The Associations Between Socioeconomic Status, Caregivers’ Depressive Symptoms, Children’s Health- Promoting Behavior, and Children’s Physical Health: A Mediation Model

YOO JOAN PAEK,Grace Chung,이상균 한국사회복지학회 2015 Asian Social Work and Policy Review Vol.9 No.2

The aim of this study was to examine the mediating effects of children’s health-promoting behaviors on the association between socioeconomic status, caregivers’ depressive symptoms, and children’s physical health outcomes. We used the first wave of “Seoul Education and Health Welfare Panel.” Data were collected from 820 fourth-grade elementary and first-year middle school students and their caregivers using self-administered surveys. Structural equation modeling was employed to analyze the mediating effects of health-promoting behaviors. Bias-corrected bootstrap confidence intervals were used to test the mediating effect. The results showed that both low socioeconomic status and caregivers’ depressive symptoms were negatively associated with a child’s health-promoting behaviors. Children’s health-promoting behaviors were positively associated with physical health. However, children’s physical health was not significantly associated with socioeconomic status but was marginally associated with caregivers’ depressive symptoms. We found that children’s health-promoting behaviors significantly mediated associations between both socioeconomic status and children’s physical health and between caregivers’ depressive symptoms and children’s physical health. Based on the findings, we suggest the development and implementation of school-based, health-enhancement programs as a means to improve the general health of all children and to reduce health inequalities.

The Influence of Perceived Stress, Self-esteem, and Positive Future Orientation on the College Adjustment of North Korean Defectors in South Korean Universities:An exploratory examination of multiple mediating and moderating effects using a risk and resi

YOO JOAN PAEK 한국학교사회복지학회 2013 학교사회복지 Vol.- No.26

The aim of this study is to understand the effects of perceived stress, self-esteem, and positive future orientation on the college adjustment of North Korean defectors in South Korean universities, and to examine the mechanisms through which self-esteem and positive future orientation affects the association between stress and college adjustment from a risk and resilience perspective. Convenience sampling strategy was used to obtain a sample of 103 North Korean defectors who were enrolled in universities around the Seoul Metropolitan area. Self-administered survey questionnaires were utilized for data collection. Multivariate regression analyses and bootstrapping method were employed to examine the mediating and moderating effects of perceived stress, self-esteem, and positive future orientation on college adjustment. The analytic results indicate that perceived stress has a direct and indirect negative effect on college adjustment. Self-esteem, and positive future orientation are positively associated with college adjustment at the level of statistical significance. Significant indirect effects of stress on college adjustment through self-esteem and positive future orientation suggest that students with higher level of stress are not only at risk for poor college adjustment, but also more likely to have reduced level of self-esteem and more negative outlook on the future, which ultimately leads to poor college adjustment. No significant moderating effects between key independent and the dependent were found. Implications of the study findings are discussed.

The Impact of Poverty on Children’s Physical Health Trajectories

Joan P. Yoo(유조안),Kristen S. Slack,Jane L. Holl 한국사회복지학회 2011 한국사회복지학회 학술대회 자료집 Vol.2011 No.4

Impact of Childhood Socioeconomic Position on Self-Rated Health Trajectories of South Korean Adults

YOO JOAN PAEK,유민상 한국사회복지학회 2016 Asian Social Work and Policy Review Vol.10 No.1

The aim of this study was to examine the impact of childhood socioeconomic position (SEP) on adult health trajectory in South Korea. Seven waves of data from the Korea Welfare Panel Study (KOWEPS, 2007–2012; Korea Institute for Health and Social Affairs, 2014) were analyzed using latent growth curve analysis. Health condition was measured by self-assessment. The major independent variables were indicators of childhood and adult SEP. The findings suggest that those who perceive their childhood economic condition to be more affluent are more likely to assess their health to be better at the intercept. The insignificant effect of childhood economic condition on the slope and the quadratic term suggest that the initial gap remains over time. On the other hand, a disruption in education as a result of poverty was significantly associated with the intercept, slope, and quadratic term. The results suggest that although the large gap at wave 1 somewhat decreases, the gap in health remains because of the significant quadratic term. Childhood SEP has a a lasting effect on adult health trajectories, after controlling for adult SEP. Significant findings support policies and programs that are targeted to reduce socioeconomic disparities in childhood to enhance equality and public health

