폐암 환자의 활동상태, 불안, 우울, 사회적 지지, 증상경험과 기능적 상태의 관계: 불쾌감이론 기반으로

김금순 ( Keum Soon Kim ),이명선 ( Myung Sun Yi ),방경숙 ( Kyung Sook Bang ),조용애 ( Young Ae Cho ),이정림 ( Jung Lim Lee ),이은 ( Eun Lee ) 서울대학교 간호과학연구소 2013 간호학의 지평 Vol.10 No.2

본 연구는 불쾌감 이론을 기반으로 생리적 요인(폐암 병기와 활동상태), 심리적 요인(불안과 우울), 상황적 요인(사회적 지지)과 증상경험 및 기능적 상태와의 관계를 파악하여 폐암 환자의 증상경험을 관리하는 간호실무에 적용하고자 시행되었다. 본 연구에서 대상자가 지각하는 증상경험은 일반 암 관련 증상과 폐암 특이 증상 점수를 합친 것으로 평균 12.62점이었다. 이는 일반 암 관련 증상을 살펴 본 Baek10)의 27.7점과 Lee와 Kim19)의 23.1점과 비교 시 낮았으며, 일반 암 관련 증상과 폐암 특이 증상 점수를 함께 측정한 Lee3)의 평균 17.15점보다 낮은 점수였다. 이러한 차이는 연령과 현재 치료에 의한 것으로 생각된다. 본 연구의 대상자는 70세 미만으로 60대가 50.5%를 차지한 반면에 Baek10)의 연구에서는 60대 이상이 66.5%인 것을 보면 연령이 증가할수록 증상이 심하다는 연구 결과7)를 지지하고 있다. 특히, 폐암은 연령이 증가할수록 발생이 높아져 70대에서의 발생이 34.5%로 가장 높은 것을 볼 때 증상관리에 대한 요구가 높음을 알 수 있다.2) 또한 본 연구에서는 현재 치료를 받고 있는 대상자가 38.6%로 Lee3)의 43.9%와 전체 대상자가 항암화학요법을 받고 있는 Baek10)의 연구와 비교 시 낮았기에 증상경험이 낮은 것으로 생각된다. 또한 대상자가 지각하는 영양상태나 건강상태가 좋을수록 증상경험은 낮은 것을 발견하였다. 그러나 본 연구대상자들의 56.4%가 암을 진단받은 지 2년이 경과하였고, 38.6%가 현재 치료를 받고 있음에도 불구하고 영양상태가 나쁘다고 인지하는 경우는 3.0%였으며 또한 지난 한달 간 4 kg 이상의 체중감소가 있었던 경우도 2.0%에 불과하였다. 또한 대상자의 80.2%가 현재 건강상태를 보통 이상으로 지각하고 있었다. 따라서 추후에 대상자의 영양과 건강상태에 대한 지각이 증상에 미치는 영향을 규명할 필요가 있다고 생각된다. 생리적 요인인 폐암 병기, 활동상태와 증상경험 간의 관계를 살펴보면, 폐암 병기와 증상경험 간에는 유의한 상관관계를 보이지 않았으나 활동상태와 증상경험 간에는 유의한 중등도의 순상관관계를 보여 활동상태가 저하될수록 증상경험이 심한 것으로 나타났다. 폐암 환자에 있어서 병기는 치료의 방향을 결정하는데 중요한 변수이나 대상자가 경험하는 증상과는 유의한 관계를 보이지 않았고, 오히려 병기와 상관없이 현재 항암화학요법과 같은 치료 중에 있는 대상자의 증상경험이 더 심각한 것으로 나타났다.3,19) 그러나 본 연구에서는 항암화학요법을 받고 있는 대상자의 증상점수가 그렇지 않은 대상자보다 높았지만 유의한 차이는 아니었기에, 질병 관련 생리적 요인에 대한 추가적인 탐색이 필요하다고 사료된다. 본 연구는 외래를 방문하는 환자를 대상으로 하여 활동상태가 ECOG PS 0에서 2단계로 활동상태가 저하될수록 증상경험은 유의하게 높았고, 이는 선행연구의 결과를 뒷받침하고 있다.3,10,11) 심리적 요인인 불안, 우울과 증상경험 간의 관계를 살펴보면, 불안과 우울 모두 증상경험과 유의한 중등도의 순상관관계를 보여 불안, 우울과 같은 심리적 디스트레스가 높을수록 증상경험이 심하게 나타난다는 선행연구의 결과와 일치한다.20,21) Lee3)의 연구에서 비소세포폐암 환자들이 지각하는 불안과 우울과 같은 디스트레스는 증상경험에 직접적인 영향을 주며, 증상경험을 통해 삶의 질에 매우 부정적인 영향을 주는 요인으로 밝혀졌다. 