국가 암 조기검진 대상자의 암 검진 수검의도 관련 요인

김록범,박기수,홍대용,이철헌,김장락,Kim, Rock-Bum,Park, Ki-Soo,Hong, Dae-Yong,Lee, Cheol-Heon,Kim, Jang-Rak 대한예방의학회 2010 예방의학회지 Vol.43 No.1

Objectives: To identify factors associated with cancer screening intention using the Theory of Planned Behavior (TPB). Methods: Among 55,920 eligible persons for National Cancer Screening Program (NCSP) in J city, 1,100 individuals were contacted. Of these, 797 were interviewed using a structured questionnaire. Thirty-six responses were excluded due to incomplete data. The remaining 761 completed questionnaires were analyzed to find factors associated with cancer screening intention. Results: Cancer screening intention was significantly associated with behavioral attitude (p<0.01) and subjective norm (p<0.01), but not with perceived behavioral control (p=0.29) in the TPB model. These three constructs explained 29.7% of cancer screening intention in multiple linear regression analysis. External factors such as socio-demographic status, health and health behavior variables explained 8.9% of screening intention. Among them, household monthly income, past cancer screening experience, exercise and daily eating habit were significantly associated with screening intention. Conclusions: Cancer screening intention may be influenced by focusing attitude, subjective norm in TPB model and other external factors. However, further studies are warranted to identify factors influencing cancer screening intention and behavior.

우울증상에 관련된 요인과 우울증상이 지각된 건강수준, 외래의료이용, 삶의 질에 미치는 영향

김록범(Rock Bum Kim),박기수(Ki Soo Park),이진향(Jin Hyang Lee),김봉조(Bong Jo Kim),전진호(Jin Ho Chun) 한국보건교육건강증진학회 2011 보건교육건강증진학회지 Vol.28 No.1

일부 지역 주민들의 모발 수은 농도와 혈중 수은 농도와의 상관성

김경연,서정욱,김병권,김유미,김록범,김대선,김정만,김춘진,홍영습,Kim, Gyeong-Yeon,Seo, Jeong-Wook,Kim, Byoung-Gwon,Kim, Yu-Mi,Kim, Rock-Bum,Kim, Dae-Seon,Kim, Jung-Man,Kim, Choon-Jin,Hong, Young-Seoub 한국환경보건학회 2013 한국환경보건학회지 Vol.39 No.2

Background: This study was carried out for the purpose of comprehensively evaluating the mercury exposure level of residents in several areas and the correlation between hair mercury concentration and blood mercury concentration. Method: One thousand one hundred ninety seven subjects were sampled from 30 sites using random assignment sampling. We performed a questionnaire survey and measured the level of total mercury in hair and blood samples from all subjects. Results: The geometric mean concentrations of hair and blood mercury in all subjects were 1.27 mg/kg [95% confidence interval (CI): 1.23-1.32 mg/kg] and 5.24 ${\mu}g/L$ [95% CI: 5.07-5.41 ${\mu}g/L$], respectively. Male (1.56 mg/kg in hair, 6.00 ${\mu}g/L$ in blood) was significantly higher than that of female (1.03 mg/kg in hair, 4.56 ${\mu}g/L$ in blood), and the concentrations were elevated as age increased up to the 50s. Education, smoking, alcohol drinking, and using of pesticides were also shown to influence mercury concentrations in hair and blood. The ratio of hair/ blood mercury concentration was 261.3. The total mercury concentration in hair was identified to be significantly related with total mercury concentration in blood (r=0.814, p<0.001). Conclusion: The geometric mean concentrations of hair and blood mercury were higher than the levels provided in international recommendations. The total mercury concentration in hair was positively correlated with the concentration in blood. The results of this study suggest that hair mercury be considered as a useful tool for the evaluation of mercury exposure.

