• 제목/요약/키워드: Physical illness

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우울 경험이 의료서비스 이용에 미치는 영향: 중·노년기 여성 만성신체질환자를 대상으로 (The Effect of Depression on the Use of Medical Service: Focusing on Patients with Chronic Physical Illness among Middle-Aged and Elderly Women)

  • 조효은;정현우;이준협
    • 보건행정학회지
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    • 제31권1호
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    • pp.46-55
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    • 2021
  • Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion: For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

학령전기 입원 아동의 건강 및 질병 개념에 관한 연구 (A study on Health/Illness concepts in Hospitalized Preschoolers)

  • 성미혜
    • Child Health Nursing Research
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    • 제6권3호
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    • pp.291-304
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    • 2000
  • The purpose of this study was to explore the health and illness concepts of hospitalized preschoolers. The subjects were 52 hospitalized preschoolers from 3 to 6 grade in one general hospital. Data were collected through semistructured interviews by author. this study was conducted from Mar 2, 2000 to Jun. 30, 2000. Data were coded and categorized by content analysis. The results were as follows : 1. Hospitalized preschoolers's answers about health concepts were coded and then classificated to 7 categories(physical well-being, food, powerfulness, exercise, obedience to authority, cleanliness, sleep.) 2. Hospitalized preschoolers's answers about health behavior to maintenance health were coded and then classificated to 8 categories (food, obedience to authority, treatment, exercise, cleanliness, powerfulness, sleep, psychological stability). 3. Hospitalized preschoolers's answers about prevention of illness were coded and then classificated to 9 categories(food, treatment, obedience to authority, powerfulness, emotional stability, psychological stability, exercise, physical well-being, ability of social adaption). 4. Hospitalized preschoolers's answers about cause of illness were coded and then classificated to 3 categories(illness, trauma, food). 5. Hospitalized preschoolers's answers about treatments of illness were coded and then classificated to 9 categories(treatment, rest, emotional stability, sleep, psychological stability, food, obedience, exercise, powerfulness). 6. The levels of health and illness concepts in this sample were higher than those of the physical causality.

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일부 외국인 근로자의 건강상태 및 의료이용에 관한 연구 (The Evaluation of the Health Status of Migrant Workers)

  • 김상순;김애련;김미한
    • 지역사회간호학회지
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    • 제8권1호
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    • pp.3-20
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    • 1997
  • The purpose of this study was to evaluate the physical and mental health status of foreign migrant workers in Korea, and to provide basic data for assessment of industrial Nurses, and to contribute to the improvement of their health status. There were 108 workers who participated in this study. They lived in Seoul and the capital region and the data were collected from 11th August to 23th, 1996. The C.M.I. was utilized for the study. The results obtained by this study were as follows: Digestive system and Inadequacy have the largest portion of the physical and mental illness respectively. With regard to physical and mental illness ac cording to the gender, the frequency of illness experienced by women was higher than men in Genitourinary system and Sensitivity. By ages, there were significant differences between those in their 20's and 30's and in their 40's, particularly Ears and Eyes system. There were significant differences in mental health illness according to educational levels. The middle school graduate group had more health ill ness than the group with higher than high school education in Anxiety. There were significant differences in the rate of job satisfaction. The dissatisfied group had more health illness in Eyes and Ears, Miscellaneous diseases, and Inadequacy. The lower the rate of working condition satisfaction, the higher the frequency rate of physical and mental health illness (Eyes and Ears, Musculoskeletal system, Nervous system, Frequency of illness, Habits, Total physical section, Inadequacy, Depression, Anxiety, Anger, Tension, Total mental section) By the accessibility of health services, the group who has respond to difficult had more health illness in Frequency of illness, Anxiety, Anger, Tension and Total mental section. There were significant differences in the reason of difficulty of health services use concerning Eyes and Ears and Miscellaneous diseases. The most important factor to explain the satisfaction of job and working condition was the satisfaction for supervisor.

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입원아동이 지각한 건강과 질병개념에 관한 연구 (A Study on Health/Illness Concepts in Hospitalized Children)

  • 성미혜
    • Child Health Nursing Research
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    • 제7권2호
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    • pp.149-160
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    • 2001
  • The purpose of this study was to explore the health and illness concepts of hospitalized children. The subjects were 129 hospitalized children from 3 to 12 years old in one general hospital. Data were collected through semistructured interviews by authors. This study was conducted from Jun. 1, 2000 to Dec. 31, 2000. Data were coded and categorized by content analysis. The results were as follows : 1. Perceived health concept were physical well-being, food, exercise, powerfulness, emotional stability, obeidence, cleanliness, sleep and ability of social adaptation. 2. Perceived health behavior to maintain health were food, treatment, exercise, cleanliness, obeidence, sleep, emotional stability, power-fulness and psychological stability, physical well-being. 3. Perceived prevention of illness were food, cleanliness, treatment, exercise, obedience, sleep, powerfulness, psychological stability, emotional stability, recreation and ability of social adaptation. 4. Perceived causes of illness were illness, trauma and food. 5. Perceived treatment of illness were treatment, sleep, rest, food, obedience, emotional stability, psychological stability, cleanliness, exercise and powerfulness.

