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Family Support and Hopelessness in Patients Admitted to Neuro-Surgical Intensive Care Unit (중환자가 지각한 가족지지와 절망감과의 관계연구)

  • 김현실;조미영
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.620-635
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    • 1992
  • This study identified correlations between perceived family support and hopelessness in patients admitted to Neuro - surgical Intensive Care Units. The purpose was to enhance theoretical understanding of the relationships of these two variables. The subjects of this study were 51 patients admitted to N-lCU, at three general hospitals in Seoul. Data were collected by researcher in structured interviews from Aug. 12 to Oct. 13, 1992. The research tools were parts of the Moos Family Environment Scale and the Beck Hopelessness Scale. The general characteristic data were analyzed for frequency and percentage ; the hypothesis was tested by the pearson product Moment Correlation Coefficient. After normality tests by using Kolmogorov - Sminorvtest, and T- test, ANOVA and Mann-Whitney U test, Kruskal -Wallis test were used on the Family Support and the Hopelessness about general charcteristics. The results of the above analysis were as follows 1) The average family support score for the group was 63.61 (tool average 51) and item average was 3.74 (tool item average 3) : the family support score of this sample was higher than average. The average family cohesion score of family support was 35.25 (tool average 27) and item average was 3.91 (tool item average 3). The average family expression score of family support was 28.35 (tool average 24) and item average was 3.57 (tool average 3). In this sample, perceived family expression was lower than family cohesion. 2) The average hopelessness score was 45.88 (tool average 60) and item average was 2.29 (tool item average 3) : the hopelessness score of this sample was low in comparison to the average. 3) The hypothesis in this study was supported. The main hypothesis that the higher the perceived family support level, the lower the level Of the hopelessness, was Supported (r=-.3869 p=.003). The sub-hypothesis that the higher the perceived family cohesion level, the lower the level of hopelessness, was supported(r=-.3688 p=.004). The sub-hypothesis that the higher the perceived family expression level, the lower the level of hopelessness, was supported (r=-.3068 p=.014). 4) General characteristics of the objects related to family support were ‘economic status’(p=.025) and ‘helping person’(P=.044) : the higher the economic status, the greater the family support. When the patient identified the helping person as a spouse, family support was rated more highly. The only general characteristic related to family cohesion was ‘helping person’(p=.041). No general characteristics were related to family expression. 5) The one general characteristic related to hopelessness was ‘education’(p=.002) : the higher their education, the lower their hopelessness. For these ICU patients, were related perceived family support and hopelessness, and family expression level was low in comparison to family cohesion level. The perceived family support of these seriously ill patients in situational crisis may have influenced the patient's emotional reaction of hopelessness. This study concluded that nurses in the ICU confirm the family support of the patient, and involve the family as the most intimate support systems in the care of the patient to help reduce the patient's hopelessness.

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Health Status of Elderly Persons in Korea (한국노인의 건강상태에 대한 조사연구)

  • 최영희;김문실;변영순;원종순
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.307-323
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    • 1990
  • This Study was done to design and test an instrument to measure the health status of the elderly including physical, psychologyical and social dimensions. Data collection was done from July 18 to August 17, 1990. Subjects were 412 older persons in Korea. A convenience sample was used but the place of residence was stratified into large, medium and small city and rural areas. Participants located in Sudaemun-Gu, Mapo-Gu, and Kangnam-Gu, Seoul were interviewed by brained nursing students, and those in Chungju, Jonju, Chuncheon, and Jinju by professors of nursing colleges. Rural residents were interviewed by community health practioners working in Kungsang-Buk-Do, Kyngsang- Nam - Bo, Jonla Buk -Do, and Kyung Ki- Do. The tool developed for this study was a structured questionnaire based on previous literature and then tested for reliability and validity. This tool contained 20 physical health status items, 17 mental-emotional health status items and 38 social health status items. Physical health status items clustered in to six factors such as personal hygiene, activity, home management, digestive, sexual, sensory, and climination functions. Mental-emotional health status items clustered into two factors, mental health and emotional health. Social health status items clustered into seven factors, grandparent, parent, spouse, friend, kinships, group member and religious role functions. Data analysis included percentage, average, S.D., t-test and ANOVA. The results of the analysis were as follows : 1. The tool measuring the health status of the elderly and developed for this research had a relatively high reliavility indicated by a cronbach=0.97793. 2. Average score of the subjects physical health status was 4, 054 in a 5 point likert scale, mentalemotional health status was 3.803, social health status was 2.939 and the total average was 3.521. The social status of the subjects was the lowest and the next was mental-emotional health status ; physical health status was the highest. 3. Educational background, perceived health status, the amount of pocket money were related to physical and mental-emotional health status and family structure was related mental-emotional physical and social health status. Occupation was related to physical and mental-emotional status. Area of residence was related to metal-emotional and social status. Source of living in the expeneses was related to physical and mental-emotional health status marital status to mental-emotional and social health status, and the number living in the home physical health status and religion to social health status. The following conciusions were derived from the above results ; 1. The health status of Korean elderly was relatively sound but social health status was the most vulnerable. The Social activity for Korean elderly is needed to improve social health. 2. Educational background, perceived health status and the amount of pocket money must be considered in the health assessment criteria of the elderly, Family structure, marial status, occupation, residence variables and sources of living expense must also be considered as significant. 3. A health education program based on the educational background of the elderly, and provision of an occupational socioeconomic welfare policy will be useful in order to increase social health status of Korean elderly.

