여성노인의 구술생애사를 통해 본 돌봄 윤리의 재구성

신경아(Kyung A Shin) 계명대학교 여성학연구소 2011 젠더와 문화 Vol.4 No.2

이 글은 최근 한국사회에서 진행 중인 노인 돌봄의 탈가족화 맥락에서 여성노인들이 자신의 경험을 어떻게 해석하는지 살펴보고 있다. 연구방법으로는 구술생애사를 선택하였으며, 노인 3명과 그들을 돌보는 가족 며느리나 딸 과의 인터뷰를 병행하였다. 인터뷰는 연구참여자들의 집을 방문하여 이루어졌는데, 자연스러운 일상적 상황 속에서 연구가 수행될 때 가장 좋은 결과를 가져올 수 있다는 문화기술지적 방법론의 규칙을 따르기 위해서였다. 세 명의 노인의 구술은 '분노하는 어머니와 벗어나고 싶은 며느리'(여정순씨), '외로운 어머니와 시어머니에 대한 기억을 갖지 못한 며느리'(이순영씨), 자식세대에 적응하려는 어머니와 보이지 않는 며느리'(권영경씨)로 각각 정의될 수 있지만, 세 사례에서 공통된 사실은 소통과 공감의 부재였다. 이 중 이순영씨는 가부장적 가족관습 속에서 자신과 며느리의 위치가 갖는 동질성을 인식하고 며느리 돌봄에 대한 기대 역시 여성에게 지워진 차별적 의무라는 사실을 깨닫고 있었다. 이러한 사례가 암시하는 것은 노인 돌봄의 탈가족화 조건 속에서 돌봄의 두 주체 시어머니와 며느리 가 소통하기 위해서는 가부장적 가족 내 여성의 위치에 대한 이해라는 젠더적 관점이 필요하다는 사실이다. Gender is a key factor in elder care. This is because most of the care givers as well as the care takers are women. This study looks into what old women have experienced in the social transformation of elder care and how they feel being faced with such rapid change in Korea. In order to collect oral histories, 3 elderly women were interviewed, while their daughter or daughter in law participated in separate interviews. The analysis of the interview data shows the lack of communication and sympathetic understanding between the care giver and the cared. The case of Yeo Jung sun can be defined as 'an angry mother and her daughter in law hoping to be free from the burden of care'. The case of Kwon Young kyung shows 'an adaptable mother as a result of her daughter in law being absent'. Lee Sun young's narrative described 'a lonely mother whose daughter in law'. Nevertheless, Lee Sun young has made a great effort to understand her daughter in law by using insightful interpretation within the framework of the patriarchal family relationship. Her story proves the fact that for communication between the cared for elder and her care giver, gender perspectives are needed to allow us see through the eyes of women within the patriarchal family and understand their positions.

Difference of The Cardiac Structure and Function Depending on Obesity Level of Healthy Adults

Kyung-A Shin(신경아),Seung-Bok Hong 대한의생명과학회 2011 Biomedical Science Letters Vol.17 No.2

The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 ㎝, whereas women were defined as being obese in case their waist measurement was over 80 ㎝. Also, regarding the BMI criteria, in case a person’s BMI was 30 ㎏/㎡, the subject was classified as belonging to an obese group, and in case a person’s BMI was between 25 ㎏/㎡ and 30 ㎏/㎡, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.

임상병리(학)과의 임상실습 교육내용 표준화를 위한 기초연구

신경아(Kyung A Shin),이준호(Jun Ho Lee) 한국보건기초의학회 2022 한국보건기초의학회지 Vol.15 No.1

This study is a basic study for standardization of clinical practice education contents of the department of biomedical laboratory science. Therefore, the importance of clinical practice education contents was evaluated. The survey was conducted from February 22 to May 27, 2021. 160 professors and 150 clinical experts from each field participated in the survey. The Mann-Whitney U test was conducted to analyze the difference in importance of clinical practice education contents between professors and clinical experts. As a result, 60 items of professors and 27 items of clinical experts were found to have an importance of 4.5 or higher among a total of 184 clinical practice education contents. The education contents that show a significant difference in importance between professors and clinical experts were 9 items (36.0%) in clinical chemistry, 8 items (30.8%) in hematology, 2 items (5.7%) in transfusion, 14 items (56.0%) in clinical physiology, and 9 items (56.3%) in histocytology. In the field of histocytology, there were the most differences in importance between professors and clinical experts. However, there were no items showing differences in importance between professors and clinical experts in the fields of clinical microbiology, immunoserology, and molecular biology. Therefore, it is necessary to prepare guidelines for standardization of clinical practice that reflect the opinions of professors and clinical experts

초 울트라마라톤대회(622 km) 경기가 심장마커와 근손상마커에 미치는 영향

신경아 ( Kyung-a Shin ),박용범 ( Yongbum Park ),김영주 ( Young-joo Kim ) 대한스포츠의학회 2018 대한스포츠의학회지 Vol.36 No.3

Purpose: Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race. Methods: A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers. Results: Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race. Conclusion: The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.