따라서 NCCN (National Comprehensive Cancer Network)의 권고와 같이 암의 진행단계마다 대상자의 불안과 우울을 평가하여 필요시 적절한 도움을 제공해야 하며,22) 이때 환자의 내적 능력인 극복력의 개념을 도입하는 것은 Lee3)의 연구에서 입증하였듯이 유용한 간호접근이 될 수 있다고 생각한다. 상황적 요인인 사회적 지지와 증상경험 간에는 유의한 상관 관계가 나타나지 않았으며, 이는 사회적 지지와 증상 간에 유의한 직접적인 관계가 나타나지 않았던 선행연구와 일치하였다.3,23) 그러나 Lee3)의 연구에서 사회적 지지는 극복력을 매개로 디 스트레스에 영향을 줌으로써 증상부담에 영향을 미치는 것으로 밝혀졌다. 또한 본 연구의 대상자가 지각하는 사회적 지지를 살펴보면, 20점 만점에 가족지지는 평균 17.69점, 친구지지는 13.63점, 의료인지지는 10.26점으로, 의료인 지지가 가장 낮으며, 이는 선행연구의 결과와 유사하였다.3,10) 이는 직접간호제공자일 뿐 아니라 옹호자, 지지자로서의 간호사의 역할 수행에 대한 도전적인 결과라 할 수 있다. 따라서 간호사의 지지를 증진시킬 수 있는 방법들에 대한 적극적인 모색이 필요하며, 아울러 증상경험에 영향을 미치는 상황적 요인들에 대한 추가적인 파악이 필요하다고 사료된다. 증상경험과 증상경험의 결과, 즉 기능적 상태와의 관계를 살펴보면, 유의하게 높은 역상관관계를 보여 증상경험이 심할수록 기능적 상태는 저하됨을 보여주고 있다. 이는 다발성 증상군의 경증군은 중증군에 비해 기능이 더 좋았다는 Lee와 Park4)의 연구결과와 호흡곤란 증상이 심할수록 기능상태는 저하되었다는 Mohan 등13)의 연구결과와 일치하였다. 또한 부작용 증상을 심하게 호소할수록 기능적 상태가 저하되었다는 Baek10)의 연구결과를 뒷받침하고 있다. 본 연구에서 폐암 환자가 지각하는 증상경험에 영향을 미치는 요인은 심리적 요인(불안과 우울), 생리적 요인(활동상태), 상황적 요인(사회적 지지)의 순으로 나타났으며, 이러한 요인들은 증상경험의 57.8%를 설명하는 것으로 나타났다. 구체적으로 살펴보면, 우울에 의해 증상경험이 43.4% 설명되었으며, 우울과 불안에 의해서는 50.7%설명되었다. 이는 Lee3)의 연구에서 폐암 환자를 대상으로 불안과 우울로 측정한 디 스트레스에 의해 증상부담이 62.8% 설명되었다는 결과보다는 낮았지만, 두 연구결과 모두 불안과 우울이 증상경험에 미치는 영향이 매우 큼을 보여주고 있다. 또한 활동상태가 증상경험에 미치는 영향을 고려하여 활동상태가 매우 저하된 중증의 환자에서의 반복연구가 필요하다고 생각된다. 또한 간호사는 폐암 환자의 증상에 대한 주기적인 평가를 기반으로 체계적인 관리를 제공함으로써 기능상태를 증진시키고 나아가 삶의 질 향상을 도모하는데 주도적인 역할을 담당해야 한다. 폐암 환자가 지각하는 증상경험, 영향요인들과 증상경험 간의 관계, 증상경험과 기능적 상태 간의 관계를 종합해 볼 때, 불쾌감 이론은 폐암 환자의 증상경험을 설명하는데 적합함을 알 수 있었다. 폐암 환자의 증상경험을 적절히 관리하기 위해서는 반드시 불안과 우울과 같은 심리적 요인들에 대한 평가와 환자상태에 맞는 간호접근이 선행되어야 하며, 이러한 과정에 간호사가 적극적으로 개입함으로써 환자 지지자로서의 역할을 수행해야 한다. 또한 불쾌감 이론과 같은 중범위 이론의 간호실무 적용이 더욱 활성화된다면 이론과 실무의 차이를 줄이고 간호실무가 과학적인 배경을 가지고 더욱 발전될 수 있으리라 사료된다. Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the outpatient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients` needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

