• 융합정보논문지
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• 제11권1호
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• pp.183-190
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• 2021

본 논문은 만성질환으로 응급실에 내원한 노인 환자의 응급의료 이용 변화 추이를 알아보고자 하였다. 2014년 1월 1일부터 2019년 12월 31일까지의 국가응급진료정보망 자료에서 응급실 퇴실 주 진단 상병코드가 8개 만성질환에 해당하는 환자를 선택하여 응급실 이용 현황 및 응급실 내원과 입원의 변화 추이를 살펴보았다. 2014년을 기준으로 만성질환으로 응급실을 내원한 노인 환자는 지속 증가하였고, 특히 85세 이상의 환자가 급격히 증가하였다. 만성질환별 응급실 내원 비율 변화추이에서는 대부분 질환에서 증가세를 보였고(P<0.001), 그 중 허혈성심장질환, 관절병증에서 높은 증가율을 보였으나 고지혈증은 전 연령에서 감소세를 보였다(P<0.001). 응급실 입원율 변화 추이에서는 고지혈증, 고혈압, 결핵을 제외한 만성질환에서 지속적으로 증가세를 보였다(P<0.001). 만성질환을 가진 노인 환자의 응급실 내원 및 입원율의 지속적인 증가는 응급의료자원의 점유 및 의료 소비량 증가 문제를 가속시킬 수 있는 원인으로 작용할 수 있으므로 적절한 만성질환 관리가 필요하다.

• 가정과삶의질연구
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• 제28권1호
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• pp.159-174
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• 2010

The purpose of this study was to examine the health care expenditure of elderly single and elderly couple households whose head is more than 60 years old. The data analyzed for the study were Korean Retirement and Income Study(KRelS) conducted in 2007 by National Pension Corporation. The major finding of this study were as follows: First, the amount of health care expenditure of elderly single households was lower than that of elderly couple households. However, ratio of health care expenditure to total consumption expenditure of elderly single households was larger than that of elderly couple households. Second, the ratio of health care expenditure in consumption expenditure in this study was larger than the ratios in past analyse showed in the previous studies. Third, common factor affecting on health care expenditure of elderly single and elderly couple households was the existence of the family member with chronic disease or handicap. The health care expenditure of elderly singer households was influenced by income, gender and the ownership of national health insurance. The influence of income for elderly singer households seemed to be greater than for elderly couple households. The variables which affected health care expenditure of elderly couple households were age and housing tenure status. The amount and ratio health care expenditure were increased as the age increases. These results show that the health care expenditures for each groups varied according to socio-demographic variables and health-related behavior variables. It is suggested that there should be a discriminative health care policy for each elderly single and elderly couple households. In addition, the health care policy for the elderly households of which member has a chronic disease is certainly necessary. Especially a health care plan for the elderly single households with lower income is in need. For the elderly couple households, the priority group of health care policy would be the high age group.

• 가정간호학회지
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• 제2권
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• pp.19-34
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• 1995

The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

• 한국노년학
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• 제41권1호
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• pp.149-168
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• 2021

본 연구는 만성질환 노인의 약물이행을 측정하기 위한 도구(Medication Adherence Scale in Elderly, MAS-E)를 개발하고 신뢰도와 타당도를 검증하는 방법론적 연구이다. MAS-E는 혼종모형을 이용한 내용 분석에 의해 개념적 기틀을 구성하고 이를 기반으로 문항을 구성하고 내용타당도를 검증하여 예비문항을 구성하였고 문항을 검토한 후 예비 조사를 실시하여 총 26문항을 최종 확정하여 본 조사를 실시하였다. 설문조사 자료는 일대일 인터뷰를 통해 지역사회에 거주하는 만성질환 노인 345 명으로부터 수집되었다. 도구평가를 위해 신뢰도와 타당도를 검증하고 검증결과를 기반으로 최종 문항을 확정하여 만성질환 노인의 약물이행 도구(MAS-E)를 개발하였다. 타당도 검증에서 문항분석, 요인분석, 총점-요인 간 상관관계를 통해 4개 요인과 18문항이 도출되었으며-약물사용 기억하기(2문항), 약물효과에 대한 기대(5문항), 처방과 지시에 따른 약물사용 실천(8문항), 의료인과의 소통(3문항), 전체 18문항은 분산의 69.7 %를 설명하는 것으로 나타났다. 최종 도구의 총점-요인 간 상관관계는 모두 유의한 상관관계를 나타냈다. 준거타당도 검증 결과, 개발된 도구는 Morisky Medication Adherence Scale (MMAS-8)과 유의하게 양의 상관관계(r = .72, p <.001)를 나타냈다. 신뢰도 검증에서 문항내적 일관성 신뢰도 Cronbach'α는 .906, Guttman 반분검사 신뢰도는 .804, 검사-재검사 신뢰도는 .912로 나타나 개발된 도구는 안정적이고 일관성을 확보하였다. 본 연구를 통해 개발된 MAS-E는 타당도와 신뢰도가 모두 검증된 도구로서 만성질환 노인의 약물이행 정도를 평가하고 약물이행 개선을 위한 중재연구의 효과 평가에 활용될 수 있을 것이다

