• 보건행정학회지
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• 제27권2호
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• 보건교육건강증진학회지
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• 제23권4호
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• pp.125-153
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• 2006

This study was intended to describe women's weight controlling by creating a hypothetic model on the weight adjustment behavior and by examining a cause and effect relationship, and to contribute to countermeasures for practicing their promotion of health and improving the quality of life through creating a predictable model. The subject of study was women who utilize the beauty shop located in Seoul, Busan and Daegu and the study period was 12 weeks from July 10 to September 30 in 2004. Gathered 1093 person's general specialty related with weight adjustment and analyzed covariance to prove the hypothesis using statistics compiled from authentic sources. Also proved coincidence of the hypothetical model. Exogenous variables of the hypothetical model are composed of recognition of her body shape, fatness level, age, stress, and self-respect. Endogenous variables are health- control mind, recognized health state, self-efficacy, intention, and behavior of weight adjustment. There were 5 measured variables for exogenous variable(x). There were 8 measured variable(y) for exogenous variable. And coincidence $x^2=297.38$, standard $x^2(x^2/df)=7.08$, GFI=0.962, AGFI=0.917, NFI=0.875, TLI=0.794, CFI=0.889, RMSEA=0.075. The result of hypothesis had an epoch-making record that 20 out of 27 hypothesis was proved positive way. Generally weight adjustment has been highly seen in housewives, the married and the old age. Health control mind seems to be high as fatness level, age, and self-respect are high and low stress. Recognized health state is high as age and self-respect are high and low stress. However, it is not much related with recognition of her body shape and fatness level. If age, self-respect, health control mind, recognized health state and self-efficacy are high intention of behavior is also high, but intention of behavior has no relation with recognition of her body shape, fatness level and stress. If fatness level, age, self-respect, health control mind, recognized health state and self-efficacy and intention of behavior are high, execution of weight adjustment will be high. However, recognized health state and stress has no influence for weight adjustment. To increase the coincidence of hypothesis and take a simple model I modified a model and then I got the coincidence $x^2=215.62$, standard $x^2(x^2/df)=6.34$, GFI=0.970, AGFI=0.931, NFI=0.902, TLI=0.901, CFI=0.915, RMSEA=0.070. This result is a bit better than original hypothetical model's so that this model might be more suitable. In this modification model, the factors of weight adjustment seems to be high according to this order self-efficacy, recognized health state, age, intention, health control mind, self-respect, fatness level and stress. With this result I suggest ; 1. Enforcement of IR that everybody can be controlled weight adjustment herself and continuous education, which is related with regular habit (food, exercise, restriction of a favorite food and behavior training etc.) is also needed. 2. Because self-efficacy is influenced to execution of weight adjustment specific program which can increase self-efficacy should have to develop and we need to utilize it to take care of herself. 3. To protect fatness and be active weight adjustment the peculiar program including the concept of self-respect, recognized health state, health control mind and intention must be developed and not only women but also all of people should be educated. 4. This hypothetical model is forecasting women's weight adjustment behavior and can be utilized for fundamental data to increase those people's health.

• 지역사회간호학회지
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• 제25권2호
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• pp.75-84
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• 2014

Purpose: This study aimed to identify the level of knowledge on preventing cardiovascular disease (CVD) and nicotine dependency among smoking male college students, and to examine the predicting factors of nicotine dependency. Methods: This study was conducted as cross-sectional descriptive research using structured questionnaires. Data were collected from 411 smoking male college students ($22.5{\pm}2.59$ yr) at two universities located in two cities in Korea from September 2012 to April 2013. Logistic regression analysis was performed to estimate age-adjusted odds ratios of nicotine dependency. Results: The mean value of nicotine dependency was $4.2{\pm}1.96$ and the percentage of participants who had strong nicotine dependency (${\geq}7$) was 10.7%. Logistic regression analysis showed that, when adjustment was made for age, nicotine dependency was predicted by the frequency of alcohol drinking (${\geq}3$ times/week), knowledge on CVD prevention, the age starting drinking, and the total length of smoking. Conclusion: Nicotine dependency was strongly related to the frequency of drinking alcohol and lower knowledge on CVD prevention. Therefore, male college students who have a dependent smoking habit and drink alcohol frequently need to take more interest in health through educational counseling to modify their lifestyle behaviors and to have preventive knowledge related to CVD.

• 여성건강간호학회지
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• 제27권4호
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• pp.326-336
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• 2021

Purpose: This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods: Using a prospective cohort study design, data on women's depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results: The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion: The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.

