• 제목/요약/키워드: financial stress

검색결과 201건 처리시간 0.024초

How to delay the progression of chronic kidney disease: focusing on medications

  • Jeesu Min
    • Childhood Kidney Diseases
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    • 제28권2호
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    • pp.51-58
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    • 2024
  • Patients with chronic kidney disease (CKD) bear a significant financial burden and face numerous complications and higher mortality rates. The progression of CKD is associated with glomerular injury caused by glomerular hyperfiltration and oxidative stress. Factors such as uncontrolled hypertension, elevated urine protein levels, anemia, and underlying glomerular disease, contribute to CKD progression. In addition to conservative treatment, several medications are available to combat the progression of CKD to end-stage kidney disease. Renin-angiotensin-aldosterone system blockers could slow the progression of CKD by reducing glomerular hyperfiltration, lowering blood pressure, and decreasing inflammation. Mineralocorticoid receptor antagonists inhibit the mineralocorticoid receptor signaling pathway, thereby attenuating inflammation and fibrosis. Sodium-glucose cotransporter 2 inhibitors exhibit protective effects on the kidneys and against cardiovascular events. Tolvaptan, a selective vasopressin V2-receptor antagonist, decelerates the rate of increase in total kidney volume and deterioration of kidney function in patients with rapidly progressive autosomal dominant polycystic kidney disease. The protective effects of AST-120 remain controversial. Due to a lack of evidence regarding the efficacy and safety of these medications in children, it is imperative to weigh the benefits and adverse effects carefully. Further research is essential to establish the efficacy and safety profiles in pediatric populations.

맞벌이 부인의 가족지원서비스 필요도 결정요인 : 전문직과 생산직 모델 비교 (Determinants of Dual-earner Wives' Needs for Family-supportive Services: A Comparison of Professional and Blue-collar Models)

  • 이명신
    • 한국사회복지학
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    • 제36권
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    • pp.199-228
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    • 1998
  • 맞벌이 부인의 가족지원 서비스 필요도를 결정짓는 요인을 조사하기 위해, 맞벌이 부인의 스트레스와 역할과중을 증대시키는 직장과 가정의 상황 구조적 요인들을 나타내는 여섯 가지 스트레스원, 역할과중, 스트레스, 네 종류의 맞벌이가족 지원서비스 (보육비지원 서비스, 직장내 보육서비스, 휴직제도, 유동근무제도)에 대한 필요도 간의 상호 관계를 설명할 수 있는 포괄적인 이론모델을 개발하였다. 맞벌이가족 지원서비스 필요도를 결정짓는 요인에 있어서의 계층간 공통점과 차이점을 비교하기 위해, 전문직 맞벌이 부인과 생산직 맞벌이 부인의 모델을 별도로 개발하여 비교하였다. 본 연구에서 개발된 모델은 진주.사천지역에 거주하는 234명의 전문직 맞벌이 부인과 208명의 생산직 맞벌이 부인으로부터 수집된 설문조사 자료를 통하여 검증되었다. 공변량 구조분석을 이용하여, 변인들 간의 구조관계를 설명할 수 있는 최적의 이론구조모델이 선정되었다 (전문직 모델: df=141, GFI=0.928, CFI=0.965; 생산직 모델: df=141, GFI=0.902, CFI=0.912). 자료분석 결과, 현재 이용 중인 보육서비스에 대한 불만족도가 높을 수록, 근무시간이 길 수록, 맞벌이 부인들의 역할과중은 증가하며, 역할과중은 스트레스를 증가시키는 것으로 나타났다. 스트레스가 증가할 수록, 맞벌이 부인들은 휴직제도를 필요로 하는 것으로 나타났다. 한편, 자녀가 어릴 수록 보육비 지원서비스를 필요로 하고 있으며, 자녀의 나이가 증가될 수록 유동 근무제도를 필요로 하는 것으로 나타났다. 보육비지원 서비스에 대한 필요도가 높을 수록 직장내 보육서비스에 대한 필요도가 높으며, 직장내 보육서비스의 필요도가 높을 수록 휴직제도에 대한 필요도가 높게 나타났다. 또한 휴직제도에 대한 필요도가 높을 수록 유동근무제도에 대한 필요도도 높게 나타났다. 이와 같은 전문직과 생산직 맞벌이 부인 모두에게 일반화될 수 있는 9가지 공통적 인과관계를 제외하고는 전문직과 생산직 부인의 서비스 필요도 결정요인에 있어 상당한 차이점이 발견되었다. 두 집단의 공통적 요인과 차별적 요인에 대한 논의를 바탕으로, 각 직장의 환경과 개인의 필요에 따라 맞벌이 부인이 가장 필요로 하는 서비스를 차별적으로 제공할 수 있는 방안이 제시되었다.