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Factors Influencing Sexual Satisfaction in Women who have had a Hysterectomy : A comparative group study (자궁적출술을 받은 부인과 자궁적출술을 받지 않은 부인의 성생활 만족 요인 분석)

  • 장순복
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.357-367
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    • 1990
  • This descriptive study was done to identify factors influencing sexual satisfaction in women who had had a hysterectomy and to compare these with women who had not had a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support, body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from. 5208 to .9462. Data collection was done during the period from June 20 to Aug.20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characterstics of the subjects and level of sexual satisfaction. t - test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows ; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had had a hysterectomy were 45years, and 1,150,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had had a hysterectomy were husband's support (R=.5793, P=.000) and the women's Knowledge of sexuality(R=.6670, P=.000) (total variance : 33.56). On the other hand, emotional status(R=.4294, P=.000), sexual behavior(R=.4294, P=.000), husband's support(R=.5274, P=.000) and attitude towards sexual relations (R=.5412, P=.000) (total variance : 54.12) were the factors influencing sexual satisfaction in the group who had not had a hysterectomy. Since husband's support and sexuality knowledge were identified as factors influencing sexual satisfaction of women who have had a hysterectomy, it can be concluded that, before a woman who has had a hysterectomy is discharged from hospital, nurses should include strategies in the nursing care plan that will promote husband's support and the women's knowledge of sexuality.

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Quality of life of Middle -Aged Persons Who have cancer (중년기 암환자의 삶의 질에 관한 연구)

  • 한윤복;노유자;김남초;김희승
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.399-413
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    • 1990
  • This descriptive study was under taken to explore relationships among the quality of life, health locus of control and perceived state of health persons with cancer to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this were 200 persons with cancer (100- in patients and 100- out patients), both male and female, between 30 and 59 years of age. Data were obtained using a convenience sample technique from two university hospitals in seoul from August, 1989, to June, 1990. The instruments used for this study were the Quality of life scale developed by Ro, You - Ja and the Health Locus of Control scale developed by Wallston & Wallston. Data were analyzed using a SAS program for ANOVA, t-test, Schefffe test, Pearson Correlation Coefficients and Stepwise multiple regression. The results were as follows : 1. The scores on the quality of life scale ranged from 95 to 191 with as mean of 147.85(range 47 to 235). The Mean scores(range 1-5) on the different dimensions were family relationships 3.50, relationships with neighbours 3.48, self - esteem 3.17, physical state and function 2.99, economic life 2.93 and emotional life 2.91. 2. Significantly higher scores on the quality of life and demographic characteristics were as follows : the quality of life for women(t=2.80, p= .006), for those without complications(t=2.54, p= .013), and for those who perceived their illness as mild(F=4.85, p= .009). Higher scores on quality of life were correlated with the following : 1) emotional state and the age group 50-59(F=3.43, p= .34). 2) economic life and higher income(F=6.72, p= .002), those without complications(t=2.68, p= .00), and those who perceived their illness as mild(F=3.11, p= .05). 3) self-esteem and marriage(F=3.64, p=.028), those without complications(t=2.18, p=.03), and those who perceived their illness as mild(F=7.72, p=.000). 4) physical state and funciton and the age group 30-39(F=4.65, p=.010), those without complications (t=2.00, p=.05), and those who perceived their illness as mild(F=3.38, p=.04). 5) family relationship and those who live with their spouse(t=2.82, p=.005). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score(r=.4364, p=.0001). 4. There was no relationship between Locus of control and quality of life in this sample. 5. Stepwise multiple regression analysis showed that: 1) the perception of current health status was the main predictor and accounted for 20.11% of the total variance. 2) sex and educational level accounted for an additional 21.71% of the total variance. 6. The quality of life and the perception of their current health status of these patients with cancer were generally lower than those of healthy adults as noted in previous studies. In conclusion, the quality of life for these cancer patients was generally low especially in regard to their emotional state. The current perceived state of health, sex, complications and perceived degree of illness were important variables relatiog to quality of life.

