• Journal of Nutrition and Health
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• 제48권4호
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• pp.371-379
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• 2015

본 연구는 우리나라 노인세대가 겪는 사회환경요인이 에너지 섭취 부족에 어떠한 영향을 주는지 알아보고자 제5기 1차년도 (2010) 국민건강영양조사 자료를 바탕으로 분석을 실시하였으며, 결과를 요약하면 다음과 같다. 1) 남녀 모두 연령이 70세 이상이고, 경제활동을 하지 않는 경우, 활동제한이 있는 경우 에너지 섭취 부족 비율이 높은 것으로 나타났다. 그 밖에 남자는 배우자는 없이 가족과 동거하는 경우, 학력, 그리고 가구소득, 여자는 자살생각 여부가 에너지 섭취량에 영향을 주는 것으로 분석되었다. 2) 에너지 필요 추정량의 75% 미만으로 섭취하는 노인의 비율은 남자는 23.7% (196명), 여자는 31.1% (324명)으로 나타났으며 에너지 섭취량이 75% 미만인 그룹의 경우 탄수화물 섭취 비율이 유의적으로 높은 것으로 분석되었다. 3) 에너지 섭취가 부족한 그룹의 경우 남녀 모두 돼지고기와 소고기가 10위 안에 포함되지 않았고 배추김치와 된장이 20위 안의 주요 급원식품에 들었다. 4) 최종적으로 남녀 모두 학력 (남자: OR = 1.480, 여자: OR = 1.614)과 경제활동 여부 (남자: OR = 1.751, 여자: OR = 1.464)가 에너지 섭취 부족에 영향을 주는 요인으로 분석되었으며, 이 외에도 남자는 70세 이상의 고령 (OR = 1.475), 여자는 배우자 없이 가족과 동거하는 경우 에너지 섭취 부족일 확률이 1.496배로 나타났다. 이상의 연구 결과 노인의 에너지 섭취량은 노화로 인한 신체적 생리적 변화 외에도 노인이 속한 사회환경, 사회구조적 변화에 민감하게 반응한다는 것을 확인할 수 있었다. 효과적인 노년기 영양관련 정책 수립을 위해서는 사회환경의 변화에 따른 영양취약계층을 선별하는 것이 무엇보다 중요하므로, 본 연구에서 확인한 노인의 에너지 섭취 부족과 관련된 요인들은 노년기 영양정책을 계획하는 데 있어 기초자료로 활용될 수 있을 것으로 사료된다.

• 의료법학
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• 제20권1호
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• pp.203-242
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• 2019

지방자치단체는 의료보장을 위해 2006년부터 국민건강보험제도 등 의료보장과 관련한 사회보험료를 지원하는 정책이 매월마다 시행되고 있다. 본 연구는 지방정부에서 노인세대 또는 저소득대가구 등의 국민건강보험료 등 공적 보험료를 지원하는 자치법규가 어떠한 내용으로 법규화되어 있는가의 특성 등에 대해 고찰하는 데 목적이 있다. 본 연구의 수행을 위한 방법으로서 국가법령정보센터의 웹사이트에 공표된 자치법규에서 조례와 조례규칙을 '건강보험료'의 검색어를 통해 검색한 결과를 통해 이루어졌다. 2019년5월 현재 제정된 조례는 201건이었는데, 광역지방자치단체는 17개 중에서 8개의 시도에서, 기초지방자치단체는 226개 중에서 193개의 시군구에서 제정되어 있으며, 조례 시행규칙은 전체 37건이 제정된 것으로 조사되었다. 이 중 조례의 경우 목적, 조례 제정시기, 사회보험료의 종류, 사회보험료의 지원 대상, 사회보험료 지원의 금액, 사회보험료 지원의 방법과 과정, 사회보험료 지원의 시기, 사회보험료의 재원 등으로 구성되어 있고, 이러한 조문 내용에 대해 분석하였다. 그리고 이러한 내용을 통해 정책적, 법적인 측면에서 논쟁이 될 수 있는 사안은 무엇인지에 대한 논의와 함께 개선 방향을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• 제38권2호
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• pp.208-214
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• 2005

