• 지역사회간호학회지
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• 제21권1호
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• pp.82-91
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• 2010

Purpose: The purpose of this study was to identify factors that influence medication adherence in patients with hypertension. Methods: One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0. Results: Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001). Conclusion: The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.

• 한국보건간호학회지
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• 제9권2호
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• pp.52-68
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• 1995

This is the quasi experimental study to evaluate the effect of individual health education for hypertensive patients at home on knowledge of hypertesnion, attitude about chronic disease, self-care management. The individual health education program was performed at each patient's home every one month through, 1 years. The first data collection was carried out in May 1991. and the last was done in July 1992 through questionaires. The study results were as follows; 1) The subjects were 22 hypertensive patients who agreed the participation of study among registered patients at a public health center in Incheon. They were consisted of thirteen males and nine females. And their duration of illness were average 5 years, their mean age were 65 years. The over all living conditions were poor and the average monthly income was 50 thousdand won. 2) The effect of individual health education through home visit was statistically significant. The Knowledge of hypertension (t= -4.40, p<.001), attitude about chronic disease (t=­2.65, p<.05), self-care management of the subjects were significantly improved. (t=-3.76, p<.001), and their blood pressure were decreased. 3) Between the knowledge of hypertesnion and the attitude about chronic disease showed significant positive relationship. But the self-care management had not relationship with these two factors. unexpectedly. 4) The knowledge of hypertension, attitude about chronic disease, and self-care management had not evenly influenced the control of hypertension. These results suggested that the effort needed to find out the other factors influencing self-care management and develop the self-care management measuring tool. And the health education programs for chronic patients were developed, systematically. And the standardized health education model was developed for home health care nursing intervention in community based.

• 한국융합학회논문지
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• 제9권9호
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• pp.363-369
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• 2018

본 연구는 경계성 고혈압 및 고혈압 환자를 대상으로 근육신전운동프로그램을 통해 측정변인의 상관관계 및 대사증후군 지표의 변화를 살펴보고자 하였다. 이를 위해 경계성 고혈압 및 고혈압 환자를 대상으로 15주간 근육 신전운동프로그램을 실시하였다. 연구대상은 28명으로 15주간 주 3회, 40분간의 근육 신전운동프로그램에 참여하였다. 이와 같은 과정을 통해 다음과 같은 결론을 얻었다. 첫째, 근육 신전운동프로그램에 참여 전 대사증후군 지표의 상관관계에서 지표 간 유의한 상관관계를 나타냈으며, 참여 후 대사증후군 지표 간에 참여 전과 차이는 있었지만 전반적으로 유의한 상관관계를 나타냈다. 둘째, 15주간의 근육 신전운동프로그램 전과 후의 비교에서 체중, 근육량, 체지방량, BMI, 허리둘레, 이완기 혈압, 혈당 등에서 유의한 차이를 나타냈다. 이는 근육의 신전운동만으로도 고혈압 환자의 대사증후군 지표의 개선을 가져올 수 있다고 판단되며, 이에 관련된 연구가 필요하다고 사료된다.

• Journal of Periodontal and Implant Science
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• 제39권4호
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• pp.391-398
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• 2009

Purpose: The purpose of this study was to quantify and compare the expressions of CRP and M-CSF in the gingival tissues of the patients with chronic periodontitis associated to hypertension. Methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. Clinically healthy gingival tissue samples from systemically healthy 12 patients were categorized as group 1 (n=12). Inflammatory gingival tissue samples from patients with chronic periodontitis were categorized as group 2 (n=12). Inflammatory gingival tissue samples from patients with chronic periodontitis associated with hypertension were categorized as group 3 (n=12). Tissue samples were prepared and analyzed by Western blotting. The quantification of CRP and M-CSF were performed using a densitometer and statistically analyzed by one-way ANOVA followed by Tukey test. Results: There were significant differences between group 1 and group 2 and between group 1 and group 3 in both CRP and M-CSF. The differences between group 2 and group 3 were not statistically significant in both proteins. However, the expression levels of CRP and M-CSF in hypertensive inflammatory gingiva showed increased tendency compared to non-hypertensive inflammatory gingiva. Conclusions: It is suggested that CRP and M-CSF might be used as inflammatory and bone resorption markers in periodontal diseased tissue. It is assumed that hypertension may be associated with the progression of periodontal inflammation and alveolar bone resorption.

• 농촌의학ㆍ지역보건
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• 제33권3호
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• pp.316-323
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• 2008

= ABSTRACT = Objectives : Incheon metropolitan city has set a model program of community partnership for hypertensive or diabetic patients detection and follow-up since 2005. This study examines the effects of the model on the compliance and the control of blood pressure or blood sugar level Methods : Telephone-surveys were done for 140 persons selected from 408 patients who were detected newly as hypertensive or diabetic patients at Gangwha-Gun and Seo-Gu in Incheon between January 1st and August 31th in 2006, and finally completed in 110 patients(78.6%). Survey questionnaires included socio-demographic(age, gender, and educational level), health behavioral (smoking, drinking, physical activity, and diet), and therapy-related (registration state, compliance, blood pressure or blood sugar control) variables. Odds ratio and 95% CI were derived from logistic regression model. Results : Registered group exhibited high compliance and well managed blood pressure or blood sugar level. The odds ratio of registration were 5.55(95% CI:1.83~16.89) for compliance and 3.78(95% CI:1.43~9.99) for blood pressure or blood sugar control after adjusting for age, gender, disease, and area Conclusions : It is independently related to compliance and blood pressure or blood sugar control whether the patient is registered or not. To control hypertension or diabetes mellitus in terms of compliance and control state, a community-based registration program through community partnership could be a powerful tool.