유방암 조기검진에 대한 단계별 행동과 관련 요인 -국가암조기검진 대상자를 중심으로-

손효경,감신,박기수,김장락,김록범,박선균,Son, Hyo-Kyung,Kam, Sin,Park, Ki-Soo,Kim, Jang-Rak,Kim, Rock-Bum,Park, Sun-Kyun 대한예방의학회 2009 예방의학회지 Vol.42 No.2

Objectives : This study was performed to evaluate the relationships between psychosocial characteristics and changes in the stage of breast cancer screening behavior. Methods : The 474 study subjects were randomly sampled from 21,459 women(age range, 40-70 years) who were eligible for the Korean National Cancer Screening Program in 2006 in Jinju, Gyeongsangnam-do. The information, including behaviors and sociodemographic characteristics, attitudes, subjective norms and self-efficacy, was collected by trained interviewers via home visits. The breast cancer screening stages were grouped as precontemplation, contemplation, action, maintenance and relapse, according to Rakowski. Results : Of the 474 women, 18.8% were in the precontemplation stage, 23.3% were in the contemplation stage, 13.1% were in the action stage, 36.6% were in the maintenance stage, and 8.2% were in the relapse stage. The distribution of stages was associated with attitude, subjective norms and self-efficacy(p for trend<0.01). To investigate the overall relationship between the variables, we conducted a linear structural equation model analysis based on the theory of planned behavior. The subjective norms and self-efficacy influenced the stage of the women's screening behavior. Conclusions : We should target on self-efficacy about the screening behavior of women by performing timely, thoughtful interventions. The support from family members, friends and other people is crucial for women to undergo breast cancer screening and to improve the breast cancer screening rate.

국내 3-7세 어린이의 혈중 납, 수은, 카드뮴 농도와 관련요인

서주희,김병권,김유미,김록범,정진용,홍영습,Seo, Ju-Hee,Kim, Byoung-Gwon,Kim, Yu-Mi,Kim, Rock-Bum,Chung, Jin-Yong,Hong, Young-Seoub 한국환경보건학회 2014 한국환경보건학회지 Vol.40 No.4

Objectives: Children are more susceptible to heavy metal toxicity than adults. The purpose of this study was to evaluate heavy metal concentrations in the blood of Korean preschoolers and investigate the association between metals in blood and related factors. Methods: A total of 512 subjects from 36 to 83 months of age were sampled. A questionnaire survey was performed and the levels of lead, mercury and cadmium were measured in the blood samples of all subjects. Their parents were interviewed in order to obtain information on basic characteristics, dietary patterns, socio-economic factors, and indoor/outdoor environment of the preschoolers. Multiple linear regression was used to analyze the association between the above factors and lead, mercury or cadmium concentrations. Results: The geometric mean concentrations of lead, mercury and cadmium in the blood were $1.45{\pm}1.58{\mu}g/dL$, $2.14{\pm}1.74{\mu}g/dL$ and $0.23{\pm}1.91{\mu}g/dL$, respectively. Results from multiple linear regression analysis showed that blood lead levels were associated with birth weight and paternal smoking status. Daily mercury intake from food and maternal education were also shown to influence mercury concentrations in blood. Also, blood cadmium concentrations were associated with maternal age and having a bus garage near the place of residence. Conclusion: This study suggests that smoking status, dietary patterns and the environmental status near the residence should be considered as important factors for preventable sources of heavy metal exposure in preschoolers.

수정된 한글 연명의료계획서(Modified Korean Physician Order for Life-Sustaining Treatment, MK-POLST) 분석을 통한 호스피스 병동 환자의 의료 중재 항목별 선호도 및 충실도 조사

한지희,천혜숙,김태희,김록범,김정훈,강정훈,Han, Ji Hee,Chun, Hye Sook,Kim, Tae Hee,Kim, Rock Bum,Kim, Jung Hoon,Kang, Jung Hun 한국호스피스완화의료학회 2019 한국호스피스.완화의료학회지 Vol.22 No.4

