• 제목/요약/키워드: Medical Insurance

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우리나라대학의 학교보건관리에 관한 실태조사 (A Study on the School Health Services in the Universities, Colleges and Junior Colleges)

  • 손무인
    • 보건교육건강증진학회지
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    • 제1권1호
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    • pp.83-97
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    • 1983
  • The present study is to provide information for the improvement of school health services through research on the current condition of its organization and practice in universities, colleges and junior colleges. The scope of this study is consisted of four components including health organizations/units, school health services, environmental sanitation and health education for the 30 universities, the 20 colleges and the 32 junior colleges in Korea. The major findings are summarized as follows: (1) Among the sampled schools, around 73% of them have the health service organization/unit. When we break down health service organization/unit into the types by the level of school, around 73% of the universities have formal organization called "health center" and 20.0% of them have an informal organization called "health room". For the colleges level, 30.0% of them have the "health center" and 40.0% of them have the "health room". The figure of junior colleges is a quite different from universities and colleges, 56.3% of junior colleges have the "health room" only but the other have no service organization at all. (2) It was found that only 22.0% of 82 schools have the health committee for the school health services. It might be necessary to have a kind of expert committee to establish an annual health service program, budget and health policy in the school. (3) Approximately 29% of those schools having formal health organizations/units appointed directors as a medical persons. 13.4% of the sampled schools are appointed doctors (including the dentists) at health service organization/unit, 9.8% are appointed pharmacist and 65.9% are appointed nurses. Therefore, the data imply that the school health services are depending mainly on nurses. (4) The major activities of school health services are covering primary medical care (84.1%), health counseling (72.0%), physical examination (68.3%), vaccination (58.5%), tuberculosis control (54.9%), parasite control (29.3%) and dental health case(9.8%). Also 69.5% of the schools have the program on the environmental sanitation and the health education program. (5) In regard to health budget taking account of 34 schools, approximately 92% of them have less than 5,000 won per students and only 8.8% of them have more 10,000 won per students. At the average health budget per students is 4089.8 won in universities, 1617.1 won in colleges and 475.0 won in junior colleges. (6) The students enjoy the benifit of medical insurance at 11.0% of 82 schools surveyed. They are all universities. (7) The study found that 56 universities, colleges and junior colleges provide the annual physical examination. Only 21.4% of them have provided it for all students and school employees. (8) 64.3% of the 56 schools surveyed keep a record of the regular physical examinations. Records must be utilized as the basic data for the evaluation of the student's health condition and so the individual student is encouraged to take care of his own health. (9) At the 59 schools which practice health counseling, the main concerns of the counsellees are venereal disease, tuberculosis and psychoneurosis. This shows the need to practice health education in the area of preventive medicine. (10) 69.5% of the 82 universities, colleges and junior colleges surveyed are concerned with supervision of the environmental sanitation in their school, but non-professionals are in charge at 70.1% of them. This indicates negligence in environmental sanitation. (11) 53.7% of the 82 schools responded that they have no special instructive measure for the students' health and 54.9% are found to be negative in the use of a health education method. This reveals a problem. They are not positive to the recognition of their function as the initiative organization for the students' health. (12) The supplementary education for the faculty of the school health services is executed only at 8.5% of all the schools surveyed.

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경기 북부 지역 초등학교 영양사의 식자재 공급관리에 대한 인식도 및 실천도 (Elementary School Dietitian's Awareness and Performance of Food Supply Management in Gyeonggi North Province)

