• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• Journal of Nutrition and Health
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• 제42권5호
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• pp.486-495
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• 2009

본 연구에서는 저염화 사업의 성과 평가 지표의 현황을 분석하고, 델파이 조사를 통하여 저염화 사업 성과 평가지표의 적절성 및 측정방법의 타당도와 수행용이성을 검증하였으며, 그 결과를 요약하면 다음과 같다. 1) 보건소에서 사용하고 있는 저염화 사업 성과 평가지표로는'소금 섭취량', '적정 소금 섭취 인구비율', '싱겁게 먹는 인구 비율', '나트륨 감소법 인지율', '가공식품 구입시 영양표시 정보 확인율', '국의 염도 감소율', '저염 실천하는 모범음식점 증가율', '참가자 만족도', '소금 판매량', '뇌졸중 사망률' 등으로 다양하게 사용하고 있었다. 2) 델파이 조사 결과, 저염화사업 성과 평가지표로서 영양학적 평가지표로는 1일 소금 섭취량이 가장 적절한 것으로 나타났으며, 적정 소금 섭취 인구비율과 싱겁게 먹는 인구 비율 등도 적절한 것으로 나타났다. 보건학적 지표로는 뇌졸중 사망률과 위암사망률이 적절한 것으로 조사되었다. 3) 영양학적 성과 지표 측정방법 중 24시간 소변 수집법이 타당성은 가장 높았으나, 수행용이성은 가장 낮은 것으로 나타났고, 짜게 먹는 식태도 조사 방법이 수행용이성이 가장 높았으며, 짜게 먹는 식행동 조사와 미각판정 방법이 수행용이성이 그 다음으로 높은 것으로 나타났다. 4) 영양학적 성과지표 측정방법의 타당성과 수행용이성을 동시에 고려하기 위하여 이들의 평균 점수에 가중치를 부여하여 순위를 비교하였을 경우 식행동 조사와 식태도 조사가 1, 2순위로 가장 높았고 음식섭취빈도 조사, 미각판정법이 그 다음 순위인 것으로 나타났다. 5) 미각판정법의 신뢰도를 조사한 결과 5개의 시료 농도별 짠맛에 대한 미각판정 결과 남자의 경우 검사자간 판정 결과의 상관계수가 0.774 (p < 0.01)였으며, 여자의 경우도 0.781 (p < 0.01)로 모두 높은 상관성을 보여주었다. 검사자내 신뢰도 조사에서는 짠맛에 대한 미각판정 결과 남자의 경우 첫 번째, 두 번째 판정결과에 대한 상관계수가 0.591 (p < 0.01), 여자의 경우 0.399 (p < 0.01)로 모두 통계학적 유의성을 보여주어 신뢰도가 높은 것으로 나타났다. 본 연구에서 델파이 조사를 1회 실시한 것이 한계점이라할 수 있으나, 이제 막 저염화 사업이 활성화되고 있는 현 시점에서 저염화 사업의 성과 평가지표개발에 대한 중요성을 인식시켰다는데 그 의미를 둘 수 있을 것이다. 또한 본 연구에서 제시된 싱겁게 먹는 인구비율은 적정 소금 섭취 인구비율과 함께 보건소 단위에서 저염화 사업을 할 때 특히 교육 효과를 평가할 수 있는 유용한 지표가 될 수 있을것으로 사료되며, 향후 저염화 사업에서 이 지표의 적합성 여부를 살펴보기 위한 실질적인 적용 연구가 필요할 것이다. 또한 본 연구에서는 제시하지 못하였으나, 미각판정 도구의 농도에 대한 선호도와 강도를 점수화하여 판정과정과 결과 판정을 컴퓨터 프로그램으로 개발함으로써 미각판정법의 표준화를 확보하는 추구 연구가 필요할 것이다.

• 대한간호학회지
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• 제43권6호
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• pp.791-800
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• 2013

Purpose: This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders. Methods: Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0. Results: The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect. Conclusion: These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.