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류마티스 관절염 여성환자의 성생활에 관한 지각된 질병의거변화와 영향요인 (Illness Intrusiveness on Sexuality and Its Influencing Factors in Rheumatoid Arthritis Women)

  • 이은남;정원태
    • 근관절건강학회지
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    • 제7권2호
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    • pp.269-280
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    • 2000
  • This study was conducted to clarify the effect of physical ability, pain, fatigue, depression, sexual satisfaction, and spouse criticism on the sexual intrusiveness of rheumatoid arthritis(RA)women. The subjects of the study were 89 RA outpatients who visited the department of rheumatology of Dong-A University Hospital in Pusan from March 2000 to April, 2000. Pain & Fatigue via graphic rating scale, depression via CES-D(Center for Epidemiologic Studies -Depression) scale and physical ability via the Health Assessment questionnaire(HAQ) were assessed. Also we used both Sexual satisfaction scale(Kim, et al, 1997) to measure sexual satisfaction and Spouse criticism scale(Kraaimaat et al. 1996) to measure spouse criticism. The Intrusiveness rating scale which was derived from Arthritis Impact Measurement Scale(AIMS) was used to measure illness intrusiveness in sexuality. The relationships between the variables such as pain, depression, fatigue, physical ability, spouse criticism, sexual satisfaction and illness intrusiveness on sexuality were analyzed by Pearson correlation. As a result, pain & depression were significantly positively related to illness intrusiveness and physical ability & sexual satisfaction was significantly negatively related to illness intrusiveness. But these variables were interrelated. So hierarchical regression was performed to examine the relative contribution of pain, depression, physical ability, and sexual satisfaction with regard to intrusiveness of RA on sexuality. It revealed that pain, depression & sexual satisfaction predicted significantly illness intrusiveness on sexuality. Therefore it is very important to reduce pain and depression and to increase sexual satisfaction for reducing illness intrusiveness.

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학령전기 아동의 건강/질병 개념에 관한 연구 (A Study on Health / Illness Concepts of Preschoolers)

  • 이은주
    • 대한간호학회지
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    • 제22권2호
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    • pp.143-156
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    • 1992
  • This descriptive study explored the health and illness concepts of preschoolers to provide understanding on which to build research. The subjects were convenience sample three to six year of age attending one art institute in Cheju city. Data were collected through semistructured interviews by author, Children were asked to draw two figures, one healthy and one ill persons. The drawings were not analysed to grasp the meaning as in a projective technique, but only to relate to their response. Data were coded and categorized by content analysis. The results of this study are summarized as follows : 1) Three year olds responded with some unrelated answers but well to questions related to their experiences of illness ; older participants answered questions related health and illness concepts more easily. Generally the levels of subjects' responses did not differ according to age and sex. 2) Preschoolers' answers about the cause, treatment and prevention of illness, and the meaning and promotion of health were coded and then classificated to 9 categories, (food, obedience to authoritys physical function, presence or absence of illness or symptoms, hygiene. treatment, traumatic injury, rest and germs). Food and obeidence to authority categories were most frequent responses the food category was associated with obeidence to authority because it seemed that the children follow the orders of their parents or other authority figures to eat or not to eat something This result was compatible with that of previous studies that preschoolers perceived illness as possible punishment for misbehavior. Participants except for one four year old boy did not suggest that germs cause illness. The children perceived themselves and their families as healthy even though they had symptoms of illness. 3) Preschoolers' health and illness concepts were. influenced by their experiences and related to their development that rules derived from authority and if not complied with, will bring punishment. These oonceptualizations may be the disparity that they perceived themselves and their families as healthy even though they were ill. A previous study by Perrin and Gerrity suggested that the level of children's illness concepts correlated with that of their physical causality and was lower than it. But the levels of health and illness concepts in this sample higher than those of the physical causality.

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정신신체 질환에서 항우울제 (Antidepressants in the Psychosomatic Disorders)

  • 서정석;문석우
    • 정신신체의학
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    • 제15권1호
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    • pp.7-13
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    • 2007
  • 항우울제는 정신과 의사뿐만 아니라 많은 비정신과 의사들에 의해 사용되어지는 정신과 약물이다. 특히 기질적 원인이 뚜렷한 신체질환과 관련된 우울증과 통증에 대하여 오래전부터 삼환계 항우울제가 사용되어 그 효과가 입증되어 왔으며 최근 새롭게 사용되는 세로토닌 관련 항우울제의 효과가 보고되면서 사용의 폭이 더욱 넓어지고 있다. 여기에서는 신체질환에 대한 우울증의 영향과 항우울제 치료, 통증에 대한 항우울제의 진통 효과와 몇 가지 정신신체질환에 대한 항우울제 사용에 대하여 지금까지의 연구 문헌을 검토 및 정리하였다. 우울증이 정신신체질환의 치료 결과에 미치는 영향에 대해서는 아직도 논란중이지만 기존의 신체질환 치료와 함께 적절한 항우울제의 병합 또는 보조적 사용으로 긍정적인 치료 결과와 환자의 삶의 질을 향상시키는 것으로 생각된다.