• 정신신체의학
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• 제10권2호
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• pp.154-165
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• 2002

목적: 입원 치료 중인 항암제 투여 환자의 우울 양상을 알아보기 위해 본 연구를 시행하였다. 방법: 2001년 11월부터 12월까지 영남대학교 의과대학 부속병원 종양내과에 입원한 대상으로 Beck's depression inventory(이하 BDI), Zung's depression scale (이하 ZDS), Hamilton depression scale(이하 HDS)을 시행하였고 정신과적 면담을 통해 축 I 질환을 진단하였다. 결과: 대상군에서 각 우울 척도의 평균 접수는 BDI 18.27${\pm}$7.73, ZDS 36.51${\pm}$10.82, HDS 15.14${\pm}$6.60으로 나타났다. 성별, 결혼상태, 종교에 따른 우울척도의 차이는 나타나지 않았다. 대상은 위암 13명, 폐암 11명, 혈액종양 10명, 기타 종양 3명(자궁암 2명, 두경부암 1 명)이었다. 고용량의 항암치료를 받는 기타 종양군의 HDS, ZDS 점수가 다른 종양군에 비해 높았다. 8명(21.6%)은 주요우울장애로, 11명(29.7%)은 적응장애로 진단되었다. 주요우울장애군에서 ZDS의 우울감, 일의 어려움, 불안, 정신활동성 지체 항목의 점수가 다른 진단군에 비해 높았다. 장애군에서 ZDS의 변비, 피로, 식욕 감소, 공허감, 수면장애, 불만족, 체중감소 항목, HDS의 건강염려증, 초조, 피로, 성욕 감소 문항의 점수가 높았다. 결론: 항암제 투여 중인 입원 환자에 있어서 적응장애와 주요우울장애와 같은 정신과적 질환이 동반될 수 있다. 정신의학적 접근이 암환자의 삶의 질을 증가시키고 치료 순응도 측면에 있어서도 중요하다. 항암제 치료중인 환자의 우울 장애 진단시 우울 증상과 혼동될 수 있는 다양한 선체 증상을 감별하기 위하여 암의 부위, 임상 경과, 치료 방법, 항암제의 부작용에 대한 고려가 선행되어야 할 것으로 생각된다.

• Tribology and Lubricants
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• 제23권5호
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• pp.228-233
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• 2007

This paper presents the case studies on the friction related wears of an automotive tire, which is strongly connected to the safety and comfort of a driver during a running of a car. Wear scars of a tire tread are affected by various causes such as an air pressure, a wheel alignment, a driving speed, road conditions, starting and braking habits of a driver. The data were collected from used tires for a replacement at the car service center. Most of the wear problems came from the improper repair and adjustment of revolving components, which cause an unbalanced wear of a tread part of a tire. Thus, the regular checking of a tire radically reduces the wear scars of a tire and may increase a driving safety and a fuel economy of a car and a wear life of a tire.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.138-150
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• 2010

Objectives: There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. Methods: This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. Results: Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. Conclusions: Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.

• 중환자간호학회지
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• 제7권1호
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• pp.11-23
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• 2014

Purpose: As the number of cases of heart transplantation (HT) and the survival rate have increased, concerns regarding post-HT life have grown. This study was conducted to explore the relationships of perceived social support to the depression and health status of HT recipients. Methods: This descriptive study targeted all recipients who had undergone HT at S University Hospital since 1994, and 32 recipients were recruited. Results: 90.6% of the recipients were men, and the average age at the time of surgery was $47.4{\pm}13.4$ years. The ejection fraction was increased from $18.47{\pm}5.63%$ to $63.25{\pm}7.57%$, and 31 cases of New York Heart Association (NYHA) class III and IV improved to class I or II after HT. The patients reported mild depression even with high perceived social support and improved health status after HT. Among those resource persons who offered support, they reported their spouse, doctors, and nurses as most meaningful to them. Conclusion: This study confirmed the positive effects of HT on the recipients' physical improvement. It also added the discovery that the importance of recipients' subjective perception of social support might be critical for their more successful recovery and adjustment to post-HT life. Focusing on a different approach to social support and types of social resources in the recovery phase is suggested for future studies on quality of life after HT.

• 근관절건강학회지
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• 제19권3호
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• pp.373-382
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• 2012

Purpose: The purpose of the study was to compare levels of health-related quality of life (HRQOL) between fallers and non-fallers among community-dwelling elderly people. Methods: A cross-sectional comparative study was conducted with the secondary analysis of 2,067 elderly people registered in S-Gu Visiting Health Care Program in Seoul, South Korea. Participants were 206 fallers and 206 non-fallers who were age- and sex-matched with fallers. HRQOL was measured by SF-8 including physical component summary (physical HRQOL) and mental component summary (mental HRQOL). Results: There were more people in the faller group having more than or equal to three chronic diseases (p<.001), living in multiplex houses (p=.004), and being dependent by the activities of daily living (ADL) (p=.001) and instrumental ADL (IADL) levels (p<.001) than those in the non-faller group. Fallers had higher levels of depression than non-fallers (p<.001). Moreover, fallers had significantly lower levels of both physical HRQOL (p<.001) and mental HRQOL (p=.001), after adjusting for number of chronic diseases, ADL, IADL, depression, healthcare insurance, and living environment. Conclusion: Among the community-dwelling elderly people, falllers had lower levels of HRQOL than non-fallers, and such a difference remained even after the adjustment for covariates. Factors that underlie the different susceptibility to HRQOL need to be explored.

• 여성건강간호학회지
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• 제29권4호
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• pp.302-316
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• 2023

Purpose: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. Methods: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). Results: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=-.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=-. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=-.56 p=.023) indirectly affected QoL. Conclusion: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.