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Analysis of Medical Expenses Structure for Patients on Percutaneous Coronary Intervention by Medical Security Type (의료보장형태에 따른 관상동맥중재술 환자의 진료비 구조분석)

  • Son, Mi-Kyung;Lee, Sok-Goo
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.195-208
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    • 2019
  • Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

A Study on the Application of the Korean Valuation Weights for EuroQoL-5 Dimension (EuroQoL-5 Dimension 한국 가중치 모형의 적용 연구)

  • Lee, Young-Hoon;Choi, Jin-Su;Rhee, Jung-Ae;Ryu, So-Yeon;Shin, Min-Ho;Kim, Jin-Hee
    • Korean Journal of Health Education and Promotion
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    • v.26 no.1
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    • pp.1-13
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    • 2009
  • Objectives: This study was conducted to estimate the health-related quality of life (HRQOL) using EuroQoL-5 Dimension (EQ-5D) and to identify its related factors among urban-dwelling adults. Methods: The data for this study were obtained from 1,134 subjects aged $20\sim91$, who participated in 'Survey on the health status and demand for health' in two cities of Korea (Dong-gu, Gwangju and Suncheon-si, Jeollanamdo). The HRQOL was measured using the EQ-5D instrument and EQ-5D index scores were calculated by two Korean valuation study model using time trade-off method. Results: The mean EQ-5D index scores for all subjects were $0.865{\pm}0.218$ (model A), and $0.921{\pm}0.170$ (model B). The EQ-5D index score was significantly different according to demographic and socioeconomic characteristics (gender, age, marital status, education, occupation, income, and health security system), self-rated health condition, health-related psychological assessments (enough sleep, fatigue rate, stress rate, and degree of satisfaction on the residence). The results of multiple linear regression showed that age, marital status, income, coverage of medical insurance, self-rated health condition, and fatigue rate were significantly related common statistical factors of HRQOL in two Korean valuation study model. Conclusion: Among the adults residing in urban environment, the HRQOL was significantly lower on the subjects with following conditions: higher age, being alone without a spouse as a result of death, divorce or separation, low income, medical aid program, poor self-rated health condition, and chronic fatigue. In order to improve the urban adults' quality of life, healthcare policy and health promotion program must be developed with considerations to factors related to the HRQOL.

A Study on the Factors Affecting the Qualities of Lives in Mothers with Disabled Children in Seoul (서울 지역 장애아어머니의 삶의 질에 영향을 미치는 제 요인에 관한 연구)