목적: 호스피스 및 완화치료 환자 또는 임종단계 환자를 위한 연명 치료 결정에 관한 법안은 2016년에 제정되어 2018년 2월부터 시행 되었다. 이 법안의 취지와 내용은 미국의 POLST에 근거한다. 이 연구의 목적은 미국의 POLST를 변형하여 만든 MK-POLST를 호스피스 병동 환자들에게 적용을 한 뒤 각 항목에 대한 선호도 및 시행 일치율을 조사하는 것이다. 방법: 2017년 2월 1일부터 2019년 4월 30일까지 경상대학교병원의 부속 호스피스 병동의 모든 입원 환자의 MK-POLST에 대한 의무기록을 후향적으로 분석하였다. 결과: 총 387명의 연구대상자 중 295명의 환자가 MK-POLST를 작성했다. MK-POLST는 환자 자신이 133건(44.1%), 배우자가 84건(28.5 %), 자녀가 75건(25.4%) 작성했다. MK-POLST가 작성된 295 명의 환자 중 단 13명(4.4%)이 주사 영양제를 거부하였으며, 5명(1.7%)은 완화적 진정을 거부하였지만, 대다수인 288명(97.6%)이 심폐소생술 및 인공호흡기 치료를 원하지 않았고, 226명(76.9%)이 승압제 사용을 원하지 않았다. 인공호흡기, 심폐소생술 및 완화적 진정을 제외한 모든 MK-POLST 항목의 시행 일치율에 대한 Kappa 값은 낮았다. 결론: 호스피스 환자들은 심폐소생술, 인공호흡기 및 승압제 사용은 거부 했지만, 대조적으로 항생제, 주사 영양제 및 완화적 진정은 대다수 또는 절대적인 경우에 선호했다. Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

일개 시지역의 저소득층 중년여성의 지각된 건강상태와 가족 지지의 관련성

이경우(Kyung Woo Lee),박기수(Ki Soo Park),강윤식(Yune Sik Kang),김록범(Rock-Bum Kim),김보경(Bo Kyoung Kim),서애림(Ae Rim Seo) 한국보건교육건강증진학회 2009 보건교육건강증진학회지 Vol.26 No.3

일개 시지역 뇌졸중 환자의 삶의 질과 사회적 지지와의 관련성

이경우(Kyung Woo Lee),하미경(Mi Kyung Ha),하근순(Keun sun Ha),김록범(Rock Bum Kim),박기수(Ki Soo Park) 한국농촌의학 지역보건학회 2010 농촌의학·지역보건 Vol.35 No.1

Objectives: The aim of this study was to investigate the association of social support and quality of life of stroke patients. Methods: Stroke patients were interviewed by a direct contact survey among 160 person. A structured questionnaire was configured about demographic features, social support and health related quality of life(SF12). Data were collected from July to August 2009. Results: Among social support, satisfaction of dependable when you need help is the highest score(5.3)and console you when you are very upset is the lowest(4.0). Vitality among health related quality of life(HRQOL) is the higest score(55.9) and general health score is the the lowest(17.4). Physical component score(PCS) is lower than mental component. The results of multiple regression analysis about the factors affecting the PCS and MCS score, disability grade and feel better variable gave effect HRQOL. Conclusions: For improvement of HRQOL, among stroke patients, community social support, specially, when patients feeling generally down-in-the dumps, the rely on to help feel better was needed.

경남 지역 농업인의 상지 근골격계 질환 유병률과 위험인자

서영선 ( Young Sun Suh ),천윤홍 ( Yun Hong Cheon ),김현옥 ( Hyun Ok Kim ),김록범 ( Rock Bum Kim ),박기수 ( Ki Soo Park ),양현수 ( Hyun Su Yang ),박형빈 ( Hyung Bin Park ),나재범 ( Jae Bum Na ),윤철호 ( Chul Ho Yoon ),이상일 ( Sang 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.6

