견과 그로 인한 차별이 가져다주는 문제를 함께 고려하면서 제도가 운영되어야 하며, 이에 있어 제도 운영상 노동자들의 주체적인 참여가 필요하기 때문이다. 이상 고려되는 직장 내 정신보건문제에 대한 제도적 접근을 담기 위하여서는 프로그램 개발이나 전문가 집단의 양성과 같은 단순한 기술적 접근과 이들의 인허가 및 사업화에 따른 적용기준 및 의무의 설정과 같은 제도적 접근에 그쳐서는 그 실효성을 담보하지 못할 것으로 판단된다. 보다 중요한 것은 이러한 정신보건문제에 대한 노사의 공감대를 이루어 내는 것이며, 사회 전반적인 인식의 확산과 더불어 바람직한 관리모습에 대한 사회적 가치관을 도출해 내는 것이 제도적인 접근의 성공을 보장할 수 있는 기반 조건이 될 것이다. 이러한 점에 있어 정신보건문제를 바라보는 기존의 가치관이 부정적이고 고착화된 모습만을 강조하였으나, 이제는 점차 긍정적이 사회활동에 수반되는 역동적인 모습으로서 비추어지는 것이 많아진다는 측면에서 그 전망을 밝게 하여 주고 있다.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.67-80
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• 1999

This study was designed to provide the basic data of nursing intervention for alleviation of effective adjustment of cancer patients by identifying the correlation between the spiritual well-being and family support. The subjects for this study were 69 patients who were diagnosed as cancer and were admitted to a university hospital in Pusan. Data were collected during the period between December 1, 1998 and January 20, 1999 by interviewing with questionnaires. Family support questionnaire consisted of 11 questions answerable on a 5 point Likert scale developed by Kang Hyun Suk(1985). Spiritual well-being questionnaire consisted of 20 questions answerable on a 4 point Likert scale modified by Kang Jeong Ho(1996). The data were analyzed by in descriptive statistics, Pearson correlation coefficient, t-test and ANOVA using SPSS/WIN program. The results of this study were as follows. 1. The mean score for family support in cancer patients was 49.48, which indicated that cancer patients perceived their state of family support as high level. The mean score for spiritual well-being in cancer patients was 55.87, which indicated that cancer patients perceived their state of spiritual well-being as moderate level. Among the components of spiritual well-being, the mean score for religious well-being was 26.94 and for existential well-being 28.93. From the above, the mean score for existential well-being was higher than that of religious well-being. 2. There were statistically significant differences in family support according to the types of primary caregivers(F=3.48, p=0.008). The spouse caregiver showed the highest family support among the caregivers. There were statistically significant differences in spiritual well-being according to the job(F=2.20, p=0.046) and the level of perceived health status(F=2.71, p=0.05). There were statistically significant differences in religious well-being according to the religion(F=2.42, p=0.004) and the number of family members(F=3.38, p=0.040). And there were statistically significant differences in existential well-being according to the job(F=2.48, p=0.026) and the level of perceived health status(F=2.74, p=0.048). 3. There were positive correlation between spiritual well-being and the family support(r=0.481, p=0.000), between religious well-being and family support(r=0.336, p=0.008) and existential well-being and family support(r=0.519, p=0.000).

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.226-235
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• 2016

The purpose of this study was to determine the relationships among the functional status, hostility, and social support in patients with percutaneous coronary intervention (PCI). The subjects were comprised of 135 patients who had received PCI from two general hospitals in Seoul, Korea. The functional status differed significantly according to gender (t=5.880, p<0.001), age (F=23.620, p<0.001), education (F=17.718, p<0.001), occupation (t=-6.498, p<0.001), monthly income (F=7.237, p<0.001), and smoking (t=2.327, p=0.025). The hostility differed significantly according to age (F=6.150, p=0.001), period after PCI (F=6.141, p=0.001), and family history (t=2.514, p=0.013). Differences were observed in the scores for social support according to age (F=2.866, p=0.039) and education (F=5.136, p=0.002). Significant positive correlations were found among functional status and social support (r=.20, p=0.025), friends support (r=.22, p=0.010) and a significant negative correlation between functional status and hostility (r=-.24, p=0.005). A significant negative correlation was found between hostility and friends support (r=-.17, p=0.046). Nurses should consider the characteristics of patients who have undergone PCI and develop nursing intervention programs to improve their functional status, hostility, and social support.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.4
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• pp.1675-1682
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• 2013

