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.

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.

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.

담뱃값 인상에 따른 고혈압 환자의 흡연감소 및 관련요인

주미현 ( Mi Hyun Joo ),한미아 ( Mi Ah Han ),박종 ( Jong Park ),최성우 ( Seong Woo Choi ),류소연 ( So Yeon Ryu ),신준호 ( Jun Ho Shin ) 한국보건정보통계학회(구 한국보건통계학회) 2019 보건정보통계학회지 Vol.44 No.1

Objectives: The price of tobacco is an important factor affecting the smoking behavior. The Korean government raised the price of tobacco by 80% from 2,500 won to 4,500 won in 2015. This study investigated the change of smoking behavior after the price raise of tobacco in hypertension patients. Methods: The analysis used the data from the third year of the National Health and Nutrition Examination Survey (2015), which examined the changes in smoking habits after cigarette price hikes. Of the adults aged 19 years and older, 958 were currently smokers and 79 of the former smokers who quit smoking less than one year, excluding those who quit smoking before the cigarette price increase, total 1,037. In 193 hypertensive patients, 193 non-hypertensive patients were selected by 1:1 age group, and a total of 386 patients were analyzed. Data were analyzed using SAS 9.3 statistical program and chi-square and multiple logistic regression analysis. Results: The smoking reduction rate was 46.6% in the hypertensive group and 44.6% in the non-hypertensive group. There was no significant difference between the two groups (p=0.683). Multivariate logistic regression analysis showed that factors affecting smoking cessation in hypertensive group were stress level, smoking prevention and smoking cessation education. In the hypertensive group, the odds ratio was 3.16 (95% CI, 1.39-7.18) in the normal range, If you receive less than the no-smoking education, the statistical significance is 4.17 (95% CI, 1.15-15.12). Conclusions: In the future, there will be a variety of measures such as the government’s continuous cigarette price increase policy, active support for stress management in hypertensive patients, and the introduction of practical policies through socio-economic approaches would be effective in reducing smoking rates in hypertensive patients.

농촌지역 주민의 공복혈당장애와 관련요인

윤혜은,한미아,강명근,박종,김기순,류소연,Yun, Hye-Eun,Han, Mi-Ah,Kim, Ki-Soon,Park, Jong,Kang, Myeng-Guen,Ryu, So-Yeon 대한예방의학회 2010 Journal of Preventive Medicine and Public Health Vol.43 No.4

Objective: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. Methods: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. Results: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). Conclusions: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.

의료기관 종사자가 인지한 병원코디네이터의 업무수행도와 종사자의 직무만족도와의 관련성

서은경,한미아,박종,류소연,최성우,김해란,Seo, Eun Kyung,Han, Mi Ah,Park, Jong,Ryu, So Yeon,Choi, Seong Woo,Kim, Hae-Ran 한국산업보건학회 2017 한국산업보건학회지 Vol.27 No.3

Objectives: This study was conducted to investigate general characteristics, job characteristics, characteristics of hospitals, and hospital coordinators, and to investigate the factors affecting the job satisfaction of medical workers. Methods: The data was collected through a self-reported questionnaire among 435 workers in plastic surgery and dermatology clinics in metropolitan city G. We investigated general characteristics, job-related characteristics, characteristics of medical institutions and hospital coordinators, job performance of hospital coordinators, and job satisfaction of medical workers. T-tests, ANOVA, correlation, and multiple regression analyses were conducted to investigate the factors related with job satisfaction. Results: The job satisfaction of the medical workers and the perceived job performance of hospital coordinators were $3.55{\pm}0.40$ and $3.74{\pm}0.43$, respectively. In multiple regression analysis, drinking frequency, number of night shifts, number of work days, and hospital coordinator introduction years were associated with the job satisfaction of medical workers. The more the overall job performance of hospital coordinators increased, the higher was job satisfaction(B=0.458, p<0.001). In detail, the more job roles(B=0.218, p<0.001), core competency(B=0.145, p=0.005), and leadership(B=0.099, p=0.037) increased, the higher was the job satisfaction of medical workers. Conclusions: The job satisfaction of the medical institution workers was associated with the perceived job performance of the hospital coordinator. In order to increase the job satisfaction of medical institution workers, a hospital coordinator with specialized job performance will be able to improve job satisfaction by carrying out efficient work in the medical institution.

