• 보건행정학회지
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• 제34권3호
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• pp.271-281
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• 2024

연구배경: 장애인의 미충족의료는 삶의 질 저하뿐만 아니라 사망에 이르는 심각한 건강결과를 초래한다. 사회경제적 요인, 개인적 요인, 환경적 요인 등 다양한 요인이 장애인의 미충족의료에 영향을 미친다. 이전 연구에서는 주로 개인의 사회경제적 요인 및 장애 특성에 따른 영향요인을 분석하였다. 이 연구는 장애인의 의료서비스 이용에 큰 영향을 미칠 수 있는 환경적 요인을 포함하였다. 방법: 한국장애인개발원의 장애인삶 패널조사를 이용하여 성인장애인 4,326명을 대상으로 미충족의료 현황과 미충족의료에 영향을 미치는 요인을 분석하였다. 장애인의 일반적 특성, 장애 특성, 환경적 특성에 따른 미충족의료 경험의 차이를 확인하였다. 로지스틱 회귀분석을 통해 장애인의 미충족의료에 영향을 미치는 요인을 분석하였다. 결과: 장애인의 미충족의료에 영향을 미치는 요인을 분석한 결과, 교육수준이 낮은 군(adjusted odds ratio [aOR], 1.229; 95% CI, 1.024-1.475), 소득수준이 낮은 군(aOR, 1.416; 95% CI, 1.015-1.976), 민간보험에 가입한 군(aOR, 1.234; 95% CI, 1.018-1.496), 일상생활에 도움이 필요한 군(aOR, 1.298; 95% CI, 1.059-1.592), 외출을 하지 않는 군(OR, 1.566; 95% CI, 1.274-1.924), 병원 방문 시 택시(aOR, 1.407; 95% CI, 1.047-1.891) 또는 장애인콜택시(aOR, 1.370; 95% CI, 1.001-1.875)를 이용하는 군, 의사소통 관련 장애인(aOR, 1.304; 95% CI, 1.029-1.651), 주관적 건강상태가 낮은 경우(aOR, 1.248; 95% CI, 1.043-1.494), 치료결과에 대한 의료진의 설명이 충분하지 않다고 느끼는 군(aOR, 4.035; 95% CI, 1.365-11.927), 전반적인 의료서비스에 만족하지 않는 군(aOR, 3.515; 95% CI, 2.741-4.508)에서 미충족의료 경험률이 유의하게 높았다. 결론: 장애인을 위한 효과적인 의료서비스 제공을 위해서는 재정 지원뿐만 아니라 사회적 지원, 의료진 교육, 장애 특성을 고려한 정책이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4567-4575
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• 2016

A number of studies have evidenced the effect of modifiable lifestyle factors such as diet, breastfeeding and nutritional status on breast cancer risk. However, none have addressed the missing data problem in nutritional epidemiologic research in South America. Missing data is a frequent problem in breast cancer studies and epidemiological settings in general. Estimates of effect obtained from these studies may be biased, if no appropriate method for handling missing data is applied. We performed Multiple Imputation for missing values on covariates in a breast cancer case-control study of $C{\acute{o}}rdoba$ (Argentina) to optimize risk estimates. Data was obtained from a breast cancer case control study from 2008 to 2015 (318 cases, 526 controls). Complete case analysis and multiple imputation using chained equations were the methods applied to estimate the effects of a Traditional dietary pattern and other recognized factors associated with breast cancer. Physical activity and socioeconomic status were imputed. Logistic regression models were performed. When complete case analysis was performed only 31% of women were considered. Although a positive association of Traditional dietary pattern and breast cancer was observed from both approaches (complete case analysis OR=1.3, 95%CI=1.0-1.7; multiple imputation OR=1.4, 95%CI=1.2-1.7), effects of other covariates, like BMI and breastfeeding, were only identified when multiple imputation was considered. A Traditional dietary pattern, BMI and breastfeeding are associated with the occurrence of breast cancer in this Argentinean population when multiple imputation is appropriately performed. Multiple Imputation is suggested in Latin America's epidemiologic studies to optimize effect estimates in the future.

