장애인의 정신건강이 건강관련 삶의 질에 미치는 영향 -제6기(2013) 국민건강영양조사 자료를 이용하여-

김예순 ( Ye-soon Kim ),김명(교신저자) ( Myung Kim ) 대한보건협회 2016 대한보건연구 Vol.42 No.2

연구목적: 본 연구의 목적은 장애인의 정신건강이 건강관련 삶의 질에 미치는 영향을 파악고자 하였다. 연구방법: 국민건강영양조사 제6기 건강설문에 응답한 만 19세 이상 장애인 479명을 대상으로 하였으며, 자료 분석은 SPSS Window 21.0을 이용하여 장애인의 일반적 특성은 빈도와 백분율, 평균과 표준편차로 분석하고, 대상자의 일반적 특성에 따른 건강관련 삶의 질의 차이는 t-test, one-way ANOVA를 실시하였다. 사후검정으로는 Scheffe 검정을 이용하였다. 장애인의 건강관련 삶의 질에 영향을 미치는 요인을 알아보기 위해서는 다중회귀분석(Multiple regression)을 시행하였다. 연구결과: 장애인에서 성별, 연령, 교육수준, 결혼 상태, 직업, 가구총소득, 의료보험 종류, 스트레스 인지·우울증상 경험·자살 생각 정도에 따라 건강관련 삶의 질이 차이가 있는 것으로 분석되었다. 건강관련 삶의 질에 영향을 미치는 요인들에 대하여 알아보고자 다중회귀분석을 실시한 결과, 연령, 건강보험 종류, 스트레스 인지·우울증상 경험·자살 생각이 영향요인인 것으로 분석되었고 26.8%의 설명력을 보였다. 결론: 장애인에 있어 스트레스, 우울, 자살은 건강관련 삶의 질에 영향을 주는 변수로, 정신건강이 건강관련 삶의 질에 영향을 미친다고 볼 수 있다. Objective: The purpose of this study was to examine the factors affecting of health-related quality of life (HRQoL) among people with disabilities. Methods: The study examines the factors affecting of HRQoL using over 19 years of age who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 data. Subjects were 479 people with disabilities over 19 years of age. Data were analyzed using descriptive statistics, X2-test, ANOVA, Scheffe test, and multiple regression with the SPSS win 21.0 program. Results: HRQoL is differentiated with gender, age, education level, marital status, occupation, house economic status, medical insurance, type of disability, and grade of disability. The significant predictors of the HRQoL were age, medical insurance, recognizing stress, depressive symptom, and thinking suicide. These factors explained 26.8% of variance in HRQoL. Conclusion: These results show that recognizing stress, depressive symptom, and thinking suicide are statistically influential on HRQoL of people with disabilities.

장애인과 비장애인 독거노인의 자살생각 영향요인 분석

김예순,남영희,Kim, Ye-Soon,Nam, Young-Hee 한국학교ㆍ지역보건교육학회 2021 한국학교지역보건교육학회지 Vol.22 No.3

Purpose: This study purposed to analyze of factors related to suicidal ideation among people with and without disabilities in elderly living alone Methods: The study examines the factors of suicidal ideation using over 65 years of age who participated in the 2017 National Survey of Older Koreans of the elderly living alone data. Subjects were 2,265 person among elderly living alone over 65 years of age. Data were analyzed using descriptive statistics, X²-test, t-test, logistic regression analysis with the SPSS win 26.0 program. Results: Suicidal ideation of the elderly living alone with disabilities were 13.6% and 9.0% of the elderly living alone without disabilities, and the elderly living alone with disabilities had higher suicidal ideation (p<.05). The significant predictors of the suicidal ideation in elderly living alone with disabilities were employment and depression. The significant predictors of the suicidal ideation in elderly living alone without disabilities were age, gender, number of chronic disease, economic state, SLCA(Society, leisure, culture, and activities) and depression. Depression was analyzed as a common factor related to suicidal ideation in disabled and non-disabled elderly living alone. Conclusion: Based on the results of this study, it is necessary to develop a program for people with and without disabilities. It is necessary to prepare various programs and community support systems to prevent and manage depression for people with and without disabilities in elderly living alone.

