Suboptimal Attainment of Cardiovascular Disease Prevention Guideline Goals in Korean Women

부선주,Erika Sivarajan Froelicher 한국간호과학회 2012 Asian Nursing Research Vol.6 No.2

Purpose: The purposes of this study were to estimate the distribution of three levels of risk for developing coronary heart disease (CHD; low, moderate, and high risk) and to evaluate the attainment of cardiovascular disease prevention guideline goals by the American Heart Association in a nationally representative sample of Korean women. Methods: This is a secondary data analysis study using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 3,301 Korean women (representing 15,600,514women) older than 20 years without cardiovascular disease. Distribution of CHD risk and level of goal attainment were calculated using sampling weights and presented in percentages. Results: Among Korean women without established cardiovascular disease, 7.9% were at high risk for CHD, 20.5% were at moderate risk, and 71.6% were at low risk. The proportion of Korean women who did not meet their goals was substantial, and most women at high risk remained unmanaged for their high blood lipids. Conclusion: Korean women at risk for developing CHD need to be managed as soon as possible to attain the guideline goals and to lower their risk for future CHD. Aggressive risk reduction efforts are urgently needed to reduce the public burden of CHD in Korean women. Purpose: The purposes of this study were to estimate the distribution of three levels of risk for developing coronary heart disease (CHD; low, moderate, and high risk) and to evaluate the attainment of cardiovascular disease prevention guideline goals by the American Heart Association in a nationally representative sample of Korean women. Methods: This is a secondary data analysis study using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 3,301 Korean women (representing 15,600,514women) older than 20 years without cardiovascular disease. Distribution of CHD risk and level of goal attainment were calculated using sampling weights and presented in percentages. Results: Among Korean women without established cardiovascular disease, 7.9% were at high risk for CHD, 20.5% were at moderate risk, and 71.6% were at low risk. The proportion of Korean women who did not meet their goals was substantial, and most women at high risk remained unmanaged for their high blood lipids. Conclusion: Korean women at risk for developing CHD need to be managed as soon as possible to attain the guideline goals and to lower their risk for future CHD. Aggressive risk reduction efforts are urgently needed to reduce the public burden of CHD in Korean women.

독거노인의 허약 영향요인

부선주 한국방문건강관리학회 2022 한국방문건강관리학회지 Vol.1 No.1

류마티스관절염 대상자의 피로 영향요인

부선주,최보민 대한임상건강증진학회 2022 Korean Journal of Health Promotion Vol.22 No.4

연구배경: 최근 류마티스관절염 치료제 개선으로 혈액염증수치를 포함한 질병활성도가 호전됨에도 불구하고 피로등 증상을 호소하는 대상자는 일정 수준으로 유지되고 있다. 피로는 류마티스관절염 대상자의 가장 흔한 주관적 증상이며, 건강행위 및 삶의 질에 영향을 미치는 주요 요인이다. 이에 본 연구에서는 류마티스관절염 대상자의 삶의 질향상을 위한 중재 개발의 기초자료 마련을 위하여, 피로 영향요인을 파악하고자 하였다. 방법: 경기도 소재 일개 대학병원 류마티스내과 외래를통원 중인 류마티스관절염 환자를 대상(n=246)으로 구조화된 설문지와 의무기록 리뷰를 통해 수집된 자료를 분석하였다. SPSS/WIN ver. 25.0 (IBM Corp, Armonk, NY, USA)를이용하여 기술통계, t-test, analysis of variance, pearson 상관분석 및 회귀분석을 이용하여 결과를 제시하였다. 결과: 연구 대상자의 피로는 10점 만점에 평균 4.4점이었으며, 56.5%는 DAS28을 기준으로 관해 수준으로 평가되었다. 피로에 유의한 영향을 미치는 요인은 통증과 학습된 무력감으로, 통증이 높을수록, 학습된 무력감이 높을수록 연구 대상자의 피로 수준이 높았다. 반면, 객관적 질병활성도지표인 DAS28에 따라 대상자의 피로 수준은 통계적으로유의한 차이가 없었다. 결론: 류마티스관절염 대상자 피로 수준을 낮추기 위해서는 통증 조절과 함께 학습된 무력감을 낮추는 것이 요구된다. 임상에서 대상자들을 마주할 때마다 대상자의 질병에대한 태도를 평가하고 관해에 대한 희망을 가질 수 있도록대상자를 적극 지지할 필요가 있다.

