고혈압 환자들의 관점에서 본 혈압관리에 대한 지식, 태도, 실천: 질적연구

이석구,전소연,Lee, Sok-Goo,Jeon, So-Youn 대한예방의학회 2008 예방의학회지 Vol.41 No.4

Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

노인들의 사회경제적 수준과 건강수준, 건강행태와의 관계

이석구,전소연,Lee, Sok-Goo,Jeon, So-Youn 대한예방의학회 2005 예방의학회지 Vol.38 No.2

Objectives: To analyze the relationships of socioeconomic status(SES) to health status and health behaviors in the elderly. Methods: Data were obtained from self-administered questionnaire of 4,587 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, socioeconomic status, health status (subjective health status, acute disease, admission experience, dental state, chronic disease etc.), activities of daily living (ADL), instrumental activities of daily living (IADL), and mini-mental state examination-Korean (MMSEK). Binary and multinominal logistic regression analyses were employed to analyze factors affecting on the socioeconomic status of the elderly. Results: With regard to the SES and health status, those with a low SES had poorer subjective health states and lower satisfaction about their physical health. Also, acute disease experiences, admission rates and tooth deciduation rates were higher in those of low SES. In the view of physical and cognitive functions, the ADL, IADL and MMSE-K scores were also lower in those of low SES. However, with regard to health behaviors, lower smoking and alcohol drinking rates were found in the low SES group, and a similar trend was shown with regular physical exercise, eating breakfast, and regular physical health check-up. From these findings, we surmise that those with low SES have a poorer health condition and less money to spend on health, therefore, they can not smoke or drink alcohol, exercise and or have a physical health check-up. Conclusion: This study suggests that socioeconomic status plays an important role in health behaviors and status of the elderly. Low socioeconomic status bring about unhealthy behavior and poor health status in the elderly. Therefore, more specific target oriented(esp. low SES persons) health promotion activities for the elderly are very important to improve not only their health status, but their health inequity also.

한국 19세 이상 성인들의 B형간염 백신 접종률 및 관련 요인

이석구(Sok Goo Lee),전소연(So Youn Jeon) 한국농촌의학 지역보건학회 2022 농촌의학·지역보건 Vol.47 No.2

본 연구는 19세 이상 성인들을 대상으로 B형간염 백신 접종률, 백신 접종이유 및 미접종 이유, 백신 접종 관련 요인을 파악하고자 하였다. B형간염 백신 접종률은 사후가중치를 적용 후 1차 38.0%, 2차 32.5%, 3차 26.9%로 나타났다. B형간염 백신 접종 관련 요인으로는 여자가, 저연령에서, 군부 거주자가, 직업이 있을 때, 고학력자가, 건강보험 가입자가, 배우자가 있을 때, 동거가족이 있을 때, 국가 권고 성인 예방접종을 인지하고 있을 때, 의사에게 성인 예방접종의 필요성을 설명 받은 경험이 있을 때, 본인의 성인예방접종 기록 보관하고 있을 때, 성인 예방접종이 감염병 예방에 도움이 된다고 높게 인지하고 있을 때, 국가나 지방자치단체의 성인 예방접종홍보 경험이 없을 때에 백신 접종률이 높게 나타났다. 결론적으로 우리나라 성인의 B형간염백신 접종률은 양적 향상 및 질적인 측면에서의 개선을 위한 국가 정책 마련이 필요함을 발견하였다. 또한 성인의 B형간염 항체 형성률을 함께 파악하여 감염병 발생 감소나 퇴치를 위해서 국가수준의 예방접종률 목표치 선정과 함께 달성 정도 평가를 위한 정기적인 성인 예방접종률 산출이 필요하다. 더욱이 국가의 예방접종통합관리시스템을 통하여 안정적으로 성인의 예방접종 기록을 관리할 수 있도록 전산등록률 향상 방안을 마련할 필요가 있다. Objectives: This study aimed to identify the vaccination coverage for hepatitis B among aged 19 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The survey was conducted through a Mixed-Mode Random Digit Dialing Survey (RDD) method. The survey included hepatitis B vaccination status, reasons of vaccination and non-vaccination, sources of information on vaccination, and other related factors. Results: The vaccination coverage for hepatitis B among adults 19 years of age and older were 38.0%, 32.5%, and 26.9% for the first, second, and third doses. A related factors with high rate of hepatitis B vaccination was women, younger than 65 years of age, rural residents, having a job, highly educated, health insurance subscribers, living with spouse, family members living together. In addition, the vaccination rate was higher in those who was aware of the states recommended adult vaccination, were explained by a doctor about the need for adult vaccination, kept their vaccination records, and recognized that it helped prevent infectious diseases, and had seen promotional materials. Conclusions: In the future, it is necessary to check the antibody retention rate along with the hepatitis B vaccination coverage of adults on a regular basis. In addition, in order to accurately and quickly identify the hepatitis B vaccination coverage, it is necessary to prepare a plan to improve the computerized registration rate to manage adult vaccination records.