Objectives: This study was performed to examine the factors affecting re-smoking in male workers. Methods: A self-administrated questionnaire survey was conducted during April 2003 to examine the smoking state of 1,154 employees of a company that launched a smoking cessation campaign in1998. Five hundred and eighty seven persons, who had stopped smoking for at least one week, were selected as the final study subjects. This study collected data on smoking cessation success or failure for 6 months, and looked at the factors having an effect on re-smoking within this period. This study employed the Health Belief Model as its theoretical basis. Results: The re-smoking rate of the 587 study subjects who had stopped smoking for at least one week was 44.8% within the 6 month period. In a simple analysis, the re-smoking rates were higher in workers with a low age, on day and night shifts, blue collar, of a low rank, where this was their second attempt at smoking cessation and for those with a shorter job duration (p<0.05). Of the cues to action variables in the Heath Belief Model, re-smoking was significantly related with the perceived susceptibility factor, economic advantages of smoking cessation among the perceived benefits factor, the degree of cessation trial's barrier of the perceived barriers factor, smoking symptom experience, recognition of the degree of harmfulness of environmental tobacco smoke and the existence of chronic disease due to smoking (p<0.05). In the multiple logistic regression analysis for re-smoking, the significant variables were age, perceived susceptibility for disease, economic advantages due to smoking cessation, the perceived barrier for smoking cessation, recognition on the degree of harmfulness of environmental tobacco smoke, the existence of chronic disease due to smoking and the number of attempts at smoking cessation (p<0.05). Conclusion: From the result of this study, for an effective smoking ban policy within the work place, health education that improves the knowledge of the adverse health effects of smoking and the harmfulness of environmental tobacco smoke will be required, as well as counter plans to reduce the barriers for smoking cessation.

• 농촌의학ㆍ지역보건
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• 제31권3호
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• pp.237-244
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• 2006

이 연구에서는 고혈압 위험군을 대상으로 8주간의 개인별 맞춤형 DASH 식이 교육을 수행하여 고혈압 식단 관련 지식수준과 DASH 식단 실천정도, 혈압 조절 효과를 분석하고자 하였다. 프로그램 대상은 고혈압 발생 위험군으로 JNC에서 정의한 고혈압전단계로 정의한 수축기압이 120-139 mmHg, 또는 이완기혈압이 80-89 mmHg인 경우와, 체질량지수가 25이상인 경우, 그리고 허리둘레와 엉덩이둘레의 비율이 남자 0.95이상, 여자 0.85이상인 경우 중 어느 하나를 만족하는 경우로 하였다. 연구는 강원도 C시에서 2002년-2003년 주민 건강행태 및 건강조사 대상 중 기준에 해당하는 경우와 보건소 및 보건지소에서 외래 환자 중 해당자를 포함하였으며 8주 교육에 참가한 141명에 대하여 효과분석을 수행하였다. 교육프로그램 적용 후 지식수준 및 DASH 식습관 실천정도가 유의하게 증가하였으며 수축기압은 참여 전 $136.03{\pm}12.40mmHg$, 프로그램 참여 후 $126.09{\pm}11.25mmHg$로 프로그램 참여 후의 평균 혈압이 낮아졌으며 이완기 혈압 또한 프로그램 참여 전 $81.80{\pm}6.32mmHg$, 프로그램 참여 후 $76.44{\pm}10.61mmHg$로 통계적으로 유의한 감소를 나타냈다. 고혈압 환자의 혈압 조절을 위한 노력뿐 아니라 고혈압 예방을 위한 보건사업이 필요하며, 이 경우 DASH 프로그램은 효과적인 교육도구로 적용될 수 있다. 향후 관련된 교육 프로그램의 개발과 프로그램 적용이 지역사회를 대상으로 소개되고 확대 적용되기를 기대하는 바이다.