The purpose of this study is to examine the effect of care workers' assistance services on behavioral changes of the elderly. To achieve this, a survey was carried out on 100 elderly people, who receive the services from care workers in J area-based elderly care facilities, and elderly patient families. The results of this study are as follows. First, the effect of care workers' assistance services on the elderly's satisfaction of physical activities showed that the nursing and caregiving services have a significant positive effect on their satisfaction of physical activities(p<.05). Second, the effect of care workers' assistance services on the elderly's satisfaction of psycho-emotional activities showed that the caregiving services have a significant positive effect on their satisfaction of psycho-emotional activities(p<.01). Third, the effect of care workers' assistance services on the elderly's satisfaction of social cognition activities showed that the caregiving services have a significant positive effect on their satisfaction of social cognition activities(p<.01). Consequently, if the elderly receive the repetitive and continuous nursing and caregiving service in the limit that is forced to deteriorate the elderly's physical, psychological and cognitive development, and slow down their activities, there will be changes and promotion in their physical, psychological and cognitive behaviors. In other words, it is of use in that care workers' continuous assistance services can improve the elderly's life, driven by the changes of their physical, psychological and cognitive behaviors.

• Journal of Hospice and Palliative Care
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• v.16 no.2
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• pp.80-89
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• 2013

Purpose: We investigated how intensive care unit (ICU) nurses understand the meaning of death, death anxiety, death concern and respect for life. Methods: From November 2009 through February 2010, a survey was conducted on 230 nurses working at the ICU of 10 general hospitals located in Seoul and Gyeonggi province. Participants were asked to answer a questionnaire consisted of 67 questions under four categories of the meaning of death, death anxiety, death concern and respect for life. Results: Participants scored 4.27 points on their understanding of the meaning of death, 4.43 on death anxiety, 4.12 on death concern and 4.18 on respect for life. Participants' meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' positive meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' negative meaning of death was negatively correlated with death anxiety and death concern and positively with respect for life. Participants' death anxiety was positively correlated with death concern and negatively with respect for life. Participants' death concern was negatively correlated with respect for life. Conclusion: Compared with nurses who served at ICU for a long time, nurses with less ICU experience scored lower on the meaning of death and respect for life, while they presented high anxiety and concern about death. A training course may help nurses develop their view on the meaning of death, which in turn would enhance their performance in caring dying patients.

• Journal of Biomedical Engineering Research
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• v.24 no.5
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• pp.427-434
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• 2003

In this paper, we present a speech-based Environmental Control System(ECS) and its application. In the concrete, an ECS using the speech recognition and an portable wheelchair lift control system with the speech synthesis are developed through the simulation and the embodiment. The developed system apply to quadriplegic man and we evaluate the result of physical effect and of mental effect. Speech recognition system is constructed by real time modules using HMM model. For the clinical application of the device, we investigate the result applied to 54-years old quadriplegic man during a week through the questionnaires of Beck Depression Inventory and of Activity Pattern Indicator. Also the motor drive control system of potable wheelchair lift is implemented and the mechanical durability is tested by structural analysis. Speech recognition rate results in over 95% through the experiment. The result of the questionnaires shows higher satisfaction and lower nursing loads. In addition, the depression tendency of the subject were decreased. The potable wheelchair lift shows good fatigue life-cycle as the material supporting the upper wheelchair and shows the centroid mobility of safety. In this paper we present an example of ECS which consists of real-time speech recognition system and potable wheelchair lift. Also the experiments shows needs of the ECS for korean environments. This study will be the base of a commercial use.

