• 치위생과학회지
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• 제23권2호
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• pp.142-153
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• 2023

Background: Cognitive impairment has been reported to be closely associated with poor oral health, and the relationship is bidirectional, as older adults with poor oral health and chewing function are at a higher risk of cognitive decline (CD). This cross-sectional study aimed to determine whether masticatory discomfort in Korean elderly increases the risk of daily living difficulty (DLD) related to CD and whether there is a difference in risk according to gender and age. Methods: The data used were obtained from the Korean Community Health Survey (2019). The final analysis included 22,154 people aged 65 years and older who completed the survey and responded to all items on the variables used in the study. Chi-square test, trend test, and complex sample logistic regression were performed for statistical analysis, to clarify the purpose of this study. Results: As masticatory discomfort increased, the elderly's DLD tended to increase (p-for trend, p<0.001). For logistic regression, adjusting for all covariates, participants who reported masticatory discomfort as "discomfort" (adjusted odds ratio [AOR]=2.45, 95% confidence interval [CI]=2.11~3.50) and "severe discomfort" (AOR=2.95, 95% CI=2.49~3.50) had a more than a two-fold increased risk of CD-related DLD compared to participants who reported "no discomfort at all." In age-stratified analyses, elderly men aged 75~84 years and elderly women aged 65~74 years had the highest risk of developing CD-related DLD. Conclusion: Oral care interventions to improve masticatory function in older adults may slow CD and improve CD-related DLD. We hope that this study will raise awareness among caregivers and clinical professionals regarding the importance of oral care for older adults with CD.

• Journal of Preventive Medicine and Public Health
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• 제56권6호
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• pp.487-494
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• 2023

Objectives: Community organization is a resident-led movement aimed at creating fundamental social changes in the community by resolving its problems through the organized power of its residents. This study evaluated the effectiveness of health community organization (HCO), Gangwon's Health-Plus community program, implemented from 2013 to 2019 on residents' health behaviors. Methods: This study had a before-and-after design using 2011-2019 Korea Community Health Survey data. To compare the 3-year periods before and after HCO implementation, the study targeted areas where the HCO had been implemented for 4 years or longer. Therefore, a total of 4512 individuals from 11 areas with HCO start years from 2013 to 2016 were included. Complex sample multi-logistic regression analysis adjusting for demographic characteristics (sex, age, residential area, income level, education level, and HCO start year) was conducted. Results: HCO implementation was associated with decreased current smoking (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.57 to 0.95) and subjective stress recognition (aOR, 0.79; 95% CI, 0.64 to 0.97). Additionally, the HCO was associated with increased walking exercise practice (aOR, 1.39; 95% CI, 1.13 to 1.71), and attempts to control weight (aOR, 1.36; 95% CI, 1.12 to 1.64). No significant negative changes were observed in other health behavior variables. Conclusions: The HCO seems to have contributed to improving community health indicators. In the future, a follow-up study that analyzes only the effectiveness of the HCO through structured quasi-experimental studies will be needed.

• Journal of Korean Biological Nursing Science
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• 제26권1호
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• pp.26-40
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• 2024

Purpose: The aim of this study was to predict the subgroups vulnerable to poorer health-related quality of life (HRQoL) according to gender in older adults. Methods: Data from 5,553 Koreans aged 65 or older were extracted from the Korea National Health and Nutrition Examination Survey. HRQoL was assessed using the EQ-5D tool. Complex sample analysis and decision-tree analysis were conducted using SPSS for Windows version 27.0. Results: The mean scores of the EQ-5D index were 0.93 ± 0.00 in men and 0.88 ± 0.00 in women. In men, poorer HRQoL groups were identified with seven different pathways, which were categorized based on participants' characteristics, such as restriction of activity, perceived health status, muscle exercise, age, relative hand grip strength, suicidal ideation, the number of chronic diseases, body mass index, and income status. Restriction of activity was the most significant predictor of poorer HRQoL in elderly men. In women, the poorer HRQoL groups were identified with nine different pathways, which were categorized based on participants' characteristics, such as perceived health status, restriction of activity, age, education, unmet medical service needs, anemia, body mass index, relative hand grip, and aerobic exercise. Perceived health status was the most significant predictor of poorer HRQoL in elderly women. Conclusion: This study presents a predictive model of HRQoL in older adults according to gender and can be used to detect individuals at risk of poorer HRQoL.