장애노인의 일상생활수행능력과 자살 생각에 미치는 영향 요인: 2017년 장애인 실태조사를 이용하여

김예순(Kim Ye-Soon),남영희(Nam Young-Hee) 고령자치매작업치료학회 2020 고령자.치매작업치료학회지 Vol.14 No.2

목적: 본 연구는 노인 장애인의 일상생활수행능력과 자살 생각 정도를 파악하고, 자살생각에 영향을 미치는 결정 요인을 분석하고자 한다. 연구방법: 이 연구는 2017년 장애인 실태조사에 참여한 65세 이상을 대상으로 자살에 영향을 미치는 요인을 분석함. 대상자는 65세 이상의 장애인 3,323 명이었다. SPSS win 21.0 프로그램을 사용하여 기술 통계, 카이스케어 검정, 다중 로지스틱회귀를 사용하여 데이터를 분석하였다. 연구결과: 장애노인의 자살 생각과 일상생활수행능력, 수단적 일상생활수행능력은 관련성 있는 것으로 분석됨(p<0.05). 자살 생각의 영향을 미치는 중요한 예측 요인으로는 인구사회학적 특성의 건강보험종류(경제력), 일상생활수행능력의 옷 갈아 입기와 이동, 수단적 일상생활수행능력의 전화사용, 세탁인것으로 분석되었다(p<0.05). 결론: 본 연구의 결과를 바탕으로 장애인 고령자를 위한 자살 생각 예방 프로그램 개발이 필요할 것으로 사료된다. Objective : This study purposed to analyze affecting factors related to suicidal ideation of elderly person with disabilities. Methods : The study examines the factors affecting of suicidal though using over 65 years of age who participated in the 2017 National survey of the disabled data. Subjects were 3,323 person with disabilities over 65 years of age. Data were analyzed using descriptive statistics, X2-test, univariable binary logistic regression with the SPSS win 21.0 program. Results : Suicidal ideation among elderly person with disabilities is related to activity of daily living(ADL) and Instrumental activity of daily living(IADL)(p<0.05). The significant predictors of the suicidal though are health Insurance(economic status), ADL(change cloths, walking), and IADL(telephone use, washing clothes)(p<0.05). Conclusion : Based on the results of this study, it is necessary to develop a suicidal ideation prevention program for elderly person with disabilities.

법정전염병의 신고현황 및 관련 특성

김예순(Ye-soon Kim),박기호(Kee-ho Park),유효순(Hyo-soon Yoo),권준욱(Jun-wook Kwon),신의철(Euichul Shin) 한국역학회 2007 Epidemiology and Health Vol.29 No.2

  communicable diseases. The purposes of the study is to estimate reporting proportion of National Notifiable Infectious Diseases(NNIDs) and investigate characteristics related to reporting using KAP(knowledge, attitude, practice) model.   Method: We surveyed randomly selected 2,185 physicians (speciality: internal medicine, family medicine, pediatrics, dermatology, general physicians) of their knowledge, attitude, and practice of NNIDs reporting through self-administered mail questionnaires. Of them, 231 physicians responded (response proportion: 10.6%).   Result: The reporting proportion was estimated to 27.0%. Recognition level (knowledge) of NNIDs was relatively high with proportion of 69.40/0, and attitude (public health importance) of reporting was 65.8%. Multiple logistic regression analysis showed that knowledge, attitude significantly affected physicians" reporting in a positive direction (O.R. 6.2, 6.2 respectively). Whereas, senior age group, specialty (family medicine, pediatrics, dermatology) showed significantly lower reporting. General (tertiary care) hospital level of care showed significantly higher reporting practice (α=0.05).   Conclusion: The NNIDs reporting proportion, 27.0% is similar with those studied recently. Continuous efforts to increase the performance level of communicable diseases surveillance system. Of those, restructuring surveillance systems considering characteristics of notifiable diseases classes must be stressed. Educational approach of physicians needs to be tailored specially to newly-designated diseases such as Group Ⅱ, Designated Group NNIDs.

