후기노인의 허약, 사회적 지지, 건강관련 삶의 질 간의 관계

이정화(Lee, Jeong Hwa),김은휘(Kim, Eun Hwi),서순림(Suh, Soon Rim) 한국노년학회 2018 한국노년학 Vol.38 No.4

본 연구는 허약의 고위험군인 후기노인의 건강관련 삶의 질 향상을 위한 기초자료를 제공하고자 허약, 사회적 지지 및 건강관련 삶의 질 간의 관계를 조사하였다. 서술적 조사연구인 본 연구를 위하여 2016년 03월 01일 부터 03월 31일까지 K군에 소재하는 노인복지시설에서 75세 이상 노인을 대상으로 구조화된 설문지를 이용하는 일대일 면담을 통해 총 211명의 자료를 수집하였다. 수집된 자료는 SPSS/WIN과 Amos 18.0 프로그램으로 t-test, Pearson’s correlation coefficient 및 경로분석을 사용하여 분석하였다. 80세를 기준으로 한 연령집단 간 차이검정결과, 80세 이상인 경우 유의하게 허약수준이 더 높고(t=-2.51, p=.013), 건강관련 삶의 질이 낮았으나 (t=3.29, p=.001), 사회적 지지는 유의한 차이를 보이지 않았다(t=1.28, p=.201). 허약, 사회적지지, 건강관련 삶의 질 간의 상관관계 분석결과, 허약수준이 높을수록 사회적 지지(r=-.21, p=.003)와 건강관련 삶의 질이 유의하게 낮았고(r=-.65, p<.001), 건강관련 삶의 질은 사회적 지지가 높을수록 유의하게 높았다(r=.18, p=.010). 사회적 지지와 건강관련 삶의 질 사이에서 허약의 매개효과를 조사한 결과, 사회적 지지는 허약에(β=-.21, p=.016) 허약은 건강관련 삶의 질에 유의한 직접효과를 미치나(β=-.06, p=.004), 사회적 지지는 건강관련 삶의 질에 유의한 직접효과를 미치지 않고(β=.00, p=.562) 허약을 매개하여 유의한 간접효과를 미쳐(β=.01, p=.012) 사회적 지지와 건강관련 삶의 질 사이에서 허약의 완전매개효과가 있었다. 사회적 지지는 허약을 예방하고 허약수준의 개선은 건강관련 삶의 질을 증진시킨다. 그러므로 후기노인의 건강관련 삶의 질 제고를 위해 연령별 사회적 지지 방안을 포함하는 다면적인 허약 예방 프로그램의 개발이 필요하다. This study investigated the relation between frailty, social support, and health-related quality of life to provide basic data to improve the health-related quality of life of old-old elderly who are a high risk group for frailty. For this descriptive study, one-on-one interviews with structured questionnaires were conducted for elderly aged 75 years or older at elderly welfare facilities in K county from March 01 to 31 in 2016, and a total of 211 elderly were interviewed. The collected data were analyzed by t-test, Pearson’s correlation coefficient, and path analysis using SPSS/WIN and AMOS 18.0 program. For the differences between the age groups, those aged over 80 years had a significantly higher frailty (t=-2.51, p=.013) and a lower health-related quality of life than those aged below 80 years (t=3.29, p=.001); however, there was no significant difference in social support (t=1.28, p=.201). The correlation between frailty, social support and health-related quality of life showed that as frailty became higher, social support (r=-.21, p=.003) and health-related quality of life (r=-.65, p<.001) were significantly lower, and health-related quality of life was significantly higher with a higher social support (r=.18, p=.010). As a result of investigating the mediating effects of frailty between social support and health-related quality of life, social support had a significant direct effect on frailty (β=-.21, p=.016) and frailty had a significant direct effect on health-related quality of life (β=-.06, p=.004); however, social support had no significant direct effect on health-related quality of life (β=.00, p=.562). Social support had a significant indirect effect on health-related quality of life and a mediating effect on frailty (β=.01, p=.012); therefore, the full mediation effect of frailty between social support and health-related quality of life was verified. Social support prevents frailty, and improving frailty enhances health-related quality of life. Therefore, it is necessary to develop a multifactorial frailty prevention program that includes age-specific social support strategies to improve the health-related quality of life in old-old elderly.

