• 인간행동과 음악연구
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• 제14권1호
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• pp.63-84
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• 2017

본 연구는 75세 이상 노인의 노래부르기 실태 조사 및 지각하는 노래부르기 혜택과 삶의 질간의 관계를 알아보고자 실시되었다. 본 연구의 대상자는 총 231명의 후기 노인으로, 이 중 90명은 타인과 함께 거주하는 일반노인, 141명은 혼자 거주하고 있는 독거노인이었다. 각 대상자는 연구자가 제작한 설문지 조사와 삶의 질 척도 검사에 참여하였다. 연구자가 제작한 설문지는 대상자의 인구사회학적 특성과 여가 수준, 노래부르기 관련 경험, 노래부르기의 혜택에 대한 인식 등을 묻는 총 49개 문항으로 구성되었다. 회수된 설문지 중 응답이 불충분한 설문지를 제외하고 총 231부를 분석한 결과, 여가 활동에 참여하는 수준과 지각된 삶의 질에 있어 일반노인과 독거노인 간 차이가 있는 것으로 나타났다. 노래부르기 관련 경험 유무에 있어서도 그룹 간 차이가 있었다. 또한 지각하는 노래부르기 혜택수준과 삶의 질 점수 간 정적 상관관계에 있는 것으로 나타났다. 이러한 결과는 노래부르기 경험에 어떠한 혜택이 있는지 인식하는 수준이 삶의 질에 있어 중요한 요인이 될 수 있음을 시사한다. 또한 노래부르기가 적극적인 여가 활동으로 활용될 수 있는 가능성을 뒷받침하여, 기존의 감상 활동에 초점이 맞추어졌던 노인을 위한 활동 영역이 확대될 수 있는 기초를 마련했다고 할 수 있다. 본 연구 결과는 노인 대상군이 삶의 질 향상을 위한 대처 전략으로써 활용할 수 있는 노래부르기 활동을 제안하는 데 있어 참고할 만한 기초 자료를 제시했다는 데 그 의의가 있다고 할 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제39권3호
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• pp.221-228
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• 2006

Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

• Journal of Preventive Medicine and Public Health
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• 제32권2호
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• pp.228-235
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• 1999

Objectives: Despite the importance of human immunodeficiency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. Methods: 169 HIV-infected males and their female sex partners were recruited from 1985 to tune 1998. We examined female sex partner's HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. Results: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell courts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) Conclusion: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.

• 한국학교보건학회지
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• 제12권1호
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• pp.45-56
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• 1999

Adolescence is vulnerable to various Health Risk Behaviors (HRB). These behaviors can affect his remaining life as well as adolescence, thus prevention of HRB is a critical issue in health education. This study is aimed to provide basic information for prevention of HRB. Thus, this study was conducted to analyze the impact of peer group's health risk behaviors on health risk perception (HRP) and that of health risk perception on health risk behaviors based on 832 respondents. The 852 subjects were selected in six middle and high schools in Seoul through random sampling. Data were collected from September, 18-October, 21, 1998, and the 832 data were analyzed after excluding the 20 incomplete and inaccurate data. Questionnaire items and measures are based on an instrument to measure Perceived Health Risk Perception, which Hodge B.C. developed in 1992. Cronbach alpha is used to test the reliability. The reliability of HRP and HRB is 0.9473, 0.8768 in this study, Statistical analysis divided into four phases. First, the impact of socio-demographic characteristics on HRP is analyzed by oneway ANOV A. Male students have lower HRP than female students. As grade goes up, HRP is getting lower. Perceived higher concern of parents and HRP are correlated. And the experience of school health education and HRP are correlated. Second, the impact of peer group's HRB on the HRP is analyzed by linear regression. Peer group's HRB and HRP are negatively correlated, Third, the impact of HRP on HRB is analyzed by linear regression. There is a correlation between high HRP and low HRB. Fourth, Powerful impact factors on HRB are analyzed by stepwise multiple regression. Grade, gender, peer group's HRB, and related HRP is entered as independent variables. Because of correlation between entered variables, three interaction variables between grade, gender, peer group's HRB and related HRP also entered, In general, peer group's HRB is the most accountable factor to HRB. And Interaction variable between HRP and peer group's HRB and HRB are negatively correlated. These results indicate that HRP may reduce the impact of peer group's HRB on HRB. Some recommendations are as follows: First, health educational programs suitable for gender and grade are required. Second, a systematic cooperation between school and home is necessary for effective prevention of HRB. Third, the educational effect for decreasing HRB by increasing HRP is statistically assisted. However, peer group has much stronger impact on HRB than subjective HRP, thus special consideration and management are necessary for peer group which does HRB more frequently.

