생명사랑 지역활동가들의 자살 예방 실천 경험 연구 : 강원지역 이장과 통장을 중심으로

김경희(Kim, Kyung-Hee),김정유(Kim, Jung-Yoo),김동현(Kim, Dong-hyun),황준원(Hwang Jun-Won),김태미(Kim, Clara Tammy) 한국정신건강사회복지학회 2023 정신보건과 사회사업 Vol.51 No.1

Association of Serum Phosphorus Concentration with Mortality and Graft Failure among Kidney Transplant Recipients

Jeon, Hee Jung,Kim, Yong Chul,Park, Seokwoo,Kim, Clara Tammy,Ha, Jongwon,Han, Duck Jong,Oh, Jieun,Lim, Chun Soo,Jung, In Mok,Ahn, Curie,Kim, Yon Su,Lee, Jung Pyo,Kim, Young Hoon American Society of Nephrology 2017 CLINICAL JOURNAL- AMERICAN SOCIETY OF NEPHROLOGY Vol.12 No.4

<P>Conclusions Serum phosphorus level 1 year after transplantation exhibits a U-shape association with death censored graft failure and patient mortality in kidney transplant patients characterized by relatively high rate of living donor transplant and low incidence of diabetes and prior cardiovascular disease compared with Western countries.</P>

Superior outcomes of kidney transplantation compared with dialysis : An optimal matched analysis of a national population-based cohort study between 2005 and 2008 in Korea

Yoo, Kyung Don,Kim, Clara Tammy,Kim, Myoung-Hee,Noh, Junhyug,Kim, Gunhee,Kim, Ho,An, Jung Nam,Park, Jae Yoon,Cho, Hyunjeong,Kim, Kyoung Hoon,Kim, Hyunwook,Ryu, Dong-Ryeol,Kim, Dong Ki,Lim, Chun Soo,Ki Wolters Kluwer Health 2016 Medicine Vol.95 No.33

<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>Data regarding kidney transplantation (KT) and dialysis outcomes are rare in Asian populations. In the present study, we evaluated the clinical outcomes associated with KT using claims data from the Korean national public health insurance program. Among the 35,418 adult patients with incident dialysis treated between 2005 and 2008 in Korea, 1539 underwent KT. An optimal balanced risk set matching was attempted to compare the transplant group with the control group in terms of the overall survival and major adverse cardiac event–free survival. Before matching, the dialysis group was older and had more comorbidities. After matching, there were no differences in age, sex, dialysis modalities, or comorbidities. Patient survival was significantly better in the transplant group than in the matched control group (<I>P</I> < 0.001). In addition, the transplant group showed better major adverse cardiac event–free survival than the dialysis group (<I>P</I> < 0.001; hazard ratio, 0.49; 95% confidence interval, 0.32–0.75). Korean patients with incident dialysis who underwent long-term dialysis had significantly more cardiovascular events and higher all-cause mortality rates than those who underwent KT. Thus, KT should be more actively recommended in Korean populations.</P></▼2>

Development of the Korea-Polyenvironmental Risk Score for Psychosis

Jeon Eun-Jin,Kang Shi-Hyun,Yan-Hong Piao,Kim Sung-Wan,Kim Jung-Jin,Lee Bong-Ju,Yu Je-Chun,Lee Kyu-Young,Won Seunghee,Lee Seung-Hwan,Kim Seung-Hyun,Kim Eui-Tae,Clara Tammy Kim,Dominic Oliver,Paolo Fusa 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.3

Objective Comprehensive understanding of polyenvironmental risk factors for the development of psychosis is important. Based on a review of related evidence, we developed the Korea Polyenvironmental Risk Score (K-PERS) for psychosis. We investigated whether the K-PERS can differentiate patients with schizophrenia spectrum disorders (SSDs) from healthy controls (HCs).Methods We reviewed existing tools for measuring polyenvironmental risk factors for psychosis, including the Maudsley Environmental Risk Score (ERS), polyenviromic risk score (PERS), and Psychosis Polyrisk Score (PPS). Using odds ratios and relative risks for Western studies and the “population proportion” (PP) of risk factors for Korean data, we developed the K-PERS, and compared the scores thereon between patients with SSDs and HCs. In addition, correlation was performed between the K-PERS and Positive and Negative Syndrome Scale (PANSS).Results We first constructed the “K-PERS-I,” comprising five factors based on the PPS, and then the “K-PERS-II” comprising six factors based on the ERS. The instruments accurately predicted participants’ status (case vs. control). In addition, the K-PERS-I and -II scores exhibited significant negative correlations with the negative symptom factor score of the PANSS.Conclusion The K-PERS is the first comprehensive tool developed based on PP data obtained from Korean studies that measures polyenvironmental risk factors for psychosis. Using pilot data, the K-PERS predicted patient status (SSD vs. HC). Further research is warranted to examine the relationship of K-PERS scores with clinical outcomes of psychosis and schizophrenia.