족저압력분포 측정장비를 이용한 골프 스윙시 족저압 분석

이동기,이중숙,이범진,이훈식,김용재,박승범,주종필 한국운동역학회 2005 한국운동역학회지 Vol.15 No.1

D. K. LEE, J. S. LEE, B. J. LEE, H. S. LEE, Y. J. KIM, S. B. PARK, J. P. JOO. PIantar foot pressure analysis during golf swing motion using plantar foot pressure measurement system. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 75-89, 2005. In this study, weight carrying pattern analysis and comparison method of four foot region were suggested. We used three types of club(driver, iron7, pitching wedge). This analysis method can compare between top class golfer and beginner. And the comparison data can be used to correct the swing pose of trainee. If motion analysis system, which can measure the swing speed and instantaneous acceleration at the point of hitting a ball, is combined with this plantar foot force analysis method, new design development of golf shoes to increase comfort and ball flight distance will be available. 1. Address acting, forces concentrated in rare foot regions and lateral foot of right foot. Back swing top acting, relatively high force occurred in medial forefoot region of left foot and forefoot region of right foot. Impact acting, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the lateral region and rarefoot region of left foot. 2. Forces were increased in address of right foot with clubs length increased. All clubs, back swing top acting, high force value observed in the lateral forefoot region of right foot. All clubs, in impact, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the rarefoot region in driver and lateral foot region in iron on left foot. 3. Right foot forces distribution were increased in address, back swing top and left foot force distribution were increased in impact, finnish

일 대학병원에 입원한 노년기 양극성 장애 환자의 인구학적 및 임상적 특징

조숙현(Sook Hyun Cho),정한용(Han Yong Jung),권영준(Young Jun Kwon),이소영(So Young Lee),김양래(Yang Rae Kim),김윤정(Yun Jung Kim) 대한노인정신의학회 2006 노인정신의학 Vol.10 No.2

Objectives : As the elderly population is continuing to increase, psychiatric diseases of the elderly are becoming an important social issue. This study looks into the demographical and clinical features of the elderly patients diagnosed with bipolar disorder in a University hospital. Methods : The study subjects include patients admissioned in the closed wards of Soonchunhyang Seoul hospital and Cheonan hospital from March, 2000 to February, 2005 who met the DSM-IV-TR criteria for bipolar disorder at the time of discharge. A total of 146 patients (76 men, 70 women) medical records were studied retrospectively. Subjects older than the age of 50 at time of admission were grouped as the old age group, whereas those who were younger than 50 as the young age group. Also among the old age group, those who had the first onset of episode under the age of 50 were grouped as the early onset group, whereas those who had the first onset after the age 50 were grouped as the late onset group. Results : The number of bipolar disorder patients in the young age group and old age group were 73 and 73 respectively. The number of early onset group and late onset group were 46 and 23 respectively. The old age group had a relatively higher incidence of bipolar II disorder than the young age group. Also in the old age group there was a higher incidence of hypomanic or depressive episode rather than manic episode compared to the young age group. And in the old age group psychotic symptoms were less common and the mean admission length shorter than the young age group. Additionally in the old age group treatment with Lithium monotherapy or with no mood stabilizers at all were relatively common. Among the old age group, late onset group had a higher rate of bipolar II disorder than the early onset group. Conclusion : This study shows differences in the demographical and clinical features among different age groups. But additional research would be required to determine whether the bipolar disorders in the elderly or late onset group are actually a different type of disorder from those of the young.