• 보건교육건강증진학회지
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• 제26권5호
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• pp.41-55
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• 2009

목적: 대상자의 에이즈에 대한 지식수준과 태도를 파악하고, 에이즈감염자에 대한 태도에 영향을 미치는 요인을 규명하기 위함이다. 방법: 본 연구는 G광역시내 보건복지 분야에 종사하고 있는 사회복지직과 간호직 공무원을 대상으로 편의 표집 하였다. 자료 수집은 대상자에게 연구목적을 직접 설명한 후 동의를 거쳐 구조화된 설문지에 각자 기입하도록 하였다. 수집된 총 252부의 질문지 중 불성실한 답변을 제외한 245부(사회복지직 124부, 간호직 121부)를 최종분석에 사용하였다. 자료수집은 2008년 12월부터 2009년 1월 사이에 이루어졌다. 측정도구인 에이즈 지식 및 HIV/AIDS 환자(감염인)에 대한 태도 문항은 많은 선행연구에서 인용되고 있는 Herek(2002, 2007)과 Carey & Schroder(2002), 국내 연구 중에는 질병관리본부(2007)의 조사 문항들을 토대로 구성하였다. 결과: 첫째, 대상자의 지식정도의 정답률은 85.9%로 나타났으며 사회복지직 공무원의 지식정도가 간호직보다 낮게 나타났다. 둘째, 통계적으로 유의미 하지 않지만 간호직 공무원의 태도가 사회복지직 보다 에이즈환자에 대해 긍정적 태도를 보여주었다. 셋째, 대상자의 에이즈에 대한 태도는 지식의 정도와 에이즈에 대한 교육경험 유무에 따라 하위영역별로 유의미한 차이가 나타났다. 넷째, 에이즈에 대한 대상자의 태도에 영향을 미치는 요인을 분석한 결과, 대상자의 에이즈에 대한 지식이 가장 큰 영향 요인으로 나타났다. 결론: 에이즈에 대한 임상실천가이면서 정책에 영향을 미치는 사회복지직과 간호직 공무원의 에이즈에 대한 지식을 증진시키고 편견을 감소시키기 위한 실천적 교육 프로그램 개발이 필요하다.

• Journal of Preventive Medicine and Public Health
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• 제39권1호
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• pp.46-52
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• 2006

Objectives: This study was performed to investigate the relationship between regional material deprivation and the standardized mortality ratios(SMRs) of community residents aged 15-64 in Korea. Methods: SMRs were investigated using the registered death data from 1995 to 2000 that was obtained from the Korean National Statistics Office with the denominators being drawn from the 1995 to 2000 census. Material deprivation was measured using the Townsend score that was calculated from the 1995 to 2000 census. The relationship between the regional material deprivation and the SMRs of the community residents aged 15-64 was investigated by using ANOVA, Spearman's rank correlation analysis and Pearson's correlation analysis. The trends in mortality inequality were investigated using the concentration index. Results: On the ANOVA, the SMRs of the men and women residents in the least deprived areas were the smallest and those in the most deprived areas were the largest. Spearman's rank correlation analysis, Pearson's correlation analysis and the concentration index revealed that significant positive relationships exist between the regional material deprivation and the SMRs of the community residents aged 15-64. Conclusions: This study suggests that there are mortality inequalities among the communities in Korea and part of this difference is due to the material deprivation of the community. Strategies aimed at reducing mortality inequalities among the communities will be needed to address economic inequalities. Further studies are needed to explore the mechanisms of how the regional deprivation influences on health and how the other factors of the community influence on the health of the community residents.

• 한국한의학연구원논문집
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• 제16권3호
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• pp.67-75
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• 2010

Objectives : In order to study the standardization of Qi-gong, and the important spread of education in Qi-gong, we investigated to the cognition of Qi-gong. Method : The descriptive investigation was accomplished to examine the level about the standardization of Qi-gong and the propensity with the Qi-gong training specialist, Qi-gong experience people and non-experience people on a national scale. The data of 572 question papers (140 specialists, 132 Qi-gong experience people, 300 non experience people) were analyzed. The period of the data collection was from Jun, 1, 2009 to Jun, 30, 2009. Result : The motives of Qi-gong participation were Qi-gong training and the individual health. The merit of Qi-gong was beneficial to health. The difficulties of Qi-gong training were the serial motion and doing training alone. And in order to popularize Qi-gong, the motion must simple and the spread of Qi-gong need. The reason of non-participation was the deficiency of the contact opportunity and the reason of participation was beneficial to health. In the future, the national policy for the activation of Qi-gong was the spread of the national exercise through the standardization of Qi-gong. Qi-gong was used in the side of the prevention and the principle of Qi-gong need the modern reinterpretation. And the effect of Qi-gong was more effective in musculoskeletal disease and the valuable part of Qi-gong was the health-longevity. Conclusion : With this, in order to develop the value of Qi-gong, the national support policy will be necessary. And the standardization of Qi-gong motion and program, the development of easy exercise, the educational prevalance, and publicity campaign will be necessary.