• 디지털융복합연구
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• 제13권10호
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• pp.425-436
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• 2015

본 연구는 우리나라의 고혈압 의료비의 지역별 변이와 지역의 사회학적, 의료공급, 건강행태 등의 변이 요인을 규명함으로써 이를 기반으로 지역별 고혈압 관리 사업 방안 마련에 기초자료를 제시하는 것이다. 이를 위해 전국 시 군 구 247개 지역을 대상으로, 2012년 지역별 의료이용 통계자료(국민건강보험공단), 지역사회건강조사(질병관리본부) 및 국토해양부 자료를 이용 분석하였다. 연구결과 전국 247개 시 군 구의 고혈압 건강보험진료비는 평균 6만2천원이었고 변동계수는 30.0으로 지역 간 높은 고혈압 의료비 변이를 보였다. 주요 변이 요인으로는 인구밀도, 유배우자율, 평균가구원수입, 인구십만명당병원수, 관외의료비비율, 월간음주율, 중증도이상신체활동실천율, 평생의사진단율 등으로 나타났다. 의사결정나무를 이용한 분석 결과 평생의사진단율, 평균가구원수입, 유배우자율, 인구십만명당병원수, 비만율, 월간음주율에서 유의한 차이가 있었다. 본 연구의 결과 고혈압 의료비의 지역 간 변이요인으로는 의료공급이나 인구사회학적 특성뿐만 아니라 건강행태에 있음을 확인하였고 이는 고혈압의료비 절감을 위한 지역보건사업 정책 결정에 참고가 될 수 있을 것이다.

• 건축역사연구
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• 제2권1호
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• pp.25-41
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• 1993

This study was made to analyze the housing adjustment phenomenon in the first half of Chosun Dynasty by applying Microsociological approach. By reviewing the housing adjustment theory of Morris and Winter, research model for the period was developed in terms of socioeconomic characteristics, normative housing deficit (=cultural norm-housing condition+family norm), constraints, behavioral propensities, and housing adjustment mechanism with the following results : 1. In the first half of Chosun Dynasty the size of the house, the house site and decorating items were specified by law (cultural norm) according to the social status. Although the law was constraints for the housing phenomenon, it was not applied universally. Frequantly the law was violated by the upper class. By the middle of the Dynasty the family norm became more important for the housing phenomenon than the cultural norm. 2. Efforts were made to practice the Confucianism as a cultural norm in the first half of Chosun Dynasty At that time Husband-Living-in-Wife's-House was more popular than Wife-Living-in-Husband's-House. Because the customs were against the Confucianism, the latter was encouraged by law. But it did not change. Instead a compromised system became popular in the middle of the Dynasty. The house shrine was practiced to increase the symbolism of the family, which, in turn, exerted influences in deciding the housing site (cultural norm). These cultural norm was not accepted as the family norm untill the second half of the Dynasty. These trends forced the man and woman use separate areas of the house, and formulated a hierarchic positions within a house. 3. It was shown that the settlement of Confucianism as a family norm was closely related to the popularization of the Ondol system in the house, which functioned as one of the behavioral propensities to encourage diversity of space for many purposes. Though the Ondol system was accepted as a useful heating system earlier, this became more popular in the middle of the Dynasty because the housing pattern with Ondol fitted very well with a large family system with patriarchism. Ondol system for one or two rooms substituted Ondol for all rooms in the second half of the Dynasty. 4. From the beginning of the Dynasty housing adjustment of the family was determined by the social status and by law (cultural norm). Within this cultural norm each family decided its adjustment mechanism according to its economic ability (family norm). Family norm was more important factor than the cultural norm to determine the micro-space pattern in the house. But this period witnessed the formations of new conditions by the ruling class's efforts to implement new ethics for hierarchy and sexual discrimination. According to these conditions the Confucianism overruled the family norm in the later period.

• 한국학교보건학회지
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• 제12권1호
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• pp.27-44
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• 1999

Obesity in children is a major concern of public health. This study was performed to illuminate its effect on weight control program and the associated factors of obesity-related habits and obesity index in primary school obese children. Weight control program consisted of behavioral modification, nutrition education and exercise during 17 weeks. The sample consisted of treatment group(n=42) and control group(n=41). There was no statistical difference between the two groups in obesity index, socioeconomic status and grade. To assess the effects of weight control program, the subjects were given pre-test and post-test such as the measurement of anthropometric values and self-reporting questionnaire. This result of this study were as follows; 1. After weight control program was applied, there was a significant decrease in obesity index among the treatment group. Obesity-related habits score of the treatment group increased significantly, While there was not much difference between the pre-test and the post-test among the control group. But exercise habit didn't increase significantly in the both groups. 2. Correlation between obesity-related habits and obesity index were not evident. 3. After application of weight control program, the factors associated with change of eating habit were children's past experience of weight control, motivational change toward weight control program and friends' support for treatment group. The factors associated with change of exercise habit were post-test motivation score and friends' support. Motivational change toward weight control and pre-test self-efficacy of exercise behavior were counter-related to exercise habit. For change of other obesity-related habits, initial obesity index, motivational change, post-test self-efficacy score of exercise behavior and paternal educational status were closely associated. But post-test self-efficacy score of eating behavior was unrelated. 4. Only the factor of experience of weight control was associated with change of obesity index. 5. For the both groups, the factors associated with change of eating habits were post-test self-efficacy of eating behavior and family's support. The factors associated with change of exercise behavior were self-efficacy changes of exercise behavior and friends' support. The factors associated with change of other obesity-related habits were self-efficacy change of eating behavior. Initial obesity index was associated with change of obesity index. 6. The rate of dropouts from weight control program was 28.6% (12/42) in treatment group. Initial obesity index, other obesity-related habits except eating exercise habits, friend's support were associated with dropout. In conclusion, these results indicated that weight control program in primary school settings was effective. Direct exercise regimen and practice was demanded. In addition to the program itself, much of the success is dependent on the degree of motivation of the children involved and support provided by their parents and friends. Further study need to be performed under the condition that the weight control progrom is applied for a longer period.