임상실습을 경험한 의과대학생과 일반대학생의 생사관과 영적안녕에 대한 비교연구

박소영,KIM CLARA TAMMY 한국콘텐츠학회 2020 한국콘텐츠학회논문지 Vol.20 No.11

본 연구는 임상실습을 경험한 의과대학생(이하 의과대학생으로 표기)과 일반대학생의 생사관과 영적안녕에 대한 특성을 살펴보고 그 상관성을 비교하고자 하였다. 연구대상은 H대학교 의과대학생 95명과 A대학교 일반대학생 103명을 대상으로 표집하였으며 연구 결과는 다음과 같다. 의과대학생과 일반대학생 모두 생사관 하위요인 중 부정적 죽음의미가 가장 높았다. 의과대학생과 일반대학생은 죽음불안과 생명존중의지에 차이를 보였는데 의과대학생은 일반대학생보다 죽음불안이 낮고, 생명존중의지가 높았다. 생사관과 영적안녕 하위요인간의 상관관계를 분석한 결과, 일반대학생의 실존적 안녕이 죽음관여도와 부적 상관관계를 보이고 생명존중의지와는 정적 상관관계를 보였다. 반면 의과대학생의 경우 종교적 안녕이 죽음의미와 부적 상관관계를 보였으며 실존적, 종교적 안녕 모두 생명존중의지와는 정적 상관관계를 보였다. 본 연구의 결과는 의료적 죽음에 노출이 될 의과대학생의 생명의료윤리교육에 차별적 컨텐츠를 구성함에 있어 도움이 될 것이다. The aim of this study was to examine the characteristics of views of life and death and spiritual wellbeing of medical and non-medical university students and to compare their correlation. To this end, 95 medical students from H University and 103 non-medical students from A University were sampled for this research. The research results are as follows: For both medical and non-medical university students, negative meaning of death was found to be most high among sub-factors of views of life and death. Medical and non-medical university students differed in death anxiety and life respect will as medical students showed lower death anxiety and higher life respect will than non-medical students. As a result of analyzing the correlation between view of life and death and the sub-factors of spiritual wellbeing, religious wellbeing showed negative correlation with meaning of death, and both existential and religious wellbeing showed positive correlation with life respect will in medical university students. The results of this study are expected to be helpful in constructing differentiated contents in biomedical ethics education for medical university students who will be exposed to medical deaths.

노인의 주관적 기대여명에 영향을 미치는 요인: 연령집단별 개입요인 비교

김연경,KIM CLARA TAMMY 한국노년학회 2019 한국노년학 Vol.39 No.4

The purpose of this study was to examine and compare factors affecting the subjective life expectancy among the elderly, and to suggest health practice and social welfare service implications for later life. A total of 4,483 seniors from the 6th wave(2016) of the Korean Longitudinal Study on Aging (KLoSA) were used for analysis. The subjects were divided into three age groups: the young-old (n=2,106, 65~74 years), middle-old (n=1,803, 75~84 years), and oldest-old (n=574, 85 years and older). Control variables were sociodemographic factors and health status factors. Independent variables were health promotion behavior, cognition of public care, participating social activity, economic activity, and receiving basic pension. The data were analyzed using hierarchical multiple regression. The main results were as follows. Health promotion behavior was associated with the young-old. Social activities and economic activity were associated with the young-old and middle-old. Receiving basic pension had a significant impact on all age groups. In the middle-old, significant results were focused on socio-demographic and health status factors compared to other groups. The results of this study will provide basic data for the elderly policy and welfare service and will help to find and improve the important factors for the life of the elderly. 주관적 기대여명(Subjective Life Expectancy)이란 자신의 수명에 대한 평가로, 주관적 인지평가에 그치지 않고, 건강한 삶을 위해 건강증진, 사회적 활동, 경제적 활동 등에서 실천적 행위를 하게 하는 기전으로 알려져 있다. 본 연구는 연령집단별 노인의 주관적 기대여명에 영향을 미치는 요인을 일반적 요인과 개입요인으로 나누어 파악하여 비교해보는 것에 목적이 있다. 연구대상자는 제 6차 고령화연구패널(KLoSA)을 이용하여 연령집단별로 연소노인(65세-74세) 2,106명, 중고령노인(75-84세) 1,803명, 초고령노인(85세 이상) 574명으로 총 4,483명이다. 일반적 요인은 통제변수로써 인구사회학적요인, 건강상태요인을, 개입요인은 독립변수로써 건강증진행위, 공적돌봄인지여부, 공식적 사회활동 참여, 일자리 및 소득보장 등에 해당하는 9가지의 변수를 설정하여 카이제곱검정, ANOVA, t-test, 위계적 다중 회귀분석을 실시하였다. 그 결과 주관적 건강상태와 기초연금은 모든 연령집단의 주관적 기대여명에 영향을 미쳤지만, 그 외의 변수들은 집단별로 차이가 있었다. 공식적 사회활동 참여, 일자리 및 소득보장요인은 연소노인과 중고령노인 집단에서 유의했고, 건강증진행위요인은 연소노인에서만 유의했다. 중고령노인은 다른 연령집단에 비해 개입요인보다 일반적 요인에서 유의미한 결과가 치중된 것으로 나타났다. 본 연구의 결과는 연령집단별 노인의 주관적 기대여명과 남은 노후를 잘 보내기 위한 실천적이고 개입 가능한 요인 탐색에 기초자료를 제공할 수 있을 것이다.