• 대한간호학회지
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• 제54권2호
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• pp.193-210
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• 2024

Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

• 대한물리의학회지
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• 제19권1호
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• pp.23-30
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• 2024

PURPOSE: The purpose of this study is to identify the incidence of chronic obstructive pulmonary disease (COPD) and risk factors for diseases in adults over 40 years of age in Korea, and to provide basic data for the prevention of COPD incidence through management. METHODS: Based on the 2019 data of the Korea National Health and Nutrition Examination Survey (KNHANES), 1,788 adults over the age of 40 who participated in pulmonary function test and health survey were selected as subjects. COPD incidence risk factors were analyzed using complex sample multiple logistic regression analysis. RESULTS: As a result of the analysis, the incidence of COPD in Korea was 11.5%, and the risk of developing COPD was higher in men, age, and current smokers. Compared to women, men had an increased risk of developing COPD by 2.369 times (95% CI 1.289-4.355). In age, the risk of COPD incidence increased by 3.702-fold (95% CI 1.923-7.124) in their 50s, 11.238-fold (95% CI 6.009-21.017) in their 60s, and 28.320-fold (95% CI 14.328-55.977) in their 70s compared to those in their 40s. In the smoking state, 2.302 times (95% CI 1.373-3.860) of past smokers and 4.542 times (95% CI 2.694-7.658) of current smokers were found to have a higher risk of developing COPD than non-smokers. CONCLUSION: To reduce the incidence of COPD, interventions are required to prevent disease development through lifestyle and smoking cessation education in subjects with COPD risk factors.

• 대한감각통합치료학회지
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• 제22권1호
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• pp.43-53
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• 2024

목적 : 청소년에서 스마트폰의 일반 사용자와 과잉 사용자 사이의 학업 성적과 정신건강상태인 범불안, 우울, 스트레스, 외로움, 자살생각의 차이를 알아보고자 한다. 연구방법 : 2022년 제 18차 청소년건강형태 온라인조사의 원시자료를 이용하여 총 51,850명 청소년의 스마트폰 사용 시간과 학업 성적, 정신건강상태를 분석하였다. 통계분석은 복합표본분석 기술통계와 선형회귀분석을 사용하였다. 결과 : 중·고등학생에서 주말의 스마트폰 평균 사용 시간은 6시간 43분이었고, 주중 시간은 4시간 39분 이었다. 성별과 학년에 따라 스마트폰 사용 시간이 유의하게 차이가 있었다. 스마트폰의 과잉 사용자와 일반 사용자 사이의 학업 성적의 차이를 비교한 결과, 평균 점수에서 과잉 사용자가 일반 사용자보다 낮게 나타났다. 정신건강상태의 차이를 비교한 결과, 과잉 사용자가 일반 사용자에 비하여 범불안, 우울, 스트레스, 외로움, 자살생각의 부정적인 점수가 높게 나타났다. 결론 : 본 연구는 우리나라 청소년의 스마트폰 사용 시간에 대한 실태와 과잉 스마트폰 사용자와 관련이 있는 요소를 제시하였다.

• 대한물리의학회지
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• 제19권3호
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• pp.103-110
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• 2024

PURPOSE: This study aims to analyze the prevalence and risk factors of stroke in Korean older adults and provide basic data for stroke prevention. METHODS: Based on the data from the 2019-2021 Korea National Health and Nutrition Examination Survey, 5,750 adults aged 65 or older who participated in the health survey were selected. Risk factors for stroke were analyzed through complex sample multiple logistic regression analysis. RESULTS: As a result of this study, the prevalence of stroke among the subjects was 6.20%. Stroke risk factors were elderly, male, low personal income level, and current and past smoking experience. The risk of stroke prevalence was OR 1.076 (95% CI 1.048-1.104) higher with each age increase. According to gender, the risk of stroke prevalence was OR 1.587 (95% CI 1.068-2.358) higher in males compared to females. In the case of individual income level, the risk of stroke prevalence was OR 1.509 (95% CI 1.011-2.253) higher in Q1, the lowest compared to Q4, which has the highest income level, and it was not significant in Q2, and Q3. Compared to non-smokers, current smokers had an OR 1.717 (95% CI 1.087-2.712), and past smokers had an OR 1.546 (95% CI 1.095-2.183). CONCLUSION: The prevalence of stroke in Korean older adults was 6.20%, and the risk factors for stroke were old age, men, low individual income level, and smoking. Therefore, prevention programs and smoking cessation education are needed for subjects with stroke risk factors.

