• 대한후두음성언어의학회지
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• 제18권2호
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• pp.108-112
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• 2007

Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms ; and the constellation of symptoms has been called laryngopharyngeal reflux (LPR). In the absence of definite diagnostic criteria, LPR disease remains a subjective entity. A diagnosis of LPR is usually based on response of symptoms to empirical treatment. Investigative modalities such as pH monitoring and, more recently, impedance studies are generally reserved for treatment failures. LPR usually requires more aggressive and prolonged treatment to achieve regression of both symptoms and laryngeal findings. The suppression of gastric acid and secretion with anti-secretary agents has been the mainstay of medical treatment for patients with acid-related disorders. The suppression of gastric acid secretion achieved with Hz-receptor antagonist $(H_2RA)$ has proved suboptimal for relief of reflux symptoms. The rapid development of tolerance and rebound acid hypersecretion after the with-drawal of $H_2RA$ limit their clinical use. Proton pump inhibitors (PPI) have been proved to be very effective for suppressing intragastric acidity, but the optimal dose and duration is unknown. Current evidence indicates that pharmacologic intervention should include, at a minimum, a 3 month trial of twice daily PPI. Symptoms of LPR improve over 2 months of therapy. The physical findings of LPR resolve more slowly than the symptoms and this continues through out at least 6 months of treatment. For most patients with LPR, twice daily dosing with a PPI is usually recommended for an initial treatment for a period of no less than 6 months treatment, and lifetime treatment may be required.

• 대한통합의학회지
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• 제10권2호
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• pp.49-59
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• 2022

Purpose : The purpose of this study is to directly understand the health condition of residents of mental health sanatoriums nationwide, which has been difficult to ascertain in surveys conducted to date. The study presents specific measures for improving the health of these residents. Methods : A "physical examination questionnaire for residents of mental health sanatoriums" was developed to check the basic physical condition of residents, and 20 out of 59 mental health sanatoriums nationwide were randomly selected. Medical personnel visited the sanatoriums, interviewing and examining the residents in person. A total of 396 health surveys were completed. Results : Many of the residents were underweight but had abdominal obesity. It was confirmed that chronic diseases among the residents were not diagnosed early or were not properly managed. Among the subjective symptoms complained of by the residents, musculoskeletal symptoms were the most common. Oral examinations revealed a serious level of oral health problems among the residents, including dental caries and missing teeth. Basic physical examinations found health problems that required additional examination or medical treatment. Blood pressure abnormalities made up the highest percentage of the health problems. Conclusion : Regular health surveys are needed to determine the health condition of residents of mental health sanatoriums. Access to and quality of primary medical services within the sanatoriums need to be dramatically improved. A delivery system for severe diseases and emergency medical care in the sanatoriums should also be specifically presented. The residents should be notified upon admission and during their stay that they have the right to the enjoyment of the highest attainable standard of mental and physical health. The issue of health rights should be addressed within a larger framework of reorganizing management plans for people in the community - not only residents - with chronic mental illness.

• 디지털융복합연구
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• 제16권12호
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• pp.427-440
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• 2018

본 연구는 치매환자를 돌보고 있는 요양보호사의 케어부담감을 알아보고, 케어부담감이 신체증상과 건강지각에 미치는 영향을 파악하기 위한 서술적 상관관계연구이다. 연구대상자는 요양보호사 174명이었으며, 자료수집은 2018년 4월 1일부터 30일까지 였다. 자료분석은 t-test 및 One-way ANOVA, Pearson's correlation coefficient, Multiple regression analysis을 활용하였으며, 사후분석은 Scheffe를 사용하였다. 연구결과 케어부담감은 "중상", 신체증상은 "중간"수준으로 나타났고, 건강은 좋지 않은 것으로 인식하고 있었으며, 주관적 안녕감은 낮게 나타났다. 케어부담감은 신체증상(r=.157, p<.05), 신체증상은 지각된 건강과 양의 상관관계(r=.220, p<.01)를 보였고, 신체증상과 주관적 안녕에 미치는 영향 요인은 요양보호사 근무동기로 나타났다. 연구결과 요양보호사의 케어부담감은 신체적, 정신적 건강상태에 영향을 미치는 요인으로 확인되었으며, 연구결과를 근거로 요양보호사의 근무지에 따른 케어 부담감에 차이가 있는지를 파악해보는 연구를 수행할 것을 제언한다. 또한 요양보호사의 케어부담감을 측정할 수 있는 도구를 개발하여 반복연구를 수행해 볼 필요가 있겠다.