Meaning and Status of Health-related Quality of Life Recognized by Medical Professionals: a Qualitative Study

Jeehee Pyo,Minsu Ock,Park Bohyun,Nam-eun Kim,Eunjeong Choi,박혜숙,Hyeong Sik Ahn 대한의학회 2021 Journal of Korean medical science Vol.36 No.3

Background: Medical professionals must maintain their health to provide quality medical care to patients safely. However, the health-related quality of life of medical professionals is a complex issue that currently lacks a standardized evaluation approach. Therefore, the purpose of this study was to identify their perceptions of the health-related quality of life of medical professionals and explore ways to measure their quality of life as accurately. Methods: This study explored the subjective health status and well-being of Korean medical professionals by conducting three focus group discussions (FGDs) with 12 physicians and 6 nurses (November to December 2019). In the FGD, we elicited participants' opinions on existing health-related quality of life measurement tools. Also, we analyzed transcribed data through content analysis. Results: Participants in this study noted the ambiguity in the current definitions of health provided by the World Health Organization. They shared various problems of their health, mainly concerning fatigue and sleep disorders due to their work pattern. Also, participants shared anxiety, burden, and fear of negative consequences due to the complexity of their work. Participants voiced the necessity of a questionnaire on health-related quality of life that reflects the working lives of medical professionals. Conclusion: Medical professionals in Korea were mainly criticizing about health-related quality of life problems caused by their work characteristics. The results of this study will provide valuable information for future health-related quality of life surveys targeting medical professionals in Korea, and also help to determine the method for monitoring the health- related quality of life for health professionals. In addition, the aspects and items identified by medical professionals as important for their health-related quality of life may be used as a basis for developing a new health-related quality of life measurement tools for medical professionals.