Multilevel Analysis of Factors Associated with Perceived Good Health and Multimorbidity among Older Adults: Using the 2017 Community Health Survey

부선주,한영란,최혜영 한국지역사회간호학회 2020 지역사회간호학회지 Vol.31 No.S

Purpose: This study aimed to identify individual- and regional-level factors associated with perceived good health and multimorbidity among older adults. Methods: Secondary analysis of the 2017 Korea Community Health Survey was conducted on a sample of 67,532 older adults. The individual level data set was combined with regional-level factors from the administrative data released on the Korea National Statistical Office website. Distribution of perceived good health and multimorbidity in 254 public health centers were calculated using sampling weights and presented as percentages. Multilevel logistic regression analyses were used to identify individual- and regional-level factors associated with perceived good health and multimorbidity. Results: Overall, 21.1% of subjects perceived their health to be good, ranging from 9.3% to 39.4% by region. The prevalence of multimorbidity was 15.9%, and varied between 6.6% and 22.6% by region. At the individual level, perceived good health was associated with men, younger age, higher educational levels, higher income levels, and those married and living with a partner and maintaining a healthy lifestyle. At the regional level, higher rates of health center personnel among public officials and higher levels of financial independence were associated with perceived good health. Multimorbidity was associated with marital status and healthy lifestyle, and higher rates of health center personnel among public officials. Conclusion: Regional factors such as health care personnel and local economy could affect population health. Our findings suggest the need to consider individual- and regional-level factors to promote good health among older adults and reduce the health gap by region.

Cardiovascular Risk Factors and 10-year Risk for Coronary Heart Disease in Korean Women

부선주,Erika Sivarajan Froelicher 한국간호과학회 2012 Asian Nursing Research Vol.6 No.1

Purpose: The purpose of this study is to describe the prevalence of cardiovascular risk factors and to estimate the 10-year risk for coronary heart disease (CHD) in a nationally representative sample of Korean women. Methods: This is a secondary data analysis using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 2,998 Korean women (weighted n ¼ 14,420,987) aged 20e79 years without cardiovascular disease or diabetes. Prevalence of cardiovascular risk factors was calculated using sampling weights and presented in percentages. Ten-year risk for CHD was estimated with the Framingham Risk Score, and the proportions for three levels of 10-year risk were presented. Results: About 18% of the sample had hypertension, 7.5% are current smoker, 30.0% had total cholesterol 200 mg/dL, 25.7% had low-density lipoprotein cholesterol 130 mg/dL, and 47.3% had high-density lipoprotein cholesterol < 50 mg/dL. About 46% of Korean women were overweight or obese,and 33.3% were sedentary. About 75% of women had one or more major risk factors. In this study sample,98.5% had a 10-year risk for CHD of < 10%, 1.4% had a risk of 10e20%, and 0.1% had a risk of >20%. Conclusion: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women. Purpose: The purpose of this study is to describe the prevalence of cardiovascular risk factors and to estimate the 10-year risk for coronary heart disease (CHD) in a nationally representative sample of Korean women. Methods: This is a secondary data analysis using the data set from the 2008 Korea National Health and Nutrition Examination Survey IV. The sample was 2,998 Korean women (weighted n ¼ 14,420,987) aged 20e79 years without cardiovascular disease or diabetes. Prevalence of cardiovascular risk factors was calculated using sampling weights and presented in percentages. Ten-year risk for CHD was estimated with the Framingham Risk Score, and the proportions for three levels of 10-year risk were presented. Results: About 18% of the sample had hypertension, 7.5% are current smoker, 30.0% had total cholesterol 200 mg/dL, 25.7% had low-density lipoprotein cholesterol 130 mg/dL, and 47.3% had high-density lipoprotein cholesterol < 50 mg/dL. About 46% of Korean women were overweight or obese,and 33.3% were sedentary. About 75% of women had one or more major risk factors. In this study sample,98.5% had a 10-year risk for CHD of < 10%, 1.4% had a risk of 10e20%, and 0.1% had a risk of >20%. Conclusion: Modifiable cardiovascular risk factors are highly prevalent in Korean women, and the combination of risk factors is common. Development and implementation of multifaceted nursing interventions are required to confront the current epidemic rise of CHD in Korean women.