• 한국인구학
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• 제31권2호
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• pp.77-100
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• 2008

지난 약 십년사이 급변하는 한국의 가족환경 속에서 대중매체들은 혼인신고 지연 등을 포함 하여 동거(cohabitation)가 많이 증가하고 있다고 보고한다. 본 연구에서는 동거자의 특성을 검증하고, 한국가족에서 동거가 가지는 의미를 탐구하고자 하였다. 조사의 초점은 아니었지만 동거의 일면을 밝혀줄 수 있는 2개의 전국조사, 즉 혼인신고와 사회통계조사, 자료를 바탕으로 다변인 로짓분석을 실시하였다. 결과들은 대체로 서구문헌에서 제시하는 이론적 틀을 수용한다. 첫째, 동거는 이혼의 증가 등 가족제도의 전반적인 변화와 관련되어있다. 혼전동거의 비율이 초혼보다 재혼에서 높았고, 초혼과는 달리 이혼 후 재혼에서는 교육수준에 따른 혼전동거비율의 차이가 거의 없었다. 둘째, 취업이나 학력 등의 면에서 사회경제적 자원이 적은 남자들이 많은 남자들에 비하여 결혼보다 동거를 택할 확률이 대체로 높았다. 셋째, 부부간 취업, 교육수준, 연령차이 등 사회경제적 지위를 비교해 보면, 결혼커플보다 동거커플에서 성역할 평등 혹은 성역 할 반전이 더 활발한 것 같다. 학력, 취업, 가족가치관, 연령 등 동거커플들의 특성이 미혼자 및 이혼자뿐 아니라 결혼부부와도 특별히 유사하지 않다는 면에서, 현재 우리나라에서 행해지는 동거를 단순히 결혼의 연장선으로 볼 수는 없는 것 같다. 결혼을 하되 당분간 두고 본다는 의미를 넘어서, 동거를 선택할 수밖에 없는 이유가 있는 것이 아닌가 생각된다. 결혼을 유지하기 어려운 사회적 여건 때문에 동거가 확산되고 있는지, 그 원인, 과정 및 결과에 관한 보다 체계적인 후속 연구가 요청된다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3763-3767
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• 2016

Background: Cervical cancer is the second most common cancer among females across the world. It is a preventable cancer and early detection is very feasible. This study aimed to identify which women characteristics are potentially associated with and may have an important in uence on the uptake of cervical cancer screening in Kurdish women living in the west of Iran.. Materials and Methods: A cross sectional study was conducted in late 2014. A random sample of women aged 40 years and above without history of cervical cancer and identi ed as Kurdish background were selected and interviewed by two trained interviewers. Information about sociodemographic and reproductive factors, history of diseases, and cervical screening was collected using a questionnaire and women who had undergone a hysterectomy were excluded. Univariate analyses were used to describe the general characteristics of the study population. Multivariable logistic regression models with self-reported screening history were used to estimate odds ratios (ORs) with 95% con dence intervals (CI). Signi cance was considered at the 5% level. Results: A total of 561 women were included in this study (mean age $43.6{\pm}5.17$ years) participation in cervical screening at least once was about 32%. Cervical screening uptake percentage was signi cantly lower among people over 60 years of age (adjusted OR= 0.26, 95% CI: 0.11-0.64), and those who were illiterate (OR= 0.41 95% CI: 0.23-0.73) and post-menopausal (OR= 0.56, 95% CI: 0.35-0.91). Women with ${\leq}1$ child were less likely to report a Pap test (adjusted OR=0.43 95%CI: 0.13-1.37) Cervical screening uptake was higher among women with health insurance (OR= 2.31, 95% CI: 1.50-3.56). Conclusions: Cervical screening participation in this study was low compared to other studies in developed countries. The screening uptake was different based on age, education, parity, insurance coverage and menopausal status. It is recommended to target these groups of women in cervical screening program.

