• 제목/요약/키워드: depression in old age

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빈곤층 여성 노인의 우울에 미치는 영향요인 (Factors Affecting the Depression of the Elderly Women in Poverty)

  • 박언아;이인숙
    • 농촌의학ㆍ지역보건
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    • 제34권2호
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    • pp.256-266
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    • 2009
  • 본 연구는 65세 이상 빈곤층 여성 노인의 우울에 영향을 미치는 요인을 파악하기 위하여 방문건강 관리사업 대상자 중 노인 교육프로그램 대상에게 수집된 기초자료를 분석한 서술적 조사연구이다. 연구대상자는 방문건강관리사업 대상자로, 2008년 4월 1일부터 5월 30일까지 기초생활수급권자, 차상위계층, 건강보험료부과하위 20%에 속하는 빈곤층 여성 노인 1,410명을 임의표출하여 조사하였다. 방문간호사가 대상자에게 자료 수집 및 방문건강관리서비스 제공에 대하여 설명하고, 대상자가 동의한 이후에 구조화된 설문지를 이용하여 직접 면담을 통해 시행하였고 이 중 1,208명만이 최종분석에 포함되었다. 수집된 자료는 SPSS프로그램을 이용하여 서술적통계분석, Pearson correlation coefficients, $x^2$-test, 다변량 로지스틱 회귀분석을 통해 분석하였고, 연구결과를 요약하면 다음과 같다. 첫째, 연구대상자의 연령은 75~84세가 54.4%로 가장 많았고, 배우자가 없는 경우가 87.8%로 무 배우자 비율이 높고, 간접적 경제수준인 의료보장 유형에서 의료급여가 74.9%를 차지하였다. 교육수준은 무학이거나 초등학교 졸업이 92.4%로 조사되었다. 둘째, 주관적 건강상태가 ‘나쁨’이 72.7%, 보유 만성질환 수는 평균 2.81개, 인지기능이 13.51점 으로 나타났다. 셋째, 일반적 특성과 건강행태, 건강수준 변수들이 우울에 미치는 영향요인을 분석한 결과, 무배우자일수록(p<.05), 인지기능이 낮을수록(p<.01), 주관적 건강감이 낮을수록(p<.001) 우울한 것으로 나타났다. 연령, 교육수준, 건강행태, 일상생활수행능력, 도구적 일상생활수행능력, 보유 만성질환 수에서는 우울정도에 유의미한 차이를 보이지 않았다. 본 연구결과를 토대로 다음과 같이 제언하고자한다. 첫째, 사회적 지지 및 가족지지를 포함한 심리 사회적 요인이나, 영양, 질병특성을 고려하여 우울에 영향을 미치는 요인을 규명하는 심층연구가 필요하다. 둘째, 빈곤층 여성 노인을 대상으로 우울 감소를 위한 중재프로그램을 제공할 때 우선적으로 차별화된 맞춤식 중재가 요구되며 노인의 기초적인 생활보장문제와 인지기능과 주관적 건강상태를 고려한 지역사회 기반의 통합 프로그램의 개발 및 운영이 요구된다.

뇌졸중 노인의 기능장애 정도, 일상생활 수행능력, 우울과 삶의 질 간의 관계 (The Relationship of Dysfunctions Degree, Daily Living Activity, Depressiveness and Quality of Life among the Elderly Suffering from Stroke)

  • 박인숙;김도연;강창렬
    • 보건의료산업학회지
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    • 제5권2호
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    • pp.173-186
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    • 2011
  • The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

한국 산모의 산후 우울과 산후 외상 후 스트레스장애 관련성: 종단적 연구 (Association of postpartum depression with postpartum posttraumatic stress disorder in Korean mothers: a longitudinal survey)

