• 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.

• 보건교육건강증진학회지
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• 제18권3호
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• pp.89-102
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• 2001

Background: Many chronic diseases are associated with the lifestyle such as smoking, alcohol drinking and exercise. Attention is increasingly paid on the effect of exercise for the management of chronic disease these days. Objective: The purpose of this study was to evaluate the status of the smoking habit, alcohol drinking and physical exercise of the patients with chronic diseases. Methods: Total 793 persons(normal:422, chronic disease patients:371) in a hospital were questioned regarding the habits of smoking and alcohol drinking, and a practice of physical exercise in 1999. The patients with chronic illness were divided into three groups(Group I included the patients of hypertension and diabetes mellitus. Group II includes respiratory disease and cancer. Group III included liver disease). The rate of exercise, the rate of smoking cessation and the rate of abstinence were assessed. In logistic regression analysis with each independent variables in each disease groups (I, II and III, odds ratio for the presence of disease was controlled for age and education. Results: The rate of exercise, the rate of smoking cessation and the rate of abstinence was 31.5%, 27.3% and 9.5% in the patients with chronic disease, respectively. In control group, those were 31.5%, 21% and 2.1%, respectively. In logistic regression analysis with exercise as independent variable, odds ratios(95% CI for age and education were significantly high, with smoking cessation, odds ratio for age was high and with abstinence, odds ratio for disease with high in all disease groups. Conclusion: It was suggested that an effort for proper changes of lifestyle related to disease such as smoking, alcohol drinking and exercise should be intervened in the patients with chronic diseases.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.22-34
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• 2021

The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.

• 농촌의학ㆍ지역보건
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• 제46권1호
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• pp.1-11
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• 2021

이 연구의 목적은 천식과 만성폐쇄성폐질환 환자들의 미세먼지에 대한 인식, 지식, 예방행위 수준과, 예방행위에 영향을 미치는 요인을 확인하기 위한 것이다. 이 연구는 서술적 조사연구로 연구대상은 대구광역시 소재 일개 대학병원 호흡기전문질환센터를 방문한 만 19세 이상, 만 80세 이하의 만성호흡기질환자를 편의표본추출하였고, 2019년 12월부터 2020년 1월까지 구조화된 자기기입식 설문조사로 자료를 수집하여, 총 212부의 자료를 분석 대상으로 하였다. 연구대상자는 212명이었으며, 이중 천식 112명(52.8%), 만성폐쇄성폐질환 100명(47.2%)이었다. 미세먼지에 대한 인식, 지식, 예방행위의 평균 점수(10점 만점)는 천식 환자는 각각 7.92점, 6.99점, 7.10점이었고, 만성폐쇄성폐질환자는 각각 7.72점, 6.24점, 6.80점 이었다.미세먼지 지식 점수는 천식환자가 만성폐쇄성폐질환자보다 유의하게 높았다(p=0.007). 미세먼지 예방행위 수준에 영향을 미치는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식 점수가 유의한 요인이었다. 이상의 결과 천식과 만성폐쇄성폐질환 환자의 예방행위에 영향을 주는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식점수였다. 미세먼지 예방행위 수준을 높이는 것은 미세먼지로 인한 만성호흡기질환의 악화를 막을 수 있으므로, 질환에 따른 대상자의 특성을 고려한 중재 프로그램의 개발과 지속적이고 반복적인 교육이 요구된다.

• ETRI Journal
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• 제36권5호
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• pp.730-740
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• 2014

The rapid increase in the number of patients with chronic diseases is an important public healthcare issue in many countries, which accelerates many studies on a healthcare system that can, whenever and wherever, extract and process patient data. A patient with a chronic disease conducts self-management in an out-of-hospital environment, particularly in an at-home environment, so it is important to provide integrated and personalized healthcare services for effective care. To help provide effective care for chronic disease patients, we propose a service flow and a new cloud-based personalized healthcare system architecture supporting both at-home and at-hospital environments. The system considers the different characteristics of at-hospital and at-home environments, and it provides various chronic disease care services. A prototype implementation and a predicted cost model are provided to show the effectiveness of the system. The proposed personalized healthcare system can support cost-effective disease care in an at-hospital environment and personalized self-management of chronic disease in an at-home environment.

