황칠나무 잎 열수추출물의 Streptozotocin에 의해 유도된 당뇨 흰쥐에서의 항당뇨 효과

김민재 경상국립대학교 보건대학원 2021 국내석사

Dendropanax morbifera Lev. (D. morbifera) is a species of native tree that is widely distributed in the southern parts of Korea including Jeju island. Since ancient times, leaves, stems and roots of the plant have been used as folk remedies to treat dermal complications and other infectious diseases. The present study was conducted to investigate the diabetes treatment effect of the plant hot water extracts (DMWE) using streptozotocin-induced diabetes in rats. In this study, thirty male 5-week-old Sprague-Dawley rats were used. The rats were divided into six groups of five rats per treatment group and administered for 4 weeks. The treatment group were normal control rats received saline (NC), diabetic control rats received saline (DC), diabetic rats treated with 500 mg/kg body weight (BW) of metformin (DT), diabetic rats treated with 50 (DM-50), 100 (DM-100) and 200 mg/kg BW (DM-200) of DMWE. After 14 days of administration of DMWEs, the BW of all groups treated with DMWEs increased significantly compared to that of DC (P<0.05), however, the BW of DM-100 and DM-200 showed no significant difference compared to that of DT. Blood sugar levels in DT and DM-200 decreased below 200 mg/dL at 3 weeks after administration of DMWEs, and at 4 weeks after treatment, blood glucose levels in DT, DM-100 and DM-200 decreased within the normal range. At 4 weeks after treatment of DMWE, the glycated hemoglobin (HbA1c) concentrations in all groups administered with DMWEs showed no significant difference compared to those of NC and DT. The HbA1c concentrations of DM-100 and DM-200 showed significant reduction compared with that of DC (P<0.05). In blood biochemical parameters, the levels of AST, ALT and BUN in DM-100 and DM-200 showed no significant difference compared to those in NC and DT, however, significant differences compared to that of DC (P<0.05). From the above results, DMWEs have been identified to be effective in the treatment of diabetes.