Body Mass Index and Weight Loss in Overweight and Obese Korean Women: The Mediating Role of Body Weight Perception

부선주 한국간호과학회 2013 Asian Nursing Research Vol.7 No.4

Purpose: This study were to assess the relationships among BMI, body weight perception, and efforts to lose weight in a public sample of Korean women who are overweight and obese and to examine the mediating role of body weight perception on the relationship between BMI and weight loss efforts. Methods: This cross-sectional study used data from the 2008 Korea National Health and Nutrition Examination Survey. The sample was 1,739 Korean women 20 years old or older with body mass index (BMI) ≥ 23 kg/m2. Bivariate relationships among variables of interests were assessed. Three separate regressions were used to test the mediating role of body weight perception on the relationship between BMI and weight loss efforts. Results: BMI and body weight perception were significant correlates of weight loss efforts. BMI was significantly associated with weight perception, but a large proportion of women underestimated their weight. Weight perception partially mediated the relationship between BMI and weight loss efforts in Korean women. Conclusion: In light of the high prevalence of overweight or obesity and the many health consequences associated with obesity, Korean women should be aware of a healthy body weight and try to achieve that weight. Nursing interventions should consider body weight perception to effectively motivate overweight and obese Korean women to lose weight, as necessary.

노인의 국가건강검진결과 분석: 보건소 방문건강관리사업과 관련된 함의

부선주,유정옥,한영란,박남희,임지영,하영미 한국방문건강관리학회 2023 한국방문건강관리학회지 Vol.2 No.1

In Korea, reliable and affordable individual health information is obtained through national health examinations, which can be actively utilized in community health services based on examination data. The purpose of this study is to analyze national health examination data in order to identify the health behavior and health status of the elderly, and to incorporate the examination results into home visiting healthcare services provided at health centers. Methods: This study is a cross-sectional survey that analyzed the national health examination data of 2018 using the National Health Insurance Service-National Health Information Database. Data analysis was conducted using the SAS program. The overall results of the health examinations were presented in terms of frequency and percentage. Results: The national health examination rate was 72.6%, and 97% of the examinees had health needs such as improving health behavior and managing diseases. It was found that 52.2% of patients had high blood pressure, followed by diabetes and dyslipidemia. The health data generated from the national health examination includes information relevant to home visiting healthcare services. Conclusion: By utilizing health data generated from national health examinations, the process of collecting data in home visiting healthcare services can be simplified. By focusing on providing customized services, it will be possible to increase the efficiency of home visiting healthcare services.