• 농촌의학ㆍ지역보건
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• 제28권2호
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• pp.71-85
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• 2003

본 연구는 충청남도 일부 농촌지역 노인을 대상으로 이들의 생활양상에 따른 주관적인 행복감과 우울상태를 파악하고, 그에 관련된 요인들을 규명하기 위하여 면접조사가 이루어진 65세 이상 노인 454명(남자, 197명, 여자 257명)의 자료를 수집, 분석하였다. 조사는 2002년 7월 1일부터 9월 30일까지의 기간에 실시하였으며, 조사내용은 조사대상노인의 인구사회학적 특성, 일상생활수행동작(activities of daily livings; ADL)의 자립유무, 주관적 행복감(subjective well-bing), Zung의 자기평가식 우울척도(self-rating depression scale; SDS) 등이었다. 주요 결과는 다음과 같다. 첫째, 조사대상 노인들은 모든 연령층에서 남자는 여자에 비해 주관적 행복감점수가 유의하게 높았고, 연령이 증가함에 따라 낮아지는 경향이었다. 둘째, Zung의 우울점수는 모든 연령층에서 여자가 남자보다 유의하게 높았으며, 여성에서만 연령이 높아짐에 따라 낮아지는 경향이었다. 셋째, 주관적 행복감점수와 Zung의 우울점수와의 편상관계수를 보면 남자는 r=-0.757 (p<0.000), 여자는 r=-0.782 (p<0.000)이었다. 넷째, ADL점수와 주관적 행복감 점수와의 관계에서는 남성은ADL점수가 높을수록 주관적 행복감 점수가 높아지는 경향이었으나 여성에서는 유의한 관계를 보이지 않았으며, ADL점수와 우울상태 점수와의 관계에서는 남녀 모두ADL점수가 높을수록 우울상태 점수는 낮아지는 경향을 보였다. 다섯째, 주관적 행복감 점수와 각 관련요소들과의 상관관계에서는 남녀 모두 사회적 모임의 참석여부, 주관적 건강상태에 대한 만족도와 유의한 양의 관련성을 보였고, 우울 점수와 관련요소들의 상관관계에서는 남녀 모두 사회적 모임의 참석여부, 주관적 건강상태에 대한 만족도, 경제상태, ADL 점수와 유의한 음의 관련성을 보였다. 여섯째, 주관적 행복감에 영향을 미치는 요인으로는 우울상태, 식습관, 거주상태, ADL점수 및 신체활동이 유의한 변수로 선정되었으며, 우울상태에 영향을 미치는 요인으로는 주관적 건강상태에 대한 만족도, 신체활동, 성별, 흡연습관, ADL점수, 경제상태, 식습관, 사회적모임의 참석여부 등이 유의한 변수로 선정되었다. 결론적으로 주관적 행복감이 높은 사람일수록 우울상태는 낮았으며, 건강한 노년생활에는 주관적인 건강상태, 신체활동 및 경제상태 등이 중요한 요인이라는 것이 확인되었다.

• 대한예방한의학회지
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• 제5권2호
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• pp.40-68
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• 2001