뇌졸중 환자의 심리재활을 위한 치유예술프로그램의 효과

강경미 경상국립대학교 보건대학원 2024 국내석사

The purpose of this study was to develop a healing arts program for psychological rehabilitation of stroke patients and verify its effectiveness. The design of this study was a non-equivalent control group pre-post design. The subjects of the study were 39 stroke patients hospitalized in P hospital located in J city, G province, of which 20 were assigned to the experimental group and 20 to the control group. The content of the healing arts program for psychological rehabilitation of stroke patients developed in this study consists of horticultural therapy, art therapy, music therapy, and literary therapy, twice a week, 50 minutes a day, 8 times a total of 4 weeks, 400 minutes. It operated for minutes. The experimental group participated in a regular rehabilitation program 5 days a week, once a day in the morning and once in the afternoon, and additionally participated in a healing arts program twice a week, once in the afternoon. The control group participated in a regular rehabilitation program 5 days a week, once a day in the morning and once a day in the afternoon. The data for this study were collected from April 1, 2024 to May 5, 2024, and the collected data was analyzed using the SPSS/PC WIN 27.0 program for real numbers, percentages, averages and standard deviations, Shapiro-Wilk test, and Chi- Analysis was performed using square test, Fisher's exact test, independent t-test, paired t-test, and analysis of covariance (ANCOVA). The results of this study are as follows. 1) Hypothesis 1: ‘The experimental group that participated in the healing arts program will have lower depression than the control group that did not participate’ The experimental group's depression score decreased from 18.75±7.41 points beforehand to 10.25±6.70 points afterward, a statistically significant difference (t=-3.96, p<.001). The control group had 14.15±6.18 points beforehand to 15.10±8.25 points afterward, with no statistically significant difference (t=0.86, p=.399). There was a statistically significant difference between the post-depression scores of the experimental and control groups using the pre-depression scores as a covariate (F=9.24, p=.004). Therefore, hypothesis 1 was supported. 2) Hypothesis 2: ‘The experimental group that participated in the healing arts program will have higher self-esteem than the control group that did not participate.’ The experimental group's self-esteem score increased from 26.30±6.95 points beforehand to 35.60±9.60 points afterward, showing a statistically significant difference (t=3.73, p<.001). There was no significant difference in the control group from 31.60±7.22 points before to 31.73±8.93 points after the test (t=0.36, p=.723). There was a statistically significant difference between the post-test self-esteem scores of the experimental and control groups using the pre-test self-esteem scores as a covariate (F=6.25, p=.017). Therefore, Hypothesis 2 was supported. 3) Hypothesis 3: ‘The experimental group that participated in the healing arts program will have higher rehabilitation motivation than the control group that did not participate.’ The rehabilitation motivation score of the experimental group increased statistically significantly from 85.90±33.76 points before to 123.25±45.42 points after the test (t=4.19, p<.001). The control group also showed a statistically significant increase from 94.35±24.41 before to 100.26±24.38 after (t=2.41, p=.027). In order to verify the program effect, the difference between the experimental group and the control group was verified using the difference between the pre- and post-values. As a result, the difference in scores for the experimental group was 37.35±39.80 points, and for the control group, 8.21±14.81 points. The experimental group was statistically higher than the control group. It was significantly higher (t=-3.05, p=.005). Therefore, the third hypothesis was supported. 4) Program satisfaction: As a result of surveying the satisfaction of those who participated in the healing arts program, the program's usefulness, interest, effectiveness, intention to recommend the program, and intention to re-participate in the program were 5 out of 5, followed by leadership of the program operator. This was followed by 4.95 points, 4.89 points for the appropriateness of the progress method, 4.74 points for the appropriateness of the program period, and 4.63 points for the appropriateness of the program time. Other comments included that it would be nice if the duration and duration of the program were longer. Based on the results of this study, it was found that the healing arts program for psychological rehabilitation of stroke patients reduces depression and improves self-esteem and motivation for rehabilitation. Accordingly, it is proposed that the healing arts program be used for psychological rehabilitation of stroke patients. 본 연구의 목적은 뇌졸중 환자의 심리재활을 위해 치유예술프로그램을 개발하고, 그 효과를 검증하는 것으로, 연구설계는 비동등대조군 사전-사후 설계 이다. 연구대상은 G도 J시에 소재하고 있는 P병원에 입원 중인 뇌졸중 환자 39명이며, 그중 20명은 실험군에, 19명은 대조군에 배정하였다. 본 연구에서 개발한 뇌졸중 환자의 심리재활을 위한 치유예술프로그램의 내용은 원예요법, 미술요법, 음악요법, 문예요법으로 구성되었으며, 1주 2회, 1일 50분, 총 4주 8회, 400분 동안 운영하였다. 실험군은 정규 재활 프로그램을 1주 5일, 1일 오전 1회, 오후 1회 참여하였으며, 1주 2회 오후에 1회 치유예술프로그램에 추가로 참여하였다. 대조군은 정규 재활 프로그램을 1주 5일, 1일 오전 1회, 오후 1회 참여하였다. 본 연구의 자료는 2024년 4월 1일부터 2024년 5월 5일까지 수집하였으며 수집한 자료는 SPSS/PC WIN 27.0 프로그램을 이용하여 실수와 백분율, 평균과 표준편차, Shapiro-Wilk test, Chi-square test, Fisher’s exact test, independent t-test, paired t-test, 공분산분석(analysis of covariance, ANCOVA)으로 분석하였다. 본 연구의 결과는 다음과 같다. 1) 1 가설 : ‘치유예술프로그램에 참여한 실험군은 참여하지 않은 대조군보다 우울이 낮을 것이다’ 실험군의 우울점수는 사전 18.75±7.41점에서 사후 10.25±6.70점으로 감소하여 통계적으로 유의한 차이가 있었다(t=-3.96, p<.001). 대조군은 사전 14.15±6.18점에서 사후 15.10±8.25점으로 통계적으로 유의한 차이가 없었다(t=0.86, p=.399). 실험군과 대조군의 사전 우울 점수를 공변량으로 한 사후 우울 점수의 차이는 통계적으로 유의한 차이가 있었다(F=9.24, p=.004). 따라서 가설1은 지지되었다. 2) 2 가설 : ‘치유예술프로그램에 참여한 실험군은 참여하지 않은 대조군보다 자아존중감이 높을 것이다’ 실험군의 자아존중감 점수는 사전 26.30±6.95점에서 사후 35.60±9.60점으로 증가하여 통계적으로 유의한 차이가 있었다(t=3.73, p<.001). 대조군은 사전 31.60±7.22점에서 사후 31.73±8.93점으로 유의한 차이가 없었다(t=0.36, p=.723). 실험군과 대조군의 사전 자아존중감 점수를 공변량으로 한 사후 자아존중감 점수의 차이는 통계적으로 유의한 차이가 있었다(F=6.25, p=.017). 따라서 가설2는 지지되었다. 3) 3 가설 : ‘치유예술프로그램에 참여한 실험군은 참여하지 않은 대조군보다 재활동기가 높을 것이다’ 실험군의 재활동기 점수는 사전 85.90±33.76점에서 사후 123.25±45.42점으로 통계적으로 유의하게 증가하였다(t=4.19, p<.001). 대조군도 사전 94.35±24.41에서 사후 100.26±24.38점으로 통계적으로 유의하게 증가하였다(t=2.41, p=.027). 프로그램 효과를 검증하기 위해 사전 값과 사후 값의 차이 값을 이용하여 실험군과 대조군의 차이를 검증한 결과, 실험군의 점수 차이는 37.35±39.80점, 대조군은 8.21±14.81점으로 실험군이 대조군보다 통계적으로 유의하게 높았다(t=-3.05, p=.005). 따라서 제3가설은 지지되었다. 4) 프로그램 만족도 : 치유예술프로그램에 참여한 대상자들의 만족도를 조사한 결과, 프로그램의 유익성, 흥미성, 효과성, 프로그램 권유 의도, 프로그램 재참여 의도는 5점 만점에 5점이었으며, 다음은 프로그램 운영자의 지도력이 4.95점, 진행 방식의 적절성 4.89점, 프로그램 기간의 적절성 4.74점, 프로그램 시간의 적절성 4.63점 순으로 나타났다. 기타 의견에 프로그램의 기간과 시간이 더 길었으면 좋겠다는 의견이 있었다. 본 연구 결과를 근거로 뇌졸중환자의 심리재활을 위한 치유예술프로그램은 뇌졸중 환자의 우울을 감소시키고, 자아존중감과 재활동기를 향상시킴을 알 수 있었다. 이에 치유예술프로그램을 뇌졸중 환자의 심리재활에 활용할 것을 제안한다.

