일부 농촌지역 성인에서 EQ-5D를 이용한 건강관련 삶의 질

한미아,류소연,박종,강명근,박종구,김기순,Han, Mi-Ah,Ryu, So-Yeon,Park, Jong,Kang, Myung-Geun,Park, Jong-Ku,Kim, Ki-Soon 대한예방의학회 2008 예방의학회지 Vol.41 No.3

Objectives : The purposes of this study were to examine the health-related quality of life(HRQoL) and to identify its related factors for a group of rural adults. Methods : The study subjects were 1,901 adults who were aged 40-70 years and who were living in Naju City, Jeollanamdo. The sociodemographic characteristics, health-related behavior, health status and global self-rated health were collected for statistical analysis. The health-related quality of life was measured by the Euroqol EQ-5D instrument. The differences on the EQ-5D index between the groups were assessed with t-test, ANOVA and hierarchical multiple regression analysis. Results : Overall, the mean value of the EQ-5D index was $0.884{\pm}0.140$ and this score was significantly different according to the socioeconomic characteristics, the health-related behavior, the health status and the global self-rated health. According to the results from the hierarchical multiple regression analysis, the HRQoL was significantly reduced for females, older subjects, and other subjects with no spouse and the subjects with osteoporosis, obesity, mental distress or poorer global self-rated health. Conclusions : The HRQoL for rural adults was related to the socioeconomic characteristics, the health status and the global self-rated health, A better understanding of the factors related to the HRQoL would help to improve the rural adults' quality of life.

Intravesical gemcitabine for non-muscle invasive bladder cancer: An abridged Cochrane Review

한미아,Philipp Maisch,정재흥,황준을,Vikram Narayan,Anne Cleves,황의창,Philipp Dahm 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.6

Purpose: To assess the comparative effectiveness and toxicity of intravesical gemcitabine instillation for non-muscle invasive bladder cancer (NMIBC). Materials and Methods: We performed a comprehensive literature search on 11 September 2020. We included RCTs in which participants received intravesical gemcitabine for primary or recurrent NMIBC. Two review authors independently assessed the included studies and extracted data for the primary outcomes (time to recurrence, time to progression, grade III to V adverse events) and the secondary outcomes (time to death from bladder cancer, time to death from any cause, grade I or II adverse events, and disease-specific quality of life). We performed statistical analyses using a random-effects model and rated the certainty of the evidence using GRADE. Results: We found seven studies with 1,222 participants. Gemcitabine may reduce the risk of recurrence over time, but may have a similar effect on progression and grade III to V adverse events compared to saline. Gemcitabine may reduce recurrence and progression compared to mitomycin. We are uncertain about the effect of gemcitabine on the grade III to V adverse events compared to mitomycin. Gemcitabine may reduce recurrence and progression compared to giving BCG again in recurrent high-risk NMIBC after BCG treatment. Conclusions: Based on the findings of this review, gemcitabine may have a favorable impact on recurrence and progression-free survival than saline and mitomycin but we are uncertain about how major adverse events compare. The same is true when comparing gemcitabine to BCG in individuals with high-risk diseases who have previously failed BCG.

대사증후군과 알라닌 아미노전이효소와의 관련성 - 국민건강영양조사 제3기(2005년)

한미아(Mi Ah Han),류소연(So Yeon Ryu),박종(Jong Park),강명근(Myung Geun Kang),김기순(Ki Soon Kim) 한국역학회 2008 Epidemiology and Health Vol.30 No.1