항암화학요법 관련 오심과 구토 완화를 위한 비약물요법에 관한 연구동향

소향숙,최자윤,조인숙,김영재,김지영,김애숙,김옥미,김춘심,김현오,설영애,안정옥,이애리,이영자 성인간호학회 2003 성인간호학회지 Vol.15 No.3

Purpose: Purposes of this study were to understand the current trends on complementary therapy in relieving chemotherapy-induced nausea and vomiting and to suggest the future research direction. Method: Subjects were selected on CINAHL, MEDLINE, Korean Academy Data Base from 1980 to 2001 which used nausea, vomiting, chemotherapy and complementary therapy as key words in experimental studies. Eight korean articles and twenty-one international articles were analyzed in terms of general characteristics, research methods, and types of complementary therapy. Data were analyzed by using descriptive statistical methods. Result: Since 2000, researchers have more actively used complementary therapy. In subject characteristics, mean age was 35.5 years old, 45% of the researchers were performed with high level of incidence of chemotherapy induced vomiting, 14% of them set limit of consecutive cycle during research, and 65% of them did not comment the selecting criteria of sample. About 60% of them were designed post-test only control group: 35% used INV by Rhodes, 31% used Likert scale, and 24% used VAS for dependent variable. Muscle relaxation therapy was mostly applied for relief of nausea and vomiting. Conclusion: Further studies will be needed to control extrinsic variables affecting nausea and vomiting in research design and to accumulate evidence with studies applying various complementary therapies.

간호실무에서 신봉이론(Espoused theories)에 대한 탐색적 연구

서문자,김혜숙,이은희,박영숙,조경숙,강현숙,임난영,김주현,이소우,조복희,이명하,지성애,하양숙,손영희,권성복,김희진,추진아 성인간호학회 2001 성인간호학회지 Vol.13 No.1

As a nursing practice involves nurses' actions in a specific context of health care, this study has focused on exploring the espoused theories in nursing practice within the action science perspectives, Espoused theories are the belief, principles, and rationale expressed by the practitioner as guiding her/his actions in a situation of practice. The data were analysed qualitatively and 25 elements of espoused theories of nursing action were identified and clustered into 6 categories. The 25 elements of espoused theories are as follows: The clinical nurse worked in wholistic and individual nursing, focussed on the patient's needed, comfort and supportive nursing (5 theories of nursing goal) ; excellent skills, knowledge based, assessment and data collection, explaining, educating or a scientific basis(6 theories of nursing intervention): advocacy, value oriented, treatment, account- ability and commitment(4 theories of nursing ethics) ; human respect. partnership, trust(3 theories of patient-nurse relationship) : knowledgable, accumulated clinical experiences and personally lived experiences. positive perspectives(4 theories of nurse), role of intervention. rewarding peer relationship(3 theories of situations) The above mentioned espoused theories are similar to that of nursing textbooks which students learned through basic nursing education and almost the same as the Acts ofa Nurse in Korean. However, we are doubtful whether nurses actually do as they think. Therefore. it is recommended to review the theories-in-use in order to and any discrepancies between the espoused theories and the reality of nursing actions