농촌 노인들의 신체활동 정보이해력 도구 개발

박진영 경상국립대학교 보건대학원 2024 국내석사

Objectives: Physical literacy, which encompasses the ability to engage in physical activities, confidence, knowledge, motivation, and other factors, plays a crucial role in positively influencing participation and maintenance of physical activities. This study aims to develop a questionnaire for assessing physical literacy among elderly in rural of South Korea. Methods: To develop the questionnaire, a literature review and interviews with rural elderly individuals were conducted. To evaluate the reliability and validity of the developed questionnaire, a snowball sampling method was used to recruit 260 elderly individuals aged 65 and above living in rural areas. The reliability was evaluated using cronbach’s alpha as the internal consistency reliability measure, while construct validity was assessed through exploratory factor analysis and criterion validity by conducting multiple logistic regression analysis. Results: The developed physical literacy questionnaire consisted of a total of 20 items. Exploratory factor analysis revealed four factors based on an eigenvalue of 1.0, which were named as motivation (7 items), physical competence (2 items), confidence (3 items), and knowledge and understanding (8 items). Analysis results showed that for each unit increase in scores in the motivation, the likelihood of engaging in physical activity increased by 2.143 (95% CI of OR, 1.393-3.296), while it increased by 1.455 (95% CI of OR, 1.172-1.808) in the physical competence, 1.406 (95% CI of OR, 1.058-1.868) in the confidence, and 1.485 (95% CI of OR, 1.089-2.025) in the knowledge and understanding. The cronbach's alpha for the overall internal consistency reliability of the questionnaire was 0.944. Conclusion: This study successfully developed a questionnaire for assessing physical literacy among rural elderly individuals and evaluated its validity and reliability. Measurement of physical literacy in the elderly can help identify their tendencies and abilities to maintain an active lifestyle in old age, and the tool can also be used as an evaluation instrument for programs aimed at promoting physical activity participation among the elderly.