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고등학교 교사의 건강지각과 건강증진행위의 관계 (The Relationship Between High School Teachers Health Perception and Health Promotion Behavior)

  • 김동환;박영수
    • 한국학교ㆍ지역보건교육학회지
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    • 제4권
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    • pp.21-41
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    • 2003
  • The purposes of this study were to ; first, investigate High School Teachers health promotion behavior types; second, explore the effects High School Teachers perceived benefits and perceived barriers have on their health promotion behavior ; third, suggest a desirable course that will increase teachers health. To this end, this researcher conducted a survey on health promotion behavior, perceived benefits, and perceived barriers to 329 High School teachers working in Goyang-si, Gyonggi-do. The results of the survey are as follows: Health Promotion Behavior A closer look at high school teachers health promotion behavior shows that male teachers, compared with female teachers, more actively promote their health. However, female teachers are more aware of their personal hygiene and disease risks. Older teachers, rather than younger teachers, are more willing to promote their health through better eating habits and more frequent exercise. A comparison between married and single teachers revealed that married teachers promote their health through better eating habits, and single teachers receive less stress and are better at managing their stress. Teachers working in technical high schools are better at managing their stress and personal hygiene than academic high schools teachers. Teachers working after 8 o'clock show better health promotion behavior through proper eating habits, stress management, regular exercise, disease prevention: however, teachers working before 7:30 are poor at managing their stress. Teachers not teaching supplementary lessons and not supervising night self-study are better at managing their stress, exercise schedule, and disease prevention than teachers who are. Perceived Benefits, Perceived Barriers, and Health Promotion Behavior A Comparison between male and female teachers shows that female teachers firmly believe improved eating habits and regular exercises would greatly enhance their health. However, female teachers felt more discomfort in their working environment and in utilizing medical institutes. Teachers in the 20s and 40s perceived health benefits through regular lifestyle and exercise. Teachers with less experience feel more pressure from their work environment. Teachers below their 30s feel more dissatisfaction towards using medical facilities. Teachers working in Technical High Schools are more aware of promoting their health through regular health checkups, exercise, and lifestyle ; however, teachers from Academic High Schools feel more pressure from their work environment. Teachers not performing supplementary lessons and supervising night self-study sessions are more willing to go through regular health checkups than those performing them. Also, teachers with supplementary lessons and night self-study supervisions claimed lack of leisure time, pressure from work environment, and inconvenience in using medical facilities a deterrent to promoting their health behavior. The Relationship between Health Promotion Behavior, Perceived Benefits, and Perceived Barriers The correlation ratio between Health Promotion Behavior and Perceived Benefits shows a positive relationship. The results show that High School teachers believed regular health checkups are necessary in maintaining their health. This research shows that teachers consider the following factors important in the order shown ; regular lifestyle and exercise, prevention of geriatric diseases, improving ones eating habits. In short, teachers who are more aware of the importance of regular health checkups are also more aware of the importance of promoting their health. The correlation ratio between Health Promotion Behavior and Perceived Barriers shows negative relationship. High School Teachers believe that lack of leisure activity, pressure from work environment, familys financial burden, fear of diseases, inconvenience in using medical facilities are a deterrent in promoting their health behavior. In other words, teachers with less leisure time and negative pressures from their work environment were less active in promoting their health behavior. This study shows that High School teachers will be able to promote their health behavior by maintaining regular health checkups, lifestyle, exercise, and preventing geriatric diseases. However, teachers believed that insufficient leisure time and negative pressure from their work environment acted as a deterrent to maintaining their health behavior. Most High School teachers believe they are at present healthy, and they were actively engaged in Preventative Health Promotion. The result of this study demonstrates that External factors have a large impact on teachers, which in turn acts negatively on their Health Promotion Behavior. In order to guarantee teachers health promotion behavior, systematic health checkups and increased leisure time, improvement in their work environment are necessary. Teachers also need to take a more active interest in their health.

