의료보장유형에 따른 연령표준화 결핵 사망률비와 관련 요인

나백주(Baeg-Ju Na),강문영(Moon-Young Kang),홍지영(Jee-Young Hong),김은영(Eun-Young Kim),김건엽(Keon-Yeop Kim),이무식(Moo-Sik Lee),양상규(Sang Kyu Yang) 한국농촌의학 지역보건학회 2006 농촌의학·지역보건 Vol.31 No.1

보건소 금연사업 담당자의 직무분석

나백주(Baeg Ju Na),이무식(Moo Sik Lee),김건엽(Keon Yeop Kim),김은영(Eun Young Kim),배경희(Kyung Hee Bae),이주열(Ju Yul Lee),오경희(Kyung Hee Oh),오종두(Jong Doo Oh) 한국보건교육건강증진학회 2006 보건교육건강증진학회지 Vol.23 No.4

응급의료센터를 보유한 의료기관 입원 중 응급실경유입원 관련 요인

나백주 ( Baeg Ju Na ),정설희 ( Seol Hee Chung ),이선경 ( Sun Kyung Lee ),오경희 ( Kyung Hee Oh ),김건엽 ( Keon Yeop Kim ) 한국보건행정학회 2009 보건행정학회지 Vol.19 No.2

Objectives: The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods: This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi?square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results: The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300?699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion: We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

일부 농촌지역주민에서 Bioelectric Impedance로 측정한 체지방비율에 대한 고찰

나백주,박요섭,선병환,남해성,신준호,손석준,최진수,Na, Baeg-Ju,Park, Yo-Sub,Sun, Byung-Hwan,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su 대한예방의학회 1997 예방의학회지 Vol.30 No.1

Obesity usually is defined as the presence of and abnormally amount of adipose tissue. In many epidemiologic study, obesity as a health risk factor has been estimated by Body Mass Index(BMI) in general. This study was conducted to review of body fat percent measured by Bioelectric impedance analyzer as a estimator of obesity in a rural adult population. The study subjects were 421 men and 664 women who reside in the area on the Juam lake. They were sampled by multistage cluster sampling. Their mean age was 59 years old. Body fat percent increased with age, but BMI decreased with age in this study. Body fat percent was more larger at female and elder on the same BMI. The correlation coefficient between with body fat percent and body mass index was low (r=0.4737). Body fat percent was explained by not only BMI but also sex and age $(r^2=0.63)$. The result suggested that it is inadequate for BMI only to estimate obesity about elderly person who reside in the rural community. The relation of body fat percent and body mass index of this study agreed with the preceding know-ledges and studies in general.

농촌지역 주민의 심혈관 질환 위험요인 평가

나백주,박경수,임정수,선병환,남해성,손석준,Na, Baek-Ju,Park, Kyung-Soo,Lim, Jung-Su,Sun, Byeong-Hwan,Nam, He-Sung,Sohn, Seok-Joon 한국농촌의학지역보건학회 1998 농촌의학·지역보건 Vol.23 No.2

Cardiovascular diseases are the leading cause of death and disability in Korea. Their risk factors can be classified as either modifiable or nonmodifiable and among modifiable factors are high bood pressure, elevated blood cholesterol, obesity and cigarette smoking. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in a rural community and to get basic data for the development of a community-based rick reduction intervention program. Evaluation involved population-based, cross-sectional samples of adult residents in a rurual community. We measured blood pressure, body fat percent by bioelectric impedance fatness analyzer and serum cholesterol and interviewed adult residents over 20-year-old age. Blood pressure was checked twice and hypertension was classified by the sixth report of the Joint National Committee on Detection. Evaluation, and Treatment of High Blood Pressure. The Cutpoints for high blood cholesterol was used National Cholesterol Treatment Guidelines and those for obesity was 25% in male. 30% in female. The results were as follows: 1. Prevalence of definitive hypertension was 59.7% in males and 54.4% in female. 2. Prevalence of hypercholesterolemia was 14.3% in male and 18.2% in female. 3. Prevalence of obese was 10.7% in male and 41.1% in female. 4. Among definitive hypertension, hypercholesterolemia, and obesity 52.1% possessed one risk factor, 12.6% two risk factors and 2.5% three risk factors in males. In females 41.4% possessed one risk factor and 27.6%. 5.7% respectively. 5. The smoking rate was 65.8% in males and 5.2% in females. Our results are used effectively for the community-based intervention towards cardiovascukr diseases risk reduction. However, because of limitations in our study design, further datas are needed including other risk factors and in-person clinical datas.

범이론적 모형에 근거한 고등학생의 흡연시작 관련요인

홍지영,나백주,김건엽,이무식,Hong, Jee-Young,Na, Baeg-Ju,Kim, Keon-Yeop,Lee, Moo-Sik 대한예방의학회 2006 예방의학회지 Vol.39 No.1

Objective: This study was conducted to investigate the relationship between the intention of smoking and its related factors in high school students. Methods: Our study subjects were 1,203 high school students who resided in one city and in one county region. We conducted a self-administered questionnaire survey from June 7 to June 19, 2004. Both the decisional balance and temptation inventory showed high reliability estimates. We provided good fit for the 12-item decisional balance inventory and the 10-item temptation inventory by using a confirmatory factor analysis. We also used multiple logistic regression analysis to identify the major contributing factors for the intention to start smoking. Results: On the univariate analysis, the subjects who were female, the 2nd and 3rd grade students, the students in vocational high school, the ex-drinkers or current drinkers, and ex-smokers were found to be significantly more distributed in the groups with intention to start smoking. Except for the concept of the cons, the group with intention to start smoking showed significantly higher standardized T scores for the 7 concepts of decisional balance and temptations. On the multiple logistic regression analysis, the females, the 2nd and 3rd grade students, the students in vocational high school, the experience of cigarette smoking and low T score of the cons were significantly related to the intention to start smoking. Conclusions: The intention to start smoking in high school students was affected by various factors such as gender, the school grade and the experience of smoking. Therefore, further research should be conducted for providing the essential data for developing a brief instrument for selecting the groups with intention of starting smoking among adolescents.

