• 농촌의학ㆍ지역보건
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• 제36권2호
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• pp.120-129
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• 2011

목적: 뇌졸중으로 인한 장애인이 증가하고 있으나 이들을 대상으로 질보정수명을 구한 연구가 없었다. 이 연구의 목적은 일개 시에서 뇌졸중 장애인을 대상으로 EQ-5D로 그들의 건강 관련 삶의 질 수준을 평가하고, 우리나라 전체 뇌졸중 장애인의 QALYs 감소분을 추정하기 위하여 수행 하였다. 방법: 2008년 3월을 기준으로 경주시 장애인 등록현황에서 50세 이상인 장애인 중 뇌졸중이 원인으로 파악된 982명을 대상으로 설문조사자들이 방문하여 대면면접조사를 통해 일반적 특성, 임상적 특성, EQ-5D 등의 자료를 수집하였다. 제4기 국민건강영양조사 에서 일반인구집단과 동반질환이 없는 군을 건강비교군으로 선정하여 성별, 연령별 표준화를 통해 비교함으로써 효용 가중치 차이를 구하였다. 이 효용 가중치 차이를 우리나라 전체 뇌졸중 장애인에 적용하여 전체 QALYs 감소분을 추정하였다. 결과: 대상자 982명 중 조사응답자는 566명으로 응답률은 57.6%였다. 여성, 70대 이상군에서 EQ-5D 지표값이 남성이나 60대 이하군에 비해 더 낮았고, 상대 비교군과의 차이도 크게 나타났다. 건강비교군과 일반인구집단 비교군과의 비교에 따른 전체 QALYs 감소분은 각각 연간 67,011.6 QALYs와 54,167.1 QALYs로 추정되었다. 결론: EQ-5D로 우리나라 전체 뇌졸중장애인의 QALYs 감소분을 추정하였고, 이 연구를 바탕으로 뇌졸중 장애인을 대상으로 한 공중보건정책의 집행이나 평가를 수행하여 보다 근거에 기반한 장애인 정책을 수행할 수 있을 것으로 생각한다.

• 대한예방한의학회지
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• 제16권3호
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• pp.15-26
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• 2012

Objective : Only a few studies have investigated the life expectance and health related quality of life (HRQOL) about stroke patients. The purpose of this study is to analyze the life expectancy, preference based quality of life(QOL) and quality adjusted life years(QALYs) of stroke patients. Methods : We used data of 10,533 adults from 4th Korean national health and nutritional examination survey 2009 for evaluating HRQOL of stroke patients. We also analyzed the life expectancy for stroke patients using life table from national public health data. Finally we calculated the QALYs with and without stroke conditions and assumed the difference of QALYs. Results : The mean age of stroke patients was assumed to be 65. Lower income and less educated groups were prone to be exposed to the stroke conditions. Common comorbidities of stroke patients were ischemic heart attack, hypertension, diabetes and hyperlipidemia. The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly at chronic stroke group. Participants with chronic stroke conditions had an almost 6-fold higher risk of impaired health utility(the lowest quartile of EQ-5D utility score) compared with non stroke participants, after adjustment of age, gender, income, education, comorbidity variables. The differences of life expectancy and QALYs between non-stroke and stroke group from the age of 65 till death were assumed to be 0.767 year and 3.103 QALYs. Conclusions : Although the authors analyzed the affecting factors of QOL and assumed the differences of life expectance and QALYs about stroke patients using domestic national data and statistic references, well designed cohort studies should be needed to prove the causal effects of affecting factors and to assume more correct QALY differences.

• 여성건강간호학회지
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• 제25권1호
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• pp.73-85
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• 2019

Purpose: To determine whether maternal attitude toward sex during pregnancy and health-related quality of life could influence sexual function of pregnant women. Methods: In this study, 138 second and third trimester pregnant women completed self-report questionnaires during their visits to women's hospitals or community health centers to assess their general characteristics, attitude toward sex during pregnancy (PIES-M), health-related quality of life (EQ-5D), and sexual function (FSFI-6K). Multiple regression analysis was performed to test the research model with SPSS version 23. Results: Pregnant women who had discontinued their sexual life after recognizing their pregnancy accounted for 27.5% of women questioned. The average sexual function score of pregnant women was higher in the second trimester than the third trimester. Attitude toward sex during pregnancy (${\beta}=-.38$, p<.001), maintaining sexual life (${\beta}=.20$, p=.028), health-related quality of life (${\beta}=.18$, p=.030), and adverse symptoms during sex (${\beta}=.18$, p=.042) were determinants of sexual function during pregnancy. Conclusion: Nurses in antenatal care units need to help pregnant women maintain a positive attitude toward sexual activity during pregnancy and manage their health-related quality of life to maintain their sexual life during pregnancy.