건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성

김한수(Han-soo Kim),류소연(So Yeon Ryu),박종(Jong Park),한미아(Mi-Ah Han),최성우(Seong-Woo Choi),신민호(Min-Ho Shin) 한국농촌의학 지역보건학회 2018 농촌의학·지역보건 Vol.43 No.1

본 연구는 농촌 지역에 거주하며 당뇨병이 없는 건강한 성인을 대상으로 혈청 비타민 D와 인슐린 저항성 및 췌장의 베타세포 기능과의 관련성을 확인하기 위하여 시행되었다. 연구대상은 전라남도 해남군에 소재한 종합병원 건강검진실에서 건강검진을 받은 당뇨병이 없는 20세 이상 성인 374명이었고, 분산분석과 공분산분석을 이용하여 혈청비타민 D 수준에 따라 HOMA-IR과 HOMA-β을 비교하였다. 분석결과, 연구대상 중 비타민 D 결핍군, 불충분군, 충분군은 각각 38.5%, 48.1%, 13.4%이었다. 비타민 D 수준에 따른 HOMA-IR 평균은 충분군 1.92±1.08, 불충분군 1.99±1.04, 결핍군 2.91±1.05로 통계적으로 유의한 차이가 있었으며, 다른 관련변수를 통제한 상태에서 비교한 공분산 분석 결과에서도 비타민 D 수준에 따른 HOMA-IR은 통계적으로 유의한 차이가 있었다. 비타민 D 수준에 따른 HOMA-β 평균은 충분군 84.69±1.07, 불충분군 78.41±1.04, 결핍군 80.48±1.04이었고, 통계적으로 유의한 차이가 없었다. 결론적으로 우리나라 농촌지역 성인의 혈청 비타민 D 수준은 부족한 경우가 매우 높았고, 비타민 D수준에 따른 인슐린 저항성은 관련이 있음을 알 수 있었다. 인슐린 저항성 및 당뇨병 예방을 위해서 비타민 D의 충분한 형성을 위한 보충제, 햇볕노출과 영양 섭취 등에 대한 충분한 정보 및 교육이 필요할 것으로 생각된다. Objectives: This study was conducted to examine the association of serum Vitamin D with insulin resistance and β-cell function in Korean health checkup examinees. Methods: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and HOMA-β, the used statistical analysis were ANOVA and ANCOVA. Results: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were 1.92±1.08 in sufficient group, 1.99±1.04 in the insufficient group and 2.91±1.05 in deficient group and there were statistically significant different(p<0.001). The mean values of HOMA-β were 84.69±1.07 in sufficient group, 78.41±1.04 in the insufficient group and 80.48±1.04 in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of HOMA-β were not statistically significant according to the level of serum Vitamin D. Conclusion: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.

중환자실 간호사의 인공호흡기관련 폐렴 예방을 위한 감염관리 수행도 및 관련 요인

이현화 ( Hyeon Hwa Lee ),한미아 ( Mi Ah Han ),박종 ( Jong Park ),최성우 ( Seong Woo Choi ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.1

Objectives: Ventilator-associated pneumonia (VAP) is the most common form of nosocomial infections in intensive care units. The purpose of this study was to measure infection control knowledge and practice for VAP, and investigate the factors associated with them among staff nurses in intensive care units. Methods: The 232 staff nurses working in three university hospitals were surveyed by closed ended questionnaires using scoring system about infection control knowledge, practice for VAP and general characteristics. Practice scores for VAP were compared in groups of nurse. The factors associated to practice for VAP were analyzed with multiple linear regression using a SPSS version 16.0 statistical program. Results: The score of knowledge and performance of infection control were 4.85±1.18 and 1.82±0.13, respectively. In multiple regression analysis, the level of performance of infection control was significantly higher in nurses who cared for less than 3 patients compared to nurses who cared for more than 4 patients (β=0.04, p=0.067). And nurses with experience of education for the VAP prevention within 2 years had higher performance for the VAP prevention (β=0.05, p=0.009). The level of knowledge was higher, performance of infection control better. Conclusions: Performance for the VAP prevention was associated with the number of patients in charge, experience of education and the level of knowledge for the VAP prevention. So the level of performance of the VAP prevention will be improved by the reasonable nurse-to-patient ratio in intensive care unit and supplying of education and increasing of the level of knowledge for the VAP prevention.