In this study, grade of subjective symptom appealed by laborer of Jeollabuk-do was evaluated using questionary regarding factor made effect on musculoskeletal disease and in addition, studied relationship with health promotion life style of them. Based on the result, relationship of general characteristics of musculoskeletal subjective symptom and life-style of the subjects was concluded as below. 1. General characteristics of study subjects were as following. Ratio of male was higher as 57.7% of male and 42.2% female and age distribution was 5.1% of 20s, 34.99% of 30s, 36.3% of 40s and 23.7% of 50s and therefore, $30{\sim}40$ aged groups showed highest ratio. Most subjects (74.9%) was married status and in case of education level, high-school graduate and dropout (23.3%) and over-college graduate (46.8%) showed highest distribution. $1{\sim}2$ Mil. KRW (29.5%) and $2{\sim}2.99$ Mil. KRW (21.2%) is the main income distribution and however there was high ratio of non-reply (29.0%). In case of employment period, $10{\sim}14$ years (15.3%) and over 15 years (29.6%) showed highest ratio and there were many non-reply (39.4%) and in addition, 67.6% replied as own house and 14.3% as lease on deposit base in question of residence type. 2. Subjects showed high ratio of subjective symptom appeal of 62.79% and many cases (50.23%) appealed 1 or 2 symptoms. Symptom by body region was 29.8% (waist), 27% (shoulder), 21.2% (knee), 15.5% (neck), 9.5% (ankle), 8.1% (wrist) and 5.0% (elbow) in order. In case of relationship with general characteristics, female comparing with male, non-residence of own house, subjects with lower education level and employment period of $10{\sim}14$ years showed higher appeal rate and kind of symptoms than others. Therefore, it was concluded that rate of musculoskeletal symptom appeal have close relationship with gender, level of living, education level, age and employment period. 3. In case of severe pain of upper body except waist and ankle, it was appealed in both or right side and it means that upper body pain is originated from right side and right region pain is transited to both region pain. In addition, there was 39.41% of non-reply to existence of right-left region pain and therefore, it was evaluated that, in may cases, there was no awareness of their own symptom condition even on subjective symptom. 4. Degree of pain was, as pain over middle level, evaluated as 2.79 on full mark of 4.0 and in order of waist (2.97), ankle (2.83), knee (2.82), wrist (2.82), neck (2.79), shoulder (2.70) and elbow (2.62). In addition, 71.97% appealed $2{\sim}3$ cases for the latest 1 week. Owing to subjective symptom, 54.95% drop into hospital or pharmacy, 10.32% made temporary retirement or absence, 7.99% transferred into more comfortable duty and $39.4{\sim}54%$ experienced one or more managing mentioned above. 5. Fulfillment of health promotion life style of subjects was evaluated on full mark of 4.0 and total score was 2.63. Average mark of each area was personal relationship (3.05), self-realization (2.92), stress management (2.63), health control (2.48), physical exercise (2.19) and nutrition management (2.19) and personal relationship was highest and physical exercise and nutrition management were lowest. As general characteristics influencing health promotion life style, gender, residence style and employment period showed significant difference. Male showed higher mark than female and showed higher mark in order of own house, others, lease on deposit base, monthly rent. Subjects with longer employment period showed higher mark with significant difference. 6. Accounting of factor influencing each area of health promotion life style, self-realization showed significance in marriage status, income, residence style and education level and health control in age, residence style and employment period. Physical exercise showed significant difference in gender, age, residence style and employment period and nutrition in gender, age, residence style and employment period. Stress management showed significant difference in residence style and employment period and however not in personal relationship. 7. Health promotion life style relating with existence and kind of pain showed significant difference in all area except personal relationship area. In absence of pain, there was statistically significant high score in all area even in total health promotion life style and all area. Accounting of kind of pain, cases of $1{\sim}2$ kinds of pain and $5{\sim}6$ kinds of pain showed relatively high score and it was lower than mark of subject stated absence of pain. 8. Subjects appeal symptom were classified by symptom region and difference of total and each areas were evaluated. General area (p=0.002), self-realization (p=0.012), health management (p=0.023), physical exercise (p=0.028), nutrition management (p=0.028) and stress control (p=0.001) showed statistically significant difference and not in personal relationship area. Especially, elbow, shoulder and neck area marked high and group appealed pain of knee, arm and elbow, foot and ankle marked low. Based on those results, subjective symptom should be accounted seriously in diagnosis of occupational musculoskeletal disease of laborer and among subjective symptom, general characteristics of gender, age, condition of living, education level and employment period make effect. Generally subject appeal symptom marked lower than subject without symptom appeal and it means that life management of subject appealing musculoskeletal pain make important role in management and treatment of occupational musculoskeletal disease.

• 대한후두음성언어의학회지
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• 제26권1호
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• pp.25-33
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• 2015

Background and Objectives:The objective of this study was to investigate the features of post-thyroidectomy subjective voice disorder by Voice Handicap Index (VHI) and Voice Symptom Scale (VOISS) through aerodynamic analysis and to investigate the appropriate voice therapy intervention. Materials and Methods:Twenty post-thyroidectomy patients who had no recurrent laryngeal nerve paralysis through laryngeal stroboscopy were enrolled for this study. Acoustic and aerodynamic evaluations were performed before operation, 2 weeks and 3 months after operation. Subjective voice evaluation was performed by VHI and VOISS. Aerodynamic evaluation was compared and analysed by maximum phonation time(MPT), phonation threshold pressure(PTP), mean air flow rate(MFR), etc. Subjective voice evaluation was surveyed through VHI and VOISS. To evaluate patients' symptoms related to functional voice disorder, scores on physical domain in VHI and VOISS were selected to be compared for each session. Results: The 10 out of 20 participants who complained of voice symptoms had no significant difference with pre-operation in acoustic evaluation, but all showed higher scores on 2 weeks and 3 months after operation compared to pre-operation, in VHI-physical domain and selected questionnaires in VOISS. They reduced MPT and increased PTP value simultaneously. Laryngeal massage and breathing training were simultaneously treated to them, 5 participants resulting in improvement in MPT and PTP compared to pre-treatment. Conclusion:Patients who complained voice change with no organic damage after thyroidectomy were all shown to have reduced MPT and increased PTP in some by aerodynamic evaluations. Reduced MPT may imply some problem in air flow beneath glottis. Increased PTP suggests much more effort in vocalization mechanism than pre-operation. Comparing aerodynamic evaluations in post-thyroidectomy may provide information on behavioral interventions. Additionally, study on laryngeal massage and breathing training simultaneously treated to patients with such voice disorder is needed to be conducted with larger number of participants.