• 보건행정학회지
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• 제23권4호
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• pp.376-386
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• 2013

Purpose: The purpose of study is to estimate the number of chronic disease patients and medical care expenditure at the time baby-boomers belong to 65 years old aging population, and compare with current 65 year-old aging population. Methods: Analysis method used an estimating formula devised by the researcher and estimated the number of chronic disease patients and medical care expenditure of each generation. Results: When comparing the estimated number of chronic diseases patients of each generation, 40.6% of the first generation, 76.4% of the second generation, 95.2% of third generation are expected to get chronic disease. When comparing each generation's total medical care expenditure, based on the estimated number of chronic diseases patients of each generation, the second generation( 1,206,251,224 thousand won) showed higher than other generation. This study compared the number of chronic disease patients and medical care expenditure between the second generation of the elderly and current elder generation. As a result, the second generation patients was higher than the fourth generation in high blood pressure, diabetes, psychological and behavioral disorder, and neurological diseases whereas the fourth generation is only high the number of patients in heart disease. As for total medical care expenditure, the second generation paid more in high blood pressure, psychological and behavioral disorder while the fourth generation in neurological disease and heart disease. Conclusion: It is desired that considering the number of chronic disease patients and medical care expenditure of baby boomers accounting for 14.6% of total population, in-depth follow-up study is carried out that inquires into what are issues with a current chronic disease management project, what business is needed in order to manage these issues, and how to fund to cover increasing medical care expenditure.

• 한국융합학회논문지
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• 제12권11호
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• pp.359-369
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• 2021

본 연구는 국민건강영양조사 제 8기 원시 자료를 활용하여 65세 이상 2,701명의 정상 노인과 만성질환 노인의 활동 제한에 영향을 주는 요인을 파악하기 위해서 복합표본 로지스틱 회귀분석을 실시하였다. 만성질환 노인이 정상 노인보다 활동 제한을 느낀다고 조사되었다. 뇌졸중, 고혈압 환자의 활동 제한 요인으로는 주관적 건강 상태, 경제 수준, 스트레스 인지 정도, 중강도의 일과 여가이다. 심장질환 환자의 활동 제한 요인으로는 주관적 건강 상태, 경제 수준이었으며, 관절질환 환자의 활동 제한의 요인으로는 주관적 건강 상태, 고강도의 일과 여가이다. 폐 질환 환자의 활동 제한요인으로는 교육 수준, 고강도의 일과 여가이며, 내분비계 환자의 활동 제한의 요인으로는 주관적 건강 상태, 스트레스 인지 정도, 고강도의 일과 여가이며, 암 환자의 활동 제한의 요인으로는 주관적 건강 상태, 스트레스 인지 정도, 중강도의 일과 고강도의 여가이다. 만성질환 노인의 지속적인 활동 참여를 위한 재활프로그램과 정책적 지원이 필요하다.

• 한국지역사회생활과학회지
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• 제28권1호
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• pp.5-16
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• 2017