중환자실에 근무하는 의료인의 전비강에서 PBP2a Rapid Kit와 직접 Coagulase 검사를 이용한 Methicillin-resistant Staphylococcus aureus의 검출

홍승복 ( Seung-bok Hong ),신경아 ( Kyung-a Shin ),손재철 ( Jae-cheol Son ),신경섭 ( Seob-kyeong Shin ) 대한임상검사과학회 2010 대한임상검사과학회지(KJCLS) Vol.42 No.2

We evaluated the performance of a novel screening test, PBP2a MRSA rapid kit (Dinona Inc., Iksan, Korea), for methicillin-resistant Staphylococcus aureus (MRSA) based on a immunochromatographic assay. The test is able to detect penicillin-binding protein 2a (PBP2a) using the nasal specimens from health care workers. The nasal specimens were obtained from 69 healthcare workers and were incubated in enrichment broth followed eight hours incubatin in BHI with cefoxitin 4 μg/mL. These broth were tested by PBP2a Rapid Kit. The enrichment broths were also directly tested for tube coagulase using the conventional identification method. 19 of 22 MRSA showed positive results by PBP2a rapid test and direct coagulase test (the sensitivity for detection of MRSA, 86.36%). While, 8 of 47 non-MRSA showed false positive results for the two tests. All of the 8 non-MRSA which showed false positive were co-colonizing isolates with MRCNS and MSSA. In addition, 46 of 49 methicillin-resistant staphylococci (MRS) showed positive results for PBP2a MRSA rapid kit (the sensitivity for detection of MRS, 93.8%), and all of 20 non-MRS showed negative results (specificity, 100%). The combination of PBP2a MRSA rapid kit and direct coagulase test showed the good sensitivity for detection of MRSA from anterior nares but frequently showed false positive results from the co-colonizing carrier with MRCNS and MSSA.

한국 비만성인의 대사증후군 유병에 따른 내장지방지수와 인슐린저항성, 췌장 베타세포기능과의 관련성

신경아,Shin, Kyung-A 한국융합학회 2020 한국융합학회논문지 Vol.11 No.9

The purpose of this study was to investigate the relationship between VAI, insulin resistance, and pancreatic beta cell function according to the prevalence of metabolic syndrome in obese adults. From 2017 to 2019, 1,797 obese adults who received medical checkups at a general hospital in Bundang. Diagnosis of metabolic syndrome is NCEP-ATP III. HOMA index was used for insulin resistance and pancreatic beta cell function. VAI was higher in the metabolic syndrome than in the control(p<.001). As the number of risk factors for metabolic syndrome increased, the VAI value was higher(p<.001). The prevalence of metabolic syndrome increased as the VAI quartile increased(p<.001). VAI was also shown to be related to HOMA-IR and HOMA-β in the control, but not in the metabolic syndrome. 본 연구는 비만성인을 대상으로 대사증후군 유병에 따라 VAI와 인슐린저항성, 췌장 베타세포기능과의 관련성을 알아보고자 하였다. 2017년 1월부터 2019년 12월까지 분당지역 일개 종합병원에서 건강검진을 받은 만 19세 이상 비만성인 1,797명을 대상으로 분석하였다. 대사증후군은 NCEP-ATP III의 기준에 근거하였다. 인슐린저항성 및 췌장 베타세포기능은 HOMA 지수를 이용하였다. 대조군보다 대사증후군 진단군에서 VAI가 높았으며, 대사증후군 위험요인 개수가 증가할수록 높은 VAI값을 보였다(각각 p<.001). 또한 VAI 사분위수가 증가함에 따라 대사증후군 유병률이 증가하였다(p<.001). VAI는 대조군에서 HOMA-IR 및 HOMA-β와 관련이 있는 것으로 나타났으나, 대사증후군 진단군에서는 HOMA-IR 및 HOMA-β간에 관련이 없었다.