한국 노인의 폐렴구균 백신 접종률 및 관련 요인

이석구(Sok Goo Lee),전소연(So Youn Jeon) 한국농촌의학 지역보건학회 2021 농촌의학·지역보건 Vol.46 No.2

65세 이상 노인의 폐렴구균 국가무료 백신 접종은 2종류 중 한 개에 대해서만, 그것도 보건소에서만 접종이 가능하여 다른 국가예방접종 감염병과 달리 전산등록 자료에 의한 백신 접종률 파악이 불가능한 실정이다. 따라서 이 연구는 65세 이상 노인에게 권고되고 있는 2종의 폐렴구균 백신 모두에 대하여 백신 접종률을 파악함과 동시에 백신 접종 이유나 미접종 이유, 백신 접종 관련 요인을 파악하고자 하였다. 본 연구의 모집단은 65세 이상 노인이 되며, 최종 분석대상자수는 총 1,150명이었으며 컴퓨터 전화조사 방법을 사용하였다. 조사내용은 폐렴구균 백신 접종현황(접종여부-2회, 접종일자, 백신종류, 접종기관종류, 접종비용 지불여부, 자료원), 백신 접종을 한 이유, 백신 접종에 대해서 알게 된 정보원, 백신 접종을 하지 않은 이유, 백신 접종 관련 요인이었다. 65세 이상 노인의 폐렴구균 백신 접종률은 56.2%로 미국(2017년) 69.0%, 영국(2019년) 69.2% 보다 낮은 수준이었다. 폐렴구균 백신 접종 관련 요인으로는 여자가, 연령이 낮을수록, 시부 거주자가, 직업이 없을 때, 고학력자가, 의료보장이 있을 때, 기혼자가, 동거가족이 있을 때에 백신 접종률이 높게 나타났다. 또한 국가 권고 성인 예방접종을 인지하고 있을 때, 의사에게 성인 예방접종의 필요성을 설명 받은 경험이 있을 때, 본인의 성인 예방접종 기록을 보관하고 있을 때, 성인 예방접종이 감염병 예방에 도움이 된다고 높게 인지하고 있을 때, 국가나 지방자치단체의 성인 예방접종 홍보 경험이 있을 때 백신 접종률이 높게 나타났다. 앞으로 국가지원 대상이 아닌 성인 예방접종에 대해서도 정확한 접종기록 관리를 위한 대안의 개발이 필요하며, 국가의 감염병관리 정책 근거자료로 활용할 수 있도록 정기적인 성인 예방접종률 산출이 이루어져야 할 필요가 있다. Objectives: This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. Results: The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. Conclusions: In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country"s infection control policy.

