65세 이상 노인에서 우울증을 동반한 만성질환상태에 따른 자가 평가 건강수준

이명진,손혜숙,Lee, Myeong Jin,Sohn, Hae Sook 한국농촌의학지역보건학회 2012 농촌의학·지역보건 Vol.39 No.4

Objectives: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. Methods: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using ${\chi}^2$-test and multiple logistic regression. Results: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. Conclusions: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking. 본 연구는 부산지역 65세 이상 노인을 대상으로 질병상태를 정상, 만성질환, 우울증, 우울증을 동반한 만성질환의 4군으로 구분하여 질병상태에 따른 자가 평가 건강수준을 비교하고, 자가 평가 건강 수준에 관련된 요인을 관찰하고자 하였다. 연구 자료로 부산광역시 2009년 지역사회건강조사 자료를 활용하였고, 그 중 65세 이상 노인 2,549명을 추출하여 연구 대상으로 하였다. 자료는 SAS program(ver. 9.2)을 이용하여 ${\chi}^2$-test, multiple logistic regression을 복합표본분석 방법으로 분석하였다. 분석 결과 자가 평가 건강수준이 만성질환과 우울증의 단일질환만을 가진 경우보다 만성질환에 우울증을 동반한 경우 매우 낮게 관찰되었고, 만성질환자의 우울증 동반율이 높았다. 질병 상태이외에 여자에서, 교육수준이 낮은 경우, 경제수준이 낮은 경우, 중등도 운동을 하지 않는 경우, 걷기 운동을 하지 않는 경우 자가 평가 건강수준이 낮았다. 본 연구결과를 토대로 노인 만성질환관리 사업에 우울증 관리를 연계한 사업 모형을 개발하여 지역사회에 적용할 것과 노인 만성질환 관리 사업에서는 우선대상으로 취약계층과 여성을 고려하고, 운동 사업을 연계하는 것을 제안한다.

베트남전 참전자 2세의 건강상태에 관한 조사 - 부산지역 고엽제 위해증 환자를 대상으로 한 설문조사 결과 -

김학준,손혜숙,엄상화,박수경,유병철,이종태,전진호,Kim, Hak-Joon,Sohn, Hae-Sook,Urm, Sang-Hwa,Park, Soo-Kyung,Yu, Byung-Chul,Lee, Jong-Tae,Chun, Jin-Ho 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.1

Objectives : To propose the referential data to evaluate the health impacts of Vietnam veterans' children whose father were exposed to herbicides in Vietnam War. Methods : Vietnam veterans who visited to Pusan Veteran Hospital for medical care were recruited from April to October, 1998. They were 71 and asked about their own combat history, symptoms and illness, and health status of their 182 children. The informations were collected by direct and phone interview. Exposure estimation was also performed as exposure score depending on year and unit of participation, and personal episodes related to exposure to herbicide in the war. It classified into three groups; lower(<18.0), moderate(18-53), high$(\geq53)$ exposure group. Results : The mean age and the period into the combat of the veterans were 52.8 years and 15.0 months. The mean exposure score was $18.1{\pm}9.9$, and mainly distributed in lower (46.5%) and moderate(52.1%) exposure group. Most(90.1%) of them were diagnosed as sequelae(21 cases) and suspected sequelae(43 cases) of the herbicides by Korean veteran's hospital diagnostic criteria. The major sequelae was peripheral neuropathy 13 cases, chloracne 5 cases, and the major suspected sequelae was hypertension 20 cases, diabetes mellitus 18 cases, liver disease 12 cases, central neuropathy 11 cases, etc. About birth, 42.2% and 16.9% experienced spontaneous abortion and stillbirth, respectively. The mean exposure score was higher in stillbirth experience group(p<0.05). About half of the children(90 cases, 49.5%) hold the abnormal health status: those were skin pigmentation 38 cases, rash 23 cases, congenital anomaly 15 cases, general weakness 12 cases, purpura 8 cases, visual disturbance 8 cases, etc. These health problems had no association with father's exposure level(p>0.05). Conclusions : These results were depend on their own answers, and expectation for compensation did not excluded, therefore, this study may have limitations: inaccuracy of informations due to recall bias and response bias. Nevertheless, through this study, we could image the fundamental aspect for health impacts of Vietnam veterans' children for preparing the national control program and policy. A large scale epidemiologic study with valid exposure assessment on the health impacts of Vietnam veterans' children is recommneded.