조선후기 천문학자 이덕성의 생애와 천문활동

안영숙,민병희,서윤경,이기원,AHN, YOUNG SOOK,MIHN, BYEONG-HEE,SEO, YOON KYEONG,LEE, KI-WON 한국천문학회 2017 天文學論叢 Vol.32 No.2

The life and astronomical activity of Lee Deok-Seong (李德星, 1720-1794) was studied using various historical sources, including the astronomical almanac, Seungjeongwon-Ilgi (Daily records of Royal Secretariat of Joseon dynasty), and the Gwansang-Gam's logbooks during Joseon dynasty (A.D. 1392-1910). We present the results of the study including the following main findings. First, from the investigation of Lee's family tree, we find that a number of his relatives were also astronomers, notably Samryeok-Gwan (三曆官, the post of calendrical calculation). Second, we find that he took part in the compilation of an annual astronomical almanac over a period of at least 16 years. His major achievements in the astronomy of the Joseon dynasty were to establish a new method of calendar-making calculation and to bring astronomical materials to the Joseon court through a visit to China. The Joseon dynasty enforced the Shixianli (時憲曆, a Chinese calendar made by Adam Shall) in 1654 without fully understanding the calendar. So an astronomer and an envoy were dispatched to China in order to master the intricacies of the calendar and to learn as much of Western science as was available in that time and place. Lee Deok-Seong worked at the Gwansang-Gam (觀象監, Royal Astronomical Bureau) during the reigns of King Yeongjo (英祖) and Jeongjo (正祖). As best as we can ascertain in relation with the calculations in the Shixian calendar, Lee visited China four times. During his trips and interactions, he learned a new method for calendar-making calculations, and introduced many Western-Chinese astronomical books to Joseon academia. Lee greatly improved the accuracy of calendrical calculations, even while simplifying the calculation process. With these achievements, he finally was promoted to the title of Sungrok-Daebu (崇祿大夫), the third highest grade of royal official. In conclusion, history demonstrates that Lee Deok-Seong was one of the most outstanding astronomers in the late-Joseon dynasty.

비지시적 지도방법에 의한 유아의 읽기와 쓰기 행동의 발달

이영자,이종숙 德成女子大學校 1985 德成女大論文集 Vol.14 No.-

Many studies(Clay, 1972; Rossman, 1980; Hildebreth, 1936; Schickedanz, 1978) showed that young children's reading-writing behaviors develop through certain fixed stages. To investigate whether Korean childern also follow similar developmental stages of reading, the authors of this study revised Clay and Rossman's reading development stages according to the results of a pilot study and proposed six hierachical stages of reading development. They are: (1) pre-reading stage, (2) making-up stage, (3) paraphrasing stage, (4) the stage of paraphrasing plus repeating actual words by memory, (5) the stage of paraphrasing plus reading actual words of the text, and (6) the stage of reading actual words of the text. The authors also proposed that there are two transitional stages between stages 1 and 2 and stages 5 and 6. The authors also revised the Hildebreth and Schickedanz' writing development stages as follow: (1) scribbling stage, (2) the stage of appearance of one or two distinctive features of print, (3) the stage of appearance of intentional markings that look like actual alphabet letters, (4) the stage of creating actual letters, (5) the stage creating actual words, and (6) the stage of creating sentences. The main purpose of this study were to see whether the development of reading and writing behavior followed the hypothesized stages in order and to examine the effects of undirective teaching method of reading. Besides of these purposes, this study had two additional purposes of seeing whether reading readiness had effects on young childen's development of reading and writing behaviors and of developing a good reading and writing readiness scale. For these purposes, 32 preschoolers of age 3 to 5, were selected from the kindergarten located in middle class neighbors on the basis of reading-writing readiness scores and classified into high and low readiness groups. Those who were able to read were excluded from the sample. A half of each group(while the other half served as controls) were observed individually during undirective reading sessions in which the children were read 4 storybooks and asked to read them back to the experimentet once everyweek over a three month period. The children's responses during these sessions were audiorecorede and transcribed on coding sheets afterwards. The data were analyzed with the stastical method of correlations and ANOVA. The results showed that preschooler's reading and writing behaviors progressed through the hypothesized stages and the undirective teaching method in reading facilitated their development. The results also showed that the reading and writing readiness scale consisting of subtests of visual discrimination, phonological awareness, and abilities of drawing basic lines, had a moderate predictability in reading and writing development in the future. Furthermore, this study demonstrated significant differences in reading ability between low and high readiness groups. The results of this study suggest that we, educators in early childhood education, should understand young children's reading-writing developmental stages and encourage them to read and write actively on their own level and to retain their initial interest in reading and writing. The results also imply that the undirective method of reading and writing could be a good example of such encouragement.