지역사회 노인들의 신체적 기능상태와 관련 요인

이석구(Sok-Goo Lee),전소연(So-Youn Jeon) 한국노년학회 2006 한국노년학 Vol.26 No.4

본 연구는 충청남도에 소재한 도농복합시에 거주하고 있는 65세 이상 노인들을 대상으로 신체적 기능상태를 평가하고, 이에 영향을 미치는 관련요인을 밝히고자 수행하였다. 연구대상 지역은 5개동, 1개읍, 10개면으로 구성된 지역이며 조사지역을 통리별로 세분화하여 선정하였고, 선정된 통리에 거주하고 있는 65세 이상 노인들에 대하여 2003부터 2004년까지 2년 간 전수조사를 실시하였다. 조사에 참여한 노인들은 총 11,956명(65세 이상 노인인구의 77.8%)이었으며 이중에서 응답내용이 불충분한 196명, 의사에게 치매 진단을 받았거나 한국판 간이정신상태 검사결과 확정적 인지기능 장애(20점 이하)로 판정된 1,000명을 제외한 10,760명을 최종 분석대상으로 하였다. 조사방법은 노인들의 가구를 방문하여 연구자가 개발한 구조화된 설문지를 통한 직접 면접조사 형식으로 이루어졌으며 주요 분석결과를 요약하면 다음과 같다. 첫째, 노인들의 기능상태는 인구사회학적 특성별로 차이가 있었으며 성별로는 남성에서, 젊은 노인일수록, 교육수준이 높을수록, 직업이 있는 경우, 도시 거주자, 주관적 생활수준이 양호한 노인들에서 활동적 상태의 비율이 보다 높게 나타났다. 둘째, 노인들의 주ㆍ객관적인 건강수준에 따라 기능상태에 유의한 차이가 있음을 발견하였다. 입원경험이 없을수록, 우울증상이 없을수록, 감각지각 능력이 양호할수록 기능상태 역시 양호하였다. 셋째, 현재 흡연과 음주를 하고 있는 노인들이 기능상태가 양호하였고, 운동을 실천하고 있는 노인, 규칙적으로 식사하는 노인들의 기능상태가 보다 양호하였다. 넷째, 노인들의 사회적 지지가 좋을수록 활동적 상태의 비율이 높게 나타났다. 특히 가족 지지에 있어서 유배우 노인들이, 동거 가족수가 많을수록, 가족과의 관계가 좋을수록 기능상태가 양호하였다. 결국 노인들의 전반적인 건강수준이 양호하고, 사회적 지지가 양호한 노인들이 신체적 기능상태가 보다 양호하다는 결론을 도출하였다. 나아가 기능상태와 관련 요인을 고려하여 개개인에 적합한 노인 보건의료복지 서비스의 개발은 노인들의 건강 불평등을 해소하기 위한 주요 전략이 될 것이다. This study was performed to evaluate the status of physical function, and to investigate related factors above 65 year old living a mixed rural-urban city. The survey area included 5 Dongs, 1 Eup, 10 Myeons(Korean administrative district unit). And we divided survey area by Tong and Ri, more smaller survey unit, then surveyed all resident older adults for 2 years, 2003-2004. The enrolled subject was 11,956(77.8% of total elderly), we analysed 10,760 data finally except 196 incomplete data and 1,000 data with low cognitive function score(below MMSE-K test score 20). The survey method was direct interview at subject's home with structured questionnaire. The study results were as follows. First, the status of physical function was different by sociodemographic characteristics, revealed better in male by sex, more younger old by age, higher level of education, having job than jobless, urban resident in living area, more abundant living condition subjectively. Second, it revealed that the status of physical function was better in the case of healthier, subjectively or objectively. For example, the functional status was more fine in no hospital admission history, no depression experience, and more intact sensori-cognitive function. Third, those who performed exercise regularly, smoke, drunk alcohol beverage, and took a meal regularly were better. Finally, in the relation with social support, the functional status was better when the old's social support was better. Especially in family support, the functional status was fine in case of living with spouse, having more larger family size, more frequent relationship with their family. As a result, those who has good general health status and social support were better in physical function. To develope individual elderly's health and welfare programme properly in considering functional status and its related based on this study results, it will be important strategy for mitigating health inequity in old ages.