• 보건행정학회지
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• 제23권1호
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• pp.35-43
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• 2013

Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.497-507
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• 2018

본 연구는 암생존자의 삶의 질에 대해 보다 면밀한 검토를 통해 이들을 위한 서비스 및 정책 마련을 위한 기초자료를 제공하고자 수행되었다. 이에 본 연구는 사회문화적 영향을 다르게 수용하게 되는 성차(gender difference)를 중심으로 암생존자의 삶의 질의 차이와 예측 요인들의 상대적 영향력을 검증하였다. 이를 위해 국민건강영양조사 제 6기 중 2013년 자료에서 추출한 암생존자 203명을 표본으로 남녀 집단간 삶의 질 평균차이 검증과 위계적 회귀분석을 실시하였다. 그 결과 삶의 질의 하위 영역 모두에서 여성이 남성에 비해 낮은 삶의 질을 보였으며, 전체적인 삶의 질에 있어서도 여성의 삶의 질은 유의미하게 낮았다. 위계적 회귀분석 결과, 성차에 따른 예측 변인이 다르게 나타났는데 남성은 주관적 건강인식이 유의한 정적 영향을 미치고 있었으며 여성은 미충족 의료욕구(unmet medical need)가 가장 큰 예측력을 가진 유의미한 변인으로 부적 영향을 미치고 있었으며, 또한 연령이 높을수록 삶의 질이 낮았으며, 주관적 건강인식과는 유의미한 정적 관계를 보였다. 이러한 결과를 통해 성차를 고려한 암생존자 관리의 방향성 제고가 필요하며 여성암생존자 중 고령, 건강상태가 좋지 못한 경우, 의료서비스의 접근성이 낮은 집단에 대한 보다 집중적 서비스를 마련해야하는 등의 실천적 함의와 후속연구에 대한 제언을 제시하였다.

• 한국산학기술학회논문지
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• 제19권2호
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• pp.125-136
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• 2018

대설 재난은 한국에서 태풍 및 호우 다음으로 두 번째로 많은 자연 재해라고 할 수 있다. 대설 재난으로 인한 2005년에서 2014년 사이의 연 평균 경제 피해액은 약 80억원이다. 심각한 경제적 피해에도 불구하고 한국에서 대설 재난에 대한 경제 효과 연구는 거의 없다. 본 연구의 목적은 다중 회귀모형을 이용하여, 대설 재난의 경제적 피해액과 강설량, 강설일, 인구밀도, 비도시지역 비율 및 수도권 더미 변수 등 간의 연관성을 확인하는 것이다. 2005년부터 2014년 사이의 대설 재난 피해액 관련 데이터는 행정안전부 (국민안전처)에서 발행하는 자연 재해 연보를 이용하였으며, 강설량 및 강설일과 같은 날씨 관련 데이터는 기상청에서 수집하였다. 인구와 비도시 관련 데이터는 지자체 통계 데이터를 사용하였다. 연구 결과 강설일, 강설량, 비 도시면적 비율 등이 대설 재난 피해에 영향을 주는 것으로 나타났다. 본 연구의 결과는 한국의 대설 재난 관리 정책에 적용될 수 있다.