  Purpose: The aim of this study was to investigate the association between the metabolic syndrome and alanine aminotransferase(SGPT) levels in Korean adults.   Methods: The study subjects were 4,325 adults aged ≥ 19 years without an apparent cause of liver disease from the Third Korea National Health and Nutrition Examination Survey(2005). The metabolic syndrome was defined using criteria established by the NCEP/ATP Ⅲ, while abdominal obesity was assessed based on the Asia-Pacific guidelines. Subjects with SGPT ≥ 40 IU/L were considered to have elevated SGPT levels. Demographic characteristics, waist circumference, blood pressure, triglyceride, HDL cholesterol, fasting blood sugar were recorded for statistical analysis.   Results: The prevalence of elevated SGPT levels was significantly increase with the presence of the metabolic syndrome and its components. In multiple logistic regression analyses, odds ratio for the elevated SGPT levels was significantly high in the subjects with the metabolic syndrome compared to the subjects without metabolic syndrome after adjusted for socio-demographic characteristics and health-related behavior.   Conclusions: The metabolic syndrome was independently associated with SGPT levels in Korean adults.

콩팥 손상 환자의 임상적 고찰

이창용,조원진,백승,임동훈,김철성,노준,한미아 조선대학교 의학연구원 2015 The Medical Journal of Chosun University Vol.40 No.4

Recently, renal traumas caused by traffic and industrial accidents have risen sharply due to rapid industrialization and an increase in automobiles. The evaluation of patients with suspected renal trauma relies mainly on clinical assessment, urinalysis and imaging studies. We retrospectively reviewed the medical records of 76 patients who presented to our hospital with renal trauma between January 2008 and December 2014. According to the review, A total of 76 patients presented to our hospital with suspected renal trauma. There were 61 male and 15 female between 2 and 83 years old. By cause, traffic accident was the most common cause of injury, accounting for 39 cases. The remaining injuries were caused by falls in 26 cases, assault in 8 cases and sports-related trauma in 3 cases. Surgical exploration was required in 18 patients for renal or associated injuries. We are of the opinion that close and prompt cooperation with other associated medical departments is mandatory in order to reduce morbidity and mortality caused by multiple injury. Accurate renal injury staging was essential to successful management of traumatized patients.