농업인을 위한 농업 안전 건강정보이해력 도구 개발

이경예 경상국립대학교 보건대학원 2024 국내석사

Background: Health literacy in the workplace plays a crucial role in preventing work-related diseases and injuries. Health literacy refers to the complex ability to access health information, obtain necessary information, understand and assess its appropriateness, and use it for health management, disease prevention, and utilization of medical services. Agriculture is one of the most dangerous professions worldwide, necessitating new approaches to protect the safety and health of farmers. Objective: The objective of this study is to develop an instrument to measure Agricultural Safety Health Literacy(ASHL) based on the existing occupational health literacy tools and to validate the reliability and validity of the developed instrument. Methods: The development of the instrument involved preliminary item development, expert evaluation, and preliminary testing. As a result, a instrument with 22 items across five factors—access, understanding, appraise, apply, and attitude—was defined as the Agricultural Safety Health Literacy(ASHL) instrument. The survey was conducted on 245 farmers living in four cities and counties in Gyeongnam, and data collection was conducted from May 11 to May 31, 2024. Cronbach's α, a coefficient that measures the internal consistency of each item, was measured for reliability verification. Exploratory factor analysis and confirmatory factor analysis were performed to examine the construct validity, and predictive validity was evaluated using a paired t-test for changes in health literacy before and after education. Results: The overall Cronbach's α for the instrument was 0.92, indicating high reliability. The Cronbach's α for the subdomains were 0.75 for access, 0.82 for understanding, 0.83 for appraise, 0.77 for apply, and 0.88 for attitude, demonstrating good reliability. As a result of exploratory factor analysis, five factors were extracted and 64.4% of the total variance was explained. As a result of confirmatory factor analysis, the goodness-of-fit index was shown as GFI=0.851, AGFI=0.816, CFI=0.901, NFI=0.835, RMSEA=0.071, and χ²/df=2.2. The score change before and after the educational intervention was confirmed to have predictive validity with a significant increase in all areas(p<0.005). Conclusion: This study is significant in that it is the development of a instrument for understanding agricultural safety health literacy to evaluate the health and safety of farmers. The developed instrument will be used to improve the health behavior of farmers and to prevent and manage various health problems that may occur in the agricultural working environment.

노인여성의 대사증후군 위험요인, 나이, 좌식시간 간의 상관분석

박윤정 경상국립대학교 보건대학원 2024 국내석사

기혼직장여성의 우울 경험 빈도에 미치는 영향 요인 : 영과잉 음이항(Zero-Inflated Negative Binomial, ZINB) 회귀분석 모델을 이용하여

정세희 경상국립대학교 보건대학원 2024 국내석사

한국 소아청소년 암생존자의 학교복귀에 대한 통합적 문헌고찰

주은영 경상국립대학교 보건대학원 2024 국내석사

This integrative review aimed to examine status and difficulties about return to school of childhood and adolescent cancer survivors in Korea and to identify factors and services of successful return to school for them. This study was guided by the method of Whittemore and Knafl (2005) and eight databases were used including the Pubmed, Embase, KoreaMed, KISS, CINAHL, SCOPUS, DBpia, and RISS. Selected studies was nine published in Korean and English between 2005 and 2023. The reviewed studies included quantitative studies (n=4), qualitative studies (n=2) and mixed methods study (n=1). Among four quantitative studies, one study was a cross-sectional study. Childhood and adolescent cancer survivors had higher rates of grade repetition and dropping out of school compared with healthy peers. Also they had more problems about relationships with peers and teachers, academic performance, and emotional aspect. Based on the results, various services and supports should be provided to childhood and adolescent cancer survivors in order to help successful re-entry to school and adaptation.