대학생들의 떡에 대한 기호도 및 이용현황

이현옥,노숙령,김기숙,이숙영,이복희,박미정 중앙대학교 생활과학연구소 2002 생활과학논집 Vol.15 No.-

The survey study was conducted to investigate the rice cake consumption pattern including the frequency of intake and the degree of preference and the area of improvement for Korean rice cake among college students. About the motive for purchases of rice cake, 'taste is good(43.3%)' was the highest, and 'eat as a snack' the next (42.9%). The reason which does not eat the rice cake frequently was uncomfortable to eat (24.1%), insipid(21.4%), not variously assorted(17.9%) in the order named. The college students surveyed were eating rice cake as a snack mainly. They wanted the rice cake to be charmed and be in pretty shape, and fusion style for gift. And they wanted to be rice cake more sweetened and cool taste like ice cream. Therefore, traditional rice cake is required for further research for the development of product which is more acceptable for the young adults.

한 도시지역 저소득층 주민의 정신건강수준

이영문,김흥모,이문숙,이호영 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 본 연구에서는 A시 지역사회 정신보건사업을 시행하면서, 지역사회 정신보건사업의 일차적 관리대상인 저소득층 주민들의 정신건강수준을 파악하고, 정신건강수준에 영향을 미치는 요인을 알아봄으로써 지역사회에 정신질환자들이 통합되어지기 위해서 시행해야 하는 사업계획을 수립하는데 기초자료로 활용함에 그 목적이 있다. 대상 및 방법: 본 연구의 대상은 A시에 거주하는 20-59세의 저소득층 주민들 536명이며, 조사도구로는 정신건강수준을 집단적으로 선별 검사할 수 있는 조사도구인 GHQ와 자아존중감 정도를 측정하는 SES도구를 이용하여 설문지를 통한 면접조사를 실시하였다. 대상인구의 인구. 사회학적 특성과 자아존중감 정도에 따른 정신건강수준을 알아보았고, 또한 정신건강수준을 세 가지 유형(전반적 정신건강수준, 사회생활 적응 정도, 불안·우울감 정도)으로 나누어 분석하였다. 결 과: 1) 대상인구의 인구학적 특성에 따른 정신건강수준을 살펴보면 여성보다 남성이, 연령이 높을수록, 배우자 없이 혼자 사는 계층이, 그리고 신체적 건강상태가 나쁠수록 전반적 정신건강수준과 사회생활 적응 정도가 낮았으며, 불안·우울감 정도도 높았다. 2) 대상인구의 사회. 경제적 특성에 따른 정신건강수준을 살펴보면 무직이나 단순근로직이, 교육수준이 낮을수록 월세나 임대로 사는 저소득계층에서 전반적 정신건강수준과 사회생활 적응 정도가 낮았으며, 불안·우울감 정도도 높은 것으로 조사되었다. 3) 자아존중감 정도가 높을수록 전반적 정신건강수준과 사회생활 적응 정도가 높았으며, 불안·우울감 정도는 낮았다(p<0.01). 4) 정신건강수준에 영향을 미치는 요인으로는 자아존중감과 신체적 건강상태, 연령을 들 수 있는데 이 가운데 자아존중감이 가장 많은 영향을 주었으며, 그리고 자아존중감이 높은 상태에서 신체적 건강상태가 좋을수록, 또한 연령이 증가할수록 전반적인 정신건강수준이 유의하게 증가되는 것으로 조사되었다. 5) 정신건강 위험집단의 특성에 대해 비위험집단을 비교 분석한 결과 위험집단이 비위험집단에 비해 20대와 40대가 이환율이 높은 것으로 조사되었으며, 배우자가 없는 계층이, 학력수준이 낮은 계층, 단순 근로직인 계층, 신체적 건강상태가 나쁜 계층에서 이환율이 높았다.(p<0.05). 결 론: 위의 결과로 보아 향후 지역사회 정신보건사업은 전반적으로 정신건강수준이 낮은 저소득층을 주요사업대상으로 추진해야 하고, 이환율이 높은 계층 즉, 20대와 40대이고 배우자가 없이 혼자 살며 학력수준이 낮아 단순근로직에 종사하고 신체적 건강상태가 나쁜 계층에 우선적으로 역점을 두어 정신건강 프로그램을 개발하고 교육과 홍보를 지속적으로 해 나가야 될 것으로 판단한다. Objective: This study was performed to support and enhance the community mental health for the urban poor. The purpose of the study were as follows: 1) to investigate the mental health states of the urban poor, who are the first target population, 2) to identify the factors influencing their mental health states. Methods: The subjects were community residents in low socioeconomic level, who are 20-59 years old. And the scale used was GHQ(General Health Questionnaire) which is used for screening the mental health states of groups and self-esteem. The survey subjects were directly