요부 안정화 운동이 어깨의 통증 및 관절 가동 범위에 미치는 영향

한소희,한미아,류소연,최성우 대한임상건강증진학회 2015 Korean Journal of Health Promotion Vol.15 No.1

Background: Lumbar stabilization exercise was used to improve spinal mobilization and stabilization. This research was conducted to investigate the effects of lumbar stabilization exercise programs on shoulder pain and range of motion among a group of elderly individuals. Methods: The study subjects were 28 elderly patients from C hospital, Gochang, Jeollabukdo. They were randomly divided into 3 groups: lumbar stability exercise group, passive upper arm exercise group, and conservative therapy group. The therapies were conducted for 4 weeks. Shoulder pain and range of motion were measured both before and after therapies. The homogeneity of study subjects was analyzed using the chi-square and Kruskal-Wallis tests. For the pre-/post-status comparison, the Wilcoxon’s signed-ranks tests and Kruskal-Wallis tests were conducted. Results: General characteristics including age, sex, and disease history of the 3 groups were comparable. After 4 weeks of exercise, shoulder pain was significantly reduced in the lumbar stability exercise group (6.4±2.9 vs. 3.6±3.1, P=.026) and range of motion was significantly increased in the same group. More specifically, right flexion (121.1±12.0° vs. 137.9±11.9°, P=.008), right abduction (96.6±21.8° vs. 129.7±50.7°, P=.008), and left abduction (92.0±21.8° vs. 110.3±21.2°, P=.038) increased significantly. Conclusions: Shoulder pain and range of motion improved significantly in the lumbar stability exercise group. Further study is needed to look into the longer effects of this exercise program using more subjects. 연구배경: 요부 안정화 운동은 요부근력, 하지 근력, 가동범위 등에 효과적이라고 알려져 있다. 본 연구에서는 노인들을 대상으로 요부 안정화 운동이 어깨 통증과 관절 가동 범위에 미치는 영향을 알아보고자 하였다. 방법: 전라북도 G군에 소재한 노인요양병원에 입원 중인 노인을 대상으로 실시하였다. 선정 기준에 적합한 28명의 노인들을 대상으로 보존적 치료를 병행한 요부 안정화 운동군(9명), 보존적 치료를 병행한 수동 상지 운동군(10명), 보존적 치료만 적용한 군(9명)에 무작위 배정하였다. 얼굴 통증 척도를 이용하여 안정 시와 움직임 시의 통증 정도를 측정하였으며, 측각기를 이용하여 상지의 굴곡과 외전의 관절 운동 범위를 측정하였다. 대상자의 동질성은 Chi-square test와 Kruskal-Wallis test로 분석하였고, 전후비교는 Wilcox signed rank test, 세 군 간 비교는 Kruskal-Wallis test로 분석하였다. 결과: 안정 시 통증점수는 요부 안정화 운동군에서 유의하게 감소하였고(6.4±2.9 vs. 3.6±3.1, P=.026), 관절 가동범위와 관련하여 우측 굴곡에서는 요부 안정화 운동군이유의하게 증가하였다(121.1±12.0° vs. 137.9±11.9°, P=.008). 우측 외전에서는 요부 안정화 운동군(96.6±21.8° vs. 129.7±50.7°, P=.008)과 수동 상지 운동군(77.5±18.5° vs. 95.1±19.1°,P=.028)이 유의하게 증가하였으며, 좌측 외전은 요부 안정화 운동군이 유의하게 증가하였다(92.0±21.8° vs. 110.3±21.2°,P=.038). 결론: 노인 환자의 통증과 관절 가동범위의 증가를 위해서 요부 안정화 운동이 효과적인 중재 방법으로 사료된다. 향후 연구에서는 더 많은 대상자를 대상으로 요부 안정화운동 프로그램의 장기적인 효과를 알아보는 연구와 노인들에게 요부 안정화 운동 프로그램을 다양하게 적용할 수있는 프로그램 개발이 필요할 것이라 판단된다.

요양병원 요양보호사의 노인 구강건강관리 수행도 관련요인

최세은,한미아,박종,류소연,Choi, Se-Eun,Han, Mi-Ah,Park, Jong,Ryu, So-Yeon 한국치위생학회 2017 한국치위생학회지 Vol.17 No.5

Objectives: Oral health management is important to improve the quality of life among the elderly. This study investigated the performance of elderly oral health management among some care workers in long-term-care hospitals. Methods: The study subjects were 174 care workers in 10 long-term-care hospitals. Data on general characteristics of care workers, attitude, recognition and knowledge of elderly health, performance of elderly oral health management were collected by a self-administered questionnaire. Data were analyzed through descriptive analysis, t-test, ANOVA, correlation and multiple regression analysis by using a SPSS version 23.0 statistical program. Results: The performance score of oral health management was $4.34{\pm}0.64$ on the 5-point Likert scale. The subjects who exercised more than 2 times a month were significantly higher in their performance of elderly oral health management compared to subjects who did not exercise (${\beta}=0.232$, p=0.035). And, the subjects who cared 10-19 persons were significantly higher in performance of elderly oral health management compared to subjects who cared more than 20 elderly (${\beta}=0.246$, p=0.020). The oral health behavior of care worker (${\beta}=0.271$, p<0.001) and the knowledge of oral health care (${\beta}=0.055$, p=0.008) were positively related to the performance of elderly oral health management. Conclusions: The educational program designed to improve knowledge of care workers in accordance with the standard textbook for training care workers should be developed, and the long term education program should be reinforced to improve the performance for elderly oral health care. If care workers can care a proper number of old persons, they will give oral health care to them.