일부 중소병원 행정직원의 코로나19 유행에 따른 이직의도와 영향요인 : 근무환경, 직무스트레스, 신체적 피로 및 직무만족을 중심으로

박진숙 경상국립대학교 보건대학원 2022 국내석사

Purpose: This study aims to provide primary data for improvement by identifying the working environment, job stress, physical fatigue, and job satisfaction levels for administrative staff working at medical institutions in the COVID-19 pandemic situation and examining factors affecting job turnover. Methods: In this study, six medical institutions designated as screening and relief hospitals with more than 100 beds and less than 300 beds in the J city area of ​​Gyeongnam Province, except for medical personnel (doctors and nurses) who directly participate in patient treatment, were hospital workers who were working as administrative personnel. Data were collected by using a questionnaire. During the collection period, from October 20, 2021, to October 23, 2021, all 140 copies were collected for 140 people. The collected data were analyzed using SPSS/WIN 23.0 program, and real number and percentage, mean and standard deviation, independent t-test, ANOVA, scheffe test, Pearson correlation coefficients, and hierarchical rarity analysis were used. Results: 1. In terms of demographic, job-related, and COVID-19 work-related characteristics of the participants, there were 111 women (79.3%), the average age was 35.06±10.33 years, 73 'unmarried' status (52.1%). As for the education level, 87 people (62.1%) had ‘college or less’, 65 people (46.4%) from the 'general affairs department', working experience averaged 8.83±9.39 years, and 116 people were 'employee/manager' in the job position. Seventy-seven people replied that the salary level was ‘normal’ (55.0%), 58 people were ‘dissatisfied’ (41.4%), 131 people were ‘regular workers’ (93.6%), and 74 people did not exercise regularly (52.9%). Regarding the health status of the workers compared to the pre-COVID-19 situation, 85 people replied that they were ‘healthy’ (60.7%), 76 people said ‘yes’ to have experienced turnover (54.3%), 69 people have had ‘no contact’ with suspected COVID-19 patients (49.3%) while 55 people have had '1-5 times' of experience (39.3%). Among all participants, 115 people (82.1%) said 'no' for the quarantine experience. Also, as a result of multiple response analyses for increased work after the outbreak of COVID-19, 112 people have gone through ‘Fever check’ (80.0%). 2. Looking at the participants’ working environment, job stress, physical fatigue, job satisfaction, and turnover intention, the average score of working environment was 3.16±0.50 out of 5, and 'institutional support' among the sub-factors was the lowest at 2.63±0.67. For job stress, the average score was 3.28±0.53 out of 5, and 'risk of infection' was the highest with 3.51±0.79 points. The average score for physical fatigue was 3.01±0.65 out of 5, and in particular, ‘difficulty due to new roles and demands’ scored 3.16±0.68 points, which corresponded to factors with high physical fatigue. The average scores of job satisfaction and turnover intention were 2.84±0.70 and 3.04±0.76 out of 5, respectivley. 3. As a result of examining the differences in the working environment, job stress, physical fatigue, job satisfaction, turnover intention according to the characteristics of the participants, it was found that if they were satisfied with the salary level, they perceived the working environment as good. However, those who categorized their salary level as 'normal' and 'dissatisfaction' were bound to have higher job stress, physical fatigue, and job satisfaction. Turnover intention differed according to which rank they belonged to; ‘employees and managers’ had higher turnover intention than ‘chief’ and ‘agent level or higher,’ while ‘discontent’ had higher turnover intention than ‘satisfaction’ and ‘normal’ in monthly salary level. 4. As a result of analyzing the correlation between the participants’ working environment, job stress, physical fatigue, job satisfaction, turnover intention, the turnover intention had a negative correlation with the working environment (r=-.63, p<.001) and job satisfaction (r=-.58, p<.001), and positive correlation with job stress (r= .30, p<.001) and physical fatigue (r= .49, p<.001). 5. As a result of hierarchical regression analysis to find out the effect of the subject's work environment, job stress, physical fatigue, and job satisfaction on turnover intention, the variable that had a significant effect on turnover intention was physical fatigue (ß=.31. p<.001), dissatisfaction with salary level (ß=.26, p<.001), working environment (ß=-.24, p=.003), job satisfaction (ß=-.23, p=.001) in order. In other words, the higher the physical fatigue, the higher the dissatisfaction with the salary level, the worse the working environment, and the lower the job satisfaction, the higher the turnover intention. The total explanatory power of these variables explaining turnover intention was 60.9% (F=22.46, p<.001, R2=.609, Adj-R2=.582). Conclusion: In this study, the factors affecting the turnover intention of the administrative staff of small and medium hospitals in the context of COVID-19 in this study were physical fatigue, satisfaction with salary level, working environment, and job satisfaction. The increased workload of hospital administrative staff concerning COVID-19 patients increases physical fatigue, which is expected to increase turnover intention. In addition, dissatisfaction with salary level, working environment, and the job was found to be a factor that increased turnover intention. Therefore, it is necessary to change administrative staff’s salary level and compensation system in small and medium-sized hospitals.