• 치위생과학회지
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• 제14권4호
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• pp.488-494
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• 2014

본 연구는 경상북도 일개 도 농 복합시의 보건소에서 실시하는 노인 불소도포, 스케일링사업에 참여한 65세 이상 노인을 282명을 대상으로 하였다. 자료수집 기간은 2011년 1월부터 12월까지로 연구의 목적과 내용 및 취지를 설명하고 자발적인 연구 참여에 동의한 사람들을 대상으로 하였다. OHIP-14 설문 문항은 5점 만점으로 측정하였으며, 점수가 높을수록 구강건강 삶의 질이 낮아지는 것을 의미하며, 다음과 같은 결과를 얻었다. 1. 치아우식증 개수가 적을수록, 잔존치아 수와 일일 칫솔질 횟수가 많을수록, 의치를 장착하지 않은 그룹에서 구강건강 삶의 질이 유의하게 높았다. 2. 사회경제적 특성에 따른 구강건강관련 삶의 질의 하위영역 점수를 비교한 결과, 기능적 제한 점수는 학력이 높을수록 적었다. 신체적 동통 점수는 나이가 많을수록, 학력이 낮을수록 더 많이 느끼고 있었다. 신체적 능력저하는 학력이 낮을수록 더 많이 느끼고 있었다. 3. 구강건강상태와 칫솔질 횟수에 따른 구강건강관련 삶의 질의 하위영역 점수를 비교한 결과, 기능적 제한과 신체적 동통, 정신적 불편, 정신적 능력저하, 사회적 능력저하, 사회적 불리 점수는 치아우식증 개수가 많을수록 삶의 질이 낮았고, 잔존치아가 많을수록, 의치장착을 하지 않은 그룹에서 삶의 질이 좋았다. 4. 구강건강관련 삶의 질에 영향을 미치는 요인을 규명하기 위한 다중회귀분석 결과 충치의 개수와 의치장착이 유의한 변수로 나타났다. 이 연구결과 노인들의 구강건강상태의 수준과 노인들의 삶의 질이 유의한 관련성이 있는 것으로 나타났다. 구강건강 삶의 질을 유지하기 위하여 나이가 들더라도 잔존치아 수를 많이 유지할 수 있도록 하고, 필요한 경우에는 의치를 장착할 수 있도록 지원하는 것이 중요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.109-117
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• 2015

Background: Follow-up clinical consultations could improve overall health status as well provide knowledge and education for cancer prevention. Materials and Methods: This is the cross-sectional study using the Korean Community Health Survey (KCHS) 6th edition for 2012, with 115,083 respondents who underwent cancer checkups selected as subjects. Associations between the presence of consultation and the socioeconomic status were determined using statistical methods with the SAS 9.3 statistical package (Cary, NC, USA). Findings: Among the recipients, 32,179 (28.0%) received clinical consultations after cancer screenings. Those in rural areas (odds ratio, OR=0.71, 95% confidence interval (CI), 0.69-0.73) visited follow-up clinics less frequently than did those in urban areas. Starting at the elementary school level, as the education level increased to middle school (OR=1.26, 95% CI: 1.19-1.34), high school (OR=1.29, 95% CI: 1.23-1.36) or college (OR=1.76, 95% CI: 1.65-1.89), the participation rates also increased. When compared with the lowest quartile group, the quartile income level showed a statistical trend and difference as follows: second lowest quartile (OR=1.11, 95% CI: 1.07-1.16), third lowest (OR=1.12, 95% CI: 1.07-1.17) and highest quartile income (OR=1.29, 95% CI: 1.23-1.35). In addition, the people with economic activities (OR=0.87, 95% CI: 0.84-0.90) visited follow-up clinics less frequently than did the others. Current smokers (OR=0.93, 95% CI: 0.89-0.98) and inveterate drinkers (OR=0.88, 95% CI: 0.85-0.94) had a tendency to visit less often than did non-smokers and other drinkers with all cancers combined. Interpretation: We suggest primary prevention through lifestyle modifications including smoking and drinking, and environmental interventions may offer the most cost-effective approach to reduce the cancer burden.

• Nutrition Research and Practice
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• 제9권3호
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• pp.278-287
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• 2015

BACKGROUND/OBJECTIVES: Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. SUBJECTS/METHODS: Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. RESULTS: For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. CONCLUSION: Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.