  • 어금희;박영심
    • 한국식품영양학회지
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    • 제21권4호
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    • pp.562-571
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    • 2008
  • The principal objective of this study was to assess dietitian's awareness and performance with regard to food suppliers' selection guidelines and purchase guidelines for the receipt of safe food materials. A questionnaire was administered to 203 dietitians working at an elementary school in Gyeonggi North province, and 190 responses were ultimately returned. Excluding responses with incomplete answers and significant missing data, 161 responses(79.3%) were ultimately utilized for data analysis. We determined that meat/poulty and seafood were purchased mainly by manufacturer's branch(59.8% and 78.3%), and processed food and kimchi were generally purchased by producer's cooperatives(47.7% and 44.9%). 78.3% of the contracts were made via informal purchasing and the frequency of contracts was less than 3 times per year(53.4%). Market studies were conducted individually(54.7%), and by group(47.2%). Dietitian and parents volunteered(50.3%) or dietitians, and school and foodservice staffs(45.3%) participated - together in receiving and inspection. School contracted with $4{\sim}5$(39.1%) and $6{\sim}8$ food suppliers(29.8%). Dietitians(42.3%) or school councils(40.2%) evaluated food suppliers once per semester(60.2%). The majority of dietitians(96.3%) conducted sanitary education for food suppliers once per semester (68.3%). All 13 guidelines which were usually used to evaluate food suppliers were thought to be important(more than 4) based on a 5 scale(1: never important, 5: very important). Among them, 'sanitary storage status of food products(4.85)', 'have a chill car(4.83)' and 'proper control of refrigerator, freezer and storage room(4.81)' were the most crucial guidelines. As dietitians evaluated food supplier's-observances of 13 guidelines, 'have a chill car(4.89)', 'hold medical examination of employees(4.89)' and 'hold liability insurance for handling product(4.80)' were fulfilled relatively well. The guidelines for conducting education for their employees(4.45) and keeping their establishment and equipment sanitary(4.79) were important, but were not observed well(3.39 and 3.37). Additionally, the difference between the importance and the observance score of the 'HACCP certificate' were fairly significant(4.44 and 3.54). Dietitians tended to report that purchasing management related to the removal of foodborne illness factors(4.71), return confirmation(4.50) and purchase specification(4.32) were important. The difference between importance and performance was highest in the process of changing food suppliers when the contracts were violated more than three times. Dietitian's age, education work experience and employment type had no observable effects on how important they considered purchase management to be, but their work experience significantly affected performance in terms of the removal of foodborne illness factors(p<0.05). As supplier management is the most critical factor, it is clearly desirable to educate suppliers at specialized training centers and to supervise suppliers in accordance with the established sanitary guidelines.

중년여성의 스트레스와 갱년기 증상과의 관계 (The Relationship between the Stress and Climacteric symptoms of Middle-Aged Women)

  • 박복희;이영숙
    • 여성건강간호학회지
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    • 제6권3호
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    • pp.383-397
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    • 2000
  • This study of purpose was to define the relationship between the stress and climacteric symptoms of middle-aged women in order to provide basic data for the development of women's health care program as nursing intervention. The research tools used were a Soon-Young Park's stress questionnaire (4 points scale) and a self diagnostic MENSI scale (3 points scale) developed by a research team of Ill-Yang Pharmacy Co. This research was conducted in Korea in Muan-Gun. Chonnam province, from 22th November to 20th December 1999. The research used a survey design. Seven hundred eleven healthy middle-aged women, aged 40 to 64, and were a convenience sample by stratified ratio using the matching fixed residential and aging blocks. The data were analyzed by GLM. Pearson correlation coefficient and Scheffe test using SAS/ PC+. The results were summarized as follows : 1. The percentage of psychological stress with the following items was: fatigue and enervation, 70.0%; nervous, 61.8%; weakness, 58.5%; The percentage of physical stress with the following items were ; fatigue of eye. 82.3%; backache, 78.0%; headache, 73.8%. 2. The level of psychological stress was 40% of below average level (0-5 points), 31.7 of average level (6-12points), 20.8% of precaution level (13-19 points), and 7.5% of warning level (over 20points). The level of physical stress were 20.1% of below average level (0-5 points), 34.8 of average level (6-12 points), 29.4 of precaution level (13-19 points), and 15.7% of warning level (over 20 points). There were higher physical stress level than psychological stress level of the subjects. 3. The percentage of climacteric symptoms with the following items were : numbness, 75.3%; forgetfulness, 71.0%; pain of joints, 71.0%. The level of climacteric symptoms were 61.8% of mild level 1(10-15 points), 33.0% of moderate level (16-30 points), 5.2% of severe level (over 31 points). 4. There were high positive correlations significantly between the climacteric symptoms and the psychological stress (r=.564. P<0.000), and between the climacteric symptoms and the physical stress of the subjects(r=.678, P<0.000). 5. There were significant differences in the climacteric symptoms of the subjects among below average level, average level, precaution level, and warning level of the psychological stress (F=74.108. P<0.000. Scheffe test). 6. There were significant differences in the climacteric symptoms of the subjects among below average level, average level and precaution level, and warning level of the physical stress ((F=128.181, P<0.000, Scheffe test). In summary, climacteric symptoms complained by middle-aged women are high positive correlated to the level of the stress. Also climacteric symptoms were affected by stress.