성인 장애인의 일상생활활동과 우울 영향 요인 - 한국복지패널 장애인 부가조사를 이용하여 -

김예순 ( Ye Soon Kim ),김선용 ( Seon Yong Kim ),김명 ( Myung Kim ) 대한보건협회 2014 대한보건연구 Vol.40 No.4

연구목적 : 본 연구의 목적은 장애인의 우울에 미치는 영향을 파악고자 하였다. 연구방법 : 한국복지패널 장애인 부가조사에 응답한 만 18세 이상 65세 미만인 성인 장애인 486명을 대상으로 하였으며, 자료 분석은 SPSS Window 20.0을 이용하여 장애인의 일반적 특성은 빈도와 백분율로 분석하고, 우울에 따른 ADL과 IADL의 비교는 Chi-Square-test로 분석하였다. 장애인의 우울에 영향을 미치는 요인을 알아보기 위해서는 다중회귀분석을 시행하였다. 연구결과 : 우울 장애인과 비우울 장애인에서 ADL과 IADL 점수를 비교한 결과 통계적으로 유의미한 차이를 보였다. 장애인 대상자의 우울에 영향을 미치는 요인들에 대하여 알아보고자 단계적 변수 선택에 의한 다중회귀분석을 한 결과, 성별, 장애등급, 장애발병연령, ADL이 영향을 미치는 것으로 분석되었다. 결론 : 장애인에 있어 신체 기능을 향상 시킬 수 있는 활동 중심의 중재가 우울 정도를 개선시킬 수 있는 요인이며, 장애인의 우울을 예방할 수 있는 프로그램 개발도 절실하다. Objective : The purpose of this study was to examine the factors affecting of depression among persons with disability. Methods : The study examines the factors affecting of depression using age between 18 years old and 65 years old who participated in the korea Welfare Panel data(n=486). Data were analyzed using descriptive statistics. Chi-Square test and stepwise multiple regression with the SPSS 20.0 program. Results : There were significant differences in ADL and IADL scores between normal group and a depression group. The proportion of disabled with adequate ADL and IADL status were greater for persons with disability in the normal group than for those in the depression group. Factors significantly influencing depression were age, degree of disability level, Age of disability Occurrence, and ADL. Conclusion : These results indicate a need to focus on ADL related factors to intervention in depression. Also, depression prevention programs are necessary for persons with disability.

우리나라 병원들의 전략지향 및 관련 특성 분석

윤혜원,신의철,김예순,정기택,Youn, Hye-Won,Shin, Eui-Chul,Kim, Ye-Soon,Jung, Ki-Taek 대한병원협회 2008 대한병원협회지 Vol.37 No.3

As healthcare environment being more complex and turbulent, strategic approach of hospitals became more important. This study was to investigate strategic orientation of Korean hospitals and their related characteristics. We surveyed managers of 360 hospitals randomly selected from all hospitals in Korea. For typology of strategic orientation, we used that developed by Miles and Snow, and results are as follows. Firstly, major types of organizational strategic orientation of Korean hospitals were analyzer(42.0%) and prospector(34.0%). Secondly, characteristics affecting to hospitals' strategic orientation significantly were hospital ownership and sex of managers. Medical corporation had a high tendency of prospector strategic orientation by 2.7 times compared to personal ownership. Female managers had a low tendency of prospector strategic orientation by 0.2, which was statistically significant. Though 60+ age group (compared to twenties and thirties) and middle managers (compared to CEO) had a tendency of being more prospector strategic orientation, but insignificant. The study result that majority of strategic orientation were prospector and analyzer reflects Korean hospital environment are complex and unstable. Hospital managers need to more focus on environment and boundary spanning function for maintenance and survival of their organizations.