• 디지털융복합연구
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• 제17권8호
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• pp.453-463
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• 2019

본 연구는 국민건강영양조사 제7기 2차년도(2017) 자료를 이용하여 우리나라 1인 가구의 건강관련 삶의 질에 미치는 영향 요인을 규명하기 위해 시도되었다. 연구 대상자는 301명이었고, SPSS Win 25.0 프로그램을 이용하여 복합표본 빈도분석, 기술통계, t-test 또는 분산분석과 일반선형 회귀분석을 실시하였다. 주요 결과로는 우리나라 1인 가구의 건강관련 삶의 질 점수는 평균 0.92점이었으며, 통증 및 불편감 영역에서 2.5%의 대상자가 중증의 문제가 있는 것으로 나타났다. 회귀분석 결과 건강 관련 삶의 질은 가구 소득 수준이 하, 교육 수준은 초졸 이하, 현재 음주는 하지 않는 경우 각 각 0.034, 0.039, 0.031 낮았다. 주관적 건강상태는 좋거나 보통, 활동 제한이 없는 경우, 관절염이 없는 경우 0.072, 0.065, 0.103, 0.040 각 각 높았으며, 본 모형은 우리나라 1인 가구의 건강 관련 삶의 질을 43.1% 설명하였다. 이상의 결과를 토대로 우리나라 1인 가구의 건강 증진을 위한 정책 마련에 기초를 제공하였으며 1인 가구 대상자의 건강 관련 삶의 질을 향상시키기 위해 지속적으로 관심을 가지고 다학제간 접근의 중재안을 마련하는 것이 필요하다.

• 보건행정학회지
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• 제8권2호
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• pp.1-24
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• 1998

There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.

• 치위생과학회지
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• 제11권4호
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• pp.311-317
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• 2011

본 연구는 2005년도에 실시된 제 3기 국민건강영양조사 자료를 이용하여 어린이의 생활안전행동과 구강보건행동의 관련성을 알아보고 사회인구학적 연관 요인을 평가하여 어린이의 생활안전행동와 구강보건행동을 효과적으로 증진하기 위한 기본 방향을 세우고자 수행되었다. 본 연구를 통하여 우리나라 어린이들의 생활안전행동과 구강보건행태에 대하여 다음과 같은 결론을 얻었다. 1. 대체로 어린이의 생활안전행동과 구강보건행동의 연관성이 발견되지 않았고 따라서 어린이의 생활안전행동과 구강보건행동의 변화를 추구함에 있어서 공통위험요인접근법 적용의 근거를 발견하지 못하였다. 2. 우리나라 3-11세 어린이는 56.3%가 하루 2회 이상 칫솔질을 실천하였고 74.7%가 예방적 치과진료 경험이 있는 것으로 나타났다. 자동차 뒷좌석 이용을 제외한 생활안전행동의 실천은 현저하게 부족하여 자동차 보호장구 이용율 10.4%, 자전거 안전모 착용율 4.3%, 및 인라인스케이트 안전모 착용율 29.0%에 그쳐(Table 2), 특히 생활안전교육의 강화의 필요성이 절실함을 보여주었다. 3. 미취학 어린이에 비하여 7세 이후 취학어린이에게서 생활안전행동과 구강보건행동의 실천률이 낮은 것으로 조사되어, 초등학생의 생활안전교육과 구강보건교육이 강조되어야 할 것으로 사료된다. 4. 3-6세 아동에서 거주지역 또는 가정의 경제수준 등 사회경제적 요인과 생활안전행동 및 구강보건행동의 연관성이 관찰되었으나, 취학아동에서는 대체로 유의한 연관성이 없었다(Table 3).