• Korea journal of population studies
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• v.27 no.2
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• pp.1-34
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• 2004

최근 한국사회에서는 출산율의 저하로 인한 사회경제적 영향을 우려하여 대책방안을 강구하여야 한다는 논의가 증대되고 있다. 그런데 국가정책을 개발${\cdot}$추진하기 이전에 반드시 요구되는 것은 저출산 현상의 올바른 인식과 철저한 원인규명이다. 따라서 본 연구에서는 출산율 변화의 원인을 다각적으로 살펴보고, 향후 변화방향을 전망해 보고자 한다. 먼저 자녀출산의 변화를 결혼상태 변화와 유배우부인의 출산율 변화 부분으로 나누어 살펴본 결과, 과거와는 달리 최근의 출산율 저하는 유배우 부인에 의해서가 아니라 미혼자의 결혼연장 또는 독신생활에서 기인되는 것으로 나타났다. 이들 두 요인에 영향을 주는 변수로는 경기침체 및 직장불안정, 결혼가치관의 변화와 초혼연령의 상승, 자녀양육 관심증대, 자녀양육비 부담, 가정과 직장의 양립을 위한 사회적 인프라 부족, 여성의 자아욕구 및 사회참여 증대, 자녀효용가치 감소, 이혼 등 가족해체의 증대, 그리고 불임부부의 증대 등인 것으로 판단된다. 향후 출산율 변화를 전망해 보면, 저출산을 일찍 경험한 서구 선진국의 경우와는 달리 정책의 추진에 한계가 있어 선진국보다 더 낮은 출산율을 회복하는 데는 많은 어려움이 있을 것이라는 판단이다. 더군다나 젊은 미혼남녀의 가치관이 개인주의화 되는 경향이 있다는 점을 감안한다면 출산율 회복정책을 추진한다 하더라도 한계가 있을 수밖에 없을 것이다. 수년간 실시된 각종 실태조사를 분석한 결과에 의하면 현재의 경기침체가 회복될 경우 약 20%의 출산율 상승 가능성이 있으며, 이 때의 합계출산율은 약 1.43명 수준이 될 수 있을 것으로 예견된다. 또한 종합적 체계적 출산회복정책을 효과적${\cdot}$효율적으로 추진한다면 약 10년 후에는 합계출산율이 약 1.6 수준으로 회복될 것이라는 낙관적 견해를 가져본다. 그렇지만 정책의 강도에 따라서 회복수준은 현저하게 상이할 것이다.를 진단, 치료함에 있어 진행성 신질환의 가능성을 시사하는 예후인자가 없다면 신생검보다는 지속적이고 정기적인 추적관찰만으로도 충분할 것으로 생각된다도 등은 양군 사이에 유의한 차이가 관찰되지 않았다. 발견 당시 혈청 $C_3$치의 감소는 모두 11명(61.1%)에서 관찰되었는데, 증상군에서는 7명(87.5%), 집단뇨검사군에서는 4명(40%)으로 증상군에서 혈청 $C_3$치의 감소가 보다 현저하였다. 그러나 추적관찰 기간 동안 증상군에서는 7명 중 4명, 집단뇨검사군에서는 4명 중 1명에서 혈청 $C_3$치는 정상범위로 증가하여 최종 관찰시점에서는 6명 (33.3%)에서만 혈청 $C_3$치의 감소가 지속되고 있다. 혈청 $C_3$치의 감소를 보인 경우를 다시 병리조직학적 분류에 의해 세분하여보면 발병당시에는 I형 8명(61.5%), II형에 1명(100%), III형 2명(50%)에서 관찰되었는데, 최종 시점에서는 I형 4명(30.8%), II형 1명(100%), III형 1명(33.3%)이었다. 또한 증상군에서 세포성 반월체형성과 세뇨관위축의 빈도가 높았으며, 사구체 혈관벽 비후와 사구체 간질의 증가의 정도가 집단뇨검사군에 비해 통계적으로 유의하게 높았다. 결론: 무증상성 요이상을 가진 환자에서 신장조직검사 실시 후 MPGN으로 진단되는 증례가 증가하고 있고, 오히려 증상을 동반하는 경우보다 빈도가 증가한다는 사실은 집단뇨 검사에서 소변의 이상소견이 발견되어 신장 조직검사를 실시할 경우 혈청 $C_3$치의 감소 여부에 관계없이 MPGN도 진단적 고려 대상이 되어야 한다고 생각한다.신장 조직검사를 시행한 결과 진행성 경과를 취할 수 있는 막 증식성 사구체 신염과 매우 희귀한 증례인 신유전분증 등으로 진단됨으로써 지속성 단백뇨의 경우 정확 진단적 접근이 필수적임을 알 수

• The Journal of the Korea Contents Association
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• v.15 no.2
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• pp.363-369
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• 2015

Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.