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선천성 식도폐쇄 수술 후 열공탈장의 호발과 그 유발인자 (High Incidence of Hiatal Hernia in Esophageal Atresia and Its Etiologic Factors)

  • 손해영;장은영;장혜경;오정탁;한석주
    • Advances in pediatric surgery
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    • 제17권2호
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    • pp.170-178
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    • 2011
  • Hiatal hernia is a very rare disease in the pediatric population. However information from our esophageal atresia postoperative follow-up program has hypotheses; "Hiatal hernia may more frequently occur in postoperative esophageal atresia patients (EA group) than in the general pediatric population (GP group)" and "The tension on the esophagus after esophageal anastomosis may be an important etiologic factor of hiatal hernia in EA group". To prove the first hypotheses, we compared the incidence of hiatal hernia in the GP group with the incidence in the EA group. The Incidence in the GP group was obtained from national statistic data from Statistics Korea and Health Insurance Review and Assessment Service of Korea. The incidence in the EA group was obtained from the medical record and the imaging studies of our esophageal atresia postoperative follow-up program. To prove the second hypothesis, the presumptive risk factors for the development of hiatal hernia in EA group, such as the type of esophageal atresia, degree of esophageal gap, the stage operation and the redo-operation with resection and re-anastomosis of esophagus were analyzed statistically. The total number of patients in the EA group was ninety-nine and there were 5 hiatus hernias. The incidence of EA group (5 %) is significantly higher than incidence of GP group (0.024 %). (p=0.0001) The statistical analysis of the presumptive risk factors for hiatal hernia development in EA group failed to show any evidence of correlation between postoperative esophageal tension and the hiatal hernia. This study shows that the postoperative patients with esophageal atresia have high occurrence of hiatal hernia and should be followed up carefully to detect hiatal hernia.

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정부 및 공공기관의 보건 관련 웹 사이트의 웹 접근성 - 자동 및 전문가 평가 - (Web Accessibility of Healthcare Websites of Korean Government and Public Agencies: Automated and Expert Evaluations)

  • 이용정
    • 한국비블리아학회지
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    • 제26권4호
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    • pp.283-304
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    • 2015
  • 본 연구는 정부 및 공공기관의 보건 관련 웹 사이트들의 웹 접근성을 한국형 지침에 따라 평가하여 장애인이나 노령자들과 같은 정보이용 소외집단들이 겪을 수 있는 문제점들을 파악하고자 하였다. 본 연구에서는 총 27개의 보건 관련 웹 사이트의 접근성을 자동평가 및 전문가 평가를 수행하여 측정하였다. 두 단계의 평가를 실시한 결과를 종합해 볼 때, 국립병원이나 국립재활원 등과 같은 의료기관들은 웹 접근성 오류가 거의 없는 것으로 나타났으며, 그 외에도 건강보험심사평가원, 보건복지부, 보건사업진흥원, 식품의약품안전처, 그리고, 한국의료분쟁 조정중재원 등은 웹 접근성 준수율이 매우 높았다. 그러나 전문가 평가를 실시한 결과, 자동평가에서는 오류가 없는 것으로 나타났던 적절한 대체텍스트의 제공이 매우 미흡한 것으로 나타났으며, 텍스트 콘텐츠의 명도 대비가 표준에 미치지 않아 전맹자나 저시력자들의 웹 접근성을 지원하기 힘든 것으로 평가되었다. 그 외에도 기본언어표시와 마크업 오류 등 정확한 정보의 전달을 어렵게 하는 문제들이 나타났고, 반복영역 건너뛰기, 콘텐츠 선형화, 그리고 키보드 사용보장을 준수하지 않는 문제들이 발견되어 시각장애뿐 아니라 인지장애 내지 운동장애가 있는 이용자에게는 웹 접근성을 심각하게 방해하는 요소가 될 수 있는 것으로 파악되었다. 본 연구는 국내 연구로서는 처음으로 정부 및 공공기관의 보건관련 웹 사이트들의 접근성을 한국형 지침에 따라 평가했다. 또한, 이러한 웹 사이트들을 대상으로 자동 평가로 측정하기 어려운 웹 접근성의 정도와 상세한 내용 분석을 포괄하는 전문가 평가를 수행했다는 점에서 웹 접근성 연구 분야에 기여했다고 볼 수 있다.