• 대한간호학회지
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• 제36권1호
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• pp.127-135
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• 2006

Purpose: The purpose of this study was to identify the factors influencing symptom self management (SSM) in the patient with a chronic mental disorder. Method: Data was collected by questionnaires from 204 chronic mental disorders in an outpatient clinic in a General Hospital and Public Mental Health Centers in Seoul and Kyunggi Province. The data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression, Results: The score of SSM showed a significantly positive correlation with the score of the level of self efficacy (SE) (r=.33, p=.00), social support (SS) (r=.27, p=.00), self care agency (SCA) (r=.36, p=.00) and daily living ability (DLA) (r=.34, p=.00). The score of DLA showed a significantly positive correlation with the score of level of SE (r=.46, p=.00), SS (r=.51, p=.00), and SCA (r=.52, p=.00), The most powerful predictor of SSM was SCA ($14\%$). A combination of SCA, DLA, and SS account for $20 \%$ of the variance in SSM. Conclusion: This study suggests that SCA, DLA, and SS are significant influencing factors on SSM in patients with chronic mental disorders.

• 대한의생명과학회지
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• 제14권4호
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• pp.211-218
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• 2008

The purpose of this study was to investigate the effects of dietary Chungkookjang (Korean fermented soybean) powder on blood glucose level, lipid profiles, antioxidant enzymes activities and histological changes in kidney of streptozotocin (STZ)-induced diabetic rats. Male Sprague-Dawley rats of three groups including nondiabetic group fed normal diet (NC), diabetic group fed normal diet (DC) and diabetic group fed Chungkookjang diet (DCH; 100 g/kg diet) were reared for 8 weeks. The serum glucose, triglycelide and total lipid levels in the DCH group were significantly lower (P<0.05) than the DC group. The renal xanthine oxidase, catalase and glutathione S-transferase activities in the DC group were significantly higher than the NC group. The xanthine oxidase, superoxide dismutase and glutathione S-transferase activities in the DCH group were significantly lower than the DC group (P<0.05). Tubular epithelial change, such as Armanni-Ebstein cells, was significantly reduced in the DCH group compared to the DC group. In conclusion, these results indicated that Chungkookjang supplement seems to be beneficial to correct the hyperglycemia and hyperlipidemia as well as to protect kidney against diabetic changes.

• 대한지역사회영양학회지
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• 제7권3호
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• pp.345-353
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• 2002

A survey was carried out to investigate the breastfeeding knowledge, breastfeeding rates ultra related factors among women in Seoul and the Chungbuk area, in order to obtain baseline data for the development of an education program on breastfeeding. Subjects included 671 lactating mothers who visited public health or pediatric centers, between December, 1999 and February, 2000 and were interviewed using a questionnaire. The results are as follows: In the breastfeeding knowledge, most of the subjects (93.4%) know correctly that 'breastfeeding is better for a baby's emotional development than formula feeding,'whereas only half of the subjects (51.7%) answered correctly the question on whether 'formula is more nutritious than breastmilk.'The breastfeeding rates were about 57%, 40%, 33% and 12%, respectively for baby's aged 1, 3, 6, and 12 months. These results showed that the breastfeeding rate rapidly decreased with the baby's age. Lower breastfeeding rates were associated with high educational level (college graduate and above), high income, mothers'employment, no experience of attending breastfeeding education programs, and no planning on breastfeeding prior to pregnancy. There was a significant relationship between the level of knowledge and breastfeeding practice; the higher the knowledge score, the higher the breastfeeding rate. In conclusion, an education program should be developed and offered for each low breastfeeding rate group, in order to promote breastfeeding.