일부 농촌지역 비닐하우스 재배자들의 농부증 실태와 관련요인

이인배(In-Bae Lee),이연경(Yeon-Kyeng Lee),장성실(Sung-Sil Chang),이석구(Sok-Goo Lee),조영채(Young-Che Cho),이동배(Dong-Bae Lee),이태용(Tae-Yong Lee) 한국농촌의학 지역보건학회 1999 농촌의학·지역보건 Vol.24 No.1

드라이클리닝 근로자들의 유기용제 폭로와 자각증상

김수영,김정윤,이연경,이석구,이영수,조영채,이태용,이동배,Kim, Soo-Young,Kim, Jeong-Yun,Lee, Yeon-Kyeng,Lee, Sok-Goo,Lee, Young-Soo,Cho, Young-Chae,Lee, Tae-Young,Lee, Dong-Bae 대한예방의학회 1998 예방의학회지 Vol.31 No.4

To investigate the exposure levels of organic solvents and subjective symptoms of dry-cleaning workers, 77 male and 52 female dry-cleaning workers who had been worked in a small city of Chungnam province, and a large city, Taejon were selected for the study group. Air concentrations of organic solvents in the working environment were analyzed, and subjective symptoms of dry-cleaning workers were surveyed, from July to August 1996. The results obtained were as follows : 1. The concentrations of organic solvents in the working environment were within permissible TLV-TWA limits. 2. For the 13 symptom clusters, the most frequently complained symptom clusters were fatigue as 71.3%, and followed by depression and urinary disturbances as 53.5% and 51.9%. Other symptom clusters complained were below 50%. 3. Positive response rates of subjective symptoms were significantly higher in worker groups such as lived in a large city, female, higher education level, more frequently alcohol drinking, higher concentration of organic solvent in working environment, work in alone. 4. Workers who had used solvent B showed 2.3 point higher scores of subjective symptoms than those of solvent A. Of the subjective symptoms scores, amnesia and nervousness were higher in solvent B user group than solvent B user group. 5. As a result of factor analysis, 3 factors such as depression, urinary disturbance and neurologic disturbance were selected. 6. As a result of the logistic regression analysis, sex, the number of fellow workers, working time, region, job tenure, smoking, alcohol drinking, ventilating system, concentration of organic solvent in working environment and place of residence were selected for the related variables. For the conclusion, even though the concentrations of organic solvents in the working environments of dry-cleaning workers were within permissible limit of TLV-TWA, many dry-cleaning workers complained symptoms, such as fatigue, depression, urinary disturbances and so on. And the factors affecting to the symptoms of dry-cleaning workers were the number of fellow workers, work hours, region, job tenure, smoking and alcohol drinking.

새로이 발견된 고혈압 환자들의 약물치료 및 생활양식 개선의도와 순응도와의 관계

배상수,이석구,Bae, Sang-Soo,Lee, Sok-Goo 대한예방의학회 2001 예방의학회지 Vol.34 No.4

Objectives : To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. Methods : The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. Results : Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11 - month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. Conclusion : Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