잠재계층분석을 활용한 한국 1인 가구의 건강관련 삶의 질 유형화

이지수 한국융합과학회 2023 한국융합과학회지 Vol.12 No.9

연구목적 본 연구는 한국 1인 가구의 건강관련 삶의 질에 영향을 미치는 주요 영향요인들을 바탕으로 잠재계층분석 방법을 적용하여 잠재계층을 분류하고, 그 유형과 특성을 파악하여 한국 1 인 가구의 건강관련 삶의 질을 지속적으로 유지하고 증진시킬 수 있는 간호중재 개발의 기초자료로 제공하고자 시행된 연구이다. 연구방법 2016년에서 2019년도까지 총 4년의 국민건강영양조사 자료를 병합하여 사용한 횡단연구이고 연구 대상자는 전체 응답자 중 1인 가구만 추출하여분석한 이차 자료 분석 연구로써 SPSS 25 (IBM, New York, USA)을 이용하여 기술통계 분석과Mplus 8 (Muthen & Muthen, Los Angeles, CA, USA을 이용한 잠재계층분석 방법을 시행하였다. 연구결과 한국 1인 가구의 건강관련 삶의 질은 잠재계층분석을 통해 ‘건강관련 삶의 질 -전반적 안정형 그룹’, ‘건강관련 삶의 질-활동 저하 그룹’, ‘건강관련 삶의 질-통증 불편 그룹’으로총 3개의 잠재계층으로 분류되었다. 건강관련 전반적 안정형 그룹은 삶의 질 5가지 척도가 모두충족된 것을 보였고, 건강관련 활동 저하 그룹은 운동능력과 일상활동이 저하됨을 알 수 있었다. 또한 건강관련 통증 불편 그룹은 만성질환이나 질환을 앓고 있는 집단으로 삶의 질 저하를 나타냄을 알 수 있었다. 결론 본 연구는 잠재계층분석을 적용하여 한국 1인가구의 건강관련 삶의 질위험계층을 파악하고 삶의 질에 영향을 미치는 요인을 확인하는 새로운 시도로써, 1인 가구의건강관련 삶의 질을 지속적으로 유지하고 증진시키고 삶의 질 향상을 관리하는 적극적 예방정책을 세우는데 유용한 자료를 제공하였다는데 의의가 있다. Purpose The purpose of this study was to identify the types of quality of life (QoL) of single-person households in Korea based on the five dimensions of EQ-5D and to predict factors affecting the types of quality of life. Methods This study was secondarily analyzed using data from the National Health and Nutrition Examination Survey. The subjects were 2,054 adult single-person households, and data were analyzed using SPSS 20.0 and Mplus 8 for latent analysis. Results The health-related quality of life of single-person households in Korea was analyzed through potential class analysis: 'type 1: Health-related quality of life - overall stable group', 'type 2: health-related quality of life-low activity group', 'type 3: health-related quality of life-pain discomfort group' ' was classified into a total of three latent layers. The health-related overall stable group showed that all five measures of quality of life were satisfied, and the health-related activity-decreased group showed deterioration in motor ability and daily activities. In addition, it was found that the health-related pain discomfort group was a group suffering from chronic diseases or diseases and showed a decrease in quality of life. As a result of comparing latent type 1 and latent type 2, socioeconomic status (p<.05), employment status (p<.05), and subjective health status (p<.001) were found to be significant. As a result of comparing latent type 1 and latent type 3, socioeconomic status (p<.05), current smoking status (p<.001), and subjective health status (p<.001) were found to be significant. As a result of comparing latent type 2 and latent type 3, socioeconomic status (p<.05), subjective health status (p<.001), and stress (p<.001) were found to be significant. Conclusion The results showed significant heterogeneity in quality of life types, and the predictors of health-related quality of life by type were also different. These findings provide basic information for developing nursing interventions to improve quality of life. Subtype specific characteristics should be considered during the development of interventions.

