• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.35-45
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• 2021

Globally, cardiovascular diseases and chronic obstructive pulmonary disease (COPD) are the leading causes of the non-communicable disease burden. Overlapping symptoms such as breathing difficulty and fatigue, with a lack of awareness about COPD among physicians, are key reasons for under-diagnosis and resulting sub-optimal care relative to COPD. Much has been published in the past on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of the prevalence and impact of COPD management in commonly encountered cardiac diseases is lacking. The purpose of this study was to summarize the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We also discuss the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched PubMed, Scopus, EMBASE, and Google Scholar for studies published 1981-May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. The clinical implications of the diagnosis of COPD in cardiac disease includes the recognition of hyperinflation (a treatable trait), implementation of acute exacerbations of COPD (AECOPD) prevention strategies, and reducing the risk of overuse of diuretics. The pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. The appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thus reducing the risk of mortality, improving exercise tolerance, and quality of life.

• 보건교육건강증진학회지
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• 제31권5호
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• pp.109-120
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• 2014

Objectives: This study was to examine the associations between obesity level and major chronic diseases in older population in Korea, using different obesity indicators. Methods: Data was from the 2008 KloSA Biomarker pilot, a nationwide sample of 514 non-institutionalized subjects (age $63.6{\pm}9.8$ years; women 57.2%). Anthropometric information was collected by home visiting nurses. Portable bioimpedence devices(Omran HBF359) were used for measuring fat mass. Obesity cut-offs used the Asian criteria of $BMI{\geq}25$, $WC{\geq}90/85cm$, and $fat%{\geq}25/35$ for men and women. Chronic disease prevalence was defined by physician-diagnosed history of 8 specified diseases. Results: Prevalence of chronic diseases significantly increased with increment of obesity level by BMI, WC and fat %. Odds ratios of acquiring chronic diseases remained significant in the obese group (BMI OR 2.76, 95%CI 1.82-4.19; WC OR 2.73, 95%CI 1.81-4.11; Fat OR 1.87 95%CI 1.26-2.78), after adjusting for age, sex, marital status, education, work participation, household income, smoking, drinking, and exercise. Conclusions: Obesity measured by all three indicators, BMI, WC, and fat mass cannot be disregarded, accentuating the significant effect on increases in disease risks among older population. BMI and WC measure appeared better to assess the risks of chronic diseases.

• 한국사회복지학
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• 제48권
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Child Health Nursing Research
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• 제26권2호
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• pp.309-322
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• 2020

Purpose: The purpose of this integrative review was to synthesize previous research on perceptions of school health care among school-aged children and adolescents with chronic diseases. Methods: This study was performed in accordance with Whittemore and Knafl's stages of an integrative review (problem identification, literature search, data evaluation, data analysis, and presentation of the results). Four databases (PubMed, CINAHL, Embase, and Web of Science) were used to retrieve relevant articles. Results: Eighteen articles were included in this review. We identified five thematic categories: peer-related issues, a safe school environment, self-perception of an existing disease, self-management, and a supportive school environment. Conclusion: It is necessary to establish a school health care system with a supportive environment for children and adolescents with chronic diseases.

• 대한치과의사협회지
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• 제49권10호
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• pp.609-617
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• 2011

The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

• 융합정보논문지
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• 제11권8호
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• pp.160-167
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• 2021

본 연구는 국민건강영양조사 2019 자료를 이용하여 만성질환 가족력에 대한 만성질환의 유병률과 위험도를 실증적으로 도출하고자 하였다. 연구 대상자는 5,691명으로 만성질환 가족력과 관계있는 인구사회학적 변수들을 통제한 후, 만성질환 유병에 대한 만성질환 가족력의 위험도인 오즈비를 검증하기 위해 로지스틱 회귀분석을 수행하였다. 주요 결과는 성별, 나이, 소득수준, 교육수준, 거주지역을 통제한 경우, 만성질환 가족력이 없는 집단 대비 가족력이 있는 집단에서 만성질환이 발병할 위험도인 오즈비는 고혈압 2.623, 이상지질혈증 1.868, 당뇨병 1.964, 관절염 1.435로 유의하게 나타났다. 이러한 결과는 가족력 검사에 대한 표준화 도구를 개발하고 보건의료의 예방의학 차원에서 가족력이 있는 구성원에 대한 건강과 질병 관리 시스템이 필요함을 시사한다. 본 연구는 만성질환 유병률에 영향을 미치는 인구사회학적 변수를 통제하고, 만성질환에 대한 가족력의 위험도를 실증적으로 확인하여 보건의료 측면에서 실천방안을 제언했다는 점에서 의의가 있다.