국립공원 안전관리전담자들의 외상 후 스트레스 실태 및 관련요인

김형욱,한미아 한국응급구조학회 2016 한국응급구조학회지 Vol.20 No.2

119 구급대원의 직접의료지도 이용경험과 관련요인

주미현,한미아 한국화재소방학회 2016 한국화재소방학회논문지 Vol.30 No.3

직접의료지도란, 현장에서 환자에게 응급처치를 수행하거나 이송하는 구급대원이 의사에게 전문적인 지도와 자문을 제공받는 행위를 말한다. 본 연구는 직접의료지도의 이용 실태를 파악하고 관련요인을 조사하고자 실시되었다. 광주광역시에 근무하고 있는 119 구급대원 153명을 연구대상으로 하였고, 자기기입식 설문조사를 이용하여 자료를 수집하였다. 통계분석은 SAS version 9.3을 이용하였다. 연구대상자 중 약 82%가 최근 한 달 이내 직접의료지도 경험이 있었고, 다중로지스틱 회귀분석 결과 기혼자인 경우(OR = 3.87, 95% CI = 1.22~12.27), 1급 응급구조사인 경우(OR = 2.87, 95%CI = 1.02~8.09), 심혈관계 응급환자를 처치한 경우(OR = 9.19, 95% CI = 1.87~45.08)에 직접의료지도 이용에 대한 교차비가 유의하게 높았다. 따라서 향후 직접의료지도 내용과 제도 개선 시 119 구급대원의 특성과 처치하는 환자의 질병상태를 고려한다면 직접의료지도 활성화에 도움이 될 것이다. Medical oversight (MO) means the advice and direction provided by a physician to rescue workers who provide medicalcare or carry patients at the scene of an emergency. The purpose of this study was to investigate the utilization of MOand related factors among some 119 rescue workers in Gwangju. A self-reported questionnaire was completed by 153 rescueworkers in these 119 safety centers. The data were analyzed by SAS version 9.3. Overall 82.4% of the subjects utilizedMO during the past month. In the multiple logistic regression analysis, the married subjects (OR = 3.87, 95%CI = 1.22~12.27), level 1 emergency medical technicians (OR = 2.87, 95% CI = 1.02~8.09), and subjects who treated cardiovascularemergency patients (OR = 9.19, 95% CI = 1.87~45.08) had significantly higher odds ratios for the utilizationof MO. The experience of MO accounted for 82%. The development of strategies and education plans taking these resultsinto consideration will help to improve the utilization of MO.

119 구급대원의 직무관련 특성과 외상 후 스트레스가 직무만족도에 미치는 영향

최성수,한미아,박종,류소연,최성우,김해란 대한응급의학회 2015 대한응급의학회지 Vol.26 No.4

Purpose: The purpose of this study was to investigate the current status of post-traumatic stress (PTS), job satisfaction, and associated factors with job satisfaction among 119 rescue crews. Methods: The study subjects were 507 rescue crews who worked in G Metropolitan City and J province. General characteristics, job-related characteristics, PTS, and job satisfaction were collected by self-reported questionnaires via official e-mail. Job satisfaction by subjects' characteristics was tested using t-test, ANOVA, and multiple linear regression analysis. Results: Of 507 rescue crews, the overall PTS scores and job satisfaction score were 13.58±12.99 and 85.19± 13.37, respectively. In multiple linear regression analyses, job satisfaction scores were significantly lower in subjects with fair (β=-3.53, 95% CI=-5.89~-1.17) or poor (β=-7.69, 95% CI=-11.67~-3.71) self-rated health and with longer duration of career (β=-3.53, 95% CI=-6.62~-0.44). Regarding rescue field related characteristics, witness injury of co-workers (β=-3.02, 95% CI=-5.61~-0.44), obvious dead treatment (β=-3.60, 95% CI=-6.37~-0.83), and PTS (β=- 4.21, 95% CI=-7.56~-0.88) showed association with lower job satisfaction. Conclusion: Job satisfaction showed association with general characteristics, field related factors, and PTS. Risk reduction of rescue field and management of PTS will help to increase the job satisfaction of 119 rescue crews.

