• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• 한국치위생학회지
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• 제20권5호
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• pp.611-621
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• 2020

Objectives: This study aimed to verify the impact of dental health care insurance coverage policy by analyzing the changes in dental care utilization and expenditures over 5 years from 2012 to 2016, when the dental health insurance coverage expansion policy was implemented. From the national cohort data collected by the Korea Health Panel Survey, a retrospective study was conducted for all household members using dental services. Methods: This study statistically verified the difference in the dependent variables by frequency analysis, chi-square test, t-test, and one-way analysis of variance (SPSS version 22, IBM Co. USA, p<0.05). Results: The annual utilization rate steadily increased from 23.4% to 26.1% between 2012 and 2016. Although there were differences in utilization rates by gender, age, and income level, patients kept using the dental services in 2016 regardless of the type of health insurance. The average annual copayment for patient expenditures (out-of-pocket amount) increased from ￦463,844 to ￦537,401 in 2012 and 2016, respectively. Of the dental care expenditures over 5 years, the ratio of uninsured expenses by the elderly decreased from 38.5% to 25.9%, and the national health insurance service coverage increased from 40.3% to 49.1%. Conclusions: Although this policy did not reduce overall patient expenditures, it has been found that there was a positive effect on the elderly and low-income groups; it increased the utilization and access to dental services.

• 한국노년학
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• 제40권2호
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• pp.239-255
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• 2020

본 연구의 목적은 단독가구 노인의 가족관계가 지역사회참여에 영향을 미치는지 또한 이러한 관계는 성별에 따라 차이가 있는지 고찰하는 것이다. Baltes와 Baltes(1990)의 선택, 적정화, 보상 이론(SOC)과 Prandini(2014)의 가족구성원이 사회적 자본이 된다는 주장을 바탕으로 노년기에 가족관계가 지역사회참여에 영향을 미칠 수 있는지 검증하였다. 이를 위하여 본 연구에서는 한국보건사회연구원에서 실시한 2017년 노인실태조사에서 1인가구를 추출해 연구대상자(남 n=370, 여 n=1770)로 삼았으며, 친구·이웃만남과 경로당·복지관 참여를 종속변수로 다중회귀분석을 실시하였다. 연구결과는 다음과 같다. 남성의 경우 가족관계가 친구·이웃 또는 경로당·복지관 참여에 유의미한 영향을 보이지 않았으나, 여성의 경우는 가족과의 연락빈도가 친구·이웃만남에 정적(+)인 영향을 보였으며, 경로당 복지관 참여에는 가족연락빈도와 자녀관계 만족도가 정적(+) 영향이 나타난 반면 가족만남빈도는 경로당 복지관 참여에 부적(-) 영향이 나타났다. 여성의 경우 가족구성원이 사회적 자본이 된다는 Prandini(2014)의 주장이 지지되는 것으로 보이나, 어떠한 종류의 지역사회참여인가에 따라서 그 영향이 다를 수 있음을 확인하였다. 아울러 이에 대한 실천적 논의와 제언이 제시되었다.

• 한국학교ㆍ지역보건교육학회지
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• 제23권4호
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• pp.49-61
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• 2022

Objectives: It is reported that the depression of women with disabilities is higher than that of men with disabilities and people with disabilities. Therefore, the purpose of this study is to identify the depression level and influencing factors of middle-aged women with disabilities. Method: For this study, the 2020 survey on the disabled was used. The subjects were 2,546 middle-aged and disabled women over the age of 40 who responded to the survey. For data analysis, SPSS Window 26.0 program was used. Descriptive analysis, chi-square test, and multiple logistic analysis were performed to identify factors affecting depression in middle-aged women with disabilities. Results: In this study, marital status, subjective economic status, disability type, subjective health status, subjective obesity, chronic disease, exercise, stress and suicidal ideation, and self-going ability variables of middle-aged and elderly women with disabilities were found to be related to depression. Factors affecting the depression of middle-aged women with disabilities were analyzed to be marital status, smoking, stress, and suicidal ideation variables. Conclusion: Stress and suicidal ideation should be reduced to effectively reduce depression and improve depression in middle-aged and elderly women with disabilities. And the development and application of health education and programs that can promote mental health are required.