성인 남성에서 흡연과 건강수준과의 연관성 - 비만지표 및 건강 관련 삶의 질 중심으로 -

박종은,김소영,엽경은,박종혁 한국보건사회학회 2018 보건과 사회과학 Vol.0 No.48

The purpose of this study was to investigate the distribution of obesity indices and health-related quality of life index according to current smoking status and lifetime pack-years of smoking among Korean men aged ≥19 years using data from the fourth (2007-2009) and fifth (2010-2012) Korea National Health and Nutrition Examination Survey (KNHANES). We also examined whether smoking is actually associated with obesity, abdominal obesity, and impaired health-related quality of life. Using anthropometric measurements measured in the health examination, obesity was defined as body mass index (BMI) of ≥25kg/m² and abdominal obesity was defined as waist circumference of≥90cm. The health-related quality of life was assessed using the EuroQol-5 dimension (EQ-5D) and EuroQol-Visual Analogue Scale (EQ-VAS) and the lowest (5th) quintile of the EQ-5D index scores or EQ-VAS scores was determined to have a poor healthrelated quality of life. A total of 13,880 men, 3069 (23.6%) were non-smokers, 4864 (29.4%) were former smokers, and 5947 (47.0%) were current smokers. Obesity-related indices and health-related quality of life index were generally better in non-smokers than in former and current smokers. Multivariate-adjusted odds ratios (ORs) of abdominal obesity were significantly increased in past andcurrent smokers compared to non-smokers. The odds ratio of overall obesity defined by the BMI was increased in former smokers who quit smoking compared to non-smokers, but current smokers did not show any difference. The OR for impaired health-related quality of life for current smokers compared to non-smokers was higher for the EQ-VAS scores. However, former smokers were not associated with impaired health-related quality of life. There were also trend of increasing ORs for obesity, abdominal obesity, and impaired health-related quality of life with increasing pack-years of smoking. In conclusion, smoking was associated with metabolically adverse abdominal obesity. Also, continuing smoking has been shown to have impaired health-related quality of life. Therefore, smoking prevention and smoking cessation should be addressed as important public health issues in the prevention of smoking- and obesity-related complications and improvement of health-related quality of life. 본 연구는 2007년∼2012년 국민건강영양조사 자료를 활용하여 만 19세 이상 성인 남성을 대상으로현재 흡연상태 및 평생 흡연력에 따른 비만지표와 건강 관련 삶의 질 지수의 분포를 파악하고, 흡연과비만 및 복부비만, 삶의 질 저하와의 연관성에 대해 알아보았다. 검진조사에서 측정된 신체계측치를 이용하여 비만은 체질량지수(Body mass index) 25kg/m2 이상으로 정의하였고, 복부비만은 허리둘레90cm 이상으로 정의하였다. 건강 관련 삶의 질에 대한 평가는 EuroQol-5 dimension (EQ-5D)와EuroQol-Visual Analogue Scale(EQ-VAS)을 이용하였고, EQ-5D index scores와 EQ-VAS scores 의 가장 낮은 5분위수(lowest 5th Quintile)에서 삶의 질이 낮은 것으로 정의하였다. 총 13,880명의연구대상자 중 비흡연자는 3,069명(23.6%), 과거흡연자는 4,864명(29.4%), 현재흡연자는 5,947명(47.0%)의 분포를 보였다. 비만 관련 지표와 건강 관련 삶의 질 지표들은 과거흡연자와 현재흡연자에비해 비흡연자에서 전반적으로 더 양호한 것으로 나타났다. 복부비만의 교차비는 비흡연자에 비해 흡연력이 있는 과거흡연자와 현재흡연자에서 유의하게 증가하였고, 체질량지수로 정의한 비만의 교차비는비흡연자에 비해 금연을 하고 있는 과거흡연자에서 유의하게 증가하였다. 삶의 질 저하에 대한 교차비는비흡연자에 비해 지속적으로 흡연 중인 현재흡연자에서 유의하게 증가하였지만, 과거흡연자는 비흡연자와 유의한 차이를 보이지 않았다. 또한, 비만 및 복부비만, 삶의 질 저하의 교차비는 흡연갑년이 증가할수록 유의하게 증가하는 경향성을 보였다. 결론적으로 한국 남성에서 흡연은 대사적으로 불건강한 복부비만과 관련성이 있는 것으로 나타났고, 흡연자는 비흡연자나 금연한 사람들에 비해서 건강과 관련된 삶의 질도 더 낮은 것으로 확인되었다. 따라서 흡연예방과 금연은 흡연 및 비만과 관련된 합병증을 예방하고 삶의 질을 향상시킬 수 있는 중요한 공중보건학적 이슈로 다루어져야 할 것이다.

EQ-5D를 이용한 일개 광역시 성인의 건강관련 삶의 질 측정

조민우 ( Min Woo Jo ),이상일 ( Sang Il Lee ),길선령 ( Seol Ryoung Kil ),이지호 ( Ji Ho Lee ),강위창 ( Wee Chang Kang ),손혜숙 ( Hae Sook Sohn ),유철인 ( Cheol In Yoo ) 한국보건행정학회 2008 보건행정학회지 Vol.18 No.3