고혈압 노인의 도농 간 신체활동참여 관련요인

백현희(Hyun-Hee Paek),이석구(Sok-Goo Lee) 한국농촌의학 지역보건학회 2015 농촌의학·지역보건 Vol.40 No.2

본 연구는 도시와 농촌 지역에 있어서 만성질환 노인의 일반적 특성에 따른 신체활동 실천율의 차이와 신체활동 관련요인을 알아보았다. 연구결과, 일반적 특성에 따라서는 도시의 경우 연령이 낮을수록 근력 운동을, 여자보다 남자에서 걷기, 유연성 운동, 근력 운동을, 배우자가 있는 경우 유연성 운동과 근력 운동을 각각 많이 하였다. 또한, 아파트 거주자가 걷기, 유연성 운동, 근력 운동을, 소득수준이 높을수록 유연성 운동을, 교육수준이 높을수록 걷기, 유연성 운동, 근력 운동을 각각 많이 하였다. 농촌의 경우도 아파트 거주자가 유연성 운동을, 교육수준이 높을수록 걷기, 유연성 운동, 근력 운동을 각각 많이 하였다. 신체활동 관련 요인은 도시의 경우 교육수준, 일상생활활동, 삶의 질이었고, 농촌의 경우는 활동제한, 일상생활활동이었다. 연구 결과를 종합하면 전반적으로 도시와 농촌 고혈압 노인 모두 낮은 신체활동 실천율을 보였으며, 일반적 특성에 따라서도 실천율에 차이를 보였고, 신체활동 관련 요인도 차이를 보였다. 따라서 도시와 농촌 모두 기초체력을 증진하고 유지시킬 수 있는 관련 특성을 고려한 체계적인 신체활동 프로그램 개발이 시급히 이루어져야한다. Objectives: This study was performed to find the differences in physical activity according to general characteristics and factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. Methods: This study included 681 participants (221 rural, 460 urban) with hypertension from The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). The collected data were analyzed through an x²-test to examine the differences in physical activity and multiple logistic regression to assess factors related to physical activity between the elderly over 65 with hypertension living rural and urban areas. Results: The significant statistical factors related with physical activities for the urban hypertension group were education level, activities of daily living, and quality of life. However, the related factors for rural residents were activities of daily living and limitation of activity. Conclusions: The study results indicated that the factors that affected the level of physical activity revealed difference in case hypertension between the urban and rural groups. An awareness of the importance of physical activity will have a positive influence on improving the physical function and quality of life for elderly people with hypertension.

고혈압 유병 여부에 따른 금연의사에 영향을 미치는 요인

신재덕(Jae-Deok Shin),이석구(Sok-Goo Lee) 한국콘텐츠학회 2020 한국콘텐츠학회논문지 Vol.20 No.9

본 연구는 금연을 통한 혈압조절이 중요한 고혈압 환자군과 정상 혈압군을 대상으로 각각의 금연의사와 관련된 요인을 파악하고 비교하기 위한 이차자료 분석 연구이다. 2010년부터 2018년까지 1,981명(고혈압 환자군 407명, 정상 혈압군 1,574명)을 대상으로 분석하였다. 교차분석에서 유의한 변수에 대한 다변량 로지스틱 회귀분석을 실시한 결과 고혈압 환자에서의 유의한 변수는 결혼상태, 교육수준, 주관적 건강상태, 최근 1주일간 한번에 적어도 10분 이상 걸은 날수이었으며, 정상 혈압군에서는 흡연량으로 두 군에서 차이를 보였다. 흡연자의 고혈압 여부 등 대상자의 특성에 따른 맞춤형 관리와 금연교육을 통해 효과를 높일 필요가 있으며, 심뇌혈관질환 등 이차적 질환으로의 발생이 가능한 고혈압 환자군 우선의 집중 교육을 통해 금연의사를 높여야 할 것이다. The purpose of this study is to identify factors related to the intent of quit smoking in adult hypertension and normal group. Data are based on the National Health and Nutrition Survey from 2010 to 2018. The survey was performed on 1,981 male adults(Hypertension group 407, Normal group 1,574). In the hypertension group, single was 0.226 times lower in the will to intention to quit smoking than the group spouses. Also, high school graduation was 2.102 times higher than middle school graduation, and the worse the subjective health status was, the higher the intention was to quit smoking. It was also 5.427 times higher than when people did not walk if the day they walked for more than 10 minutes a day was one day of the week. The characteristics of hypertensive patients should be understood. In quit smoking education, it is necessary to recommend health exercises and proper exercise to patients. It should be used as the basis data for a quit smoking policy for efficient personalized management of hypertensive patients.