데이터마이닝 기법을 활용한 국민건강보험 상해상병 관리모형 개발

박일수,한준태,손혜숙,강석복,Park, Il-Su,Han, Jun-Tae,Sohn, Hae-Sook,Kang, Suk-Bok 한국데이터정보과학회 2011 한국데이터정보과학회지 Vol.22 No.3

우리나라의 건강보험제도권 내 해당되지 않은 상해상병 진료건 중 국민건강보험으로 부당 잘못 청구되는 진료건을 적발하여, 환수조치하기 위해서는 정확한 상해상병 조사대상자 선정이 필요하다. 그러나, 국민건강보험공단의 한정된 인력으로 증가하는 상해조사관련 업무량을 보다 효율적으로 대처하고, 수행하기 위해서는 상해요인조사 업무 효율화 및 환수 결정율 제고를 위한 조사대상자 발췌기준의 고도화 방안을 마련해야 한다. 이에 본 연구에서는 상해상병 유형에 대해 일정금액 이상 진료건의 발췌 등과 같은 과거의 발췌기준에서 데이터마이닝 기법과 같은 통계적 모형과 업무규칙을 함께 적용한 하이브리드 모형으로서 상해상병 조사대상자 선정기준을 제시하고자하였다. We developed the hybrid model coupled with predictive model and business rule model for administration of injury by utilizing medical data of the National Health Insurance in Korea. We performed decision tree analysis using data mining methodology and used SAS Enterprise Miner 4.1. We also investigated under several business rule for benefits (expense paid by insurer) and claims of injury in National Health Insurance Corporation. We can see that the proposed hybrid model provides a quite efficient plausible results.

보건예방사업을 위한 B형간염 표면항체 검사방법 비교

이정녀,엄상화,이종태,전진호,손혜숙,Lee, Jeong-Nyeo,Urm, Sang-Hwa,Lee, Jong-Tae,Chun, Jin-Ho,Sohn, Hae-Sook 대한예방의학회 2000 Journal of Preventive Medicine and Public Health Vol.33 No.2

Objectives : The purpose of this study was to suggest a proper method for the detection of heaptitis B surface antibody(anti-HBs) in a screening program for hepatitis B vaccination. Methods : Sensivitity, specificity and predictive values were compared between Immunochromatographic assay (ICA) and passive hemagglutination(PHA) in 978 subjects(565 males, 413 females, 19-78 years ranging in age, mean 46.5 years old). EIA was used as a standard method for the detection of HBsAb. Results : Sensitivity in the detection of anti-HBs of PHA and ICA was 88.7%, and 94.9%, specificity was 94.3% and 96.6%, negative predictive value was 96.5%, and 98.0%, and positive predictive value was 82.3%, and 91.3%,, respectively. False negative rate(11.3%) of PHA was higher than that(5.1%) of ICA. The higher the titer of anti-HBs in EIA was, the lower the false negative rate was. There was no false negative result in the cases with $101mIU/{\beta}c$ or more in EIA Conclusion : We suggest that ICA should be the choice of screening method in the detection of anti-HBs in Hepatitis B vaccination program.