The Impact of Material Hardship on Children`s Physical Health Trajectories

Joan P. Yoo(유조안),Kristen S. Slack,Jane L. Holl 한국아동복지학회 2012 한국아동복지학 Vol.- No.37

본 연구는 미국에서 복지수급을 받고 있는 가정에서 자라나는 아이들의 빈곤 경험이 이들의 건강궤적에 미치는 영향에 대해 탐색적으로 분석하는 데 그 목적 이 있다. 최근 건강불평등에 대한 연구를 통해 빈곤이 개인의 건강에 장?단기적 으로 미치는 영향에 대한 관심이 증대되고 있으나, 아동기의 빈곤이 건강궤적에 미치는 영향에 대한 연구는 아직까지 탐색적인 수준에 머무르고 있다. 따라서 본 연구는 물질적 빈곤 경험이 저소득층 아동의 건강 궤적에 미치는 영향을 분석함 으로써 아동 건강불평등의 영향요인에 대한 이해를 증진시키고자 한다. 본 연구 에서는 1998년에 복지수급을 받고 있던 저소득층 가구들을 표본으로 2001년부터 2004년까지 총 4차년도의 패널데이터를 수집한 일리노이 가족 연구(Illinois Families Study)와 이 연구의 아동부가조사(Illinois Families Study-Child Well-being Supplement) 데이터를 활용하였다. 질병으로 인한 아동의 의료이용 횟수와 앓아누운 날 수를 주요 종속 변수로 활용하였으며, 데이터의 분석은 패널데이터의 특성을 고려하여 다층성장모형 분석방법을 이용하였다. 독립변수들을 투입하지 않은 무조건모형에 서는 의료이용 횟수와 앓아누운 날 수는 아이의 연령이 증가함에 따라 감소하는 것으로 나타났으며, 이는 전반적으로 아동의 건강상태가 계속 좋아지는 것으로 해석될 수 있다. 반면에 물질적 빈곤과 건강궤적의 관계에서는 물질적 빈곤을 많 이 경험할수록 저소득층 아동의 건강궤적에 부정적인 영향을 미치는 것으로 나 타났으며, 물질적 빈곤의 개별적인 종류가 저소득층 아동의 신체적 건강에 미치는 영향은 측정 지표에 따라 다르게 나타났다. 구체적으로 불안정한 주거와 아동 의 미충족 의료수준은 아동의 질병으로 인한 의료 이용궤적의 초기값과 유의미한 관계를 갖는 것으로 조사되었으며, 식품 미보장은 아동이 앓아누운 날 수로 측정된 건강궤적의 변화율과 통계적으로 유의미한 관계를 갖는 것으로 나타났다. 이러한 미국의 연구 결과는 한국에서 아동 건강 불평등에 대한 연구의 활성화 및 이를 극복하기 위한 정책적?실천적 방안 모색의 필요성에 대한 함의를 지닌다. The aim of this study is to understand the relationship between indicators of material hardship and the health trajectories of low-income children, and to explore how material hardship explains individual differences in low-income children`s health trajectories. The analyses for this paper are conducted using data from the Illinois Families Study (IFS) and the Illinois Families Study-Child Well-being Supplement (IFS-CWB). IFS is a five-year panel study that examined the well- being and adaptation of former and current welfare recipients and their families. Multilevel growth curve analysis is employed to examine the association. While the analytic findings suggest that the associations between material hardship variables vary by health outcomes, results show that generally children who experience economic hardships are more likely to show trajectories of health that led to worse health than their counterparts. Particularly, children`s unmet medical needs and housing insecurity were found to be associated with number of sick visits to health professional trajectory, while food hardship was found to be associated with number of days a child was sick in bed trajectory. Implications for the study findings are discussed.