한국 성인의 혈청 요산 수치와 인슐린저항성 및 대사증후군 구성요소간의 연관성

신경아,김은재,Shin, Kyung-A,Kim, Eun Jae 중소기업융합학회 2020 융합정보논문지 Vol.10 No.11

본 연구는 한국 성인의 성별에 따른 혈청 요산 수치와 인슐린저항성 및 대사증후군 구성요소간의 관련성을 확인하고자 하였다. 2018년 6월에서 2020년 5월 사이에 경기지역 종합병원에서 건강검진을 받았던 20세 이상 남성 2,365명, 여성 2,063명 총 4,428명을 대상으로 단면연구를 시행하였다. 연구결과 남녀 모두 정상군보다 대사증후군 진단군에서 요산치가 높았으며, 고요산혈증군에서 대사증후군과 그 구성요소의 발병률은 정상군보다 높았다. 고요산혈증은 남성에서 혈압상승(p=0.006)과 고중성지방혈증(p<0.001), 여성에서 대사증후군(p=0.012)과 낮은 HDL-콜레스테롤(p<0.001) 발병 위험을 높이는 요인으로 나타났다. 따라서 남성과 여성 모두에서 고요산혈증은 대사증후군 및 그 구성요소와 관련이 있었으며, 특히 여성에서 대사증후군 발병의 독립적인 예측인자임을 확인하였다. The purpose of this study was to investigate the relationship between serum uric acid levels, insulin resistance and components of metabolic syndrome. It was conducted on 4,428 adults over the age of 20 who had undergone health checkups at a general hospital in Gyeonggi-do from June 2018 to May 2020. As a result of the study, uric acid levels were higher in the metabolic syndrome subjects than normal subjects in both men and women. and the incidence of metabolic syndrome and its components was higher in the hyperuricemia group than in the normal group. Hyperuricemia was found to increase the risk of elevated blood pressure(p=0.006) and hypertriglyceridemia(p<0.001) in men and metabolic syndrome(p=0.012) and low HDL-cholesterol(p<0.001) in women. Thus, in both men and women, hyperuricemia was associated with metabolic syndrome and its components, and it was confirmed that it was an independent predictor of the onset of metabolic syndrome in women.

당뇨와 고혈압 환자를 제외한 건강검진을 실시한 한국 성인남녀의 대사증후군 구성요소와 총 빌리루빈간의 관련성

신경아,Shin, Kyung-A 대한임상검사과학회 2018 대한임상검사과학회지(KJCLS) Vol.50 No.2

빌리루빈은 내인성 항산화제로서 항염작용이 있으며, 고혈압, 당뇨병, 대사증후군 및 인슐린 저항성과 역상관 관계에 있다고 보고된다. 그러나 간 특이적 지표와 비교하여 빌리루빈과 대사증후군간의 관련성을 평가한 연구는 부족하다. 본 연구에서는 건강검진을 실시한 한국 성인남녀를 대상으로 ALT, GGT와 비교하여 총 빌리루빈과 대사증후군 유병률 사이의 관련성을 조사하고자 하였다. 이 횡단면 연구에는 2015년 3월부터 2018년 2월까지 경기도 소재 종합병원에서 건강검진을 실시한 20세 이상 성인남녀 22,568명이 포함되었다. American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI)의 지침에 따라 대사증후군을 진단하였다. 남녀 모두에서 대사증후군 위험요인이 없는 군보다 대사증후군 진단군에서 간 효소치가 높았으며, 총 빌리루빈과 직접 빌리루빈치는 낮게 나타났다. 남녀 모두에서 혈청 총 빌리루빈은 복부비만(r=-0.066 vs r=-0.055), 중성지방(r=-0.127 vs r=-0.136)과 약한 역상관 관계를 보였으며, 이는 ALT와 GGT보다 약한 관련성이었다. 또한 남녀 모두에서 ALT와 GGT뿐만 아니라 총 빌리루빈은 대사증후군 발생 가능성을 예측하는 지표는 아닌 것으로 나타났다. Bilirubin has an anti-inflammatory effect as an endogenous antioxidant and has been reported to be inversely correlated with hypertension, diabetes, metabolic syndrome, and insulin resistance. On the other hand, there is a lack of research evaluating the association between bilirubin and metabolic syndrome compared to liver-specific indicators. This study examined the association between the total bilirubin and metabolic syndrome prevalence in Korean adults who underwent health screening compared to ALT and GGT. This cross sectional study included 22,568 adult males and females aged 20 years or older who underwent a health examination at the General Hospital of Gyeonggi Province from March 2015 to February 2018. Metabolic syndrome was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) guidelines. In both genders, the metabolic syndrome diagnosed group had higher liver enzymes, and the total bilirubin and direct bilirubin were lower than those without the metabolic syndrome risk factors. The serum total bilirubin showed a weak inverse correlation with abdominal obesity (r=-0.066 vs r=-0.055) and triglyceride (r=-0.127 vs r=-0.136) in both males and females, which is weaker than ALT and GGT The data were statistically significant. In addition, total bilirubin as well as ALT and GGT in both men and women were not predictors of the likelihood of developing metabolic syndrome.