  • 조현진;고민선;유혜지;안숙희
    • 여성건강간호학회지
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    • 제28권1호
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    • pp.46-55
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    • 2022
  • Purpose: This study aimed to determine the level of postpartum posttraumatic stress disorder (PTSD) and postpartum depression (PPD) in Korean mothers with healthy babies and to explore the factors related to postpartum PTSD. Methods: This study used a longitudinal survey design to explore the levels and association of PPD and PTSD. Two hundred women were recruited during pregnancy and the data were collected via online survey from 166 mothers (84% retained) who gave birth to healthy babies, at two postpartum periods: Fear of childbirth was assessed at the 1st week; and spousal support, PPD, and postpartum PTSD were surveyed at the 4th week postpartum. Descriptive statistics, t-test, one-way analysis of variance, Chi square test, and multiple regression were done. Results: The mean age of mothers was 33.12 (±3.97) years old. Postpartum PTSD was low (8.95±6.49) with 1.8% (n=3) at risk (≥19). PPD was also low (6.68±5.28) and 30.1% (n=50) were identified at risk (≥10). The comorbid rate of PPD with PTSD was 6%. Mothers who did not have a planned pregnancy had higher scores of PPD (t=-2.78, p=.008), whereas spousal support and PPD had negative relationship (r=-.21, p=.006). The overall explanatory power for postpartum PTSD was 55.2%, of which PPD was the only significant variable (β=. 76, t=13.76, p<.001). Conclusion: While only 1.8% was at risk of postpartum PTSD at 4 weeks postpartum, PPD prevalence was 30.1% and PPD was the only influential factor of postpartum PTSD. Assessment and counseling of PPD are required as well as screening for postpartum PTSD. More research is also needed on postpartum PTSD in Korean women.

임상가를 위한 특집 3 - 한국 노인에서 저작불편감과 복합만성질 환의 연관성: 제4기 국민건강영양조사 (Chewing difficulty and multiple chronic conditions in Korean elders: KNHANES IV)

  • 한동헌
    • 대한치과의사협회지
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    • 제51권9호
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    • pp.511-517
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    • 2013
  • To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

Comparison of Adults with Attention-Deficit Hyperactivity Disorder Depending on the Age of Being Diagnosed in Childhood and Adulthood: Based on Retrospective Review in One University Hospital

  • Cho, Seong Woo;Lee, Yeon Jung;Lee, Seong Ae;Hong, Minha;Lee, Sang Min;Park, Jin Cheol;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권3호
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    • pp.183-189
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    • 2017
  • Objectives: The study aimed to identify the characteristics of attention-deficit hyperactivity disorder (ADHD) that was not diagnosed in childhood or adolescence, but only in adulthood. Methods: The characteristics of patients diagnosed with ADHD in adulthood were compared with those of patients diagnosed in childhood were assessed via a retrospective review of the medical records at one university hospital from 2005 to 2013. If the age at which they were confirmed as having ADHD was less than 19 years old, they were grouped as childhood-diagnosed group (CD); if they were 19 years old or more, they were grouped as adulthood-diagnosed group (AD). Results: The CD and AD included 50 (46.3%) and 58 (53.7%) patients, respectively. Inattention was the most common symptom in both groups. Behavioral and emotional problems were the second most frequent symptoms in the CD and AD, respectively. The intelligent quotient was significantly higher in the AD than in the CD. The most common comorbidity was depression in the CD and personality disorder in the AD. The most common reason for visiting the hospital was referral by acquaintances in the CD and media coverage in the AD. Conclusion: Clinicians should put ADHD on the index of suspicion when they examine adults with various psychiatric symptoms, because the diagnosis of ADHD might have been missed in childhood and the symptoms of ADHD might have changed as they grew up.

소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험 (A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS)