Measurements of health related quality of life can be used to compare patients with specific conditions to average individuals in the general population in a similar age and gender group. However there are few data available regarding health related quality of life for the general population of Korea. Therefore, this study was conducted to examine the validity of the Korean version of EQ-5D and to measure the health related quality of life of the general adult population in a metropolitan city. The survey was cross-sectional and employed a stratified and multistage sampling design through 100 examination sites in 5 districts of Ulsan. A total of 12,644 individuals from 4,112 households participated in the survey. Of these, we analyzed data from 8,068 adults who were over 19 years old and completed the EQ-5D. To examine the validity of the questionnaire, the differences in 5 dimensions and the EQ-5Dindex were analyzed with regard to demographic and socioeconomic factors such as sex, age, income, and education. In addition, visual analogue scales (VAS) were used to evaluate the overall health related quality of life issues of the respondents. The level of health related quality of life of the general adult population was then compared with the results from the third Korean National Health and Nutrition Examination Survey and other countries. There were a small number of people with problems related tomobility, self-care, and usual activity. In addition, many people complained ofpain/discomfort and anxiety/depression. The complaint rate in each dimension, VAS, and EQ-5Dindex indicated relatively better states for males, the younger group, the higher income group, and the higher education group. In addition, the level of health related quality of life of the general population of Ulsan was relatively higher than that of Koreans nationwide as well as the populations of other countries. EQ-5D provided a valid measure of the health-related quality of life of the general adult population. In addition, the results of a survey of Ulsan revealed that the quality of life of its population is better than that of the overall population of Korea and of the populations of other countries.

직군별 건강관련 삶의 질

김선미,이지원 한국보건복지학회 2022 보건과 복지 Vol.24 No.3

This study aimed to identify factors related to health-related quality of life (EuroQol-5 Dimension) for occupational groups of the domestic working-age population based on the 2019 Korea National Health & Nutrition Examination Survey data. We provide data for the development of health management programs for them by identifying health-related quality of life by occupational group. This study is a secondary data analysis study. The subjects were 4,144 working-age population (19~65 years old and the final analysis was done by classifying them into white blue and others by occupation. These data were analyzed using the chi-square test multi-variable logistic regression using SPSS 26.0. Subjective health status suicidal ideation and stress perception were common factors affecting health-related quality of life in all groups. In addition sleep time in the white group body mass index (BMI) in blue, and BMI, sleep time, and smoking in other groups were health-related quality-of-life related variables. There were differences in health-related quality of life related factors by occupational group. It is necessary to improve subjective health status by improving health behaviors that greatly affect quality of life by occupation and to help manage mental health to cope with stress and prevent suicidal ideation. 본 연구는 2019년 국민건강영양조사 데이터를 활용하여 국내 생산가능인구의 직군별 건강관련 삶의 질의 관련요인을 규명하고자 하였다. 직군별로 건강관련 삶의 질의 5가지 차원을 파악함으로써 직군별 건강관리 프로그램 개발의 기초자료를 제공하고자 한다. 본 연구는 2차 자료분석 연구로 대상자는 생산가능인구 4,144명(만 19세 이상 ∼ 65세 미만)을 white, blue, others 직군으로 분류하여 최종분석하였고 SPSS 26.0을 활용하여 교착분석, 다변량 로지스틱 회귀분석을 실시하였다. 주관적 건강상태, 자살생각 및 스트레스 인지는 모든 직군의 건강관련 삶의 질에 영향을 미친 공통요인이었고, 특히 white 군에서는 수면시간이, blue 군에서는 체질량지수가, others 군에서는 체질량지수, 수면시간, 흡연이 건강관련 삶의 질의 주요 관련 요인이었다. 직군별 건강관련 삶의 질 관련 요인은 차이가 있는 것으로 나타나 직군별 삶의 질에 부정적인 영향을 미치는 건강행태를 개선하여 주관적 건강상태를 향상시키고 스트레스에 대처하고 자살생각을 예방하기 위한 정신건강 관리가 필요하다.