Intravenous Patient-controlled Analgesia for Postoperative Pain Management in Patients with Cerebral Palsy

Won Joan Yoo(유원준),Chin Youb Chung(정진엽),In Ho Choi(최인호),Tae-Joon Cho(조태준),Joon O Lee(이준오),Hee-Soo Kim(김희수),Chong Sung Kim(김종성) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.5

목적: 뇌성마비 환자에서 fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법(intravenous patient-controlled analgesia) 의 수술 후 통증 조절에 대한 안전성과 효용성을 평가하고자 하였다. 대상 및 방법: 60명의 환자를 대상으로 수술의 복잡성에 따라 대 수술과 소 수술로 나누어 두 군으로 분류하였고 각 군을 수술 후 통증 조절 방법에 따라 fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법을 사용한 군과 pethidine정맥 주사를 사용한 군으로 세분하였다. 통증의 강도는 Wong-Baker’s faces pain scale에 따라 평가하였다. 결과: 대 수술군에서는 경정맥 자가 통증 치료법을 사용한 환자군에서 pethidine을 사용한 환자군보다 유의한 통증의 감소가 있었고 소 수술군에서는 경정맥 자가 통증 치료법을 사용한 환자군과 pethidine을 사용한 환자군 사이에 유의한 통증 감소 효과의 차이는 없었다. Fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법과 pethidine정맥 주사 요법에 따른 부작용은 큰 차이를 보이지 않았다. 결론: Fentanyl과 ketorolac을 이용한 경정맥 자가 통증 치료법은 뇌성마비 소아 환자에서 수술 후 중등도 이상의 통증 조절에 있어 안전하고 효과적이다. Purpose: The purpose of this study was to evaluate the safety and efficacy of intravenous patient-controlled analgesia (PCA) with fentanyl and ketorolac for postoperative pain management in patients with cerebral palsy. Materials and Methods: Sixty patients were categorized based on operation complexity into either a minor operation group or a major operation group, and then subdivided based on the analgesic methods used, i.e., intravenous PCA with fentanyl and ketorolac or intravenous pethidine injection. Pain intensity was assessed using the Wong-Baker's faces pain scale. Results: In the major operation group, patients that received PCA had significantly lower pain scores than those who received intravenous pethidine injection, while no significant differences in pain scores were observed in the minor operation group. Moreover, the side effects of these two analgesic methods did not differ significantly. Conclusion: Intravenous PCA with fentanyl and ketorolac is effective and safe for moderate to severe postoperative pain control in pediatric patients with cerebral palsy.

스트레스, 자존감, 그리고 미래지향성이 북한이탈주민 대학생의 학교적응에 미치는 영향에 관한 연구: 다중 매개 및 조절 효과에 대한 탐색적 분석을 중심으로