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Burdens, Needs and Satisfaction of Terminal Cancer Patients and their Caregivers

  • Chang, Yoon-Jung;Kwon, Yong Chol;Lee, Woo Jin;Do, Young Rok;Lee, Keun Seok;Kim, Heung Tae;Park, Sook Ryun;Hong, Young Seon;Chung, Ik-Joo;Yun, Young Ho
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.209-215
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    • 2013
  • Objectives: Terminal cancer patients and their caregivers often experience traumatic stress and need many types of assistance. In the present study we interviewed terminally ill cancer patients and caregivers to determine how much burden they experienced and to find out what factors are most important for satisfaction. Design: We constructed a questionnaire including overall care burden and needs experienced, and administered it to 659 terminal cancer patients and 659 important caregivers at 11 university hospitals and 1 national cancer center in Korea. Results: Finally, 481 terminal cancer patients and 381 caregivers completed the questionnaire. Care burden was not insubstantial in both and the caregiver group felt more burden than the patient group (P<0.001). While the patient group needed financial support most (39.0%), the caregiver group placed greatest emphasis on discussion about further treatment plans (44.8%). Stepwise multiple logistic regression analyses showed that in the patient group, patient's health status (OR, 2.03; 95%CI, 1.16-3.56) and burden (OR, 2.82; 95%CI, 1.76-4.50) influenced satisfaction about overall care, while in the caregiver group, high education level (OR, 1.84; 95%CI, 1.76-4.50), burden (OR, 2.94; 95%CI, 1.75-4.93) and good family function (OR, 1.94; 95%CI, 1.24-3.04) were important. Conclusions: Our study showed that burden was great in both terminal cancer patients and their caregivers and was perceived to be more severe by caregivers. Our study also showed that burden was the factor most predicting satisfaction about overall care in both groups.

중년여성의 관절염 발생 영향요인 분석 (Risk Factors of Arthritis in Middle-aged Women in Korea)

  • 양경미;이종은;정혜선;김숙인;이소영;이윤정;김순례
    • 지역사회간호학회지
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    • 제17권4호
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    • pp.512-520
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    • 2006
  • Purpose: To investigate the risk factors of arthritis, this study was carried out with 1,829 Korean women aged between 40-64 who responded to a health behavior survey. Methods: Data were extracted from the results of the 2001 National Survey on Health and Nutrition conducted by the Ministry of Health and Welfare. Results: 1 Financial difficulty and continuous anxiety about health were directly associated with arthritis. The odd ratios of these two factors of arthritis were 1.43 and 1.82 respectively. 2. With regard to the presence or absence of arthritis according to demographic characteristic, the incidence of arthritis was higher in the age between 50-64, in the group whose education level was middle school or lower, and in those who experienced the death of spouse, divorce or separation. Nevertheless, it was not significantly different according to financial status and employment status. 3. Concerning the presence or absence of arthritis according to psychological characteristic, the incidence of arthritis was found to be higher in those who were not healthy by subjective health assessment, in those who were always anxious about their health, in those who were always depressed and sad, and in those who felt heavy stress. 4. With regard to the presence or absence of arthritis according to the health behavior, the incidence of arthritis was higher in postmenopausal cases and cases who were having hormone therapy, and the incidence of arthritis was higher in those who did not drink alcohol, those with BMI higher than 25, and those who slept shorter than 7 hours a day. Conclusion: Based on the above results, it is required to provide a means applicable to communities by developing preventive education that can prevent the incidence of arthritis in middle-aged women as well as intervention programs.

