일부 농촌지역 사망신고자료에 기재된 사인에 관한 연구 -사망신고사인과 조사사인의 비교-

남해성,박경수,선병환,신준호,손석준,최진수,김병우,Nam, Hae-Sung,Park, Kyeong-Soo,Sun, Byeong-Hwan,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su,Kim, Byong-Woo 대한예방의학회 1996 예방의학회지 Vol.29 No.2

This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: $38.9\sim44.6%$, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.1%), injury and poisoning(7.1%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.

농촌지역과 어촌지역 주민들의 건강행태 비교

남해성(Hae-Sung Nam),이정애(Jung-Ae Rhee),신준호(Jun-Ho Shin),손명호(Myong-Ho Son),권순석(Sun-Seok Kweon),나백주(Baeg-Ju Na),김순영(Soon-Young Kim) 한국농촌의학 지역보건학회 2002 농촌의학·지역보건 Vol.27 No.1

일부 농촌지역 시설노인의 건강상태

남해성(Hae-Sung Nam),박경수(Kyeong-Soo Park),이정애(Jung-Ae Rhee) 한국농촌의학 지역보건학회 1999 농촌의학·지역보건 Vol.24 No.2

남원지역 고연령 인구에서 당뇨병의 유병률

김상국(Sang Guk Kim),양승원(Seung Won Yang),박상후(Sang Hoo Park),이경록(Kyung Rok Lee),박재홍(Jae Hong Park),장안수(An Soo Jang),서정평(Jeong Pyeong Seo),이숭(Soong Lee),남해성(Hae Sung Nam),손명호(Myung Ho Sun),신명근(Myung Geun S 대한내과학회 2001 대한내과학회지 Vol.60 No.6

Background : Significant ethnic and geographic differences exist in the prevalence of diabetes mellitus, which has increased dramatically in South Korea. But a few population-based studies were performed in South Korea. The purpose of this study was to determine the prevalence of diabetes mellitus, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) by the World Health Organization (WHO) and the American Diabetic Association (ADA) diagnostic categories, and to investigate their associated risk factors. Methods : Between march 22, 1999 and July 14, 1999, a random sampling of 1445 residents over 40 year of age in five villages in the Namwon county of South Korea was carried out. Among these subjects, 665 (46.0%) participants completed 75 g OGTT. WHO and ADA diagnostic criteria were used for the diagnosis of diabetes mellitus, IGT and IFG. Detailed questionnaire were performed and anthropometric data were collected. Results : After age-adjustment for population projection for Korea (1999), the prevalence of diabetes and IGT were 13.7% and 13.8% with WHO criteria, while the prevalence of diabetes, IGT and IFG were 15.8%, 12.8% and 5.7% with ADA criteria. The age-adjusted prevalence of previously diagnosed diabetes was 5.8%. The level of agreement between WHO and ADA diagnostic criteria except IFG was high (κ=0.94; p<0.001). The ROC curve analysis determined FSG of 114.5 mg/dL (6.4 mmol/L) to yield optimal sensitivity and specificity corresponding to a PP2SG 200 mg/dL (11.1 mmol/L). The prevalence of diabetes and IGT with ADA diagnostic criteria rose with increasing age (p<0.05). The difference in the prevalence of diabetes, IGT and IFG by BMI was not significant. The prevalence of diabetes rose with increase in the waist-hip ratio. The prevalence of diabetes was increased in subjects with dyslipidemia (Odds ratio 2.29, 95% CI: 1.16-3.49).