• 한국산학기술학회논문지
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• 제13권9호
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• pp.4053-4064
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• 2012

본 연구의 목적은 아로마발반사요법과 발반사요법이 농촌의 본태성고혈압 노인 환자의 혈압, 맥박, 그리고 혈중지질농도에 미치는 효과를 확인하기 위함이다. 연구방법은 비동등성 대조군 전 후 유사 실험연구로, 2008년 6월 30일부터 8월 9일까지 6주간 충청남도 G군 소재 C보건진료소에 등록된 본태성고혈압 환자로 실험군 I(아로마 발반사요법) 24명, 실험군 II(발반사요법) 27명, 대조군(기존의 처치) 20명을 대상으로 하였다. 수집된 자료는 SPSS/WIN 12.0 프로그램으로 분석하였다. 연구결과는 6주 간 아로마발반사요법과 발반사요법을 각각 적용한 후 실험군 I과 실험군 II 모두 대조군에 비해 수축기 혈압(p<.05)과 이완기 혈압(p<.05)에서 유의한 차이를 보였고, 맥박수도 유의하게 감소하였으나(p<.05), 혈중지질농도의 변화는 세군 간에 통계적으로 유의한 차이가 없었다(p>.05). 결론적으로 아로마 발반사요법과 발반사요법은 농촌의 본태성고혈압 노인 환자의 혈압 하강과 맥박수 감소에 긍정적인 기여를 하는 것으로 나타났으므로 향후 아로마발반사요법과 발반사요법을 본태성고혈압 환자의 간호중재방법으로 활용 할 수 있을 것이다.

• 한국산학기술학회논문지
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• 제17권11호
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• pp.236-247
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• 2016

본 연구는 Y시 보건소의 고혈압 건강교실 프로그램이 대상자의 고혈압 관련 지식, 자가간호행위, 삶의 질 및 생리적 지수에 미치는 효과를 검증하기 위한 비동등성 대조군 전 후 시차 설계를 이용한 유사실험 연구이다. 프로그램에 참여한 대상자는 고혈압 환자 총 48명으로 이 중 실험군은 23명, 대조군은 25명이었으며, 연구기간은 2015년 8월 31일부터 10월 23일까지 8주간, 주 2회 고혈압 건강교실 프로그램을 운영하였다. 자료 분석은 SPSS/WIN 21.0 프로그램을 이용하여 t-test, ${\chi}^2$-test, Fisher's exact test 그리고 t-test로 분석하였다. 고혈압 건강교실 프로그램 적용 후 고혈압 관련 지식(t=-3.76, p<.001), 자가간호행위(t=-3.33, p<.002), 생리적 지수 중 수축기 혈압(t=6.27, p<.001)과 이완기 혈압(t=4.70, p<.001), 총 콜레스테롤(t=3.08, p=.003) 및 복부둘레(t=2.52, p=.015)는 차이가 있는 것으로 나타났으며, 두 군 간에 통계적으로 유의한 차이가 있었다. 따라서 지역사회 재가 고혈압환자를 위한 건강교실 프로그램이 고혈압환자의 질병관련 지식 및 자가간호행위를 향상시킬 수 있는 유용한 간호중재 프로그램임을 확인 할 수 있었다.

• 대한지역사회영양학회지
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• 제11권5호
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• pp.661-672
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• 2006

This study was performed to determine the dietary risk factors associated with hypertension. The hypertensive group were composed of 112 hypertensive patients (male 53, female 59) who first visited the hypertension clinic and had been diagnosed as having primary hypertension ($SBP{\ge}140mmHg\;or\;DBP{\ge}90mmHg$). The regular visitors or the subjects on special diets or medical therapies were excluded. The normal group consisted of as subjects (male 41, female 54) matched with age and socioeconomic levels. The subjects having higher intakes (above the 75 percentile) in energy, protein, iron, vitamin A or C showed significantly higher hypertension risk estimated with odds ratio after the covariance factors (age, sex and BMI) were adjusted. More than 2400 mg of sodium (6 g of salt) intake was associated with significantly higher risk of hypertension (odds ratio: 1.773, CI: 1.014-3.014 for $SBP{\ge}140mmHg$; odds ratio: 2.373, CI: 1.359-4.215 for $DBP{\ge}90mmHg$). Hypertensive group showed significantly increased intakes of vegetables and fish and shell fish compared to the normal group. When the vegetable intakes were classified into Kimchi, fresh vegetables and cooked vegetables with seasoning, the hypertensive group was observed as having higher intakes of Kimchi and cooked vegetables with seasoning. The intakes of highest quartile for vegetables (${\ge}327g/day$) (odds ratio: 3.164, CI: 1.740-5.752), fish and their products (${\ge}102g/day$) (odds ratio: 2.756, CI: 1.486-5.109), grains(${\ge}311g/day$) (odds ratio 2.393, CI: 1.186-4.832), meats and their product (${\ge}106g$) (odds ratio: 2.210, CI: 1.225 - 3.987) compared to the lower were significantly associated with the higher risk of hypertension estimated with DBP (${\ge}90mmHg$) after covariance factors were adjusted. In conclusion, our findings confirm that higher intake of energy or sodium are associated with the increased risk of hypertension. Because increased intake of vegetable or fish was associated with the higher risk of hypertension, in contrast with the finding of western countries, choosing or preparation of vegetables or fish with reduced salt is recommended.

• Journal of Preventive Medicine and Public Health
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• 제40권6호
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• pp.487-494
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• 2007

Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.

• Journal of Chest Surgery
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• 제24권2호
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• pp.123-134
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• 1991

Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]