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Investments on Pro-poor Development Projects on Goats: Ensuring Success for Improved Livelihoods

  • Devendra, C.
    • Asian-Australasian Journal of Animal Sciences
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    • 제26권1호
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    • pp.1-18
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    • 2013
  • The elements that determine the success of development projects on goats and the prerequisites for ensuring this are discussed in the context of the bewildering diversity of goat genetic resources, production systems, multifunctionality, and opportunities for responding to constraints for productivity enhancement. Key determinants for the success of pro-poor projects are the imperatives of realistic project design, resolution of priorities and positive impacts to increase investments and spur agricultural growth, and appropriate policy. Throughout the developing world, there exist 97% of the total world population of 921 million goats across all agroecological zones (AEZs), including 570 breeds and 64% share of the breeds. They occupy a very important biological and socioeconomic niche in farming systems making significant multifunctional contributions especially to food, nutrition and financial security, stability of farm households, and survival of the poor in the rural areas. Definitions are given of successful and failed projects. The analyses highlighted in successful projects the value of strong participatory efforts with farmers and climate change. Climate change effects on goats are inevitable and are mediated through heat stress, type of AEZ, water availability, quantity and quality of the available feed resources and type of production system. Within the prevailing production systems, improved integrated tree crops - ruminant systems are underestimated and are an important pathway to enhance C sequestration. Key development strategies and opportunities for research and development (R and D) are enormous, and include inter alia defining a policy framework, resolution of priority constraints using systems perspectives and community-based participatory activities, application of yield-enhancing technologies, intensification, scaling up, and impacts. The priority for development concerns the rainfed areas with large concentrations of ruminants in which goats, with a capacity to cope with heat tolerance, can be the entry point for development. Networks and networking are very important for the diffusion of information and can add value to R and D. Well formulated projects with clear priority setting and participatory R and D ensure success and the realisation of food security, improved livelihoods and self-reliance in the future.

대학생의 건강증진행위에 영향을 미치는 요인에 관한 연구 (A study of Factors Influencing Health Promoting Behavior in College Students)

  • 백경신
    • 지역사회간호학회지
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    • 제14권2호
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    • pp.232-241
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    • 2003
  • Purpose: To investigate the factors influencing health promoting behavior in college students and to provide a basic data for developing an effective health promotion program. Method: The subjects were 711 college students living in Jecheon city and were selected using a convenience sampling method. The instruments used in this study included the Health Promoting Lifestyle Profile developed by Walker et al.(987). Perceived Health Status developed by Lawston et al. (1982). Self-Esteem scale developed by Rosenberg(1965), Self-Efficacy scale developed by Becker et al. (1993), and Health Locus of Control developed by Wallston et a1.(1978). The data were analyzed by descriptive statistics, pearson correlation coefficient, and stepwise multiple regression using SPSS/WIN program. Results: I) The mean score of health promoting behavior was 2.39 point out of 4. In terms of sub-domains of health promoting behavior, self-actualization(2.78) showed the highest mean score, followed by interpersonal support(2.75), stress management(2.38), nutrition(2.11), exercise(2.04), and health responsibility (1.97). 2) The health promoting behavior had significantly positive correlations with self-efficacy, powerful others health locus of control, internal health locus of control, chance health locus of control, and perceived health status. 3) In the relationship between general characteristics and health promoting behavior, health promoting behavior was significantly different by gender(t=2.17, p=.03), and financial status of parents (F=10.79. p= .00). 4) The most powerful predictor of health promoting behavior was self-efficacy. A combination of self-efficacy, self-esteem, powerful others health locus of control, and sex accounted for 40.4% of the total variance in health promoting behavior. Conclusion: The findings of this study showed that health responsibility and exercise were the domains where the college student showed relatively lower scores than other domains, self-efficacy was the most important predictor of health promoting behavior. Therefore, it is suggested that health promoting programs should focus on health responsibility, and exercise. Nursing strategies that can enhance self-efficacy should also be developed in order to promote healthy lifestyles in college students.