우리나라 의료제공체계의 주요 이슈와 개선책

신의철 ( Eui Chul Shin ),김예순 ( Ye Soon Kim ) 대한보건협회 2007 대한보건연구 Vol.33 No.2

작업 중심 회상치료가 치매환자의 우울과 기억 및 문제행동에 미치는 영향

김선용 ( Seon Yong Kim ),김예순 ( Ye Soon Kim ) 고령자·치매작업치료학회 2014 고령자.치매작업치료학회지 Vol.8 No.2

목적 : 본 연구는 노인병원에 입원한 치매환자를 대상으로 실시한 작업 중심 회상치료가 우울과 기억 및 문제행동에 미치는 영향에 대해 알아보고자 하였다. 연구방법 : 본 연구는 A시 치매거점병원에서 치매로 진단받은 6명의 치매환자를 대상자로 선정하였다. 연구방법은 단일군 전후실험설계(one group pretest-post test design)를 적용하였다. 대상자 중재 기간은주 3회씩 4주간 총 12회기, 회기당 40분씩 작업 중심 회상치료를 시행하였다. 중재 전후 비교측정을 위해 우울은 한국판 노인우울척도(Geriatric Depression Scale Korean Version; GDS-K)를 사용하였고, 기억 및 문제행동은 기억 및 문제행동-개정판(Revised-Memory and Behavior Problem Checklist; R-MBPC)를 사용하여 측정하였다. 수집된 자료는 SPSS version 20.0 통계 프로그램을 사용하여 분석하였다. 우울과 기억 및 문제행동의 중재 전-후 변화를 분석하기 위해 윌콕슨 부호순위 검정(Wilcoxon signed rank test)을 실시하였으며, 우울과 기억 및 문제행동의 상관관계를 알아보고자 스피어만 상관분석(Spearman correlation)을 실시하였다. 연구결과 : 작업 중심 회상치료 중재 전에 비하여 중재 후에 치매환자의 우울과 문제행동은 감소하고 기억은 증가하였으며, 통계적으로도 유의미한 것으로 분석되었다(p< .05). 결론 : 본 연구 결과를 통하여 노인병원에 입원한 치매환자에게 작업 중심 회상치료를 적용하였을 때, 우울과 기억 및 문제행동의 감소를 보였다. 이에 향후 노인병원에 입원한 치매환자들에게 작업 중심회상치료를 적용하여 우울과 기억 및 문제행동의 개선을 기대할 수 있을 것이다. Objectives : Is this study, the treatment of dementia elderly care in the geriatric hospital admission conducted by the occupational reminiscence therapy a positive affect on depression, memory and behavioral problems were investigated. Methods : This study selected six patients diagnosed with dementia in Andong base hospital in person. The study design was applied one group pretest post test design. The period of administration was three times a week ofr 40 minutes per session for four weeks. Depression were evaluated using the Geriatric Depression Scale Korean Version(GDS-K), Memory and Behavior Problem were evaluated using the Revised-Memory and Behavior Problem Checklist(R-MBPC) using was assessed before and after the intervention. The data was analyzed using the statistical program SPSS version 20.0. Intervention results was Wilcoxon signed rank test and Spearman correlation. Results : Occupational Reminiscence Therapy after intervention than before intervention was statistically significant in Depression, memory and behavioral problems of dementia(p< .05). Conclusion : According to the results of this study, hospitalization in dementia in the elderly Occupational Reminiscence Therapy program when applied the improvement of Depression, memory and behavioral problems easing the effect was confirmed.