Objective. To evaluate the prevalence and risk factors of upper extremity musculoskeletal diseases (MSDs) among Korean farmers. Methods. The study was carried out from June 2013 to August 2015 on 850 farmers and 203 non-farmers (controls) in Gyeongnam Province. Physical examinations were performed by rheumatologists, orthopedists, and rehabilitation specialists. Plain radiography, a nerve conduction examination, and magnetic resonance imaging were performed, and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was used to assess upper extremity function. Results. Thirty-four different types of upper extremity MSDs were detected in the 1,053 study subjects. The prevalence of any MSD in farmers was 8.96-fold higher than in control (p<0.001). The most obvious difference in prevalence between farmers and non-farmers was hand osteoarthritis (48.2% vs. 4.9%). Mean total DASH score was higher for farmers than non-farmers (14.29±13.66 vs. 10.03±10.85, p<0.001). Among farmers, myofascial pain syndrome, rotator cuff tear, and epicondylitis were more prevalent among overhead workers (growing persimmons, pears, and grapes) than in non-overhead workers (growing rice and upland crops). The following factors were associated with a rotator cuff tear; older age, overhead work, high waist circumference, and lower level of education. Hand osteoarthritis was found to be associated with older age, a female gender, high waist circumference, and longer total work time. Conclusion. The prevalence of upper extremity MSDs is much higher in farmers than non-farmers and greater still for farmers doing overhead work. Various factors contribute to the occurrence of upper extremity MSDs, and thus, the authors suggest an efficient preventive strategy, which involves consideration of type of work and risk factors, be established for farmers to reduce upper extremity MSDs. (J Rheum Dis 2015;22:366-373)

개인수준의 사회적 자본이 우울증에 미치는 영향

이진향(Jin Hyang Lee),박기수(Ki Soo Park),김록범(Rock Bum Kim),김봉조(Bong Jo Kim),전진호(Jin Ho Chun) 한국농촌의학 지역보건학회 2011 농촌의학·지역보건 Vol.36 No.2

본 연구는 개인수준의 사회적 자본과의 연관성을 파악하기 위해 수행되었다. 연구대상자는 2009년 지역사회 건강조사 대상자 18,104명이었다. 연구대상자의 우울증 유병률은 CES-D로 측정한 후 기준점을 16점으로 하였을 때 9.0%였으며 21점을 기준으로 하였을 때 5.7%, 25점을 기준점으로 하였을 때 3.6%였다. 대상자의 인구학적 특성, 건강행태 및 만성질환이환 여부를 통제한 후 사회적 자본과 우울증과의 관련성을 분석한 결과 요인 중 신뢰와 비공식집단 참여여부가 통계적으로 유의하였다. 신뢰하는 집단일 경우 그렇지 않은 집단에 비해 교차비가 0.536(95% CI .419∼.689)이고 비공식집단에 참여하는 집단은 그렇지 않은 집단에 비해 교차비가 0.657(95% CI .516∼.836)로 우울증이 낮았다. 인구학적 특성과 건강행태, 만성질환 이환여부에서는 연령, 결혼상태, 월소득, 흡연, 문제음주 여부, 수면시간, 체질량지수, 아침식사, 관절염 이환여부 등이 유의하게 영향을 미쳤다. 신뢰 수준과 비공식적 집단 활동 참여라는 사회적 자본이 우울증에 예방적 효과를 주므로, 보건사업의 영역에 지역 주민들의 사회적 자본을 높일 수 있는 방안을 고려하여, 이의 향상을 통해 주민들의 우울감을 낮추는 변화가 필요하다. Objectives: This study was performed to investigate the relationship between individual-level social capital and depression. Methods: Data from the 2009 Community Health Survey were analyzed for this study. We used chi-square tests and hierarchical logistic regression analyses to determine the relationship between individual-level social capital and depression. The Korean version of the Center for Epidemiological Studies-Depression Scale was used to measure depression. Results: After controlling for socio-demographic factors such as, health behavior and chronic illness morbidity, that are associated with individual-level social capital, trust and informal participation significantly affected depression. Respondents with "be trust"(0.536, 95% CI 0.419-0.685) and who participate in “informal groups”(0.657, 95% CI 0.516-0.836) had significantly lower odds ratios of depression. Conclusions: Considering and introducing measures to increase the social capital of residents, need reduce depression. It is especially necessary to enhance resident empowerment.