부산지역 여성들의 스트레스 실태조사

김희진(Hee Jin Kim),손혜숙(Hae Sook Sohn) 한국인체미용예술학회 2001 한국인체미용예술학회지 Vol.2 No.1

  Objectives : To estimate the meanings of skin care on stress management for middle-aged women.<BR>  Methods : The subjects were 389 middle-aged women; 116 who visited the professional skin care shop periodically(cases) and 273 with rare experience of skin care(controls). Questionnaire survey for general characteristics, degree of skin care and stress level was done from February 14 to March 13, 2000. Stress level measured with psychosocial well-being index(PWI), and data were analyzed using PC SAS(ver. 6.12).<BR>  Results : The major type of self skin care were use of matched cosmetics to her own skin(62.3%), use of sun blocks(55.6%), pack/massage(48.1%), and cases did more actively these healthy behavior(p<0.05). On the basis of self perceived skin status, stress group was lower in the healthy skin group(p=0.081), and income(γ=-0.137, p=0.011) and the degree of self skin caret (γ=-0.124, p=0.014) had negative correlation with the stress level.<BR>  Conclusions : Though this study has limitations of cross-sectional study, the results shows that there was significant negative correlation between stress and self skin-care. It means that skin-care could be concerned to stress care. We suggest that the efforts of specialist for spreading the proper methods of skin-care to improve the effect of skin-care on stress care and the more valid study to evaluate the effects of skin-care on stress control among middle-aged women would be needed.

65세 이상 노인에서 우울증을 동반한 만성질환상태에 따른 자가 평가 건강수준

이명진(Myeong Jin Lee),손혜숙(Hae Sook Sohn) 한국농촌의학 지역보건학회 2012 농촌의학·지역보건 Vol.37 No.4

Objectives: To compare the self-rated health in chronic disease patients with depression, chronic disease patients, and depression patients, and to observe the related factors to the self-rated health of people age 65 and older. Methods: The subjects were 2,549 elderly people, over 65 years old in Busan Metropolitan City who participated in 2009 community health survey. Association between self-rated health and general characteristics, life style and disease status were observed. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Analysis of complex sample was done with SAS (ver. 9.2), using χ2-test and multiple logistic regression. Results: Among total 2,549, there were 740 normal people (29.8%), 50 people with depression (1.8%), 1,495 people with other chronic diseases (58.2%), and 264 people with the comobidity of depression and other chronic diseases (10.1%). Good self-related health accounted for 20.3% for the whole, 33.4% for normal, 16.7% for chronic disease, 16.1% for depression, and 3.2% for chronic diseases with depression. Disease, gender, education, income, alcohol drinking, regular exercise and regular walking were independent factors associated with the good self-related health. Conclusions: It is suggested that when the chronic disease control program for the elderly is developed, depression care should be considered along with the program. This program should be given priority to the women and the vulnerable classes and should also be related to the regular walking.

부산, 울산 및 경상남도 만 19세 남자의 고도근시 유병률

이상준,엄상화,유병철,손혜숙,홍영습,노맹석,이용환,Lee, Sang-Joon,Urm, Sang-Hwa,Yu, Byeng-Chul,Sohn, Hae-Sook,Hong, Young-Seoub,Noh, Maeng-Seok,Lee, Yong-Hwan 대한예방의학회 2011 Journal of Preventive Medicine and Public Health Vol.44 No.1

Objectives: The purpose of this study was to estimate the prevalence and correlated factors of high myopia in 19 year-old men in Southeast Korea. Methods: This retrospective study was based on the medical checkup data of conscription during 2005. The study subjects were 19 years old men in Busan, Ulsan and Gyeongsangnam-do. The health checkup data of the conscripts consisted of noncycloplegic autorefraction test, the biometric data and social factors. To analyze the social and biometric effects, we classified the biometric factors into 4 or 5 groups and the social factors into 3 groups. High myopia was defined as a spherical equivalent of under -6.0 diopter. Data analysis was performed using the chi square test for trends and multiple logistic regression analysis. The SAS(version 9.1) program was used for all the analyses. Results: The prevalence of high myopia was 12.39% (6256 / 50 508). The factors correlated with high myopia were the residence area (OR, 2.07; 95% CI, 1.77 to 2.4 for small city; OR, 2.01; 95% CI, 1.72 to 2.34 for metropolis; the reference group was rural area), academic achievement (OR, 1.43; 95% CI, 1.34 to 1.53 for students of 4-and 6-year-course university; the reference group was high school graduates & under) and blood pressure (OR, 1.54; 95% CI, 1.10 to 2.16 for hypertension; OR, 1.09; 95% CI, 1.02 to 1.17 for prehypertension; OR, 1.10; 95% CI, 1.01 to 1.20 for hypotension; the reference group was normal blood pressure). Conclusions: More than one tenth of the young men were high myopia as one of the risk factor for visual loss. Further studies on high myopia and its complications are needed to improve eye health in Southeast Korea.