일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인

신희영,신준호,남해성,류소연,임정수,이정애,정은경,Shin, Hee-Young,Shin, Jun-Ho,Nam, Hae-Sung,Ryu, So-Yeon,Im, Jeong-Soo,Rhee, Jung-Ae,Chung, Eun-Kyung 대한예방의학회 2002 Journal of Preventive Medicine and Public Health Vol.35 No.2

Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration. 전라남도의 일개 군에서 1998년 1월 1일부터 1998년 12월 31일까지 사망으로 신고된 건수는 총 504건이었으며, 이중 설문조사와 의무기록조사로 확인사인의 추정이 가능했던 388건을 연구대상으로 하였다. 확인사인을 신고사인과 비교하고 사망자와 사망관련 변수, 신고자의 특성 그리고 사망신고담당 공무원의 특성에 따른 양자간의 일치율을 통해 신고사인의 정확성과 관련된 인자를 파악하였다. 신고사인과 확인사인의 전체적 일치율은 19대 분류상 62.6%을 보였다. 19대 분류에 의한 사인별 일치율을 보면 손상, 중독 및 사망의 외인이 가장 높았고, 그 다음으로는 내분비, 영양 및 대사질환, 신생물, 순환기계질환 순이었다. 반면에 낮은 일치율을 보인 질환은 피부 및 피하조직의 질환, 근골격계 질환, 정신 및 행동장애 이었다. 사망자 및 사망관련변수에 따른 확인사인과 신고사인의 일치율은 사망자가 남자일 때, 사망 연령이 50대와 60대일 때, 그리고 사망원인 진단자가 의사일 때 높았다. 신고자의 특성별로는 신고자의 연령이 증가함에 따라 일치율이 감소하였으며, 신고자의 교육 정도와 직업과도 유의한 관련성이 있었다. 또한 사망신고 담당 공무원의 특성에 따라서는 공무원의 직급이 6급인 경우 7급 이상인 경우에 비해 일치율이 높았다. 확인사인과 신고사인의 일치여부를 종속변수로 하여 단변량분석을 실시한 후 통계적으로 의미 있는 변수에 대한 로지스틱 회귀분석의 결과를 보면, 사망원인 진단자가 의사인 경우 비차비 2.67(95% 신뢰구간: 1.21-5.89)로 높았으며, 사망신고담당 공무원의 직급이 7급 이상인 경우 비차비 0.30(95%신뢰구간: 0.12-0.78)로 낮았다. 사망신고자료에 기재된 신고사인의 정확성과 관련된 요인에 대한 결과를 종합하여 볼 때 무엇보다 중요한 일은 사망을 의사로 하여금 진단하게 하는 일이다. 또한 사망신고담당 공무원의 업무를 명확히 해야 하며 이들을 대상으로 하는 정기적이며 강화된 교육도 강조되어야 할 것이다.

일 도시 시설노인들과 지역노인들의 건강관련 삶의 질 비교

박경수,서용길,남해성,손석준,이정애,Park, Kyeong-Soo,Seo, Yong-Gil,Nam, Hae-Sung,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1998 예방의학회지 Vol.31 No.2

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

농촌지역 노인들의 인지기능 장애와 사망과의 관련성

선병환,박경수,나백주,박요섭,남해성,신준호,손석준,이정애,Sun, Byeong-Hwan,Park, Kyeong-Soo,Na, Baeg-Ju,Park, Yo-Seop,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Rhee, Jung-Ae 대한예방의학회 1997 예방의학회지 Vol.30 No.3

