• 대한지역사회영양학회지
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• 제22권3호
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• pp.207-217
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• 2017

Objectives: The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM). Methods: A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3. Results: About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were 'internet (50.0%)' and 'expert advice (45.0%)'. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as 'the cause of ketosis', 'the goal of nutrition management for GDM', 'the importance of sugar restriction on breakfast'. The major obstructive factors in dietary management were 'eating more than planned when dining out', 'finding the appropriate menu when dining out'. The preferred nutrition information contents in developing management program were 'nutritional information of food', 'recommended food by major nutrients', 'the relationship between blood glucose and food', 'tips on menu selection at eating out'. The subjects reported that they need management program such as 'example of menu by calorie prescription', 'recommended weight gain guide', 'meal recording and dietary assessment', 'expert recommendation', 'sharing know-how'. Conclusions: Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.324-333
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• 2018

본 연구의 목적은 만성질환인 고혈압, 이상지질혈증, 관절염, 갑상선 질환, 우울증, 아토피, 알레르기, 당뇨병 등의 잠재계층이 어떻게 구성되어 있는지와 유형화된 만성질환의 예측요인을 살펴보고자 하는 것이다. 연구대상은 2014년 국민건강영양조사에 참여한 대한민국 국민으로, 표본추출방법은 층화집락표본추출방법을 사용하였으며 표본 수는 총 7,550명이고, 이를 대상으로 잠재계층분석을 적용하였다. 결과적으로 1 class 유형은 고혈압, 당뇨 그룹으로 고혈압을 앓고 있을 확률이 78.6%이고 당뇨병을 앓고 있을 확률이 34.6%이었다. 2 class 유형은 아토피, 알레르기 그룹으로 아토피를 앓고 있을 확률이 20.3%이고 알레르기를 앓고 있을 확률이 42.2%이었다. 3 class 유형은 이상지질, 관절염, 갑상선질환, 우울증 그룹으로 이상지질 56.1%, 관절염 50.9%, 갑상선 질환 19.4%, 우울증 28.75%로 나타날 확률을 지닌 집단이었다. 4 class 유형은 만성질환을 갖고 있지 않은 정상집단으로 나타났다. 준거변수인 4 class와 1 class를 비교하였을 때, 연령, 운동능력, 자기관리, 비만, 고콜레스테롤 유병여부 등이 유의하게 나타났고, 2 class와 비교하였을 때, 성별, 연령, 교육수준 등이 유의하게 나타났으며, 3 class와 비교하였을 때, 성별, 연령, 통증 및 불편, 고 콜레스테롤 등이 유의하게 나타났다. 결과적으로 세 유형 모두 연령은 복합적인 만성질환을 일으킬 수 있는 요인으로 나타났는데, 이는 질환을 일으킬 수 있는 결정적인 시기가 오기 전에 예방이 중요하다는 것을 의미한다. 따라서 연령에 따른 질병의 유병율 발생 시기를 파악하여 이에 적절한 예방적 노력이 필요하다.

• Nutrition Research and Practice
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• 제12권1호
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• pp.69-77
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• 2018

BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998-2014). In our analysis, 4,148 patients with T2DM, aged ${\geq}30years$, were categorized according to the duration of their illness (< 5 years, 5-9 years, and ${\geq}10years$). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (${\geq}10years$) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61-3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ${\geq}10years$ (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.

• 한국산학기술학회논문지
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• 제20권2호
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• pp.580-586
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• 2019

본 연구는 국민건강영양조사 제6기 원시자료를 이용하여 만20~44세의 성인 여성 2,134명을 대상으로, 가임기 여성의 만성질환과 구강건강행태의 관련성을 살펴보고, 각 요인들이 치주질환에 미치는 영향에 대하여 살펴보고자 한다. 본 연구결과 다음과 같다. 연령대(p<0.001), 교육수준(p<0.001), 결혼상태(p<0.001), 소득수준(p<0.05), 흡연(p=0.05), 출산경험(p<0.001)은 통계적으로 유의한 차이를 나타냈다. 만성질환 요인은 고혈압(p<0.001), 비만(p<0.001), 당뇨(p<0.001), 고콜레스테롤혈증(p<0.05), 저콜레스테롤혈증(p<0.001), 고중성지방혈증(p<0.001)에서 통계적으로 유의한 차이를 나타냈다. 구강건강 행태요인은 치통(p=0.05), 교정치료(p<0.05), 저작불편(p<0.05) 에서 통계적으로 유의한 차이를 나타냈다. 치주질환에 영향을 미치는 위험요인을 살펴본 결과, 만성질환요인에서 정상군에 비해 비만군에서 1.576배, 당뇨군에서 2.569배 치주질환 위험도가 더 높은 것으로 나타났다. 구강건강행태요인은 구강위생용품미사용자가 1.372배 치주질환 위험도가 더 높은 것으로 나타났다. 주관적 구강건강상태는 좋은 여성에 비해 나쁜 여성이 1.614배 치주질환 위험도가 더 높은 것으로 나타났다. 이상의 결과로 볼 때 여성의 만성질환 중 당뇨병이 치주질환 가장 큰 위험도를 나타냈으며, 당뇨와 비만은 관련성이 크므로 치주질환 위험요인으로 중요한 변수라 사료된다. 이에 복합적인 만성질환과 치주질환의 위험성을 살펴볼 필요가 있으며, 향후 여성의 치주질환을 위한 구강보건교육프로그램 확대 및 구강보건정책 마련이 필요하다.