남녀 대학생의 인유두종 바이러스 백신접종 및 의도 관련 요인

이승연,한미아,박종,류소연 대한임상건강증진학회 2015 Korean Journal of Health Promotion Vol.15 No.3

Background: Human papillomavirus (HPV) is the most common viral infection of the reproductive tract and can cause cervical cancers. The purpose of this study was to investigate HPV vaccination status and related factors among male and female college students. Methods: The study subjects were 489 students conveniently sampled from Seoyeong University located in Gwangju. General characteristics, HPV vaccination status and knowledge of cervical cancer and HPV infection were collected by self- administered questionnaires between August 25 and September 19. The collected data were analyzed by chi-square tests, t-tests and multiple logistic regression analyses. Results: Of 328 female students, 22.9% were vaccinated. But none of the male students (n=161) were vaccinated. Vaccination intention of male and female students were 18.6% and 55.5%, respectively. In multiple logistic regression analysis, adjusted odds ratio (aOR) for HPV vaccination were significantly high in female subjects with high allowance (aOR=2.23, 95% confidence interval [CI]=1.13-4.42) or high knowledge score of cervical cancer (OR=1.10, 95% CI=1.02-1.16). Intention of HPV vaccination were associated with participation in school clubs, chronic disease and knowledge score of cervical cancer in male students. In female students, school record, family history, self-rated health and knowledge score of cervical cancer were associated with intention of vaccination. Conclusions: HPV vaccination rate was found to be low. Prevention efforts considering these results might be helpful in increasing HPV vaccination rate and reducing HPV-associated health risks. 연구배경: 인유두종 바이러스는 가장 흔한 생식기 감염으로, 여성에서 자궁경부암의 원인이다. 본 연구는 광주지역 일부 대학생들을 대상으로 인유두종 바이러스 백신접종 실태와 관련 요인을 파악하고자 하였다. 방법: 광주광역시에 위치한 1개 대학교 학생들을 대상으로 자기기입식 설문 조사를 통해 일반적 특성, 인유두종바이러스 백신접종 여부 및 의도를 수집하였고 카이제곱, t검정, 다중로지스틱 회귀 분석을 통해 접종 및 의도와 관련된 요인을 파악하였다. 결과: 대상자는 총 489명, 평균 연령 남자는 20.7±2.0세, 여자는 20.1±2.3세였다. 인유두종 바이러스 접종현황에서남자는 한 명도 접종을 하지 않았고, 여자는 75명(22.9%) 이 예방접종을 받았다고 응하였다. 여학생에서 한 달 용돈이 20만 원 이하인 군에 비해 21-40만원인 경우(OR=2.23, 95% CI=1.13-4.42), 자궁경부암과 인유두종 바이러스 지식이 높을수록(OR=1.06, 95% CI=1.01-1.12) 인유두종 바이러스 백신접종 가능성이 높았다. 인유두종 바이러스 백신접종 의도가 있는 경우 남자 30명(18.6%), 여자 141명(55.5%) 이었다. 백신 접종의도는 남자에서는 동아리 활동을 하는경우, 만성질병이 있는 경우, 자궁경부암과 인유두종 바이러스 지식 점수가 높을 경우 의도가 높았고, 여자에서는 학업성적이 상위권인 경우, 자궁과 유방질환의 가족력이 있는 경우, 주관적 건강상태가 나쁜 경우, 자궁경부암과 인유두종 바이러스 지식 점수가 높을수록 백신접종 의도가 높았다. 결론: 본 연구에서 남녀 대학생들은 인유두종 바이러스백신 접종률은 전체적으로 낮았다. 향후 남녀 모두에서 인유두종 바이러스 백신 및 인지도를 향상시킬 수 있는 방안이 필요할 것으로 판단되며, 본 연구에서 밝힌 접종이나접종 의도 관련요인을 고려한다면 인유두종 바이러스 백신 접종률을 높일 수 있으리라 판단된다.