• 성인간호학회지
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• 제12권1호
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• pp.30-39
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• 2000

Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: $61{\pm}15$), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3. The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2501-2504
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• 2014

Background: Capecitabine is an oral fluoropyrimidine derivative which is frequently used alone or in combination regimens for the treatment of metastatic breast cancer. Although overall and progression free survivals have increased in recent years with the use of new generation drugs, predictive factors that would further improve the outcomes are needed. Previous studies have demonstrated the relation between post-treatment increase in mean corpuscular volume (MCV) and predicting therapy response as well as survival. The present study investigated the clinical impact of MCV elevation in metastatic breast cancer patients treated with capecitabine. Materials and Methods: The data of a total of 82 patients from three centers followed between June 2005 and June 2013 were retrospectively analyzed. The demographic data and hormone receptor status of the patients, as well as initial examination before and after treatment and data concerning progression were recorded. MCV ${\geq}100$ fl was considered as macrocytosis. Capecitabine was given at a dose of $2500mg/m^2$ daily for 14 days every three weeks. Pre-treatment and post-treatment MCV and other parameters of complete blood count were recorded. Post-treatment initial evaluation was performed after 2 cycles of therapy. Results: The median age of the patients was 46.5 years (range 26-72 years) and 54% were premenopausal. Performance status was ECOG 0 and 1 in 81 (99%) patients. The median number of cycles for capecitabine therapy was 5 (min-max: 2-18). The median ${\Delta}MCV$ level (post-treatment values at sixth week - baseline) was 6.4. Whilst ${\Delta}MCV$ was ${\geq}6.4$ in 42 patients, it was <6.4 in 40 patients. Clinical benefit (complete response+partial response+stable disease) was observed in 37 (88%) of 42 patients with a median ${\Delta}MCV$ ${\geq}6.4$ and in 30 (75%) of 40 patients with ${\Delta}MCV$ <6.4 with no statistically significant difference (p=0.158). No significant difference was determined between the group with ${\Delta}MCV$ ${\geq}6.4$ and the group with ${\Delta}MCV$ <6.4 in terms of progression-free survival (11 vs 12 months) (p=0.55) and overall survival (20 months vs. 24 months) (p=0.11). Conclusions: The identification of new predictive markers in metastatic breast cancer is very important. In some recent studies, increase in MCV has been suggested as a marker in tumor response. In the present study, however, no significant difference was determined between tumor response and increase in MCV. Further studies including higher numbers of patients are needed to determine whether increase in MCV is a predictive marker or not.

• 정신신체의학
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• 제25권2호
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• pp.193-199
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• 2017

연구목적 불면은 자살사고의 위험요인으로 알려져 있으나 아직 어떻게 자살의 위험에 영향을 미치는지 그 기전은 명확하지 않다. 이에 불면 증상이 회복탄력성과 자살사고와 상관이 있는 지를 살펴보고, 회복탄력성이 불면증상과 자살사고의 매개요소가 될 수 있을지 알아보고자 한다. 방 법 432명의 대학생을 대상으로 자기보고식 설문지를 통하여 일반적 특성 및 관련 검사를 수행하였다. 불면증 심각성 척도, 한국판 코너-데이비드슨 회복탄력성척도, 벡 자살사고 척도 및 벡 무망감 척도를 활용하여 불면증상, 자살사고, 회복탄력성, 무망감에 대해 조사하였으며, 각 요소간의 상관분석 및 경로분석을 수행하였다. 결 과 불면증상이 심할수록 회복탄력성이 낮았고, 자살사고가 증가되는 것을 알 수 있었다. 이는 무망감, 연령, 성별, 동거가족, 가정 내 월수입을 통제하여도 유의하였다. 더불어 입면의 어려움과 유지의 어려움을 겪는 불면증상이 자살사고와 연관됨을 확인하였다. 경로분석을 통하여 불면증상이 자살사고에 직접적, 간접적으로 영향을 미침을 확인할 수 있었으며, 회복탄력성도 유의하게 자살사고에 영향을 주는 것으로 평가되었다. 이에 회복탄력성이 불면과 자살사고와의 관계에 유의미한 중재자가 됨을 확인하였다. 결 론 수면상태와 회복탄력성에 대한 평가 및 개입이 자살사고를 낮추어 자살을 예방하는데 기여할 수 있을 것으로 기대한다.