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일본의 소규모 다기능 노인복지시설에 관한 연구 - 기존 주택을 재활용한 택로소를 중심으로 - (A Study on Small-scale Multi-functional Welfare Facilities for Elderly, Japan - Focusing on the Takurosyo Renovated Existing Houses-)

  • 이승은;김성룡;이을규
    • 한국농촌건축학회논문집
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    • 제15권4호
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    • pp.95-102
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    • 2013
  • Recently (2010), South Korea's aging rate is 11%. and expected to be 32.3% in 2040, and Japan's aging rate in 2010 is 23%, and in 2040 is expected to be 34.5%. As aging progresses, it is increasing with the elderly person with dementia. However, elderly welfare facilities are insufficient. To take care stability of elderly people with mental and physical disabilities, we need to prepare a lot of welfare facilities for the elderly. Whenever physical conditions and service needs change of the disability elderly, Elderly are forced to move to the other facility. They move from familiar places, beloved local base to unfamiliar places. They are under a lot of stress in order to adapt to new environment. This research is to check out the possibility of the systems and the effectiveness of various services and the flexibility of management in Japan. Takurosyo is responsible for a variety function of elderly medical welfare facilities. Within a short time, our country, has entered into a super-aged society, elderly health and welfare facilities are needed. However, because it requires enormous financial, it is difficult to build a new building in reality, However, if remodeling existing buildings, We can build many low-cost small-scale multi-functional welfare facilities such as the takurosyo. Such that facility would be available to us.

IMF와 경기침체 전후 음독자살 환자에 대한 분석 -1997년부터 2004년까지 일개 대학병원 응급센터 연구조사를 중심으로- (Trends Analysis of Suicidal Poisoning in Korea- Comparison before and after the IMF Crisis and the Economic Recession)

  • 이원재;박규남;최승필;이미진
    • 대한임상독성학회지
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    • 제3권1호
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    • pp.33-39
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    • 2005
  • Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

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교원임용 시험을 준비하는 중등학교 기간제 교사들의 교직생활과 삶에 관한 질적 연구 (A Qualitative Study on the Lives of Non-Tenured, Secondary School Teachers Who Are Preparing for Teachers' Exam)

  • 민은영;장유진
    • 한국산학기술학회논문지
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    • 제18권12호
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    • pp.359-371
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    • 2017
  • 본 연구에서는 교원임용 시험을 준비하고 있는 기간제 교사들의 교직생활과 삶을 탐색하였다. 이를 위해 10명의 기간제 교사들을 대상으로 반구조화된, 일대일 면담을 진행하였고, 합의적 질적 연구 방법을 사용하여 자료를 분석하였다. 연구결과, 대부분의 참여자들은 경제적 필요를 충족시키고 자신의 꿈인 교사생활의 기쁨과 보람을 맛보며, 임용 시험에 실질적인 도움을 얻고자 기간제 교사직을 선택한 것으로 나타났다. 기간제 교사생활에서 경험하는 어려움으로는 학교 관리자로부터의 차별 대우가 가장 두드러졌으며, 이로 인한 자존감의 저하와 정체성의 혼란을 겪고 있는 것으로 파악되었다. 이러한 차별이 오히려 임용 시험 준비에 대한 강한 의지로 전환되어 참여자들은 안정되고 당당한 교사 신분을 얻기 위해 임용시험준비에 전념하고 있다고 진술하였다. 하지만, 시험준비 과정에서 부족한 공부시간, 끝없는 공부양, 다양한 삶의 역할 수행, 체력 저하, 난해한 시험 유형, 이전 실패경험에서 오는 불안감 등으로 상당한 스트레스를 경험하는 것으로 확인되었다. 연구결과를 토대로 향후 연구의 방향에 대해 제언하였다.