• 한국생활과학회지
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• 제21권5호
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• pp.903-913
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• 2012

This study investigated the effects of depression, anxiety, and impulsiveness on suicidal thoughts among adolescents with the goal of better understanding the psychological needs of adolescents and to provide them with more effective counseling and guidance. Participants for this study included 340 high school students in their first and second year living in large urban centers. Respondents answered a questionnaire that documented their experiences related to depression, anxiety, impulsiveness, and suicidal thoughts. Data analysis was performed using the means, standard deviations, correlation analysis, and multiple regression using the IBM SPSS 19.0 statistics program. The results were as follows. There was no statistically significant difference in anxiety and impulsiveness based on gender. However, female respondents demonstrated a higher rate of suicidal thoughts than male respondents. Second, in both sexes, comparative analysis between depression, anxiety, impulsiveness, and suicidal thoughts revealed that respondents with higher levels of depression and anxiety demonstrated elevated levels of suicidal thoughts. Impulsiveness demonstrated a correlation with suicidal thoughts only for female participants. Third, while depression and anxiety affected suicidal thoughts in both male and female respondents, impulsiveness did not affect suicidal thoughts, with depression having the strongest effect.

• 성인간호학회지
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• 제23권3호
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• pp.267-277
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• 2011

Purpose: The purpose of this study was to evaluate the effects of a sex education program for middle aged men patients with diabetes and their spouses. Methods: The research design for this study was a non-equivalent control group quasi-experimental study. The subjects were 23 diabetic patients and their spouses with half of the subjects exposed to a structured sex education program. Sexual Beliefs and Information Questionnaire, Dyadic Sexual Communication Scale, Sexual Frequency Scale, Derogatis Sexual Function Inventory and International Index of Erectile Function-5 were used for data collection. Results: In the experimental group, sexual knowledge of diabetic patients and sexual communication with their spouses were improved after two weeks following the program. Also, in the experimental group, sexual knowledge, sexual communication, and sexual frequency in both diabetic patients and their spouses were improved after six weeks following the program. In the experimental group, sexual satisfaction of diabetic patients was improved after six weeks following sex education program, however their spouses in the experimental group showed no significant differences than those of the comparison group. Conclusion: The results of this study suggest that sex education program for both diabetic patients and their spouses could be utilized in public health centers, hospitals, and clinics.

• 대한간호학회지
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• 제34권2호
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• pp.213-224
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• 2004

Purpose: This study was aimed to evaluate the effect of progressive muscle relaxation training using biofeedback on perceived stress, stress response, immune response and climacteric symptoms, Method: This was a crossover, pre-post test design, The study subjects are 36 middle-aged women who were selected at 2 public health centers, The independent variable was Biofeedback training for 4 weeks, twice a week and home training for 4 weeks, Dependent variables were perceived stress, stress response, immune response, and climacteric symptoms measured with Hildtch's scale (1996), Result: Progressive muscle relaxation training using biofeedback was not effective in reducing perceived stress, but it was shown to be effective in reducing physiological stress responses such as pulse rate and EMG, Though blood pressure and skin conductance were repeatedly down, and skin temperature slowly increased, there were no statistically significant differences. Progressive muscle relaxation training using biofeedback was not effective in reducing serum cortisol, enhancing immune responses, or decreasing climacteric symptoms. Conclusion: The findings point to a pressing need for further, well-controlled and designed research with consideration in selection of subjects and instruments, frequency of measurements, the sampling method, and intervention modalities.

• 대한간호학회지
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• 제42권2호
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• pp.291-301
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• 2012

Purpose: The purpose of this study was to investigate homebound status and significant related factors for community-dwelling female elders according to age. Methods: The participants were female elders over 65 years of age registered in public health centers. Data were collected by interviewing the elders, who voluntarily completed the entire survey. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 18.0. Results: There were statistically significant differences in homeboundness and related factors between the young-old (65 to 74 years of age) and the old-old (75 years of age or older). The level of homeboundness of the old-old was higher than that of the young-old. Multiple logistic regression showed, timed "up and go", depression, and fear of falling as significantly associated with homebound status of the young-old, while hand grip strength (right), timed "up and go", static balance ability, severity of urinary incontinence, and fear of falling as significant for the old-old. Conclusion: The findings of this study indicate that homebound status and related factors for elders are different according to age, and therefore, interventions to prevent and help homebound elders get over being homebound should be developed according to age.