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지역사회 저소득층 노인의 연령주기별 주관적 건강지각 관련 요인
추진아,김은경 한국자료분석학회 2014 Journal of the Korean Data Analysis Society Vol.16 No.3
We aimed to identify self-rated health [SRH] levels and factors associated with SRH by age group among a community-dwelling elderly population. We conducted a cross-sectional study with 2,076 older participants registered in the S-Gu visiting health care program in Seoul. The participants were divided into three age groups: the young-old (n=1,103, 65-74 years), the old-old (n=754, 75-84 years), and the oldest-old (n=219, 85 years or greater) groups. SRH was categorized into poor vs. good groups. Sociodemographic, health-related, and environmental characteristics (i.e., residence type and living-alone status) were included in this analysis. The health-related characteristics were categorized into physical (the number of chronic diseases and fall experience), functional (activities of daily living [ADL] and instrumental ADL), and psychological domains (depression). With increased age, the elderly group reported their health as poor by 41.7%, specifically the young-old group by 39.9%, the old-old group by 42.6%, and the oldest group by 47.5%. Factors associated with poor SRH were identified differently by age group. Particularly, the number of chronic disease and ADL were strong factors associated with poor SRH among the oldest-old group. Age group-specific nursing strategies may be required for improving SRH levels of a community-dwelling, older population group. 본 연구는 저소득층 노인의 연령주기별 주관적 건강지각과 관련요인을 파악하기 위한 횡단적 상관관계 연구이다. 연구대상자는 S구 방문건강관리사업에 등록된 65세 이상 노인 2,076명을 연령주기별로 구분한 연소노인(65-74세, 1,103명), 고령노인(75-84세, 754명), 초 고령노인(85세 이상, 219명)이다. 주관적 건강지각 관련 요인은 인구사회학적 요인을 비롯하여 신체적 건강관련 요인(만성질환, 낙상경험), 기능적 건강관련 요인[일상생활수행능력(activities of daily living; ADL), 도구적 일상생활수행능력(instrumental activities of daily living; IADL)], 심리적 건강관련 요인(우울), 환경적 요인(주거형태, 독거여부)을 조사하였다. 자료 분석은 SPSS 15.0을 이용하여 서술통계와 카이제곱검정, 다중 로지스틱 분석을 하였다. 연구결과, 주관적 건강지각은 전체 노인의 41.7%가 불량이었고 연령주기별로 차이가 없어 연령이 증가할수록 좋아진다는 기존연구와 달리 저소득층 초 고령노인의 주관적 건강지각이 상대적으로 부정적이었다. 연령주기별 주관적 건강지각의 관련요인은 연소노인과 고령노인은 유사한 특성을 보이며 신체적, 기능적, 심리적 건강관련 요인으로 만성질환, 낙상경험, IADL, 우울뿐 아니라 환경적 요인으로 주거형태의 복합적인 영향을 받지만 초 고령노인은 신체적, 기능적 건강관련 요인인 만성질환과 ADL에만 영향을 받는 독특한 특성을 보였다. 특히 연소노인과 고령노인의 주관적 건강지각에는 IADL이 중요한 영향요인이지만 초 고령노인은 ADL이 중요한 영향요인이었다. 이상의 결과는 저소득층 초 고령노인에 대한 정보가 미비한 상태에서 초 고령노인의 주관적 건강지각의 영향요인에 대한 정보를 제공하는 의의가 있다고 하겠다.
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심근경색증 환자의 심장재활을 위한 TES 프로그램이 운동능력, 자기효능, 이행에 미치는 효과
추진아,김매자,홍경표 한국간호과학회 2003 Journal of Korean Academy of Nursing Vol.33 No.8
Purpose: This study aimed to develop a TES program to improve exercise capacity to promote patient compliance to the prescribed exercise, and to test the feasibility of the program. Method: The 8-week TES program consisted of three components : exercise training, self-efficacy enhancement and social support. Using the matching of gender, age, and the left ventricular ejection fraction, thirty one subjects were consecutively assigned to either TES group (n=15, 52+7 years) or Control group (n=16, 58+11 years) 3 weeks after MI. With the exception of exercise compliance (only after the TES program), the exercise capacity and exercise self-efficacy were both measured both before and after the 8-week TES program. Result: The VO2peak (p= .043), anaerobic threshold (p= .023) and exercise duration (p= .015) improved in TES group compared to Control group after 8 weeks. The cardiac exercise self-efficacy (p= .036) was significantly higher in TES group than Control group. There was a significant increase of exercise compliance(p= .005) in TES group compared to Control group. Conclusion: The 8-week TES program improved the exercise capacity, exercise self-efficacy and exercise compliance. A appropriately implemented TES program in cardiovascular nursing practice may promote healthy behavioral modification and, therefore, contributing to reduce the risk of mortality and morbidity in MI patients.
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추진아,Choo, Jin-A 한국가정간호학회 2008 가정간호학회지 Vol.15 No.2
Recent shortening of hospitalization has partly led to the transition of health care services from hospitals to communities in cardiovascular (CVD) care. Home healthcare nursing is an alternative modality of care for chronically ill CVD patients. Cardiac rehabilitation (CR) has been redefined as a "secondary prevention center", consisting of: patient assessment; nutritional counseling; blood pressure and diabetes management; tobacco cessation; psychosocial management; and physical activity counseling. Improvement in health-related quality of life (HRQOL) is a major goal of the CR that integrates physical, psychological and social dimensions of care. The review of evidence on effects of CR on HRQOL may allow home healthcare nurses to provide better comprehensive care for CVD patients. There is evidence on beneficial effects of CR on HRQOL in patients with myocardial infarction (MI) as well as patients with chronic heart failure. Specifically, home-based CR, which is more cost-effective than hospital-based CR, has been reported to produce comparable improvements in HRQOL with hospital-based CR in MI patients. In conclusion, a newly-designed, home-based CR may be required to be applied to Korean home healthcare nursing system for improving HRQOL.
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추진아,김은경 지역사회간호학회 2011 지역사회간호학회지 Vol.22 No.1
Purpose: The present study was to apply the Attitudes-Social influence-Efficacy (ASE) model in order to identify factors associated with the assertive behavior of non-smoking college students when they are exposed to secondhand smokes in Korea. Methods: Data were collected from non-smoking college students (N=1,656, 76.6% female) at two universities in Seoul and Gyeonggi-do. The main outcome measure was the assertive behavior. ASE factors such as attitudes toward being assertive, social influences, and self-efficacy as well as socio-demographic, health- related, and smoking-related factors were self-administrated. Results: The mean of the assertive behavior (range 1~5 points) was 2.23; 37.6% was not at all assertive, while 4.3% was always assertive. Higher assertiveness was significantly correlated with a higher level of positive attitude, social influence and self-efficacy (p<.05 for all). Stepwise multiple regression analyses showed that the social influence was the strongest factor associated with the assertive behavior (β=0.430, p<.001, R2=.246), followed by self-efficacy, motive to assertiveness, having any family member who had diseases, and male gender. These factors explained the assertive behavior by 39.7%. Conclusion: The ASE model may explain the assertive behavior of non-smoking college students under secondhand smoke exposure. Social influence and self-efficacy were significant factors associated with their assertive behavior.
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