• 보건행정학회지
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• 제9권1호
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• 의료법학
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• 제12권2호
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• pp.265-291
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• 2011

Changes in a drug's availability from prescription only to over-the-counter (OTC) status is of concern to physicians from both public health and individual patient perspectives. Government has generally been supportive of changes in medications from prescription(Rx) to over-the-counter (OTC) status in Korea, however, recognizing that there are both benefits and risks to any health care intervention, health care professionals are conservative in implementing changes to either the process or structure of health care. Changes in status of a drug from Rx to OTC can represent a change in both structure and process. Cost and convenience seem to be major factors in determining whether, given the choice, patients purchase a medicine over the counter or obtain it on prescription. With current arrangements, exemption from prescription charges provides an incentive to continue to obtain products on NHS prescription even when they are available over the counter. There is therefore no simple relation between the availability of over the counter medicines and the level of prescribing of deregulated products. The appropriate use of over the counter medicines-particularly those that have only recently been deregulated-places a burden of care on community pharmacists and calls for closer working relationships with general practitioners. In particular, systems for referral and for recording details of both prescribed and over the counter medicines need to be developed, and a direct route needs to be established for community pharmacists to report adverse drug reactions to over the counter products. Reclassification of prescription medicines-by making them available through pharmacies without a prescription-provides the opportunity for consumers to purchase a wider range of medicinal products without making a demand on NHS resources. There is, however, no simple relation between availability of over the counter medicines and demand for NHS prescriptions. In the late 1980s the UK government fuelled the over the counter market by making it easier to reclassify certain medicines from prescription only status to allow over the counter sale in pharmacies. To explore the influence of deregulation of medicines on NHS prescribing, this article presents analyses of consumer behaviour in using medicines and prescribers' attitudes to over the counter medication and collates findings from research. Policy makers should be aware that patients' expectations in relation to OTC medicines may be in conflict with evidence-based practice.

• Journal of Preventive Medicine and Public Health
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• 제21권2호
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• pp.390-403
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• 1988

The objectives of the study were to provide the basic informations needed in the development of balanced medical services throughout the nation. As the national health care system was expanding rapidly along with the economic growth, quantitative re-evaluation of the system is of great need. For that reason, characteristics of the admitted patients were analyzed for the case-mix and patients' flow within and through regions. Materials were 421,530 cases of inpatients, who were reported through Korea Medical Insurance Corporation(KMIC) for insurance claim, during the period of March 1, 1985 through February 28, 1987. Korean Diagnosis Related Groups(K-DRGs) classification system was adopted for the study of case-mix and 189 cities and counties were classified into 5 district groups by factor analysis results of K-DRGS. The major findings of this study were as follows ; 1) Factor analysis of case-mix, employing K-DRG system, revealed 5 distinct funtional district groups. Group A(18 districts) was prominent for tertiary medical care. In group B(36 districts), rather simple procedures were prevalent. Group C(26 districts) was distinctive for the medical care of well organized internal medicine practices with qualified clinical laboratories. Group D(17 districts) was characterized by relatively high balanced medical care. Group E (92 districts) was with very low level of medical care. 2) Analysis of the case-flow through the districts showed 3 types of flow patterns : inflow, outflow, and balanced types. Inflow type of case-flow was found in Group A, C and D while Group B and E showed outflow type. Inflow was most prominent in Group A and Group E was of typical outflow type. Group B was consistently the outflow type except for Major Diagnostic Category XX regardless of the disease treaters, but Group C and D were inflow or outflow types according to the disease tracers.