• 보건의료생명과학 논문지
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• 제8권2호
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• pp.155-163
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• 2020

본 연구는 국민건강영양조사 제7기 제3년도(2018년)원시자료를 바탕으로 한국전기-후기노인의 안전 의식 및 건강요인이 손상 및 손상기전에 미치는 영향요인을 알아보고자 하였다. 연구 대상자는 1년간 손상발생 여부에 응답한 전-후기노인 1608명을 최종 대상자로 하였다. 분석은 빈도분석, 교차분석, 다중 로지스틱회귀분석을 실시하였다. 연구결과는 노인은 성별, 결혼상태, 안전의식, 건강요인이 손상발생률과 관련성이 있으며, 전기노인은 여성일수록, 결혼상태가 별거 및 이혼 등의 상태일 때, 안전의식이 낮을수록, 2주간 몸의 불편감, 1달간의 와병여부, 1년간의 입원여부, 2주간의 외래 진료여부, 연간 미충족 의료서비스 경험이 있을수록 손상 발생율이 높았다. 후기노인도 여성, 별거 및 이혼 상태, 안전의식 수준이 낮고, 와병 여부, 입원여부, 연간 미충족 의료서비스 경험자일수록 손상발생률이 높았다. 따라서 손상사고 발생율을 낮추는 예방 교육으로 사회활동이 많은 전기노인은 교통수단 이용증가에 따른 맞춤형 안전교육, 후기노인은 건강행태에 따른 맞춤형 안전의식 고취 교육을 선별적으로 강화하고, 다양한 운송수단에 대한 음주운행 시 법적 처벌 강화, 교육의 통합 시스템적인 접근이 요구된다 하겠다.

• 대한지역사회영양학회지
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• 제28권4호
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• pp.302-316
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• 2023

Objectives: The study aim was to identify changes in the nutritional status of older adults during the COVID-19 pandemic according to household income and demographic characteristics. Methods: Study participants were 2,408 adults aged 65 and over who participated in the 2019-2020 Korea National Health and Nutrition Examination Survey (KNHANES). To examine changes in nutrient intake levels resulting from COVID-19, data of 2019 and of 2020 were compared. Study participants were divided into three groups based on household income level to compare these changes. The changes were compared according to household income level, age group, and household type. Results: Percentages of recommended intakes for energy, protein, and most micronutrients were the lowest for the low-income group of both males and females in 2020. The Mean Adequacy Ratio (MAR) score was the lowest for the low-income group in both years. When comparing nutrient density for 2019 and 2020 by income group, the male low-income group experienced a decrease in nutrient densities of vitamin A, thiamine, calcium, and iron. For the same group, a decreased percentage for energy intake from protein was noted. Fruit intake was lowest in the low-income group for both males and females. Low-income males had the lowest intake levels for meat, fish, eggs, and legumes in both 2019 and 2020 and the lowest milk and milk product intake levels in 2020. Older adults living alone or single older adults with children had lower MAR scores than those living with a spouse. Older adults living alone experienced decreases in energy and thiamine and iron intake levels in 2020 compared to their intake levels in 2019. Conclusions: Because of the COVID-19 pandemic, nutrition intake levels worsened for older adult males in the low-income group and older adults living alone. This finding shows the need for a more systematic nutritional support strategy for the vulnerable older adults population in national disaster situations.

• 농촌계획
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• 제26권4호
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• pp.93-105
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• 2020

This study is an experimental study that examines the policy attributes that local governments should choose to manage the quality of life of rural residents. The analysis data used raw materials for the survey of the welfare status of farmers and fishermen surveyed by the Rural Development Administration. The analysis method used Quantile Regression. The policy attributes of public services were interpreted on the basis of Peterson (1981)'s theory of policy types and the discussion of Holland (2015). According to the analysis results, the higher the quality of life, the greater the importance of the relationship between the safety sector and the neighbors. The effective policy attributes for improving quality of life in rural areas are the policies of local governments where policy benefits can directly go to individuals, or lead to social improvement. It shows that the higher the level of safety and the quality of life of our neighbors, the greater its importance.