간호대학생의 성희롱 예방교육 수행의 효과

부선주,김명숙 학습자중심교과교육학회 2022 학습자중심교과교육연구 Vol.22 No.14

Objectives This study is a preliminary study conducted to investigate the effect of learning by teaching for sexual harassment prevention education. The study analyzed the effects of nursing students’ teaching experiences in providing sexual harassment prevention education to elementary school students on their gender equality awareness, sexual harassment perception, and sexual harassment behavior. Methods The study utilized a pretest-posttest non-equivalent group design with 65 subjects (40 in the experimental group, and 25 in the control group) of fourth year nursing students at a nursing school located in Gyeonggi Province. The experimental group was provided with reference materials, one observation experience of sexual harassment prevention education, and two teaching opportunities for upper elementary students. In contrast, the control group was provided with one session of lecture-type sexual harassment prevention education for 40 minutes. In order to evaluate the effectiveness, a survey was conducted on gender equality awareness, sexual harassment perception, and sexual harassment behavior before and after the intervention in both groups. The effect of sexual harassment prevention education was analyzed with the t-test. Results Gender equality awareness and sexual harassment recognition scores significantly increased in the experimental group experiencing teaching activities, compared to the control group that received lecture-type education. Sexual harassment behavior was not statistically significantly different between the groups before and after the intervention. Conclusions This study suggests that teaching experience can be an effective teaching and learning method to improve the awareness of gender equality and sexual harassment. In the future, repeated studies that expand the intensity, duration, and number of participants of the intervention program are recommended, as well as long-term effects evaluation studies on sexual harassment perception and behavior. 목적 본 연구는 성희롱 예방교육에 적절한 교수-학습 방법으로 가르치면서 배우기(Learning by teaching)의 적용 가능성을 확인하기 위한 예비연구로 간호대학생들이 초등학생에게 성희롱 예방교육을 수행하는 교수활동 경험이 강의식 교육과 비교하여 성평등의식, 성희롱 인식, 성희롱 행동에 미치는 효과를 분석하였다. 방법 비동등성 대조군 전후설계로 경기도 소재 일개 간호대학 4학년 학생 65명(실험군 40명, 대조군 25명)을 대상으로 하였다. 실험군에게는 참고자료와 함께 1회의 성희롱 예방교육 수행 관찰 경험과 초등학교 고학년 대상 2회의 교수활동 기회를 제공하였다. 대조군에게는 강의식 성희롱 예방교육(1회, 40분)을 제공하였다. 효과평가를 위해 중재 전후 성평등 의식, 성희롱 인식, 성희롱 행동에 대해 설문조사를 실시하였다. 성희롱 예방교육 수행의 효과는 t-test로 분석하였다. 결과 교수활동을 경험한 실험군이 강의식 교육을 받은 대조군에 비해 성평등 의식 및 성희롱 인식 점수가 통계적으로 유의하게 증가하였으며, 성희롱 행동은 중재 전후 그룹 간 통계적으로 유의한 차이가 없었다. 결론 본 연구를 통해 교수활동 경험(Learning by teaching)은 성평등 의식 및 성희롱 인식 수준을 향상시킬 수 있는 효과적인 교수학습 방법이 될 수 있을 것으로 생각한다. 본 연구 결과를 토대로 추후 중재 프로그램의 강도 및 기간과 대상자 수를 확대한 반복연구및 성희롱 인식과 행동에 대한 장기효과 평가 연구를 제언한다.