유조안 ( Joan P. Yoo ) 한국학교사회복지학회 2013 학교사회복지 Vol.- No.26

본 연구는 북한이탈주민 대학생의 학교 적응에 미치는 심리적인 위험요인과 보호요인들을 살펴보고자 하며, 특히 스트레스와 대학적응의 관계에 대한 자존감과 미래지향성의 매개 혹은 조절 효과를 탐색적으로 분석하는데 그 목적이 있다. 본 연구를 위해 103명의 북한이탈주민 대학생을 편의표집을 이용하여 표본을 추출하였으며, 사전조사를 통해 수정된 자기기입식 설문방식을 이용하여 데이터를 수집하였다. 다변량 회귀분석과 부트스트래핑 분석을 수행하여 매개모형과 조절모형을 검증하였다. 분석 결과, 스트레스는 북한이탈주민 대학생의 학교 적응에 부적인 영향을 미쳤으며, 자존감과 긍정적인 미래지향성은 정적인 영향을 미치는 것으로 나타났다. 아울러 스트레스는 북한이탈주민 대학생의 학교적응에 직접적인 영향을 미칠 뿐만 아니라, 자존감과 긍정적인 미래지향성을 통해 간접적인 영향을 미치는 것으로 확인되었다. 그러나 조절효과를 검증한 모형에서는 스트레스와 자존감 그리고 스트레스와 미래지향성의 상호작용 효과는 유의미 하지 않은 것으로 나타났다. 연구 결과를 토대로 북한이탈주민 대학생의 학교 적응에 미치는 요인으로서 스트레스, 자존감, 그리고 미래지향성이 갖는 함의에 대해 논의하였다. The aim of this study is to understand the effects of perceived stress, self-esteem, and positive future orientation on the college adjustment of North Korean defectors in South Korean universities, and to examine the mechanisms through which self-esteem and positive future orientation affects the association between stress and college adjustment from a risk and resilience perspective. Convenience sampling strategy was used to obtain a sample of 103 North Korean defectors who were enrolled in universities around the Seoul Metropolitan area. Self-administered survey questionnaires were utilized for data collection. Multivariate regression analyses and bootstrapping method were employed to examine the mediating and moderating effects of perceived stress, self-esteem, and positive future orientation on college adjustment. The analytic results indicate that perceived stress has a direct and indirect negative effect on college adjustment. Self-esteem, and positive future orientation are positively associated with college adjustment at the level of statistical significance. Significant indirect effects of stress on college adjustment through self-esteem and positive future orientation suggest that students with higher level of stress are not only at risk for poor college adjustment, but also more likely to have reduced level of self-esteem and more negative outlook on the future, which ultimately leads to poor college adjustment. No significant moderating effects between key independent and the dependent were found. Implications of the study findings are discussed.

잠재계층분석을 통한 아동의 건강증진행위 유형화와 영향요인 분석

유조안 ( Yoo Joan P. ),이상균 ( Lee Sang-gyun ),그레이스 정 ( Chung Grace H. ) 한국보건사회연구원 2015 保健社會硏究 Vol.35 No.2

본 연구는 아동 건강증진행위의 잠재계층유형을 확인하고, 이들 유형에 영향을 미치는 요인을 확인하였다. 연구참여 동의를 얻은 초등학교 4학년과 중학교 1학년 820명과 주양육자 820명에게서 수집한 서울교육복지건강패널 1차년도 자료를 분석하였다. 16개의 지표로 구성된 건강증진행위 결과를 바탕으로 잠재계층분석을 실시한 결과, 3개 잠재계층 유형을 확인하였다. 건강증진행위를 많이 수행하며, 건강위험행위의 실천정도가 낮은 `긍정적 건강증진행위군`, 건강위험행위의 실천가능성이 높은 `고위험건강행위군`, 기본적 운동량이 적고, 비활동적 좌식생활의 경험가능성이 높은 `비활동적 중위험 건강행위군`이 그것이다. 3개 잠재계층유형은 교차분석과 일원분석을 수행한 결과, 사회인구학적 특성과 심리사회적 요인에 따라 잠재계층유형간에 차이를 보였다. 또한 사회인구학적 요인과 심리 사회적 요인이 상호통제된 조건에서 건강증진행위 잠재계층을 예측하는 정도를 다항로짓 분석을 통해 확인하였다. 그 결과, 한부모·조손가구, 주양육자의 낮은 학력, 모의 근로활동 참여, 남자아동, 중학생, 방임경험, 낮은 자기효능감, 높은 우울 등의 특성을 가질 경우 고위험 건강행위군에 속할 가능성이 높았다. 반면, 초등학생, 높은 가족활동빈도, 높은 자기 효능감의 특성을 가질 경우 긍정적 건강행위군에 속할 가능성이 높았다. 이러한 분석결과에 기반하여 연구의 함의와 실천적 제언 및 후속연구과제를 제시하였다. This study used latent class analysis to identify heterogeneous subgroups with respect to health promoting behaviors among children. Multiple dimensions assessing physical activity, eating and sedentary behaviors were explored. This study used wave 1(2014) data from the Seoul Education and Health Welfare Panel(SEHWP), which consists of 820 matched pairs of mother and their school-aged children living in Seoul. The final model yielded three latent classes of health promoting behaviors: `positive health promoting behaviors`, `high-risk health behaviors`, and `sedentary lifestyle & middle-risk health behaviors`. We also examined associations between latent classes and predictors to determine how the patterns of health promoting behaviors relates to sociodemographic factors and psychosocial factors. Results indicated that low-income, single parent families, low maternal education level, maternal employment, children`s gender and age, neglect experience, self-efficacy, and depression significantly predicted to the above latent classes. The study suggested that there is a significant heterogeneity in the patterns of health promoting behaviors among children. Based on these findings, health promotion and intervention programs for children will need to consider this heterogeneity and enhance attention to health promoting predictors depending on the subpopulation.

