• 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.

• 한국사회복지학
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• 제48권
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Journal of Preventive Medicine and Public Health
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• 제31권2호
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• pp.293-309
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• 1998

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

• 한국엔터테인먼트산업학회논문지
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• 제13권5호
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• pp.273-280
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• 2019

본 연구는 만성질환 여성 노인의 삶의 만족도 영향요인을 파악하여 삶의 만족도를 증진하기 위한 기초자료를 제공하고자 시도되었다. 제6차 국민노후보장패널 만 65세 이상 만성질환 여성 노인 1,846명을 연구 대상으로 하였다. 일반적 특성에 따른 삶의 만족도, IADL, 대인관계를 알아보기 위하여 기술통계, t-test, ANOVA를 사용하였고, 삶의 만족도에 미치는 영향요인을 알아보기 위하여 위계적 다중회귀 분석을 이용하였다. 연구 결과 만성질환 여성 노인은 나이가 어릴수록, 배우자가 있는 경우, 교육 수준이 증가할수록, 적절한 수면, 규칙적 운동, 정기 검진을 실천하는 경우 삶의 만족도가 높았다. 삶의 만족도에 수면(β=.11, p<.001), 운동(β=.07, p<.001), 월 소득(β=.13, p<.001), IADL(β=-.05, p<.001), 대인관계(β=.38, p<.001)가 유의미한 영향을 주었으며, 그 설명력은 27%이었다. 따라서 만성질환 여성 노인의 삶의 만족도를 향상하기 위하여 적절한 수면, 운동, IADL, 대인관계를 증가시키는 중재가 필요로 할 것이다.

• 성인간호학회지
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• 제17권3호
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• pp.379-388
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• 2005

Purpose: This study was conducted to explore the degree of depression, perceived health status, chronic disease and quality of life(QOL) among rural elderly and to determine the factors related to their QOL. Method: The design of this study was a correlational study. The subjects were 423 elderly consisted of 157(37.1%) men and 266(62.9%) women dwelling in a rural area of N City. Data were collected from May to December, 2003 using a structured questionnaire. A stepwise multiple regression analysis was performed to identify the factors related to the QOL. Result: It was found that the mean score of QOL was in total with 2.15 out of 5.00 and women elderly's score was significantly lower than men(t=2.20, p=.028). Perceived health status showed statistically significant positive relationship with QOL(r=.608, p<.05), while depression(r=-.751, p<.01) and chronic illness(r=-.336, p<.01) showed statistically significant negative relationship. Depression was found to have the highest correlation with QOL among the subjects. Depression score explained QOL at the most, accounting for 36.8% of the variability, followed by perceived health(8.2%) and the number of chronic illness(.7%). Other factors related to the QOL were economic status and absence of spouse. Conclusion: In order to increase the QOL of rural elderly, it is necessary to decrease the depression, to increase their perceived health status and to decrease the number of chronic illness. We suggest the implementation of a program not only to promote physical health status and self-care ability but to take care of mental health for the rural elderly.

• 대한간호학회지
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• 제37권1호
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• pp.5-13
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• 2007

Purpose: The purpose of this study was to identify the relationship between physical activity and sleep patterns of the elderly. Methods: The subjects of this study were 154 elderly who visited a community senior center in Korea. Data was collected by an interview and a self reported questionnaire, during the period from June to October, 2006. Physical activity was measured by IPAQ Korean version(2006), and sleep pattern by Korean Sleep Scale A developed by Oh et al.(1998). Results: The prevalence of chronic illness in the subjects was 73.4 %. The mean time of vigorous activity was $6.62{\pm}31.27$ minutes/day during the past week. Moderate activity time was $28.85{\pm}50.31$ minutes/day and walking time was $28.85{\pm}50.3$ minutes/day. The total sleep time was $397.63{\pm}111.53$ minutes/day. Physical activity of the elderly significantly correlated with sex, chronic illness, job, and sleep patterns of the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of sleep pattern was the satisfaction of sleep. A combination of the number of chronic illnesses, moderate physical activities(MET), and total time of sleep accounted for 44.4% of the sleep pattern. Conclusions: Moderate physical activity is more effective than vigorous physical activity for improving the sleep quality of the elderly.

• 보건의료산업학회지
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• 제12권2호
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• pp.113-123
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• 2018

Objectives : The purpose of this study was to investigate the effect of participation in social activities on the subjective health satisfaction of the elderly in groups with and without chronic diseases. Methods : Data were used from the "2014 the Korean Elderly Survey" and the subjects were 10,451 persons aged 65 years or older. Data analysis was conducted using SPSS 18.0 statistical package. Results : The results of this study were as follows. In the case of the elderly without chronic diseases, only the employment status (${\beta}=.135$, p<.01) had a significant effect on the health of the elderly. In the case of elderly people with chronic illness, participation in lifelong education (${\beta}=.183$, p<.001), participation in social group (${\beta}=.277$, p<.001), volunteer work experience (${\beta}=.060$, p<.05), and employment status (${\beta}=.342$, p<.001) had a significant effect on health. Conclusions : Policies and systems are needed to actively encourage and support the social activities of the elderly. Additionly, care and attention are needed to provide social jobs for the elderly and build a sustainable network.