류마티스관절염 대상자의 약물복용이행 영향요인

부선주 대한임상건강증진학회 2020 Korean Journal of Health Promotion Vol.20 No.4

Background: Adherence to medication in patients with rheumatoid arthritis has been associated with decreased disease activity and morbidity in prior reports. However, adherence in this population remains suboptimal. This study evaluated the levels of medication adherence and determined the factors thereof in patients with rheumatoid arthritis. Methods: We analyzed cross-sectional data from 345 rheumatoid arthritis outpatients at a university-affiliated hospital. The level of medication adherence was then determined. Lastly, a multivariate logistic regression analysis was used to identify the predictors significantly associated with medication adherence. Results: Approximately 65% of the subjects were categorized as medication-adherent. In univariate analysis, educational level, perceived health, attitude toward medication, and level of learned helplessness all differed significantly between the adherent and nonadherent groups. When controlling for other factors, higher levels of learned helplessness significantly lowered the likelihood of patients’ adherence to medication in our cohort. Conclusions: Given that learned helplessness is modifiable, the results of this study suggest that interventions to decrease the degree of learned helplessness should be developed and implemented in order to increase the levels of medication adherence in patients with rheumatoid arthritis and improve clinical outcomes. 연구배경: 류마티스관절염의 약물 치료는 염증 완화를 위해 필요한 주요 치료로, 질병 초기에 적극적인 약물 치료를시작하여 처방에 따라 꾸준히 약물을 복용하는 것이 중요하다. 그러나 많은 대상자들이 약물복용이행을 잘하지 못하는것으로 보고되고 있다. 따라서 본 연구에서는 학습된 무력감과 약물에 대한 태도를 포함하여 류마티스관절염 대상자의 약물복용이행에 영향을 미치는 요인을 파악하고자 하였다. 방법: 경기도 소재 일개 대학병원 류마티스내과 외래를통원중인 류마티스관절염 환자 345명을 대상으로 구조화된설문지를 이용하여 자료수집하였다. 수집된 자료는 SPSS ver. 25 (IBM Corp.)를 이용하여 기술통계, t-test, chi-square test, 회귀분석을 이용하여 분석하였다. 결과: 연구 대상자의 65.2%가 약물복용이행 그룹으로 분류되었다. 약물복용이행 그룹이 불이행 그룹에 비해 약물에대한 태도가 긍정적이며 학습된 무력감이 낮았다. 회귀분석을 이용하여 약물복용이행 영향요인을 분석한 결과 학습된무력감이 높을수록 약물복용이행 가능성이 통계적으로 유의하게 낮았다(OR, 0.92; 95% CI, 0.86-0.98). 결론: 류마티스관절염 대상자들의 약물복용이행률을 증진하기 위해서는 수정 가능한 심리 정서적 반응인 학습된무력감을 낮추는 것이 요구된다. 이를 위해 정확한 지식 및행위를 기반으로 한 보건교육과 함께 대상자를 격려하고 동기를 부여할 수 있는 중재 개발 및 적용이 요구된다.

Venous Thromboembolism in a Single Korean Trauma Center: Incidence, Risk Factors, and Assessing the Validity of VTE Diagnostic Tools

부선주,오현진,황경진,정경원,문종환 연세대학교의과대학 2021 Yonsei medical journal Vol.62 No.6

Purpose: Trauma increases the risk of venous thromboembolism (VTE) in hospitalized patients. However, the risk and incidenceof VTE in Korean trauma patients are limited. Therefore, we aimed to evaluate the incidence and identify potential predictors ofVTE occurrence in Korean trauma patients. Moreover, we assessed the validity of the Greenfield risk assessment profile (RAP)and the trauma embolic scoring system (TESS) in these patients. Materials and Methods: This retrospective cohort study used the data of trauma patients who were admitted to a regional traumacenter between 2010 and 2016 and were eligible for entry into the Korea Trauma Data Bank. Clinical data were collected from hospitalmedical records. The patient’s baseline characteristics and clinical data were compared between VTE and non-VTE groups. Results: We included 9472 patients. The overall VTE rate was 0.87% (n=82), with 56 (0.59%) events of deep vein thrombosis and 39(0.41%) of pulmonary embolism. Multiple regression analysis revealed that variables, including VTE history, pelvic-bone fracture,ventilator use, and hospitalization period, were significant, potential predictors of VTE occurrence. This study showed that increasedRAP and TESS scores were correlated with increased VTE rate, with rates of 1% and 1.5% for the RAP and TESS scores of 6,respectively. The optimal cut-off value for RAP and TESS scores was 6. Conclusion: RAP and TESS, which are well-known diagnostic tools, demonstrated potentials in predicting the VTE occurrence inKorean trauma patients. Additionally, patients with pelvic-bone fractures and long-term ventilator treatment should be carefullyexamined for possible VTE.