The Effect of Infancy Childcare Center Use and Maternal Employment on Toddlers’ Language Development in South Korea

안재진,YOO JOAN PAEK 한국사회복지학회 2016 Asian Social Work and Policy Review Vol.10 No.1

Using first to fourth wave data of the Panel Study of Korean Children (PSKC), this study explores the effects of childcare center use, maternal employment, and other child and familial characteristics on the language development of toddlers in Korea. Among the 2078 families with children in the PSKC, those who completed the Receptive and Expressive Vocabulary Test at the fourth wave were selected, and a small number of disabled or prematurely born children were excluded. In addition, to clarify the effects of maternal employment, families with mothers who were either employed or unemployed for three consecutive years during the child’s infancy were selected. Regression analysis showed that neither childcare center use nor maternal employment during infancy had significant effects on toddlers’ expressive and receptive vocabulary at the fourth wave. Family characteristics, such as household poverty and maternal education level, as well as child characteristics, such as gender and birth order, had significant effects on expressed vocabulary. However, only children’s gender significantly affected the receptive vocabulary level of toddlers.

부모의 교육수준에 따른 자녀돌봄시간의 불평등 -돌봄시간 격차의 변화와 분해-

차은호,YOO JOAN PAEK 한국가족사회복지학회 2020 한국가족복지학 Vol.67 No.3

The two aims of this study are; to identify whether the gap in parental child care time based on parents’ education level has recently diverged, and to explore the background behind the change in the level of inequality in child care time. The study utilized the 2004 and 2014 Korean Time Use Survey to analyze the parental child care time of two-parent households raising preschool-aged children. Descriptive statistics, chi-square test, ANOVA, multivariable regression, Oaxaca-Blinder decomposition were conducted using data from 1,286 households in 2004 and 973 households in 2014. As a result, this study showed that the parental child care time gap of high- and low-educated households widened between 2004 and 2014. Also, it revealed that the differences between the high- and low-educated parents in the household characteristics and cultural orientation both explained the recently widening gap in child care time. Based on the results, this study urged that keen social awareness regarding the inequality in parental child care time is needed. Further, the study suggested ways to increase the amount of time the low-educated parents spend on child care, thereby alleviating educational inequality in child care time. 본 연구의 두 가지 목적은 부모의 교육수준에 따른 자녀돌봄시간의 격차가 과거에 비해 최근에 더욱 커졌는지를 확인하고, 자녀돌봄시간의 불평등 수준이 변화하게 된 배경을 탐색하는것이다. 이를 위해 통계청 생활시간조사 2004년, 2014년 자료를 이용해 미취학 자녀를 양육하는 양부모 가정의 자녀돌봄시간을 분석하였다. 기술통계분석, 카이자승검증, 분산분석, 다중회귀분석, Oaxaca-Blinder 분해분석을 실시하였으며, 분석에는 2004년 1,286가구와 2014년 973 가구의 시간일지가 활용되었다. 분석 결과, 2004에서 2014년 동안 고학력 가구와 저학력 가구간 미취학 자녀돌봄시간의 격차가 커졌음을 확인하였다. 그리고 최근 확대된 자녀돌봄시간의격차는 과거와는 달리 교육집단 간 가구특성의 차이와 문화적 지향의 차이로 함께 설명될 수있음을 밝혔다. 이러한 연구결과를 기반으로 자녀돌봄시간의 불평등에 대한 사회적 경각심을 촉구하였다. 그리고 저학력 부모의 자녀돌봄시간을 지원하기 위한 정책과 서비스를 제안하였다.