울트라 마라톤(100 km)에서 삼투압 농도와 전해질 대사의 생화학적 요인 변화에 대한 안전성 평가

신경아 ( Kyung A Shin ),김영주 ( Young Joo Kim ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.2

본 연구는 22명의 남자 아마추어 선수를 대상으로 100 km 울트라 마라톤에서의 전해질 대사 반응의 안전성을 평가하기 위해 실시하였다. 대상자의 평균 연령은 50.91±4.77세, VO2max는 48.19±6.43 mL/kg/min, 그리고 평균 경기 완주시간은 829.64±89.31분이었다. 혈액검사에 포함된 전해질 지표로는 칼슘, 무기인, 마그네슘, 소디움, 포타슘, 염소, 총이산화탄소, 음이온차이, 혈장량 변화와 삼투압 농도를 경기 전, 50 km 지점, 경기 종료 직후 측정하였다. 본 연구결과 소디움 농도는 경기 전보다 50 km 지점에서 감소하였고 50 km 지점보다 100 km 지점에서 감소하였으나, 고나트륨혈증 및 저나트륨혈증은 나타나지 않았다. 100 km 울트라 마라톤 경기에서 다른 모든 전해질 지표들의 거리별 변화는 참고범위 내에서 이루어졌으며, 혈장량 변화는 나타나지 않았다. 결론적으로 아마추어 지구력 선수들의 전해질 대사에 있어서 경기중 통계적인 차이는 있었으나 임상적으로 의미 있는 삼투압 농도와 전해질의 변화는 나타나지 않았으며 안전한 경기로 나타났다. This study was conducted to investigate the electrolyte metabolic responses to a 100 km ultra-marathon in 22 male amateur runners. Their average age was 50.91±4.77 years old and their VO2max value was 48.19±6.43 mL/kg/min. The participants completed the race with a mean finishing time of 205.55±19.61 minute. Electrolyte parameters based on blood tests including calcium, inorganic phosphorus, magnesium, sodium, potassium, chloride, total carbon dioxide, anion gap, plasma volume change and osmolality were measured pre-race, at 50 km, and at 100 km (post-race). Only slight changes in sodium level with no cases of hypernatremia or hyponatremia were observed. Additionally, all the electrolyte parameters changes were within the normal range and plasma volumes were unchanged. Overall, amateur marathon runners are not at risk to develop clinically significant electrolyte or osmolality changes during a 100 km ultra-marathon.

연구논문 : 전업 주부와 직업주부의 식생활, 영양소 섭취상태 및 건강에 대한 관심도 비교 연구

신경옥 ( Kyung Ok Shin ),윤진아 ( Jin A Yoon ),이준식 ( Jun Sik Lee ),정근희 ( Keun Hee Chung ),최순남 ( Soon Nam Choi ) 한국식생활문화학회 2010 韓國食生活文化學會誌 Vol.25 No.3

The purpose of this study was to compare the awareness of dietary patterns and health of full-time and employed housewives. The investigation gathered information on general characteristics, dietary lifestyle, nutritional status, and health by questionnaire as well as anthropometric measurements. The subjects included housewives living in Seoul and Gyeonggi Province (86 full-time and 127 working housewives) during November 2009 to January 2010. The average age, height, and weight of the housewives were 45.8±7.6 yr, 161.0±8.4 cm, and 55.7±6.3 kg, respectively. The average monthly income of the households was 3 million to 5 million won (31.4% full-time and 37.0% working housewives), and their average food expense was 200,000 to 500,000 won (46.5% full-time and 48.1% working housewives). More than 90% of the studied homes were nuclear families and the most common number of children was 2 to 3 (79.1% full-time and 76.4% working housewives). The ratio of employed housewives who ate regular meals was 35.4%, but that of the full-time housewives was 48.2% (p<0.05). Of the working housewives, 7.1% never ate breakfast and the primary reason for skipping breakfast was `busy in the morning` (61.1%). The type of food that the housewives preferred when eating out was Korean food, both for the full-time and employed housewives (76.0%). All the housewives overate calories and the full-time housewives ate more protein, fat, vitamin A, vitamin B1, vitamin B6, niacin, vitamin C, vitamin E, folic acid, and cholesterol than the employed housewives (p<0.05). Both the full-time and employed housewives were more satisfied with supper than with other meals. About 30.6% of the full-time and 33.9% of the working housewives had no interest in health, but answered that regular exercise was very important for health (33.3% full-time and 39.7% working housewives). In conclusion, working housewives have poor dietary habits and nutrient intakes, thus substantial measures to improve these problems are urgently needed.