This study was conducted to compare the nutritional status, nutrient intakes, and chronic disease risks of Chinese elderly people. MNA (Mini Nutritional Assessment) developed for elderly people was used to determine their nutritional status. In this study, participants consisted of 148 urban residents aged 65 years and over residing in three cities in Shandong Province, China. Participants were 67 (45.3%) men and 81 (54.7%) women, and average age was 72.8 years. According to MNA score, 77.7% of participants were 'well nourished', 22.3% were 'at risk of malnutrition', and 2% were 'malnourished'. Nutritional status was divided into two groups by MNA score as 'well nourished' and 'malnourished', which was formed with the combination of 'at risk of malnutrition' and 'malnourished'. Compared with the well nourished group, the malnourished group was older, and physical status indicators such as weight, BMI (Body Mass Index), and calf circumference of the malnourished group were much smaller. The malnourished group had higher prevalence rates of heart disease and stomach disorders while the well nourished group had a higher rate of hypertension. There was no significant difference between the malnourished group and well nourished group in nutritional intake below Chinese DRIs (Dietary Reference Intakes) among elder males. A higher proportion of elder females showed insufficient intakes of energy, protein, vitamin A, vitamin E, and zinc in the malnourished group compared to the well nourished group. The INQ (Index of Nutrition Quality) of calcium, magnesium, zinc, iodine, and most vitamins was less than 1 in both the malnourished and well nourished groups.

• 한국간호교육학회지
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• 제10권1호
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• pp.64-74
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• 2004

This study was conducted to investigate what contents nurses want in the intensive major course of junior nursing college. Data were collected for four months from October 2002 to February 2003 by structured questionnaires. Subjects were 240 registered nurses in working at five hospitals and four public health centers and elementary or middle schools in the capital and its suburbs and country. The collected data were analyzed using SPSS 8.0 program. The results of this study were summarized as follows : 1. Nurses working at hospitals want the programs which involve the contents as follows : emergency nursing/CPR, infection control, critical care, caner pt. care, pain control, hospice, pulmonary disease pt. care, analysis of lab. exam, heart disease pt. care, chronic disease pt. care, DM pt. care, digestive-system disease pt. care, nervous-system disease pt. care, elderly pt. care, immune-system disease pt. care, endocrine-system disease pt. care. 2. Nurses working at public health centers want the programs which involve the contents as follows : home nursing, family nursing, management of DM, HT, degenerative disease, and chronic liver disease, elderly pt. care, health education, maternity nursing, rehabilitation nursing. 3. Nurses working at elementary or middle schools want the programs which involve the contents as follows : prevention of drug abuse or misuse, sex education and consultation, health education, consultation technique, emergency care, prevention of child obesity, prevention and management of adult disease in children, teaching method, method of school health room management.

• 지역사회간호학회지
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• 제27권4호
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• pp.358-369
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• 2016

Purpose: This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life. Methods: Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using ${\chi}^2$-test, t-test, ANOVA and multiple regression analysis. Results: Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity. Conclusion: The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.

• 대한치과기공학회지
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• 제34권2호
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• pp.179-199
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• 2012

Purpose: This study was conducted to prepare the fundamental data on oral hygiene of the elderly and to assess the behavior of oral hygiene, subjective oral health, oral health problem among the elderly, and to contribute to successful enhancement of life in their declining years. Methods: The author surveyed the behavior of oral hygiene, subjective oral health, oral health problem to 192 elderly at a health center of Busan using structured self- administered questionnaire from Nov. 2nd 2009 to Feb. 10th 2010. Collected data were analysed by SPSS WIN 18.0 statistical program for frequency, percentage production, ${\chi}^2$ (Chi-square) verification, t-test, One-way ANOVA, Logistic Regression. Results: The distribution of total subjects by oral health behaviors were 56.8% for "have ever trained how to tooth brushing", 76.6% for "correctly performed tooth brushing by himself ", 71.8% for "tooth brushing a day is two times and less", 87.5% for "it doesn't tooth brushing in meals and after" and 53.6% for "it doesn't use the facility for oral health", respectively. The distribution of total subjects by the state of perceived oral health were 51.0% for "feel the oral discomfort", 51.6% for "feel the comfortable chewing on starchy food", respectively. The mean point of perceived oral health by general characteristics of total subjects were statistically significant difference in sex, type of medical insurance, smoke, exercise, and chronic disease. The mean point of perceived oral health by oral health behaviors of total subjects were statistically significant difference in educational experience on tooth brushing, recognition for tooth brushing by himself, tooth brushing a day, and tongue cleaning. The risk factors of perceived oral health were type of medical insurance and chronic disease in general characteristics, tooth brushing in meals and after and tooth brushing a day, and tongue cleaning in oral health behaviors. Conclusion: The author recommend to the prevention of chronic disease, carry out the tooth brushing in meals and after, three times and over tooth brushing a day and tongue cleaning for oral health. and the author consider that it need to prepare the active countermeasure to oral health such as reeducation for oral health and supply to the tongue cleaner.