• 근관절건강학회지
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• 제6권1호
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• pp.22-36
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• 1999

The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

• 한방안이비인후피부과학회지
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• 제33권4호
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• pp.1-15
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• 2020

Objectives : To investigate aggravating and mitigating factors of atopic dermatitis and to utilize the outcome in treatment planning. Methods : The research has a cross-sectional study design. Patients' SCORing Atopic Dermatitis (SCORAD) Index, demographic, physical characteristics, social history, serologic index and skin related instrumental measurements were analyzed with correlation and regression analysis method. Results : 48 patients in total were enrolled in the study. Skin Surface Hydration (SSH) and sex were found to be statistically significant aggravating and mitigating factors. As SSH increased, Total SCORAD (tSCORAD) and Objective SCORAD (oSCORAD) increased as well. As SSH decreased, tSCORAD and oSCORAD decreased as well. Female patient had a higher probability of suffering from severer subjective symptoms than that of male. Age, body mass index (BMI), alcohol consumption and smoking, transepidermal water loss (TEWL), IgE, IL-4, IL-5, IL-6, IFN-γ were found not to be statistically significant. There was no correlation between Subjective SCORAD (sSCORAD) and oSCORAD neither with Eczema Area and Severity Index (EASI). Conclusions : Increasing cutaneous moisture should be included in the treatment plan of atopic dermatitis. More emphasis should be put on alleviating subjective discomforts of female patients than that of male. Establishing separate strategies of managing objective eczema status and subjective discomforts respectively should be considered.

• 융합정보논문지
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• 제10권4호
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• pp.25-34
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• 2020

본 연구는 폐경 후 중년여성의 우울 증상에 영향을 미치는 요인을 확인하기 위해 시도된 이차 자료분석 연구이다. 2016년 국민건강영양조사 원시자료를 이용하여 40~65세의 중년여성 중 폐경여성 647명을 대상으로 하였다. 자료분석은 복합표본 independent t-test 및 다중회귀분석을 실시하였다. 다중회귀분석에서 폐경 후 중년여성의 우울 증상은 경제상태, 주관적 건강상태, 지각된 스트레스, 흡연여부, 신체활동 및 활동제한여부에 영향을 받는 것으로 나타났으며, 회귀모형의 설명력은 36%였다. 따라서 본 연구에서 제시된 폐경 후 중년여성의 우울 증상 영향요인을 고려하여 폐경 이행기 중년여성의 우울 증상을 감소하기 위한 중재 전략을 개발하고 적용할 것을 제언한다.

• 한국자연치유학회지
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• 제9권2호
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• pp.57-61
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• 2020

목적: 본 연구는 갱년기 증상이 있는 50대 여성 대상자들이 족욕을 하였을 때 갱년기 증상 및 수면장애에 미치는 효과를 연구하는 것이 목적이었다. 방법: 12주간 주 3회 족욕요법을 실시한 후에 갱년기 증상의 사전 및 사후 변화를 조사하였다. 결과: 안면홍조, 심장 불편감, 수면 문제, 우울감, 과민성, 불안감, 신체 및 정신적 피로, 성적인 문제, 배뇨문제, 질 건조감, 관절 및 근육 불편감이 있는 대상자는 사전보다 사후에 모두 유의성이 있게 개선되었다(p < .001). 족욕 후에 주관적 수면의 질, 수면 잠복기, 수면 기간, 수면 방해점수, 수면 약물 이용 및 수면 기능장애는 사전보다 사후가 유의하게 감소하였다(p < .001). 습관적 수면 효율성 유의하게 증가하였다. 결론: 대상자들이 족욕 후에 갱년기 증상과 수면의 질이 전반적으로 개선된 것으로 나타났다. 따라서 족욕요법은 갱년기 증상 및 수면 개선에 적합한 자연치유적 요법이라 평가한다.