노인의 장악력 및 신체계측인자, 우울, 삶의 질에 관한 연구: 2016년 국민건강영양조사를 이용하여

강소라(So-La Kang),김예순(Ye-Soon Kim),문종훈(Jong-Hoon Moon) 고령자치매작업치료학회 2018 고령자.치매작업치료학회지 Vol.12 No.2

목적: 본 연구는 노인의 장악력을 표준화하고 장악력, 신체계측인자, 우울, 삶의 질 사이에 상관관계를 알아보고자 하였다. 연구방법: 연구자는 2016년 국민건강영양조사를 분석에 이용하였으며, 활동제한이 없는 오른손잡이 노인 중장악력 검사를 완료한 919명의 자료를 분석하였다. 노인 전체, 남성, 여성의 장악력을 65세~69세, 70세~74세, 75세~79세, 80세 이상으로 구분하여 장악력을 표준화하였다. 신체계측인자에는 키. 몸무게, 체질량지수, 허리둘레가 포함되었다. 우울은 PHQ-9로 측정되었고, 삶의 질은 EQ-5D로 평가되었다. 연구결과: 노인의 오른손잡이의 비율은 87.8%, 왼손잡이 4.9%, 양손잡이 5.7%로 나타났다. 표준화 결과 및상관분석에서, 남녀노인 모두 나이가 증가함에 따라 장악력이 감소하였다(p<.01, r=-.308~-.305). 장악력은 키와 가장 높은 상관성을 나타냈다(p<.01, r=.747~.741). 장악력은 우울(p<.01, r=-.172 ~-.163)과 삶의 질(p<.01, r=.285~.267) 사이에 유의한 상관이 있었다. 결론: 본 연구의 결과는 노인의 연령별 장악력 수준을 고려할 때, 키, 우울, 삶의 질에 따라 장악력의 차이가 나타날 수 있음을 고려할 필요가 있음을 시사한다. Objective: The aim of current investigation was to standardize the grip strength of elders and to examine the correlation between grip strength, anthropometric parameters, depression and quality of life. Method: The researchers used Korea national health and nutrition examination surveys (2016) for analysis and analyzed the data of 919 elders who had completed the screening test among right-handed elderly without activity limitation. The researchers classified the age of the elders as 65~69, 70~74, 75~79, and 80 years old for standardization of grip strength. Anthropometric parameters are height, weight, body mass index, and waist circumference. Depression was measured by PHQ-9(Patient Health Questionnaire-9) and quality of life was assessed by EQ-5D. Result: The ratio of right handedness of the elderly was 87.8%, left handed 4.9%, and both handles 5.7%. In the standardization and correlation analysis, the grip strength decreased with age (p<.01, r=-.308~-.305). The grip strength showed a strong correlation with height (p<.001, r=.747~.741). There was a significant correlation between depression (p<.01, r=-.172~-.163) and quality of life (p<.01, r=.285~.267). Conclusion: The findings of this investigation suggest that height, depression, and quality of life need to be considered when assessing the level of grip strength in the elderly.

의약분업이후 약국 경영수지 및 관련 요인 분석

박혜경,권창익,엄태훈,김예순,노연숙,정규혁,이의경,Park, Hye-Kyung,Kwon, Chang-Ik,Eom, Tae-Hoon,Kim, Ye-Soon,Rho, Yeun-Sook,Jeong, Gyu-Hyeok,Lee, Eui-Kyoung 대한약학회 2008 약학회지 Vol.52 No.6

The purpose of this study is to analyze the factors affecting financial performance of community pharmacies after the implementation of the new drug policy in Korea: separation of drug prescription and dispensing (SPD). The online survey questionnaires were sent to the active pharmacists of the total 20,633 community pharmacies in Korea and 1,147 pharmacists responded to the survey (the response rate was 5.5%). The questionnaire asked simple financial data in order to compare their financial performances before and after the policy. With the SPSS package (version 12.0), two levels of data analysis were used: 1) descriptive statistics to see the financial status of the pharmacies; and 2) multiple regression analysis to find the factors. {or A multiple regression method was used for the data analysis.} The finding illustrated that the average net benefit of the pharmacies was 4,870 thousand won in August 2006, and the major factors affecting the net benefit were the location of pharmacy (geographical proximity to medical institutions), number of prescriptions, drug management services for patients, chain pharmacy membership. The findings of this study suggest that service improvement for patients, revitalization of non-prescription drug sales, professional management will contribute to promote community based pharmacy business.