요양병원 입원 환자의 욕창 발생 현황과 관련 요인: 2009년 건강보험 환자표본 자료 이용 (The characteristics related to the development of pressure ulcers in long term care facilities : the use of 2009 National Patient Sample)

  • 문미경
    • 한국산학기술학회논문지
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    • 제14권7호
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    • pp.3390-3399
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    • 2013
  • 본 연구는 2009년 한 해 동안 건강보험심사평가원의 요양급여 전체 청구자료를 통계적으로 표본 추출 한 환자표본자료를 이용하여 의료기관 종류 별 욕창 발생현황과 이중 요양병원 환자의 욕창 발생에 영향을 주는 요인을 규명하기 위해 시도되었다. 전체 의료기관 입원환자의 3.2%(n=25,339)에서 욕창이 발생하였다. 의료기관 종별로는 요양병원 입원환자의 8.2%(n=11,895)에서 욕창이 발생하여 종합병원(2.7%, n=8,052), 일반병원(1.7%, n=5,059) 보다 상대적으로 높은 비율을 보였다. 요양병원 입원환자(n=144,523)의 욕창발생에 영향을 주는 요인을 분석한 결과 의학적 진단 중 요실금을 가진 환자 군이 가지지 않은 군에 비해 욕창 발생이 2.46배 유의하게 높게 나타났다(Odds ratio(OR)=2.462, 95% confidence interval(CI)=2.038-2.974). 더하여, 고혈압질환(OR=1.456, CI=1.400-1.515), 말초혈관 질환(OR=1.357, CI=1.200-1.534)군 순으로 욕창 발생에 영향을 미쳤다. 진단 수(OR=1.193, CI=1.187-1.199)와 나이(OR=1.011, CI=1.009-1.012) 및 100침상 당 의사 수(OR=1.063, CI=1.035-1.091)가 증가할수록, 의료기관의 전체 침상수(OR=.889, CI =.869-.909)가 적을수록 욕창발생은 유의하게 높은 것으로 나타났다.

출산장려정책 중 고운맘 카드에 대한 산모들의 인식 조사 (The Survey Research on Pregnant Woman's recognition about GO-UN-MAM CARD of Childbirth Promotion Policy)

  • 김한결;임성원;이루리;박수현;고든솔;나하늘;이경숙;이현실
    • 디지털융복합연구
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    • 제10권3호
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    • pp.241-250
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    • 2012
  • 저출산은 생산인구의 감소와 함께 보험료 부담을 가중시키는 문제 뿐 아니라, 종국에는 국가의 존립을 위협하는 묵과할 수 없는 국가적인 정책과제가 되었다. 이에 본 연구는 현 정부의 출산장려정책 중 경제적 지원인 고운맘 카드의 실효성을 알아보고 산모들의 인식조사를 바탕으로 도출된 문제점에 대한 개선안을 제언하고자 한다. 분석방법은 인식도 조사를 위해서는 빈도분석을 이용했으며, 출산장려정책에 대한 선호도를 파악하기 위해 다중응답분석, 고운맘 카드 사용에 대한 만족도와 재출산 의사정도를 알아보기 위한 카이제곱 테스트를 시행했다. 분석결과, 고운맘 카드 사용으로 인한 산모들의 만족도와 재출산 의사간에는 유의한 관련성을 보였다. 또한, 산모들은 정부기관 및 의료기관과 구전으로 전파된 내용에 의해 해당 정책에 접근하는 것으로 나타났다. 그리고 정부의 지원금액 범위 내에서 병원 청구할인서비스 정도만 활용하는 것으로 나타났다. 그러나 지원금액 및 l일 사용 한도금액과 같은 금전적 요인에서 주로 불만을 표출했다. 그에 따른 상향 조정된 희망 개선안을 요구했다. 위의 결과를 토대로, 정부는 정책시행의 궁극적 목적인 출산률의 상승을 위해 고운맘 카드를 개선 발전시켜나가야 할 것이다.