• 대한간호학회지
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• 제33권5호
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• pp.570-579
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• 2003

Purpose: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. Method: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. Result: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. Conclusion: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

• 보건교육건강증진학회지
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• 제32권3호
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• pp.121-133
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• 2015

Objectives: This study aimed to examine factors that affect chronic illness anticipated stigma among patient living with Parkinson's disease. The attributes of stigma measured in this study were labeling, expectation of prejudice, negative stereotyping, and discrimination. Chronic illness anticipated stigma was correlated with measures of mental and physical health as well as certain health behaviors. Methods: The sample included 250 adults with idiopathic Parkinson's disease that attended D university hospital in B metropolitan city from June to August 2014. Results: The chronic illness anticipated stigma were significantly correlated to depression, anxiety, Schwab & England ADL, Hoehn & Yahr stage, and age. The significant predictors of chronic illness anticipated stigma were anxiety, depression, and age. These factors accounted for 47% of variance in chronic illness anticipated stigma. Conclusions: In order to reduce the chronic illness anticipated stigma, nurse involved in the treatment and care of patients with Parkinson's disease should encourage patients to attend programs of depression and anxiety management in Parkinson's disease and systemic education programs on stigma.

• 대한간호학회지
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• 제31권3호
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• pp.477-491
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• 2001

Purpose: This study was designed to construct a structural model for health promoting behavior in patients with chronic respiratory disease. A hypothetical model was developed based on the literature review. Method: Data was collected by questionnaires from 235 patients with chronic respiratory disease in a General Hospital in Seoul. Data analysis was done using SAS 6.12 for descriptive statistics and the PC-LISREL 8.13 Program for Covariance Structural Analysis. Result: The results are as follows : 1. The fit of the hypothetical model to the data was moderate. It was modified by excluding 2 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data($\chi$2=80.20, P=0.05, GFI=0.95, AGFI=0.88, NNFI=0.95, NFI=0.96, RMSR=0.01, RMSEA =0.06). 2. The perceived benefits, self-efficacy, and a plan of action were found to have significant direct effects on the health promoting behavior in patients with chronic respiratory disease. 3. The health perception, self-esteem, and activity related to affect were found to have indirect effects on the health promoting behavior in patients with chronic respiratory disease. Conclusion: The modified model of this study is considered appropriate in explaining and predicting health promoting behavior in patients with chronic respiratory disease. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

• 보건교육건강증진학회지
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• 제31권3호
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• 대한간호학회지
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• 제33권1호
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• pp.87-94
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• 2003

Purpose: The purpose of this study was to identify the factors influencing Symptoms of Stress in patients with chronic illness. Method: Data were collected by questionnaires from 1,748 patients with chronic disease in General Hospital in Seoul. Chronic diseases of were cardiac disease including hypertension, peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. Result: 1. The level of symptoms of stress was moderate(M=2.17). 2. The score of symptoms of stress showed significantly positive correlation with the score of mood state(r=.58, p=.00), perceived stress(r=.57, p=.00), and ways of coping(r=.33, p=.00). The symptoms of stress showed significantly negative correlation with the score of social support(r=-.37, p=.00) and self-esteem(r=-.19, p=.00). 3. The most powerful predictor of symptoms of stress was mood state and the variance explained was 34%. A combination of mood state, ways of coping, perceived stress, social support, and duration of illness account for 45% of the variance in symptoms of stress of the patients with chronic illness. Conclusion: This study suggest that mood state, ways of coping, perceived stress, and social support are significantly influencing factors on symptoms of stress of the patients with chronic illness.