• 한국콘텐츠학회논문지
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• 제17권2호
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• pp.429-438
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• 2017

본 연구는 만성질환 노인의 주관적 건강이 우울인식에 어떠한 영향을 미치는지 그리고 주관적 건강과 우울인식과의 관계에서 사회적 친분관계 만족과 여가생활 만족의 완충효과를 살펴보는 것을 목적으로 한다. 이를 위해 2015년 한국복지패널 10차 자료를 활용하여 만성질환을 가진 노인 4,831명을 대상으로 분석을 실시하였다. 변수들의 조절효과를 알아보기 위해 위계적 회귀분석을 실시하여 $R^2$의 변화량을 확인하였다. 분석결과 첫째, 주관적 건강, 사회적 친분관계만족, 여가생활 만족은 모두 우울인식에 직접적인 영향력을 보였다. 이는 만성질환 노인들의 주관적 건강이 좋을수록, 사회적 친분관계 만족도가 높을수록, 그리고 여가생활 만족이 높을수록 우울인식이 낮다는 것을 보여준다. 둘째, 사회적 친분관계 만족과 여가생활 만족은 주관적 건강과 우울인식과의 관계에서 조절변수로 확인되었다. 이는 사회적 친분관계나 여가생활에 대한 양적 접근보다는 당사자의 주관적 측면에 대한 접근이 중요함을 확인하는 결과라고 할 수 있다. 이러한 결과를 바탕으로 연구의 의의와 제한점 그리고 추후 연구에 대한 제언을 제시하였다.

• 한국노년학
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• 제40권2호
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• pp.257-267
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• 2020

본 연구는 지역사회에 거주하는 만성질환을 가진 노인을 대상으로 하여 자기관리 프로그램의 효과 및 사용하는 측정도구가 무엇인지 확인하는데에 목적을 두고 있다. 문헌검색을 위해 사용된 데이터베이스는 Google Scholar, RISS, Dbpia였으며, PICO 기준틀을 기반으로 연구질문을 선정하였다. 2010년 1월부터 2019년 9월까지 발표된 문헌을 검색하여 포함기준과 배재기준을 적용하여 최종 6편의 문헌을 선정하였다. 연구결과, 선정된 문헌은 Level 1-2의 질적수준을 가지고 있었다. 프로그램의 일반적 특성에서는 간호사가 가장 많이 프로그램을 진행 하였으며, 프로그램은 노인 50명 이하를 대상으로 운영되었다. 또한, 주로 보건소와 노인정, 경로당에서 프로그램이 진행되었다. 연구대상자는 고혈압을 가진 만성질환자를 대상으로한 문헌이 가장 많았으며, 프로그램의 종속변수는 모든 문헌에서 인지적 영역을 다루었고, 그 뒤로 신체적 영역을 종속변수로 측정한 문헌이 많았다. 본 연구결과는 지역사회에 거주하는 만성질환을 가진 노인에게 자기관리에 대한 중재의 효과성을 제공하고, 지역사회에 만성질환을 대상으로 하는 프로그램 개발에 대한 필요성을 강조한다. 또한, 노인의 다양한 인지적, 신체적, 정신적, 사회적, 삶의 질의 영역에 관련된 측정도구를 제시하며 다학제간 연구의 필요성을 제시힌다.

• Journal of Preventive Medicine and Public Health
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• 제44권1호
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• pp.32-40
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• 2011

Objectives: This study investigated the gender and age differential effect of major chronic diseases on activity of daily living (ADL) disability. Methods: Surveyfreq and Surveylogistic regression analyses were employed on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) with a sample of 3,609 persons aged 65 - 89. Results: After adjusting for potential covariates, stroke, among elderly men more so than women, had a 2-3 times greater odds of engendering ADL disability in the 65-69 (p < 0.05) and 70-79 age groups (p < 0.01). In comparison to elderly women, cancer, diabetes, and incontinence in elderly men was associated with a higher risk of ADL disability in the 70 - 79 age group (p < 0.05), and this association was also observed for pulmonary disease in the 80-89 age group. Among elderly women, however, a significant association between incontinence and ADL disability was identified in all three age groups. In addition, this association was found in pulmonary disease and diabetes in elderly women aged 70 - 79 years. Significant gender differences were observed in the association between stroke in the 60 - 79 age group and cancer in the 70 - 79 age group. Conclusions: Age and gender differences were observed in the effect of chronic diseases on ADL disability.