취업 여부와 수면시간이 우울 및 자살생각에 미치는 영향

정예빈,KIM CLARA TAMMY 사단법인 대한보건협회 2019 대한보건연구 Vol.45 No.3

Purpose: This study is aimed to examine the sleep duration, depression, suicidal ideation among employed population and non-employed population of 19 and older in the Republic of Korea. Method: Data was derived from the 7th Korea National Health and Nutrition Examination Survey (2017). Effects of employment status and sleep duration on depression and suicidal ideation were evaluated. Complex sample logistic regression was conducted with ‘IBM SPSS Statistics v25’ package. Result: There were significant differences in sleep duration, depression, and suicidal ideation depending on the employment status of the participants. Employment status was a significant risk factor for depression and suicidal ideation after adjusting demographic factors, mental health variables, and sleep duration. Conclusion: We need to be more concerned about unemployment and sleep patterns in terms of mental health promotion and suicide prevention. 연구목적: 본 연구의 목적은 우리나라 19세 이상 성인의 취업 여부와 수면시간에 따른 우울 및 자살생각의 관련성을 파악하는 것이다. 연구방법: 본 연구는 질병관리본부가 실시한 제 7기 2차년도(2017) 국민건강영양조사의 원시자료를 사용하였다. 수면시간과 취업 여부를 독립변수로, 우울과 자살생각을 결과변수로 설정하여 ‘IBM SPSS Statistics v25’ 프로그램을 이용해 복합표본 로지스틱 회귀분석을 실시하였다. 연구결과: 대상자의 취업 여부에 따라 수면시간, 우울, 자살생각에 유의한 차이가 있는 것으로 나타났으며 미취업자일수록, 부적절한 수면시간을 취할수록 우울 및 자살생각을 가진 비율이 높은 것으로 나타났다. 인구사회학적 요인과 삶의 질 관련 변수, 수면시간을 보정한 뒤에도 취업상태는 성인의 우울과 자살생각에 유의하게 영향을 미치는 위험요인인 것을 확인할 수 있었다. 결론: 정신건강 증진 및 자살예방의 측면에서 미취업상태와 수면양상에 대해 관심을 가지는 노력이 필요하다.

Effect of Renin-Angiotensin System Blockade on Mortality in Korean Hypertensive Patients with Proteinuria

Hyung Jung Oh,Clara Tammy Kim,류동열 전해질고혈압연구회 2019 Electrolytes & Blood Pressure Vol.17 No.2

Background: Although renin-angiotensin system (RAS) blockade is recommended for hypertensive patients with proteinuria, the effect of RAS blockade on Korean hypertensive patients has not been investigated. Methods: Among individuals who underwent a National Health Examination between 2002 and 2003 in Korea, hypertensive patients with proteinuria (defined as a dipstick test result ≥2+) were enrolled in this study. We investigated the outcomes of two groups stratified by RAS blockade prescription (with RAS blockade vs. without RAS blockade). Moreover, Cox proportional hazard regression and Kaplan-Meier analyses were performed to examine the effects of RAS blockade on mortality and end-stage renal disease (ESRD). Results: A total of 8,460 patients were enrolled in this study, of whom 6,236 (73.7%) were prescribed with RAS blockade. The mean follow-up period was 129 months. A total of 1,003 (11.9%) patients died, of whom 273 (3.2%) died of cardiovascular (CV) events. The Kaplan-Meier curves for allcause or CV mortality showed that the survival probability was significantly higher in the RAS blockade group than in the non-RAS blockade group. Multivariate Cox analysis also revealed RAS blockade significantly reduced the all-cause and CV mortality rates by 39.1% and 33.7%, respectively, compared with non-RAS blockade, even after adjusting for age, sex, and comorbid diseases; however, ESRD was not affected. Conclusion: In this study, we found that RAS blockade was significantly associated with a reduction in mortality but not in the incidence of ESRD. However, 26.3% of the enrolled patients did not use RAS blockade. Physicians need to consider the usefulness of RAS blockade in hypertensive patients with proteinuria.