• 전자공학회논문지
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• 제51권1호
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• pp.233-240
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• 2014

최근 노인인구의 증가하는 추세에 따라 만성질환자의 수도 증가하고 있으며 건강 관리문제가 중요하게 대두되고 있다. 본 논문에서는 만성질환자의 건강관리를 위한 유헬스케어 시스템을 구현하고자 한다. 제안한 만성 질환자 관리 시스템은 생체 계측 시스템과 모바일 게이트웨이 그리고 의료정보 관리 서버 그리고 클라이언트로 구성되면 생체 신호는 심전도, 혈압, 혈당, 산소포화도 등의 모듈로 구성하였다. 혈당체크는 이동성을 고려하여 생체계측 시스템으로 전송하는 방법과 게이트웨이로 전송하는 방법 중 선택할 수 있도록 구현하였다. 제안한 생체 계측 시스템과 모바일 게이트웨이는 블루투스 통신을 이용하여 전송한다. 전송된 생체 데이터는 모바일 게이트웨이에서 건강상태를 감시하거나 네트워크 서버로 전송하고 클라이언트을 이용하여 검색 할 수 있도록 하였다. 만성질환자의 생체신호 감시 시스템을 구현함으로서 측정되어진 생체 데이터를 모니터링하여 현재의 건강상태를 확인할 수 있었으며 모바일 환경에서 다양한 생체신호를 전송하였다.

• 보건행정학회지
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• 제28권1호
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• pp.35-47
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• 2018

Background: The purpose of this study is to elucidate the context of medical experience and the perception of unmet healthcare of elderly people with chronic diseases based on in-depth interview data. Methods: We carried out in-depth interviews with 10 elderly people with chronic diseases using semi-structured questionnaires based on literature review. The in-depth interview data were analyzed using thematic analysis; one qualitative research methodology, three core meaning categories, and four attributes associated with unmet healthcare were ultimately derived. Results: The context of the medical experience were based on the following three categories: (1) discomfort due to diseases and high medical needs, (2) the poor community medical environment and difficulties in accessing to metropolitan medical institutions, and (3) inconvenience caused by long waiting time and side effects of medicine. In addition, the elderly with chronic disease realized the unmet healthcare as (1) the availability related to the desired medical institutions at the right time, (2) the affordability related to their economic capacity, (3) the effectiveness of the medical services they experienced, and (4) the appropriateness related to receiving medical services in a pleasant environment. Conclusion: The perception of unmet healthcare among the elderly with chronic disease is the result of interaction of multi-level and multi-dimensional factors related with their medical experience.

• 보건행정학회지
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• 제31권1호
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• pp.65-73
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• 2021

Background: With the recent aging of the population, the transition to a disease structure centered on chronic diseases is accelerating. Moreover, the socio-economic gap and the polarization of the health gap between regions further increase the burden of disease on the country. Accordingly, this study calculated the disease cost of hypertension, diabetes, and hyperlipidemia, which are the three major chronic diseases, to establish an effective health promotion policy strategy for each region, and analyzed the gap in disease cost within the region to determine health determinants at the individual as well as the regional level. Methods: This study utilized data from the 2015 sample cohort of the National Health Insurance Service and calculated the disease cost of patients (diabetes: I10-I15, hypertension: E10-E14, hyperlipidemia: E78) based on the main diagnosis. Results: Based on our analysis, the case of medical use in cities and provinces was higher than in metropolitan cities, with relatively small medical use in Seoul and Gangwon-do. In terms of the disease cost, the cost of chronic diseases in Seoul and Jeju was the highest, but the difference in disease cost between patients in each region was the largest in Seoul and Gangwon-do. Conclusion: The results of this study provide meaningful data for implementing efficient health promotion policies by analyzing the differences in disease cost and identifying health determinants in different regions. Furthermore, in Korea, where socioeconomic differences are clearly revealed, it can be used as a basis for preparing a strategic plan, from a long-term perspective, to improve the health of patients with chronic diseases in the future.

• 융합정보논문지
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• 제8권3호
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• pp.17-24
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• 2018

본 연구는 도시지역 근로자 5,638명을 대상으로 건강행태와 만성질환 유병률과의 관련성을 파악하고자 하였다. 자료분석은 빈도, 백분율, 교차분석을 실시하고 만성질환에 미치는 영향을 분석하기 위하여 다중로지스틱 회귀분석을 사용하였다. 연구 결과 대상자의 건강행태는 남자가 흡연과 음주가 높게 나타났고, 운동은 남녀 모두 추천건강운동량 기준으로 낮게 나타났으며 만성질환 유병률은 비만과 고지혈증이 높게 나타났다. 만성질환에 영향을 미치는 중요 인자는 연령, 운동, 음주로 확인되었다. 본 연구의 결과는 국가, 지역사회 및 산업현장에서 바람직한 건강행태 형성을 위한 체계적인 건강관리프로그램을 운영할 필요가 있음을 시사한다.