일부지역 중학생의 구강건강 관리 행태와 인지도에 따른 구강건강관련 삶의 질

박정희 ( Jeong Hee Park ),이명주 ( Myeong Ju Lee ),구효진 ( Hyo Jin Goo ) 한국치위생학회(구 한국치위생교육학회) 2013 한국치위생학회지 Vol.13 No.2

Objectives: This study has attempted to investigate subjective oral health awareness, oral health behavior and analyze how the results are correlated with oral health-related quality of life against middle school students. Methods: A self-administered questionnaire survey was performed against 552 students from three middle schools in Changwon. A frequent analysis was conducted on research subjects` general characteristics, oral health awareness, oral health behavior. In addition, t-test and ANOVA were carried out to analyze oral health-related quality of life by the general characteristics, oral health awareness and oral health behavior. Results: In terms of oral health-related quality of life by general characteristics, the quality of life on oral symptoms was higher at lower school grades (p〈0.05). In terms of social welfare, oral health-related quality of life was higher as parents` monthly income increased (p〈0.05). Oral health-related quality of life was high in oral symptoms when there was no interest in oral health, in functional limitation, emotional welfare and social welfare when there is some oral health-related knowledge (p〈0.05) and in all sub categories when oral conditions are healthy (p〈0.05). Conclusions: The results of this study has come up with important information for improvement of oral health-related quality of life in middle school students by investigating the correlations between oral health awareness and oral health-related quality of life.

일부 사회복지시설 종사자의 구강건강상태에 따른 구강건강관련 삶의 질

송애희 ( Ae Hee Song ),윤혜정 ( Hye Jeong Youn ),임선아 ( Sun A Lim ) 한국치위생학회(구 한국치위생교육학회) 2016 한국치위생학회지 Vol.16 No.2

Objectives: The purpose of the study was to investigate the influencing factors of oral health-related quality of life in social workers. Methods: A self-reported questionnaire was completed by 240 social workers in Gwangju by convenience sampling method. The questionnaire consisted of general characteristics of the subjects(age, monthly salary, smoking, alcohol consumption) and systemic health condition(systemic diseases, medication, oral health status, and stress). The factors associated with oral health-related quality of life included skin dryness, eye dryness, lip dryness, and nasal dryness. The subjective dry mouth consisted of 6 questions measured by visual analogue scale(VAS). Cronbach``s alpha was 0.868 in the study. The data were analyzed for t-test, one-way ANOVA and multiple regression analysis using SPSS 18.0 program. Results: The oral health-related quality of life in social workers varied by age, oral health status, stress status, and halitosis. The oral health-related quality of life had positive correlations with the subjective perception of dry mouth and whole body dry symptoms. The health status(в=-0.410) had the influence on the oral health-related quality of life, nasal dryness(в=0.230), age(в=0.189), and halitosis (в=0.162) in order. Conclusions: The oral health-related quality of life was closely related to the health status and nasal dryness. It is necessary to develop the quality of life improvement programs including oral health prevention and care program in the social workers.

성인들의 구강건강인식에 따른 스트레스와 생활만족도, 구강건강관련 삶의 질의 차이

김은주(Eun-ju Kim),우승희(Seung-Hee Woo) 한국구강보건과학회 2020 한국구강보건과학회지 Vol.8 No.4

Objectives: The purpose of this study was to examine the differences in the level of stress, life satisfaction, and quality of life related to oral health according to the degree of perception of oral health among adults. Methods: Using a self-written questionnaire, general characteristics, oral health perception, stress, life satisfaction, and oral health-related quality of life were investigated. Results: Life satisfaction according to the perception of oral health of the study subjects showed a significant difference at the level of p<0.001 for oral health knowledge and oral health status, and the quality of life related to oral health was p<0.001 for oral health knowledge and oral health condition. There was a significant difference in level. In the correlation, stress and life satisfaction, oral health-related quality of life were negatively correlated, life satisfaction and oral health-related quality of life were positively correlated, showing a significant difference at p<0.01 level. Conclusions: The overall quality of life including life satisfaction and oral health related quality of life should be improved through continuous oral health education and stress management for adults.

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.