사별경험유형이 자살생각에 미치는 영향 : 2019 Koreans Views of Life and Death Survey를 중심으로

정예빈(Jeong, Yebin),김태미(Clara Tammy Kim) 한국정신건강사회복지학회 2020 정신보건과 사회사업 Vol.48 No.4

사별은 인간이라면 피할 수 없는 사건이다. 특히 사별 원인이 갑작스럽거나 충격적일 경우 사별자의 회복이 지연될 가능성이 크고, 이는 자살로 이어질 수 있다. 본 연구는 사별경험유형이 자살 생각에 미치는 영향에 대해 알아보고자 한다. 분석에는 ‘2019 Koreans Views of Life and Death Survey’ 자료를 이용했으며 연구대상자는 국내성인 총 1,533명이다. 자살생각은 지난 1년 이내 자살생각 여부로, 사별 경험은 자살사별 경험 여부와 자살 이외 사별경험 여부로 측정하였다. 로지스틱 회귀분석 결과 사별경험은 인구통계학적 요인과 사별에 대한 주관적 인식을 통제한 뒤에도 자살생각을 유의하게 높이는 것으로 나타났다. 자살사별을 경험한 대상자와 자살사별과 자살 이외 사별을 모두 경험한 대상자는 사별경험이 없는 대상자보다 자살생각 위험이 컸다. 본 연구결과는 자살사별경험이 자살생각을 유의하게 높인다는 것을 보여준다. 그러나 자살 이외의 원인으로 사별을 경험한 경우는 자살생각과의 관계가 유의미하지 않았다. 본 연구를 통해 자살예방을 위한 개입 전략 개발 시 사별경험유형을 고려해야 한다고 제안할 수 있다. A bereavement is an inevitable event for humans. Bereavement effects on one’s health not only physically but also mentally. Especially in case of the causal of death is a shocking event like murder or suicide, there’s a possibility to evolve complicated grief and delay recovery of the bereaved. Severe mental and physical pain caused by bereavement can lead to suicide. This study aimed to find out the suicidal ideation of adults in Korea based on their bereavement experience by suicide. Data were derived from the 2019 Koreans Views of Life and Death Survey. This study examined 1,533 adults aged from 20 to 69. Suicidal Ideation, a dependent variable, was measured based on the question whether a respondent had any suicidal thoughts within a past year (1=yes, 0=No). Bereavement experience was measured based on two questions whether a respondent had an experience of bereavement by suicide and whether a respondent had an experience of bereavement except by suicide. The participants were classified as no bereavement (n=626), bereavement by non-suicide causes (n=656), bereavement only by suicide (n=54), and bereavement both by suicide and non-suicide causes (n=197). A logistic regression was conducted using ‘IBM SPSS Statistics v25’ software package. Experience of bereavement was a significant risk factor for suicidal ideation after adjusting demographic factors and factors of subjective cognition about bereavement experience. Adults bereaved only by suicide and both by suicide and non-suicide causes had a higher probability of suicidal ideation than those never bereaved someone. The findings indicate that suicidal ideation is significantly associated with bereavement experience only if the experience is by suicidal causes. However, the relationship was not significant in cases of people who experienced bereavement by non-suicidal causes. Through this study, we can suggest that a relationship between bereavement experiences and suicidal ideation should be considered when developing intervention strategies for suicide or complicated grief.

Ambient carbon monoxide correlates with mortality risk of hemodialysis patients: comparing results of control selection in the case-crossover designs

허혁,김이진,윤유나,최문정,이혜원,권소이,KIM CLARA TAMMY,김동기,김연수,임춘수,이정표,김호,김용철 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.5

Background: Growing evidence suggests that environmental air pollution adversely affects kidney health. To date, the association between carbon monoxide (CO) and mortality in patients with end-stage renal disease (ESRD) has not been examined. Methods: Among 134,478 dialysis patients in the Korean ESRD cohort between 2001 and 2014, 8,130 deceased hemodialysis patients were enrolled, and data were analyzed using bidirectional, unidirectional, and time-stratified case-crossover design. We examined the association between short-term CO concentration and mortality in patients with ESRD. We used a two-pollutant model, adjusted for temperature as a climate factor and for nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter less than 10 μm in diameter as air pollution variables other than CO. Results: Characteristics of the study population included age (66.2 ± 12.1 years), sex (male, 59.1%; female, 40.9%), and comorbidities (diabetes, 55.6%; hypertension, 14.4%). Concentration of CO was significantly associated with all-cause mortality in the three case-crossover designs using the two-pollutant model adjusted for SO2. Patients with diabetes or age older than 75 years had a higher risk of mortality than patients without diabetes or those younger than 75 years. Conclusion: Findings presented here suggest that higher CO concentration is correlated with increased all-cause mortality in hemodialysis patients, especially in older high-risk patients.