• 한국간호교육학회지
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• 제22권1호
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• pp.72-82
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• 2016

Purpose: The purpose of this study was to identify the effects of health status and health management on activities of daily living (ADL) in older, urban-dwelling Koreans. Methods: A total of 206 subjects were recruited from one senior welfare center, six senior citizen centers, and subjects' home in two cities. Data was collected with self-reported questionnaires in order to measure health management, health status, and ADL. Data was analyzed by t-test, ANOVA, and stepwise multiple linear regression using SPSS/WIN 22.0. Results: ADL in this subject were different depending on their age, education, marital status, type of family, and average monthly living expenses. Multivariate analysis showed that age (${\beta}=-0.35$, p<.001), exercise ability (${\beta}=0.20$, p<.001), diabetes (${\beta}=-0.17$, p<.001), osteoarthritis (${\beta}=-0.15$, p<.001), caregiver (${\beta}=0.14$, p=.005), frequency of health management (${\beta}=-0.13$, p=.006), smoking (${\beta}=-0.11$, p=.019), hypertension (${\beta}=-0.10$, p=.027), and type of family (${\beta}=-0.10$, p=.036) were significantly associated with ADL. Overall, approximately 60.2% of total variability in ADL could be explained by the 11 variables in this model ($R^2=0.602$, F=32.06, p<.001). Conclusion: This study suggests that individualized health care should be continued for older, community-dwelling Koreans in order to improve their ADL. Moreover, we need to develop self-care programs and encourage them to participate in those programs.

• 대한지역사회영양학회지
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• 제19권1호
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• pp.71-83
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• 2014

The purpose of the study was to implement and evaluate a nutrition capacity training program for dietitians and other professionals working at customized home visiting health services (CHVHS). This program focused on nutrition services for hypertension or diabetes mellitus patients including topics regarding CHVHS, and composed of 10 sessions with lectures, discussion and practice. Dietitians (n = 54) and other professionals (n = 20) participated in the program and completed the questionnaire to assess their understanding of nutritional management, nutrition services and CHVHS before and after the program, and to examine program satisfaction and education needs. Subjects were mostly women (98.6%) and college or university graduates (93.2%). Total score (p < 0.001), as well as all items (p < 0.001 or p < 0.01) of understanding regarding nutritional management, nutrition services and CHVHS, were significantly increased after the program both in dietitians and in other professionals. Subjects were generally satisfied with the program, showing more satisfaction with items regarding subject's participation, acquiring new knowledge, usefulness of the program for CHVHS, and education materials. In future nutrition capacity training programs, subjects wanted to have classes regarding nutrition services for specific chronic diseases, development of education materials, methods for dietary life education, modifying eating habits and so on. Other professionals compared to dietitians, showed higher education needs in meal management (p < 0.01) and nutrition counseling skills (p < 0.05). This study showed the effectiveness of a nutrition capacity training program for home-visiting dietitians and other professionals, and suggests the need and direction for future nutrition capacity training programs.

• 보건행정학회지
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• 제30권3호
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• pp.355-365
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• 2020

Background: This study is aimed to verify individual and regional-level factors affecting the depression of Koreans and to develop social programs for improving the depressive status. Methods: This study used individual-level variables from the Korean Community Health Survey (2018) and used the e-regional index of the Korean Statistical Information Service as the regional-level variable. A multi-level logistic regression was executed to identify individual and regional-level variables that were expected to affect the extent of depressive symptoms and to draw the receiver operating characteristic curve to compare the volume of impact between variables from both levels. Results: The results of the multi-level logistic regression analysis in regards to individual-level factors showed that older age, female gender, a lower income level, a lower education level, not having a spouse, the practice of walking, the consumption of breakfast higher levels of stress, and having high blood pressure or diabetes were associated with a greater increase in depressive symptoms. In terms of regional factors, areas with fewer cultural facilities and fewer car registration had higher levels of depressive symptoms. The comparison of area under the curve showed that individual factors had a greater influence than regional factors. Conclusion: This study showed that while both, individual and regional-level factors affect depression, the influence of the latter was relatively weaker as compared to the first. In this sense, it is necessary to develop programs focused on the individual, such as social prescribing at the local or community-level, rather than the city and nation-level approach that are currently prevalent.

• Safety and Health at Work
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• 제8권2호
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• pp.117-129
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• 2017

Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

• 지역사회간호학회지
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• 제16권4호
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• pp.517-526
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• 2005

Purpose: The purpose of this study is to find taxi drivers' smoking behavior, self-efficacy and expectation level of success in smoking cessation. It will provide useful information for developing nursing interventions in health promotion programs. Method: The subjects of this study were 271 taxi drivers in Seoul and its metropolitan area. Data were collected using a self-reported questionnaire asking smoking history, smoking behaviors, health problem, stages of change for smoking cessation, self-efficacy and the expectation level of success in smoking cessation. Data were analyzed through descriptive statistics. Pearson's correlation, Mann-Whitney U test, Kruskal-Wallis test and Cronbach's a. Results: Of the taxi drivers, 83.8% were current smokers. Stages of change were as follows: 45.8% were in the precontemplation stage, 26.2% in the contemplation stage, 13.7% in the maintenance stage, 12.2% in the preparation stage and 1.5% in the action stage. In addition. 20.3% of the subjects reported health problems such as hypertension, heart disease, diabetes mellitus and respiratory disease. The expectation level of success in smoking cessation was positively related with self-efficacy. There were statistically significant differences in the expectation level of success in smoking cessation according to the number of cigarettes per day and nicotine dependency. In addition. there were statistically significant differences in self-efficacy according to the number of cigarettes per day, duration of smoking (years) and nicotine dependency. Conclusion: The results of this study suggest that taxi drivers' health problems and smoking rate were serious. Therefore more systematic health promotion programs for smoking cessation should be developed and executed by health care specialists at individual taxi companies.

• 대한간호학회지
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• 제37권5호
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• pp.790-800
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• 2007

Purpose: This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. Methods: A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. Results: Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. Conclusion: Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.