코로나19 발생 및 유행정도가 경남주민의 건강행태 및 우울감에 미치는 영향

서영미 경상국립대학교 보건대학원 2023 국내석사

Objectives: This study aims to investigate the influence factors by examining the relationship between the occurrence and prevalence of COVID-19 on the health behavior (smoking, drinking, physical activity) and depression of Gyeongnam residents using the natural test situation of COVID-19. Methods: This study was analyzed using raw data from the Gyeongsangnam-do Community Health Survey. A total of 35,880 people (17,942 people in 2019, 17,938 people in 2020) were used for the analysis, and all data were analyzed using SPSS 25.0. The effect of COVID-19 on the health behavior and depression of Gyeongnam-do residents was investigated by dividing it into Before and after COVID-19 outbreak and prevalence rates. General characteristics were investigated through descriptive statistical analysis, and changes in health behavior and depression in 2019-2020 were analyzed using t-test and χ² test. Multiple logistic regression analysis was used to investigate the correlation between changes in health behavior and depression and the occurrence of COVID-19 in Gyeongnam-do residents. In addition, through multilevel logistic regression analysis, regions with a high incidence rate and regions with a low incidence rate were classified to check whether there were differences in health behavior and depression between regions. All statistical significance levels were based on p<0.05. Results: Comparison results before and after the outbreak of COVID-19, The rate of smoking cessation attempts significantly decreased after the outbreak of COVID-19 compared to before the outbreak (p<0.001). The monthly drinking rate decreased after the outbreak of COVID-19 (p<0.001). However, the high-risk drinking rate increased after the outbreak of COVID-19 (p<0.001). The rate of walking practice increased after the outbreak of COVID-19 (p<0.001). As for the rate of experiencing depression, the rate of experiencing depression after the outbreak of COVID-19 increased (p<0.001). The prevalence of depressive symptoms also increased after the onset of COVID-19 (p=0.001). As a result of comparing regions by the difference in the incidence of COVID-19, the monthly drinking rate was higher in regions with a large number of confirmed cases than in regions with rare occurrences (p=0.017). As for the experience rate of depression, the rate of experiencing depression was higher in the area with a high incidence than the area with a rare occurrence (p<0.001), and the prevalence of depression was also higher in the area with a high incidence (p<0.001). Conclusion: This study shows that the occurrence of COVID-19 affects the health behavior and depression of residents in Gyeongnam, and there is a difference in health behavior and depression between regions according to the incidence of COVID-19.

특수학교 보건교사의 경험

김인영 경상국립대학교 보건대학원 2021 국내석사

Purpose : This study attempted to provide basic data for providing information on health care for disabled students and improving the quality of health care performance by exploring subjective experiences of health teachers in special schools. Methods : The subjects of this study were 11 people who have worked as health teachers at special schools for more than one year in the last three years. Individual in-depth interviews were conducted from December 2020 to January 2021, using semi-structured questionnaires in unstructured and open form for data collection. The collected data were analyzed using the content analysis method proposed by Elo & Kyngäs(2008). Result : The experience of health teachers at special schools were derived as 18 topical words, which were categorized into 6 themes through categorization work. 'Attachment after special school work', 'Health Care for Students with Disabilities in Need of Careful and Various Care', 'Pity for lack of legal basis', 'Ambivalence felt by taking care of students with disabilities', 'Health teachers competence needed to care for disabled students', and 'Unmet Needs for Health Care for Students with Disabilities'. Conclusion : As a result of this study, health teachers at special schools carry out various health care tasks. This includes providing, managing and consulting direct health care services related to the health care of disabled students, linking and supporting, and health education. In order to improve the quality of health care performance for student with disabilities, parents, school managers, and other faculty members should be involved along with teachers who actually perform the care. It is also believed that the government needs to listen to the needs of school workers and seek to find solutions to improve the difficulties associated with health care for disabled students.