농촌지역 노인들의 인지기능 장애와 사망과의 관련성

선병환,박경수,나백주,박요섭,남해성,신준호,손석준,이정애,Sun, Byeong-Hwan,Park, Kyeong-Soo,Na, Baeg-Ju,Park, Yo-Seop,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1997 예방의학회지 Vol.30 No.3

60세이상 노인인구를 대상으로 '농촌지역 노인들의 우울 및 인지기능 장애에 관한 연구'를 한 이정애와 정향균의 연구대상 558명에 대해 농촌지역 노인들의 인지기능 장애와 사망과의 관련성을 살펴본 결과는 다음과 같다. 1) 3년동안 동안 전체 대상자의 사망률은 558명중 57명인 10.2%이었으며 353명의 정상 인지기능군 중 사망자는 30명으로 사망률 8.5%, 126명 의 경도 인지장애군중 사망자는 14명으로 사망률 11.1%, 79명의 중증 인지장애군중 사망자는 13명으로 사망률 16.5% 이었다(표 3). 2) 3년동안 전체 연구 대상자의 생존율은 0.91이었으며 정상, 경도, 중증 인지기능 장애군의 3년 생존율은 각각 0.92, 0.90, 0.86이었다. 로그 순위 검정법으로 인지기능 정상군과 경도 및 중증의 각 인지기능 장애군의 생존곡선을 비교한 결과 통계적으로 유의하지 않았다. 또한 인지기능 정상군과 경도 이상의 인지기능 장애군간 생존곡선을 비교한 결과도 유의한 차이는 없었다. 3) 혼란변인을 보정하지 않는 Cox의 비례위험 회귀 모형의 단변량분석의 결과 95% 신뢰구간(C.I. : Confidence Interval)에서 사망위험도가 유의한 변인은 연령, 월수입, 흡연습관, 신체장애 등이었으며, 인지기능 장애정도를 정상 그리고 경도 및 중증으로 분류한 분석에서는 정상군에 비해 경도 및 중증의 사망위험도가 유의하게 높지 않았으나, 인지기능 점수(MMSEK score)의 증가에 따른 분석 결과 사망위험도가 0.94로 유의하게 낮게 나타났다(표 4). 4) 잠재적 혼란변인들의 영향을 보정한 Cox의 비례위험 회귀모형의 다변량 분석의 결과 인지기능 장애정도 및 MMSEK 점수증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 5). 5) 남녀별로 각각 인지기능 장애와 사망위험도와의 관계를 알아보기 위해 다변량 분석을 시행한 결과 인지기능 장애정도 및 MMSEK 점수 증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 6, 표 7). 이상 본 연구는 농촌지역 노인들에서 인지기능 장애정도가 사망에 미치는 영향을 알아보고자 하였지만, 인지기능 장애정도가 사망에 미치는 영향을 통계적으로 유의하게 고찰하지 못하였다. The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

일부 농촌지역 주민의 불안과 혈중 콜레스테롤의 관련성

박요섭,박경수,나백주,남해성,신준호,손석준,최진수,김병우,Park, Yo-Seop,Park, Kyeong-Soo,Na, Baeg-Ju,Nam, Hae-Sung,Shin, Jun-Ho,Shon, Seok-Joon,Choi, Jin-Su,Kim, Byong-Woo 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.3

In other to study relationship of anxiety and serum cholesterol in general population, we performed the interview survey and screening test for the Ju-am cohort and residents in controlling area at 1995. Among them, 622 people are selected for this analysis. The results were summarized as follows. 1. Anxiety and total serum cholesterol related each other in the group of anxiety. Correlation coefficient was 0.39(p<0.01). 2. According to the result of multiple regression that the total serum cholesterol regarded as the dependent variable, anxiety and total serum cholesterol were related each other positively in the group of anxiety(p<0.05). 3. As the symptoms of anxiety was dichotomized affective and somatic symptom. There was no relationship of 2 symptoms and total serum cholesterol in all subjects, but there was more relationship on the affective symptom than on the somatic symptom in the group of anxiety(p<0.05). The above results show that anxiety and total serum cholesterol related each other significantly in the anxiety group. And the relationship of psychological factors and serum cholesterol could be applied significantly in general population as well as in the special group.

일개 도농복합시 유자녀 모성의 추가출산 의지 관련요인

이무식(Moo-Sik Lee),나백주(Baek-Ju Na),김건엽(Keon-Yeop Kim),홍지영(Jee-Young Hong),김철웅(Chul-Woung Kim),김은영(Eun-Young Kim),김대경(Dae-Kyung Kim) 한국농촌의학 지역보건학회 2007 농촌의학·지역보건 Vol.32 No.3

일부 개업의의 우울 및 Burnout 정도의 관련요인

신준호,김군수,박요섭,나백주,손석준,김병우,Shin, Jun-Ho,Kim, Gun-Su,Park, Yo-Sub,Na, Bek-Ju,Sohn, Seok-Joon,Kim, Byong-Woo 대한예방의학회 1995 Journal of Preventive Medicine and Public Health Vol.28 No.3

In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBI(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and Chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBI data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality, duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.