  • Yoo, Hye-Kyung
    • Journal of Families and Better Life
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    • v.27 no.1
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    • pp.73-88
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    • 2009
  • The purpose of this study was to investigate the influence of the factors such as self-esteem, social supports, socio-economic status of parents, degree of disability in child, stress coping, religion, and sports.exercise on the qualities of lives in mothers with disabled children. Data were collect from 45 institutions(schools from kindergarten to senior-high, special education institutes, and social welfare institutions) by self-report questionnaire, and the subjects of the study were 386 mothers in Seoul whose children were attending the schools or institutions. Findings according to socio-demographic variables are as follows: 1. Mothers with disabled children in this study thought their quality of life as average degree. 2. The younger the mothers and children, the higher the quality of life was. 3. The higher the educational level and monthly income, the higher the quality of life was. 4. There was no statistically significant difference between the existence and nonexistence of spouse, and between the existence and nonexistence of religion as well. Findings analyzed by multiple regression are as follows: 1. Among 7 independent variables 'self-esteem'(${\beta}$=.49, p<.001), 'social supports'(${\beta}$=.15, p<.01), and 'socio-economic status'(${\beta}$=.11, p<.05) were found to be statistically significant in quality of life in mothers, while the rests were found not significant. 2. 'Self-esteem' was found to be the most influencing variable, meaning that the psychological factor such as self-esteem is more important than environmental factors in qualities of lives in mothers. 3. The total amount of explanation of the model was Adjusted R square=.301, so that it can be said about 30% can be explained among total variance of the qualities of lives in mothers with disabled children. Conclusions and recommendations based on the results above are: First, it is strongly recommended to conduct programs promoting self-esteem in mothers with disabled children, and to include 'self-esteem' hereafter in the studies related to qualities of lives in mothers with disabled children. Second, comprehensive and practical countermeasures should to be formulated to back up expenses for education and medical care, purchasing relative tools and equipments, plus helping to find jobs.

Study in Relation to Social Support, Compliance and Psychosocial Adjustment of Rheumatoid Arthritic Patient (류마티스 관절염환자의 사회적 지지, 치료지시 이행 및 사회심리적 적응과의 관계 연구)

  • Soh, In-Ae;Kwon, Young-Sook;Park, Chung-Ja
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.211-225
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    • 1999
  • This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

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Degree of Recognition and Preparation for the Old Age Life of Public Servants (공무원들의 노후생활에 대한 인식 및 준비정도)

  • Park, Hyun-Suk;Lim, Jung-Do
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.248-260
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    • 2012
  • This study has focused on the degree of recognition and preparation for the old age life of public servants. The subjects of this research were 731 middle-aged public employees in Pusan, Ulsan, Kyeong-Nam Province. The data were collected using a self-administrated questionnaire. The following results were obtained. First, 67.2% respondents were women. Over 45-years old were 28.4%, Middle level quality of life were 46.1%, Over 20-years career were 26.7%, Administration staffs were 33.4%, and 7th grade were 31.9%. Second, In Recognition for the old age life, Respondents and their spouse have the primary responsibility of the dependent elderly. Preferred life area was suburban rural area. The order of anticipated problems of the old age life was financial problem, health problem, and leisure activity. Third, Actually, in preparation for the old age life, the order of respondents preparation was financial stability, health, and leisure activity. Forth, In the satisfaction degree of public pension for the old age life, the order of respondence was insufficient (56.0%), appropriate (17.2%), and ignorant(26.8%).

A Case-Control Study on Risk Factors of Uterine Cervix Cancer in Korea (한국인 여성에서 자궁경부암의 위험요인에 관한 환자-대조군 연구)

  • Koo, Hye-Won;Yoo, Keun-Young;Kim, Dong-Hyun;Song, Yong-Sang;Park, No-Hyun;Kang, Soon-Beom;Lee, Hyo-Pyo;Ahn, Yoon-Ok;Lee, Chae-Un
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.159-172
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    • 1996
  • A hospital-based case-control study was carried out to investigate the risk factors of uterine cervical cancer in Korea. Information on a wide-range of life-styles, which might be related with uterine cervix cancer, has been routinely collected through a dual application of the self-administered questionnaire and the direct interview by a well-trained nurse at the Department of Gynecology, Seoul National University Hosiptal since 1992. The number of cervical cancer cases, histologically confirmed at the hospital, were 284. Included were 939 women as controls, who were free of past history of any malignancies. Adjusted odds ratio and 95% confidence limits were based on the unconditional logistic regression model. The multivariate logistic model was constructed under the consideration of biologic characteristics on the natural history of the malignancy. In the multivariate results, the uterine cervical cancer risk was higher in women of shorter height$(P_{trend}<0.05)$, less educated spouse$(P_{trend}<0.001)$(0.001), multiple marriages(adjusted OR=2,70, 95% C.I. $1.64\sim4.47$), ever had a family history (adjusted OR=2.14., 95% C.I. $1.18\sim3.89$), multiparity$(P_{trend}<0.001)$, and early age at first $(P_{trend}<0.001)$. These results strongly suggest that the uterine cervix cancer might be related to the reproductive factors, and probably with sexual behaviour of both women and men in Korea.

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