• 보건교육건강증진학회지
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• 제29권2호
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• pp.23-32
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• 2012

Objectives: This study evaluated the association between osteoarthritis (OA) and health-related quality of life (HRQoL) in elderly Korean women. Methods: We selected participants (n=2,597) aged 50 years or older from Korea National Health and Nutrition Examination Survey [KNHANES] 2005-2008. Demographic and personal characteristics, medical history of OA, and EQ-5D were extracted from the KNHANES data. Results: We found that demographic variables, including age, education level, income, and personal characteristics, were important covariates associated with the prevalence of OA and with HRQoL. In this study, OA was an important factor affecting HRQoL in women. The adjusted odds ratio for HRQoL in participants with OA was 2.92 [(95% confidence interval (CI)=2.43-3.51, p<.001)] in mobility, 2.60 (95% CI=2.17-3.10, p<.001) in pain/discomfort, 2.17 (95% CI=1.78-2.65, p<.001) in usual activities, 1.65 (95% CI=1.22-2.24, p=.001) in self care, and 1.47 (95% CI=1.22-1.77, p<.001) in anxiety/depression. After adjustment of covariates, HRQoL was significantly decreased in participants with OA. Conclusions: Our findings reveal that there is a strong association between OA and HRQoL. Preventing and controlling OA may significantly improve the quality of life for elderly Korean women.

• 한국엔터테인먼트산업학회논문지
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• 제14권5호
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• pp.267-276
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• 2020

본 연구는 제7기 국민건강영양조사의 원시자료를 이용하여, 65세 이상의 골관절염 노인 104명을 대상으로 3가지 신체활동 즉 걷기, 근력운동, 유산소 활동에 대한 각각의 실천율과, 일반적 특성에 따른 신체활동 실천율의 차이와 신체활동이 스트레스 및 삶의 질에 미치는 영향을 알아보고자 하였다. 연구 결과 여성이 남성에 비해 근력운동 실천율 낮았으며, 주관적 건강상태가 좋을수록 걷기와 유산소 활동 실천율이 높게 나타났다. 스트레스에서는 스트레스를 느끼는 군이 스트레스가 전혀 없다는 군에 비해 걷기와 유산소 활동 실천율이 높은 것으로 나타났으며, 스트레스를 조금 느낀다고 한 군이 3일 이상 걷기를 가장 많이 실천하였다. 건강관련 삶의 질(EQ-5D)에서 운동능력은 신체활동을 실천하지 않는 군에 비해 걷기, 근력운동, 유산소 활동을 실천하는 군이 운동능력이 좋았으며, 자기 관리에서는 걷기, 유산소 활동을 실천하는 군이 자기 관리에 문제가 없었고, 일상활동은 걷기, 근력운동을 실천하는 군이 일상활동 수준도 높게 나타났다. 통증/불편 영역에서는 걷기를 실천하는 군이 통증/불편감이 적게 나타났으며, 불안/우울 영역에서는 걷기 실천하는 군이 불안/우울이 적게 나타났다. 결론적으로 골관절염 노인의 삶의 질을 높이고, 스트레스를 관리하기 위해서는 신체활동 수준을 높이려는 적극적인 노력이 필요하며, 특히 여성 골관절염 노인의 신체활동의 중요성에 대한 인식개선이 우선적으로 강조되어야 한다고 본다.

• 근관절건강학회지
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• 제19권2호
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• pp.152-160
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• 2012

Purpose: The purpose of this study was to test the effects of the Tai Chi exercise on metabolic syndrome and health-related quality of life in middle-aged women. Methods: A quasi-experimental design was used. Subjects were sixty middle-aged women with metabolic syndrome. All of the subjects were met the criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III). The subjects were divided into the experiment group (n=33) trained the Tai Chi for 12 weeks and the control group (n=27). Metabolic syndrome risk factors including blood pressure, waist circumference, glucose, triglyceride (TG), and high density lipoprotein cholesterol (HDL-C) were measured before and after the 12-week period. Euro Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D) was used to evaluate the health-related quality of life. Results: The experiment group showed significant decreases in diastolic blood pressure, waist circumference, glucose, and TG; and increase in HDL-C compared to the control group. For the health-related quality of life evaluation, the experiment group showed significant improvement more than the control group. Conclusion: The Tai Chi exercise may be effective intervention in preventing cardiovascular disease caused by metabolic syndrome in middle-aged women.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9679-9685
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• 2014

Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.