60세이상 노인인구를 대상으로 '농촌지역 노인들의 우울 및 인지기능 장애에 관한 연구'를 한 이정애와 정향균의 연구대상 558명에 대해 농촌지역 노인들의 인지기능 장애와 사망과의 관련성을 살펴본 결과는 다음과 같다. 1) 3년동안 동안 전체 대상자의 사망률은 558명중 57명인 10.2%이었으며 353명의 정상 인지기능군 중 사망자는 30명으로 사망률 8.5%, 126명 의 경도 인지장애군중 사망자는 14명으로 사망률 11.1%, 79명의 중증 인지장애군중 사망자는 13명으로 사망률 16.5% 이었다(표 3). 2) 3년동안 전체 연구 대상자의 생존율은 0.91이었으며 정상, 경도, 중증 인지기능 장애군의 3년 생존율은 각각 0.92, 0.90, 0.86이었다. 로그 순위 검정법으로 인지기능 정상군과 경도 및 중증의 각 인지기능 장애군의 생존곡선을 비교한 결과 통계적으로 유의하지 않았다. 또한 인지기능 정상군과 경도 이상의 인지기능 장애군간 생존곡선을 비교한 결과도 유의한 차이는 없었다. 3) 혼란변인을 보정하지 않는 Cox의 비례위험 회귀 모형의 단변량분석의 결과 95% 신뢰구간(C.I. : Confidence Interval)에서 사망위험도가 유의한 변인은 연령, 월수입, 흡연습관, 신체장애 등이었으며, 인지기능 장애정도를 정상 그리고 경도 및 중증으로 분류한 분석에서는 정상군에 비해 경도 및 중증의 사망위험도가 유의하게 높지 않았으나, 인지기능 점수(MMSEK score)의 증가에 따른 분석 결과 사망위험도가 0.94로 유의하게 낮게 나타났다(표 4). 4) 잠재적 혼란변인들의 영향을 보정한 Cox의 비례위험 회귀모형의 다변량 분석의 결과 인지기능 장애정도 및 MMSEK 점수증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 5). 5) 남녀별로 각각 인지기능 장애와 사망위험도와의 관계를 알아보기 위해 다변량 분석을 시행한 결과 인지기능 장애정도 및 MMSEK 점수 증가에 따른 사망위험도는 어느 모형에서도 인지기능 장애정도가 사망에 미치는 위험도는 통계적으로 유의하지 않았다(표 6, 표 7). 이상 본 연구는 농촌지역 노인들에서 인지기능 장애정도가 사망에 미치는 영향을 알아보고자 하였지만, 인지기능 장애정도가 사망에 미치는 영향을 통계적으로 유의하게 고찰하지 못하였다. The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

급성 충수돌기염 환자에서 의료보장형태와 천공률의 관련성

홍지영,김건엽,이무식,남해성,임정수,이정애,나백주,Hong, Jee-Young,Kim, Keon-Yeop,Lee, Moo-Sik,Nam, Hae-Sung,Im, Jeong-Soo,Rhee, Jung-Ae,Na, Baeg-Ju 대한예방의학회 2004 예방의학회지 Vol.37 No.3

Objectives : This study was aimed at investigating the medical service utilization pattern of patients who use public medical aid compared to those who have health insurance. Methods : We selected every patient between the age of 18 and 69 who used public medical aid from January 1, 1999, to December 31, 2001, in Gwangju metropolitan city, South Korea. For comparison, a list of patients with health insurance was gathered for same period. Then the medical records of those who had been hospitalized for acute appendicitis were selected among both groups. Of those records, we compared the number of cases of ruptured appendicitis to cases of whole acute appendicitis in both groups. Regarding coding for ruptured appendicitis, International Classification of Diseases - 10 (ICD-10) was used. Multiple logistic regression was used as a statistical tool to determine the effectiveness of risk factors. Results : Even after adjusting for risk factors, such as age and sex, the proportion of perforation of acute appendicitis among public medical aid patients was found to be significantly higher than among insured patients. Conclusions : This comparative study on ruptured appendicitis among public medical aid patients and insured patients, indicates that the proportion of perforation of acute appendicitis could be an index showing that these types of patients utilize medical services differently than insured patients. We know that when abdominal pain is not properly treated at the outset, it easily develops into ruptured appendicitis complicated with peritonitis. Considering this data analysis, we guess the public medical aid system to have significant problem with medical accessibility. So additional and systematic research on the pattern of utilization of medical services of public medical aid patients is needed.