부산지역의 모유수유 실태 및 관련요인

엄길란 ( Gill-ran Eum ),손혜숙 ( Hae-sook Sohn ),김희영 ( Hee-young Kim ) 한국모자보건학회 2007 한국모자보건학회지 Vol.11 No.1

Objectives: To suggest the methods inducing breast feeding, the rate of breast feeding and the factors related to breast feeding were observed. Methods: The subjects were 207 mothers who visited three public health centers in Busan to get a vaccination to their infants aged 1~6 months. Questionnaire survey including general knowledge of breast feeding, breast feeding barriers and maternal role strains was performed to them from February to March, 2005. Results: The rate of breast feeding of subjects was 35.7%, the rate of milk feeding and mixed feeding were 35.3% and 29.0%, respectively. The Odds Ratios (ORs) of breast feeding for milk feeding were significantly higher than 1 in the cases who planned the breast feeding duration longer while they were pregnant. As increasing the scores of maternal role strains and breast-feeding barriers, ORs were significantly lower than 1. Conclusions: Although the rate of breast feeding become higher than before, it is not sufficient. To induce breast feeding, the method how to overcome the barriers of breast feeding and maternal role tension should be educated in hospital and public health centers.

보건소 금연클리닉 6개월 금연성공자의 금연지속 실패 요인

최현순(Choi, Hyeon-Soon),손혜숙(Sohn, Hae-Sook),김윤희(Kim, Yun-Hee),이명진(Lee, Myong-Jin) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.10

본 연구는 보건소 금연클리닉의 6개월 금연성공자의 금연지속 실패와 관련된 요인을 파악하고자 시도되었다. 자료는 6개월 금연성공자 347명으로부터 보건소 금연클리닉 등록카드와 전화설문 조사를 통하여 수집되었으며, 생명 표법과 Cox-proportional hazard model로 분석하였다. 금연지속 실패와 관련된 요인은 주거지가 읍·면인 경우(HR 2.50, 95% CI 1.69-3.68), 만성질환이 없는 경우(HR 1.92, 95% CI 1.21-3.04), 동거가족 흡연자가 없는 경우(HR 1.93, 95% CI 1.21-3.09) 금연보조제를 사용한 경우(HR 2.17, 95% CI 1.01-4.68)로 나타났다. 누적 금연지속 실패율은 6개월까지 가 28.6%, 24개월은 36.1%로 나타났다. 이에 보건소 금연클리닉은 금연성공 및 금연 지속률을 높이기 위하여 대상자 의 금연의지를 강화할 수 있는 다양한 중재 개발이 필요하다. This study was performed to investigate the factors related failure in continuity of smoking cessation among persons who were initially successful in quitting smoking for at least 6 months in smoking cessation clinic of public health center. Data were collected with the telephone questionnaire survey and the registered cards from 347 of 6 months quitters from 2006 to 2008 year. Data were analyzed by life table method and Cox-proportional hazard model. In Cox-proportional hazard model, Eup·Myeon of residence(HR 2.50, 95% CI 1.69-3.68), without chronic diseases(HR 1.92, 95% CI 1.21-3.04), without another smoker in household(HR 1.93, 95% CI 1.21-3.09) and usage of supplement agent(HR 2.17, 95% CI 1.01-4.68) were independently associated with the failure in continuing to stay smoke-free. The cumulative rate of failure in the continuity of smoking cessation was 28.6% at 6 month and 36.1% at 24 month. For operating a clinic program for smoking cessation, Public health center should makes strategies that a person is continuing smoking cessation for over 6 months after the first 6 momth's smoking cessation.