  • 김승태;홍경수
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제5권1호
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    • pp.83-92
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    • 1994
  • 본 연구의 목적은, 선택적 serotonin 재흡수 차단제(selective serotonin re-uptake inhibitors : SSRI)로서 불안증상을 동반한 비정신병적 우울증에 효과적인 치료제로 알려지고 있는 paroxetine의 항우울 및 항불안 효과를 검증하고, 성별 및 연령별로 효과의 차이를 파악하는 것이다. 이를 위해 8~55세 사이의 우울신경증 환자 232명을 대상으로 paroxetine과 위약을 이중맹 교차방식으로 투여한 후, 우울 및 불안 증상의 호전도를 Hamilton Depression Scale(HDS)과 Hamilton Anxeity Scale(HAS)로 측정하여 다음과 같은 결과를 얻었다. 1) HDS로 측정된 우울증상에 대해, 성별 및 연령별로 구분된 8개 대상군에서 모두 paroxetine이 위약에 비해 통계적으로 유의하게 높은 호전 효과를 보였다. 2) HAS로 측정된 불안증상에 대해서도, 성별 및 연령별로 구분된 8개 대상군에서 모두 paroxetine이 위약에 비해 통계적으로 유의하게 높은 호전 효과를 보였다. 3) 위약과 비교시, paroxetine의 항우울 효과는 소아 ${\cdot}$ 청소년 여자 환자군에서 가장 두드러졌고, 항불안 효과는 남 ${\cdot}$ 녀 소아 환자군과 35세 이하의 성인 여자 환자군에서 가장 높은 경향을 보였다. 4) 부작용으로는, 전체 232례 중 3례에서 paroxetine 투여 후 경미한 소화불량 및 복통증상을 나타내었으나, 3례 모두 약물의 감량이나 투여중단 없이 회복이 가능했다. 이상의 결과에서 paroxetine은 소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에서 2주 이내에 위약보다 유의하게 우수한 항우울 및 항불안 효과를 나타내는 것을 알 수 있었다. 향후 보다 장기간의 치료실험을 통하여 이러한 효과의 장기간 지속성에 대한 검증이 필요한 것이다.

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노인들이 지각하고 있는 건강수준에 관한 연구 (A Study on the Health as Perceived by the Aged)

  • 양경희;장혜숙;김영희
    • 지역사회간호학회지
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    • 제7권2호
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    • pp.229-243
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    • 1996
  • The purpose of this study was to develop a nursing model for the aged. This study was conducted to measure the physical, psychological and mental health status of the aged and to identify relationships between these health levels and various variables. The data were collected from 172 aged(over 60 years old) by interviews. The tools used for this study was a structured questionnaire which was developed and revised by the researchers. The tool consisted of 22 items on physical health assessment, 7 items on psychological health assessment, 9 items on mental health assessment and 10 items on an ADL evaluation. The major results of the study were as follows ; 1. In physical health, the aged complained of visual disturbance(60.5%), incontinence of urine (55.2%), back or muscle pain(73.3%), dizziness(70.3%) and diarrhea or constipation(44.2%). In psychological health, most aged people felt anger when they got some order from an other person(80.2%). Also, they had depression (69.8%) and felt like dying(64.0%). The ADL level was mostly normal for daily life. 2. The aged man was more healthy than the aged woman in physical and mental health especially the 60-64 year old group. The physical, mental health and ADL level had a positive correlation with age(p>.004), but psychological health had a negative correlation with age. 3. The physical, psychological, mental health and ADL level was positively interrelated with each other. 4. The physical, mental health, & ADL level lowered with inceasing age. Physical & psychological health worsened rapidly from 65-69 years, but for 10-15 years, their health level was preserved. Psychological health level was high in 80-84. 5. The physical health was affected by edu cational level, sex and pocket money (R=.4029, 16.24%). The psychological health was affected by the supportive style and pocket money (R=.5128, 26.30%). And the mental health was affected by education level, age, support ive style, sex and job(R=.4377, 19.16%). As seen above, we suggest the intervention of the young for the old to cope with their life and to maintain their healthy late adulthood. Also, if they have received psychological support in the institution, they will maintain healthy life condition. For further studies should be a search for variables that affect aged health, and should contribut to a nursing program better suited for the aged.