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만성질환자의 간호요구 사정 : 만성질환자 간호 센터 모형 개발을 위한 1차 연구 (Nursing Need of Patients with Chronic Illness - A Primary Study for Development for the Nursing Center of Chronic Illness -)

  • 이평숙;김소인;김순용;이숙자;박은숙;박영주;유호신;장성옥;한금선
    • 대한간호학회지
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    • 제32권2호
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    • pp.165-175
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    • 2002
  • The purpose of this descriptive study was to identify the nursing needs of patients with chronic illness. Method: The subjects of this study were 636 patients with chronic illness, 323 general nurses, and 106 public health nurses. The instruments used for this study were questionnaires including perceived functions of nursing from the center for chronic illness, preference to placement, intention to use, needs to receive services from the center for chronic illness, strategies management for nursing, and nursing needs of chronically ill patients. Results: The mean of perceived functions for nursing from the center were 3.1(0.5) in public health nurses, 2.9 (0.59) in general nurses, and 2.4(1.33) in chronically ill patients. Regards of needs to receive on services of the nursing centers were, the regularly physical examination, for health educational services which was perceived highest request amongst chronically ill patients. We found the means of each specific need as 2.2(0.6), for physical health, 2.1(0.7), for psychosocial health, and 1.8(0.6) for spiritual health. Conclusion: From the results of this study, it is suggested that establishing a nursing center for chronically ill patients consider physical, psychosocial, for spiritual health needs of chronically ill patients. It is also a consideration that direct care for symptom management and health education in the nursing center be implemented.

만성질환 노인에서 임파워먼트 이론에 근거한 다학제적 자기관리 프로그램의 효과 (Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness)

  • 박초롱;송미순;조비룡;임재영;송욱;장희경;박연환
    • 대한간호학회지
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    • 제45권2호
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    • pp.192-201
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    • 2015
  • Purpose: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. Methods: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Results: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. Conclusion: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

북한이탈주민의 신체질환과 우울증상의 연관성에 관한 연구 (Relationship between Physical Illness and Depression in North Korean Defectors)

  • 김석주;김효현;김정은;조성진;이유진
    • 정신신체의학
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    • 제19권1호
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    • pp.20-27
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    • 2011
  • 연구목적: 본 연구는 북한이탈주민의 신체질환이 우울증상에 미치는 영향을 조사하기 위해 시행되었다. 방 법: 인천 지역에 거주하는 북한이탈주민 144명(남/여=20/124)과 남한 출생 주민 376명(남/여=133/243)이 연구에 참여했다. 모든 연구 참여자에게 일대일 면담을 시행하여 인구학적 정보와 신체질환 여부를 조사하였다. 또한, 우울 증상을 평가하기 위해 역학연구센터 우울척도(The Center for Epidemiologic Sstudies-Depression Scale, CES-D)를 작성하도록 하였다. 결 과: 성별, 나이, 결혼 여부, 교육연한, 고용상태, 신체질환 여부와 같은 인구학적 변인을 통제한 이후에도 남한 출신 주민에 비해 북한이탈주민의 CES-D 점수가 높았다(${\beta}$=0.449, p<0.001). 또한 북한이탈주민에서는 신체질환이 다른 인구학적 변수와 독립적으로 높은 CES-D 점수를 예측할 수 있었으나(${\beta}$=0.243, p<0.001), 남한 출신 주민에서는 신체질환과 CES-D 점수가 유의한 관련성이 없었다. 신체질환을 동반한 북한이탈주민의 CES-D 점수($26.8{\pm}13.8$)는 신체질환이 없는 북한이탈주민($19.7{\pm}12.7$)에 비해 유의하게 높았다. 그러나, 신체질환이 있는 남한 주민($10.3{\pm}9.8$)과 신체질환이 없는 남한 주민의 CES-D 점수($9.3{\pm}8.8$)는 유의한 차이가 없었다. 결 론: 북한이탈주민은 성별, 나이, 교육, 고용, 결혼 여부와 독립적으로 남한 출신 주민에 비해 우울증상이 심하였다. 또한, 북한이탈주민에서 신체질환과 우울증의 관련성이 유의하였다. 이는 특히 북한이탈주민의 경우 신체 질환이 있을 때 우울증상에 대한 평가도 함께 이루어져야 함을 시사한다.

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