interviewed by staffs in Public Mental Health Center. SPSS PC 6.0 was used for the statistical analysis. It investigated the mental health states, according to social and demographic attributes, and self-esteem of target population. And the mental health states were analyzed to three subdomains: overall mental health states, social dysfunction, and anxiety-depression domains. Results: First, in demographic attributes, the old men, who are of low socioeconomic level, single, bad physical health, low community life satisfaction, low educational background, and having no religions, were low in overall mental health states, social function, and high in anxiety-depression domain. Second, the residents, who had high self-esteem, were high in overall mental health states, social function, and low in anxiety-depression domain. Third, the residents, who had high self-esteem scores, were significantly high in overall mental health states, social function, and low in anxiety-domain. Fourth, Among the various factors influencing the mental health states, the self-esteem was the most important factor, and the physical health was the next important factor. And the higher self-esteem they had, the better physical health states, the order they were, the higher the mental health states became. Fifth, comparing the high risk group with non-risk group, those who were in their 20`s and 40`s, had no wives or husbands, low educational background, physical workers, and were not well healthy, were apt to have mental diseases. Conclusion: In the future, the first target population in the community mental health services will be the urban poor in low mental health states. For those who are apt to have mental diseases, the first step of community mental health works is to find, select and give basic mental health services. The staffs in community mental health center have to develop various mental health programs and inform the public of them.

콩아이스크림의 상품화를 위한 고정화 효소의 이용

이숙영,이현옥,노숙령,김기숙,이복희,박미정 중앙대학교 생활과학연구소 2002 생활과학논집 Vol.15 No.-

The study was to investigate the functional properties of soy protein isolate hydrolyzed by immobilized α-chymotrypsin and the quality characteristics of soy ice cream made by the soy protein isolate treated with immobilized α-chymotrypsin. Up to the hydrolysis rate of 22.9%, treatement by immobilized α-chymotrypsin costed more time than that of α-chymotrypsin. Foam and emulsion capacity were decreased by the number of repetitive usage. Apparent viscosity and overrun of soy ice cream treated with immobilized α-chymotrypsin and α-chymotrypsin were shown similar tendency. In the sensory characteristics, soy ice cream by enzyme treatment was evaluated as much acceptable than untreacted soy ice cream in the item of beany flavor, icy feel and overall quality. For efficient use of immobilized α-chymotrypsin industrially, α-chymotrypsin immobilized on glass beads can be reused for about 11 times more than α-chymotrypsin.