성인의 자기 전 칫솔질 실천유무에 따른 구강건강상태의 비교: 국민건강영양조사 제7기의 자료를 활용하여

임지연(Ji-Yeon Lim),남해성(Hae-Sung Nam) 한국산학기술학회 2021 한국산학기술학회논문지 Vol.22 No.10

본 연구는 성인의 자기 전 칫솔질 실천 유무에 따른 구강건강상태를 비교하여, 자기 전 칫솔질 실천의 중요성을 파악하고 구강건강 예방관리의 기초자료로 활용하고자 하는 목적을 가지고 연구를 수행하였다. 제7기 국민건강영양조사자료를 활용하여 독립변수는 자기 전 칫솔질 실천유무로, 종속변수는 지역사회치주지수를 이용한 구강건강상태(건전치주군, 치주질환군)로, 보정변수는 인구사회학적 특성(성별, 연령, 교육수준, 직업, 월가구소득), 구강건강행태(어제 점심식사 후 칫솔질 실천여부, 구강용품사용여부, 최근 1년간 구강검진여부, 예방치료 경험여부)로 설정하였다. 통계프로그램은 IBM SPSS/WIN 26을 활용하였으며 복합표본을 설계하여 빈도분석, 교차분석과 로지스틱 회귀분석을 수행하였다. 그 결과 자기 전 칫솔질 실천을 하는 사람에 비해 하지 않는 사람은 치주질환군일 확률이 1.200배(95% CI=1.027-1.404) 높았다. 여성보다는 남성이, 연령이 증가할수록, 교육수준이 낮을수록 치주질환군일 확률이 높았으며, 무직에 비해 단순노무직과 농림어업직에서 치주질환군일 확률이 높게 나타났다. 점심식사 후 칫솔질 실천하지 않을수록, 구강관리용품을 사용하지 않을수록, 최근 1년간 구강검진과 예방치료를 받지 않을수록 치주질환군일 확률이 높게 나타났다. 그 외 변수(월 가구소득수준)는 통계적으로 유의하지 않았다. 이상의 결과를 보았을 때, 우리나라 성인의 자기 전 칫솔질 실천 유무와 구강건강상태는 유의한 관련성을 갖고 있음을 알 수 있다. The purpose of this study was to compare the oral health condition of adults according to their habit of brushing teeth before sleeping, to understand the importance of this practice, and to use the results to develop guidelines for oral health management. This study used data from the 7<SUP>th</SUP> KNHANES Ⅶ-2 survey. Independent variables were set to brushing teeth before sleeping, dependent variables were oral health conditions, and correction variables were demographic characteristics (gender, age, education, occupation, income) and oral health behavior (brushing teeth after lunch, using oral care products, oral check-up in the past year, preventive treatment). Data were analyzed using the IBM SPSS/WIN 26 program, a complex sample was designed and frequency analysis, chi-square test, and logistic regression analysis were performed. The results showed that people who did not brush their teeth before sleeping had a higher risk of periodontitis, compared to those who brushed [odd ratio:1.200 (95% CI=1.027-1.404)]. The probability of periodontitis was higher among men than in women, and in older people, those with lower education, daily laborer"s, agricultural workers and fishermen than among the unemployed. The higher probability of periodontitis stemmed from not practicing good oral health behavior. Income levels were not statistically significant. This study shows that brushing teeth before sleeping has a significant impact on oral health conditions.

일부 농촌지역주민에서 Bioelectric Impedance로 측정한 체지방비율에 대한 고찰

나백주,박요섭,선병환,남해성,신준호,손석준,최진수,Na, Baeg-Ju,Park, Yo-Sub,Sun, Byung-Hwan,Nam, Hae-Sung,Shin, Jun-Ho,Sohn, Seok-Joon,Choi, Jin-Su 대한예방의학회 1997 예방의학회지 Vol.30 No.1

Obesity usually is defined as the presence of and abnormally amount of adipose tissue. In many epidemiologic study, obesity as a health risk factor has been estimated by Body Mass Index(BMI) in general. This study was conducted to review of body fat percent measured by Bioelectric impedance analyzer as a estimator of obesity in a rural adult population. The study subjects were 421 men and 664 women who reside in the area on the Juam lake. They were sampled by multistage cluster sampling. Their mean age was 59 years old. Body fat percent increased with age, but BMI decreased with age in this study. Body fat percent was more larger at female and elder on the same BMI. The correlation coefficient between with body fat percent and body mass index was low (r=0.4737). Body fat percent was explained by not only BMI but also sex and age $(r^2=0.63)$. The result suggested that it is inadequate for BMI only to estimate obesity about elderly person who reside in the rural community. The relation of body fat percent and body mass index of this study agreed with the preceding know-ledges and studies in general.