• 한국체육학회지인문사회과학편
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• 제57권5호
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• pp.269-279
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• 2018

본 연구의 목적은 한국 암환자들의 근력운동 빈도, 근력, 그리고 건강관련 삶의 질과의 관계를 조사하는 것이다. 이를 위해 2014~2016년 국민건강영양조사 자료를 통합하여, 총 647명의 암환자들의 주당 근력운동 빈도, 악력, 건강관련 삶의 질의 관계를 복합표본 일반선형모형과 로지스틱 회귀분석 방법을 이용하여 분석하였다. 분석결과, 근력운동빈도가 주당 0~1일인 암환자들은 5일 이상인 암환자들에 비해(0.852±0.016 vs. 0.890±0.020 ; p=0.006), 상대 악력이 낮은 암환자들은 높은 그룹에 비해 (0.850±0.018 vs. 0.911±0.016; p<0.001) 건강관련 삶의 질 지수 (EQ-5D index) 가 유의하게 낮게 나타났다. 또한, 주당 근력운동 빈도가 0~1일인 암환자들은 5일 이상인 암환자들에 비해 운동능력에 문제가 생길 확률이 4.07배 (95% CI=1.31-12.63), 상대 악력이 낮은 그룹은 높은 그룹에 비해 운동능력에 문제가 생길 확률이 4.94배 (95% CI=2.14-11.41), 일상생활에서는 5.18배 (95% CI=1.56-17.14), 통증/불편에서는 2.46배 (95% CI=1.33-4.55) 증가했다. 본 연구결과를 통해 암환자들의 근력운동 빈도와 근력이 건강관련 삶의 질과 유의한 관계에 있는 것으로 나타났으며, 꾸준한 근력운동으로 인한 근력향상은 암환자들의 삶의 질 관리에 큰 도움이 될 것으로 사료된다.

• 한국융합학회논문지
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• 제11권4호
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• pp.295-301
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• 2020

본 연구는 국민건강영양조사 제7기 1차(2016년)년도 자료를 이용하여 성인 남성의 구강건강행위와 삶의 질 및 우울증상과의 관련성을 확인하기 위한 이차자료 분석연구이다. 만 19세 이상의 남성 2,647명을 대상으로 하였으며 PASW Statistics 18.0을 이용하여 자료를 분석하였다. 그 결과, 구강건강행위는 삶의 질(EQ-5D) 사이에서 양의 상관관계(0.142, p<0.01)가 있었으며, 우울증상(PHQ-9)은 음의 상관관계가 있었다(-0.347, p<0.01). 즉, 구강건강행위 실천률이 높은 사람일수록 삶의 질이 높고, 우울증상이 낮은 것으로 나타났다. 이러한 결과는 구강건강행위의 실천 수준이 성인 남성의 삶의 질 및 우울증상과의 관련성 있으며, 향후 성인 남성 대상의 구강건강 및 일반적인 건강향상을 위한 보건정책 개발에 필요한 기초자료로 활용할 수 있으리라 생각된다.

• 대한물리의학회지
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• 제15권3호
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• pp.109-116
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• 2020

PURPOSE: The objective of this study was to provide a basis for the need to apply psychological factors-based rehabilitation programs to osteoarthritis patients by understanding how the limitations on the activities of osteoarthritis patients relate to the health-related quality of life and depression. METHODS: This study assessed 1,994 osteoarthritis patients from the 7th Korea National Health and Nutrition Examination Survey (KNHANES, 2016-2018). The subjects were divided into two categories: with activity limitation and without activity limitation. A Chi-square test and logistic regression analysis were conducted. RESULTS: The EQ-5D index of subjects with activity limitation was .84 ± .16, it was .94 ± .12 in those with no activity limitation (p < .05). The diagnosis of depression was 16.8% and; 8.3% in those with and without activity limitation, respectively (p < .05). There was a significant difference in the odds ratio for each item in the EQ-5D. Moreover, the odds ratio for depression with an activity limitation was 2.171 (1.512 - 3.118) compared with no activity limitation. CONCLUSION: The activity limitation of osteoarthritis patients reduces the health-related quality of life significantly and increases the probability of depression. Therefore, the treatment of osteoarthritis patients should be approached considering the psychological conditions. Moreover, early diagnosis of depressive symptoms is needed to prevent symptom deterioration and increase the compliance with rehabilitation therapy.