비당뇨병 환자와의 비교를 통한 우리나라 당뇨병 환자의 삶의 질

신환호(Hwan Ho Shin),한미아(Mi Ah Han),박종(Jong Park),류소연(So Yeon Ryu),최성우(Seong Woo Choi),박선미(Seon Mi Park),김효주(Hyo Ju Kim) 한국농촌의학 지역보건학회 2015 농촌의학·지역보건 Vol.40 No.1

본 연구는 우리나라 성인 당뇨병환자의 삶의 질을 평가하고, 당뇨병이 다른 만성질환이나 정상 건강인에 비해 삶의 질이 얼마나 다른지 알아보고, 이에 영향을 미치는 요인들을 분석하고자 하였다. 연구의 대상자는 제5기(2010-2012) 국민건강영양조사 자료 중 건강 설문조사와 검진조사에 모두 응답한 자로서 분석 변수에 결측치가 없는 만 19세 이상 성인 17,655명으로 하였다. 만성질환군 및 정상 건강군에 비해 당뇨병환자에서 삶의 질의 모든 하부영역에 ‘문제 있다’라고 응답한 분율이 더 높았다. 당뇨병환자에서 삶의 질의 하부 영역 중 운동능력(36.4%)에 문제가 있다고 한 사람이 가장 많았으며, 그 다음으로 통증/불편감(35.4%)이었다. 당뇨병환자와 만성질환군 및 정상 건강군간 삶의 질의 5가지 하부 영역을 비교하기 위해 다중로지스틱회귀분석을 이용하여 당뇨병환자를 기준으로 ‘문제 있음’에 대한 교차비와 신뢰구간을 계산한 결과 운동능력은 당뇨병환자에 비해 만성질환군의 OR(95%CI)값이 0.77(0.66-0.91), 정상 건강군이 0.61(0.50-0.75)이었고, 자기관리는 0.68(0.55-0.83), 0.69(0.51-0.94)이었고, 일상활동은 0.85(0.72-0.99), 0.79(0.62-0.98)로 당뇨병환자에 비해 만성질환군과 정상 건강군이 운동능력, 자기관리, 일상활동에 문제가 있을 가능성이 낮았다. 당뇨병환자의 질적인 삶을 영위하기 위해서는 삶의 질과 관련된 다양한 변인 연구들이 꾸준히 이루어져야 할 것이며, 삶의 질에 영향을 미치는 사회 인구학적, 건강관련 특성을 반영한 다양한 건강프로그램이나 복지정책을 개발, 발전하여 지속적으로 관리해야 한다고 사료된다. Objective: This study was to evaluate the health-related quality of life (HRQoL) among patients with diabetes in Korea and to compare them with the HRQoL of individuals without diabetes history. Methods: The study subjects were 17,655 adults aged over 19 who participated in the 5th Korea National Health and Nutrition Examination Survey (2010-2012). The EuroQoL-5Dimension was used to evaluate HRQoL. Chi-square test, t-test, ANOVA and multiple regression analysis were performed to test the difference of HRQoL in diabetic subjects and controls. Results: The mobility dimension was the highest reported problem: 36.4% for diabetic subjects. The proportion of any reported problem was significantly high among diabetic subjects compared with two controls in terms of mobility [reference group: diabetic subjects, chronic controls: adjusted odds ratio (aOR)=0.77, 95% confidence interval (95% CI)=0.66-0.91, healthy controls: aOR=0.61, 95% CI=0.50-0.75], self-care [reference group: diabetic subjects, chronic controls: aOR=0.68, 95% CI=0.55-0.83, healthy controls: OR=0.69, 95% CI=0.51-0.94]. and usual activities [reference group: diabetic subjects, chronic controls: aOR=0.85, 95% CI=0.72-0.99, healthy controls: OR=0.79, 95% CI=0.62-0.98]. Also, EQ-5D index were significantly low in subjects with diabetes compared to two controls. Conclusions: Subjects with diabetes had a significantly lower HRQoL compared with two controls. To improve the quality of life of diabetics, it is necessary to study various variables related to the quality of life, and develop and manage various health programs or welfare policies reflecting socio-demographic characteristics and health related features that affect the quality of life.

농촌 지역 주민의 혈청 Ferritin 수준과 대사증후군과의 관련성

류소연,김기순,박종,강명근,한미아,Ryu, So-Yeon,Kim, Ki-Soon,Park, Jong,Kang, Myeng-Guen,Han, Mi-Ah 대한예방의학회 2008 예방의학회지 Vol.41 No.2

Objectives : The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). Methods : We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings : elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. Results : The MS was more common in those persons , with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. Conclusions : Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.