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일부 여대생의 취업스트레스, 무망감 및 우울이 출산인식에 미치는 융복합적 영향 분석 (Analysis of Convergent Influence of Job Seeking Stress, Hopelessness and Depression on Childbirth Perception among Some College Women)

  • 김승희;배상윤
    • 디지털융복합연구
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    • 제14권9호
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    • pp.389-397
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    • 2016
  • 본 연구는 일부 여대생의 취업스트레스, 무망감 및 우울과 출산인식 간의 관련성을 파악하고 출산인식에 미치는 융복합적 영향을 분석하였다. 조사대상은 전북지역의 3개 대학에서 임의로 선정된 531명으로 하였으며, 자료수집은 2016년 3월 28일부터 4월 29일까지 자기기입식 설문지를 통해 이루어졌다. 일반적특성에 따른 출산인식 점수는 연령이 높은군에서, 종교가 있는군에서, 학교생활만족도가 높은군에서, 비음주군에서 유의하게 높았다. 취업스트레스가 높은군에서, 무망감은 중증도와 중도군에서, 우울은 경도군에서 출산인식 점수가 높았다. 출산인식은 취업스트레스, 무망감 및 우울과 양의 상관관계를 보였다. 공분산 구조분석 결과, 취업스트레스, 무망감 및 우울과 출산인식의 인과관계가 확인되었다. 취업스트레스는 무망감 및 우울보다는 출산인식에 더 큰 영향을 미치는 것으로 나타났다. 이러한 결과는 여대생의 출산인식에 대한 긍정적 인식을 높이는 보건교육에 활용이 기대된다. 향후 연구에서는 출산인식에 융복합적인 영향을 미치는 추가적인 요인에 대한 분석이 필요하다.

외국인에서 발생한 심각한 이차 입술갈림코변형에 대한 한 단계 수술 (One Stage Correction of the Severe Secondary Cleft Lip Nasal Deformities in Foreigners)

  • 김석권;김주찬;박수성;이근철
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.102-106
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    • 2011
  • Purpose: It is accepted universally that correction of the cleft lip nasal deformity requires multiple stages of surgery. Following primary lip repair in infancy or early childhood, secondary surgery to improve the deformity of the lip and nose is frequently necessary. A suitable surgical procedure to correct the accompanying deformity, such as cleft palate and alveolus, must be carried out at an appropriate age. In developing countries, it is common for patients with cleft lip nasal deformity to present severe secondary deformities in adolescence, because of poor follow-up and inappropriate surgery. Methods: The first patient was a 12 year old Mongolian boy. He presented prominent lip scar, short lip, wide columella, asymmetric nostril, palatal fistula, cleft alveolus, and velopharyngeal incompetence. He underwent cheilorhinoplasty, transpositional flap, alveoloplasty by iliac bone graft, and sphincter pharyngoplasty. On follow-up, a bilateral maxillary hypoplasia and a class III malocclusion developed. He underwent LeFort I osteotomy and maxillary advancement at the age of 16 years. The second patient was an 18 year old Eastern Russian girl. She presented with a deviated nose, right alar base depression, short lip, protrusion on vermilion, large palatal fistula, and severe VPI due to short palate. She underwent the combined procedure of cheilorhinoplasty, corrective rhinoplasty, tongue flap for palatal fistula, and superiorly based pharyngeal flap. And the tongue flap was detached at postoperative 3 weeks. Results: The overall results have been extremely pleasing and satisfactory to patients. There were no postoperative complications. Conclusion: We discovered the one stage operation for radical correction was sufficient procedure to provide excellent clinical outcomes in patients with severe cleft lip nose deformity.

마리화나 흡연으로 인해 발생한 젊은 연령 뇌경색 1례 (A Case of Ischemic Stroke in Young Patient Associated with Marijuana Use)

  • 하수영;강동완;이승훈
    • 대한임상독성학회지
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    • 제18권1호
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    • pp.47-50
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    • 2020
  • A 21-year-old female patient complaining of hemiparesis was diagnosed with right middle cerebral artery infarction. No risk factor was found, despite an extensive young-age stroke work-up, except her history of marijuana use. The patient had smoked marijuana for treating depression for more than five years. Magnetic resonance angiography showed multifocal intra- and extracranial stenoses, suggesting cannabinoid-induced vasculopathy. Since the use of illicit drugs has increased nationwide, physicians should consider it as a possible cause of a stroke due to an unknown etiology.