A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8521-8526
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    • 2014
  • In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

산업재해 직업복귀자의 업무수행능력 융합적 영향 요인 (Convergence Effective Factors for Work Performance among Returning to Workers with Industrial Accident)

  • 김채봉;양정희;최보람;한성민
    • 한국융합학회논문지
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    • 제7권3호
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    • pp.149-157
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    • 2016
  • 산재 발생은 근로자의 노동력 상실과 생산성 그리고 삶의 질에 영향을 준다. 본 논문은 산재 발생 후 직업 복귀자의 업무수행능력에 영향을 미치는 요인을 융합적으로 파악하고자 한다. 본 연구 자료는 2013년과 2014년 산재보험패널 자료를 활용한 단면연구이며, 독립변수인 일반적 특성과 종속변수인 업무수행능력의 관련성을 파악하기 위해 로지스틱 회귀분석을 실시하였다. 연구 결과, 업무수행능력 감소에 큰 영향을 미치는 요인으로 장해등급 1 - 7급과 요양기간이 12개월 이상과 6 - 9개월인 것으로 나타났다. 즉, 직업복귀자의 장애 정도가 중증일수록, 요양기간이 증가할수록 업무수행능력이 큰 폭으로 감소하는 것을 확인할 수 있었다. 업무수행능력은 산재자의 성공적인 직업복귀를 간접적으로 파악할 수 있고 산재 이후 직업복귀자에 대한 사후적 관리가 중요하다는 점에서 의의가 있다. 직업복귀자의 안정된 업무수행은 근로자의 생활 안정과 삶의 질을 유지하고 기업의 생산력을 확보하는데 중요하다.

직장인의 건강관련 행위와 대사증후군 요인별 차이 융합적 연구 (The Convergence correlational Study on Office Workers' Health Related Behaviors and Prevalence Rates of Metabolic Syndrome)

  • 김미진
    • 한국융합학회논문지
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    • 제7권3호
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    • pp.99-109
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    • 2016
  • 본 연구는 대사증후군의 위험요인과의 관계를 분석함을 통해 대사증후군 및 심혈관 질환의 효과적인 예방 관리 체계 수립을 위한 근거자료를 제시하고, 대사증후군 환자 교육과 직장인의 만성질환에 관한 중요한 기초자료를 제공하고자 우리나라 직장인의 건강검진 결과를 통하여 건강관련 행위, 흡연 음주 등과 운동이 대사증후군에 미치는 영향력을 알아보고자 하였다. 연구의 조사대상은 서울에 기반한 전문 건강검진센터에서 직장의료보험으로 검진을 받은 직장인 291명으로 하였다. 본 연구의 자료는 직장인 건강검진 내용을 바탕으로 하였다.연구방법으로는 SPSS/Win Program ver 20.0을 이용하여 분석하였으며, 독립변수와 종속변수와의 관계를 분석하기 위하여 F-test 검증 및 ANOVA test를 실시하였으며, 연관성의 검증을 위해서는 $x^2$(Chi-square) 검증을 실시하였다. 연구결과는 직장인 291명 중 대사증후군 유병률이 19.2%로 나타났고, 흡연행태로 인한 대사증후군 유병률의 비흡연 그룹은 12.7%, 과거 흡연 그룹 중에서 가볍게 흡연했던 그룹은 25.0% 중흡연 그룹은 25.9%, 현재 흡연 그룹 중에서 경흡연 그룹은 29.7% 중흡연 그룹 26.7%로 분석되었다. 결과적으로, 본 연구는 직장인의 흡연과 음주 생활형태가 직장인의 대사증후군 유병률과 밀접한 융합적 관련성이 있음을 시사하고 있다.