부산 일부지역 여성들의 자궁경부암 조기검진에 대한 지식, 태도 및 경험

고광욱 ( Kwang-wook Koh ),이덕희 ( Duk-hee Lee ),이용환 ( Yonghwan Lee ),손혜숙 ( Hae-sook Sohn ) 한국모자보건학회 2002 한국모자보건학회지 Vol.6 No.1

이 연구는 도시 일부 지역 여중학생의 어머니를 대상으로 자궁경부암 조기검진의 지식, 태도 및 경험을 파악함으로써 장년기 여성 보건사업의 기초자료로 삼을 목적으로 시행하였다. 2000년 11월 20일부터 11월 30일까지 부산광역시 사상구내 4개의 여중학교 중 3개교를 임의선정하여 1학년생 어머니 921명을 대상으로 자기기입식 설문지를 이용하여 자료를 수집하였다. 설문응답자는 820명(89.1%)였다. 주요 조사결과는 다음과 같다. 1. 794%의 대상자가 자궁경부암 조기 발견 검사가 있다는 사실을 알고 있었고 알게 된 경로는 TV, 라디오가 364명(56.5%)으로 가장 많았고 보건의료기관을 통한 것은 98명(15.2%)이었다. 주변으로부터 자궁경부암 조기검사를 권유받은 경험은 264명(39,2%)에서 있었다. 2. 자궁경부암 검사를 받아본 경험이 있는 사람은 대상자의 74.4%(593명)였으나 생애 통산 수검 회수가 3회 이상인 대상자는 49.5%(292명)였고 2000년에 검진을 받은 사람은 26.8%(151명)였다. 3. 지식수준에 있어서는 문항별로 정답율 변이가 컸고 일부 구체적인 위험요인에 대한 지식수준이 낮았다. 보험조합(국민건강보험공단)에서 실시하는 성인병 검진 때 자궁경부암 검사를 무료로 받을 수 있다는 사실은 39.9%만이 알고 있었다. 태도 항목에 있어서는 경제적 부담, 부끄러움 그리고 검진시간 할애에 대해 바람직하지 못한 태도가 많은 편이었다. 4. 자궁경부암 조기검사의 수검율에 영향을 미치는 주된 요인으로 건강진단의 경험, 의료기관방문경험, 주변의 검진 권유 유무, 지식, 태도가 학력이나 수입을 보정한 후에도 유의하였다. 이상의 결과에서 본 연구 대상자들의 자궁경부암 조기검진 경험률은 높은 편이지만 주로 대중매체를 통해 획득한 지식에 따라 일회성 조기검진을 받는 것으로 나타났고 보험조합 등의 정기건강진단시 자궁경부암 조기검진 수검가능 사실을 알지 못하였다. 구체적인 지식수준과 일부 태도에 있어서 개선의 여지가 있으며 특히 건강진단 경험, 의료기관방문 경험 그리고 주변의 자궁경부암조기검진 권유, 지식주준, 바람직한 태도가 유의한 자궁경부암 조기검진의 유의한 영향요인으로 규명되었다. Objectives : The purpose of this study was to survey the knowledge, attitude and experience of uterine cervical cancer screening of women in Sasang District of Busan Metropolitan City. Methods : The data were collected by self-administered questionnaire between November 20 and 30,2000. The study subjects were 921 mothers of the 1st grade students in three girl's middle school in Sasang District of Busan Metropolitan City. Descriptive statistics and χ²test in SPSS program were used for data analysis. Results : The proportion of mothers who ever had cervical cancer screening was 74.4%. Among mothers ever had screening 49.5% had 3 or more times in their life time, 26.8% of them had the last screening in year 2000, 41.6% had regular health examination but only 11.2% of them had taken the regular health examination provided by the health insurance. Proportion of mothers who knew that there is cervical cancer screening method was 79.4% and main source of information was mass media. Only 42.5% of subjects knew that health examination of health insurance included cervical cancer examination without cost. However, many of the subjects did not know the specific risk factors for cervical cancer. The factors associated with cervical cancer screening were experience of regular health examination, experience of clinic visit and recommendation of health professional, family, neighborhood and relatives, level of knowledge about cervical cancer screening and attitude about cervical screening. Conclusions : Although the proportion of mothers who ever had cervical cancer screening was relatively high but the frequency and interval of screening were not adequate. Knowledge and the attitude about cervical cancer and its screening need to be more specific. To promote cervical cancer screening, organized community activity including the utilization of the regular health examination of health insurance and the recommendation of medical personnel are suggested.