• 대한예방한의학회지
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• 제27권2호
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• pp.49-59
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• 2023

Objectives : This study aimed to identify the factors that affect the utilization of Korean Medicine within the past year. Methods : I analyzed micro-data from the Korean Medicine Utilization Survey (2020), which surveyed the general public. "User (in last 1 year)" were defined as those who had used Korean Medicine within the past year, while "Non-user (in last 1 year)" were defined as those who had used it in their lifetime but not within the past year. I examined several factors, including general characteristics, perceptions of Korean Medicine, satisfaction with Korean Medicine, and intention for future utilization. I conducted the Rao-Scott chi-squared test and complex sample logistic regression analysis. Results : I analyzed a total of 3,762 respondents, of which 1,442 (36.3%) were User (in last 1 year) and 2,320 (63.7%) were Non-user (in last 1 year). User (in last 1 year) and Non-user (in last 1 year) differed significantly in terms of demographic characteristics, perceptions, and satisfaction with Korean Medicine. Women, the elderly, those with low education levels, non-married individuals, those with low-income, chronic diseases, and poor subjective health conditions were significant factors. Those who used Korean Medicine within the past year were more knowledgeable about Korean Medicine than those who had not used it recently, and recognized herbal medicine as safer. In terms of satisfaction, User (in last 1 year) were more satisfied than Non-user (in last 1 year). The more women, the older, the more aware of Korean Medicine, the safer they perceived herbal medicine, the more satisfied they were with its use, the better their subjective health condition, and the absence of chronic diseases, the less they experienced Korean Medicine. Conclusions : The study showed that positive experiences and perceptions of Korean Medicine increase the likelihood of its utilization. Individuals with better subjective health conditions and without chronic diseases have a lower possibility of using Korean Medicine.

• The Korean Journal of Pain
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• 제33권4호
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• pp.352-358
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• 2020

Background: Korean society is afflicted with rapid aging. Aging is a risk factor for pain, and pain can reduce patients' quality of life. Thus, adequate management and monitoring of changing trends accompanying the demographic shift are highly valuable. However, this study was conducted because no studies have investigated the recent changes in the prevalence of pain. Methods: The extent of the prevalence of pain was determined by questions related to quality of life based on the data derived from the Korea National Health and Nutrition Survey (KNHNS) from 2005 to 2016. The annual frequencies of the pain group and severe pain group were calculated using the survey questionnaire. Multiple logistic regression analysis was performed to determine possible differences in prevalence by year. Results: The prevalence of pain in all populations was 30.6% in 2005 and 18.9% in 2016. The average prevalence from 2005 to 2016 was 21.9%. A declining trend occurred over time with an odds ratio of 0.929 per year (95% CI: 0.921-0.938). The prevalence of severe pain was 2.35% in 2005 and 1.88% in 2016. Likewise, a decrease was observed over time, with an odds ratio of 0.920 per year at 95% CI 0.901-0.939. The decline in age-/sex-stratified analysis also showed a statistically significant trend in all groups. Conclusions: The prevalence of pain in Korean society, based on the KNHNS, has declined since 2005. Such a trend was observed in all ages and sexs, and was most significant in the elderly.

• 한국산학기술학회논문지
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• 제21권12호
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• pp.826-835
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• 2020

본 연구는 노인의 구강보건행위가 건강관련 삶의 질(Health-related Quality of Life, HRQOL)에 미치는 영향에서 스트레스의 매개 효과를 분석하기 위하여 국민건강영양조사(2010-2015)를 활용한 이차 자료분석 연구이다. 65세 이상 노인 8,148명을 대상으로 사회 경제상태, 건강 상태, 흡연 및 음주 습관, 스트레스 여부, 그리고 구강보건행위(칫솔질 횟수, 정기적인 치과 검진여부, 치간 세정도구 사용)를 조사하였으며 건강관련 삶의 질 측정을 위해 EuroQol-5 Dimension(EQ-5D) index를 사용하였다. 연구결과, 사회경제학적 수준이 낮거나 고혈압, 당뇨병을 가진 노인들에서 HRQOL이 낮았으며, 칫솔질 횟수가 적거나 정기적인 치과방문을 하지 않거나 치간 세정도구를 사용하지 않는다고 응답한 노인들에서 HRQOL이 낮았다. 그리고 스트레스는 노인의 삶의 질에 부적 상관을 보였으며 구강보건행위와 삶의 질의 관계에서 부분매개효과를 확인하였다. 이러한 결과는 노인의 구강보건행위와 삶의 질의 관계에서 스트레스 매개효과가 있음을 의미한다. 그러므로, 노인의 건강관련 삶의 질 증진을 위해 건강증진프로그램을 수행할 때 스트레스 해소 및 구강건강증진 프로그램을 포함한 융합적인 프로그램이 필요하며, 그러한 정책마련을 위한 기초자료로 제공하고자 한다.