장애인과 비장애인의 건강격차에 미치는 영향 요인 : 주관적 건강수준을 중심으로

최민혁,황인경,윤태호 한국자료분석학회 2018 Journal of the Korean Data Analysis Society Vol.20 No.2

The purposes of this study were to (a) examine disparity in perceived poor health status among people with and without disability, (b) compare the impact of factors, especially income level, on the perceived health status, and (c) determine the impact of disability status on perceived health by income level. The 2014 national survey for the people with disability and the 2013 Korea national health and nutrition examination survey were used to examine the impact of predictors on perceived poor health. logistic regression models were used to estimate the odds ratio of perceived poor health. Among people with disability, 53.7% reported poor self-rated health. People with disability were 3.76 times more likely to report perceived poor health status. The OR of perceived poor health among people with disability was higher in people with severe disability, including brain injury, renal failure, and physical disability. The impact of disability was greater in people with lower income levels. To improve the health status of persons with disability, policies are needed to reduce health disparities among socioeconomic levels. 본 연구는 장애인과 비장애인간의 건강수준에 미치는 요인을 파악하고 특히 장애요인(장애 유무, 정도, 유형)이 미치는 영향과 소득수준에 따른 장애요인의 영향을 살펴보고자 수행되었다. 이를 위해 2014년 장애인실태조사와 2013년 국민건강영양조사 원자료 11,566건을 활용하여 장애인과 비장애인의 주관적 불건강 수준을 산출하였으며, 가중치를 적용한 복합 자료를 위한 로지스틱 회귀분석을 활용하여 장애요인이 주관적 불건강에 미치는 영향을 살펴보았다. 더불어 소득수준에 따라 장애요인이 미치는 영향을 확인하였다. 장애인의 주관적 불건강 수준은 53.7%(95% CI 52.2-55.2%)로 비장애인 14.0%(95% CI 13.0-15.0%)보다 3.8배 높았다. 일반적 요인을 보정한 후 장애인이 비장애인에 비해 주관적으로 불건강할 가능성은 3.76배(OR=3.76) 높았으며, 특히 중증장애를 가진 경우 5.58배 높았다. 장애유형별 영향은 뇌병변장애를 가지고 있는 경우 가장 컸으며(OR=11.17), 다음으로 신장 장애(OR=6.27), 지체 장애(OR=3.63) 및 정신 장애(OR=3.60) 등의 순이었다. 소득수준별로 장애유무의 영향을 살펴보았을 때, 소득수준이 높은 집단에 속한 경우 보다 소득수준이 낮은 집단에 속한 경우에 영향이 더 컸다. 연구결과를 바탕으로 볼 때, 장애인의 사회경제적 수준을 높이는 정책이 필요하다.

장애노인의 장애수용이 주관적 건강상태와 삶의 만족도에 미치는 영향

고민석(Min-Seok, Ko) 한국보건복지학회 2015 보건과 복지 Vol.17 No.-

The purpose of this study is to analyze the relationships among disability acceptance, self-rated health status and life satisfaction of the elderly with disabilities. From the fifth panel survey of employment for the disabled, data for 516 elderly over age of 65were analyzed with SPSS 22.0 and the Sobel test. The results were as follows: First, there were significant differences in sex, age and causes of disabilities. Second, the mean scores of self-rated health status in aging with disability group were higher than those in disability with aging group. Third, disability acceptance of the elderly with disabilities had a positive influence on the self-rated health status and life satisfaction. Also, the self-rated health status had a mediating effect on the relationship between disability acceptance and life satisfaction in elderly with disabilities and aging with disability group. However, the self-rated health status that had a mediating effect was not statistically significant in disability with aging group. This study shows that it is important to provide an integrated health and welfare support program that coincides with a variety of social programs to elderly with disabilities. In addition, a differentiated service support program should be provided to disability with aging group.

장애인 건강 상태의 재구성: 이차적 건강 상태 경험에 관한 질병 내러티브 분석

문영민 한국보건사회연구원 2024 保健社會硏究 Vol.44 No.1

The primary focus of this study is ‘secondary health conditions’ among individuals with disabilities, characterized by their occurrence several years after the onset of the primary disability. While the conceptualization of these secondary health conditions acknowledges the significance of disability and the passage of time, the discourse predominantly addresses the association with impairment, omitting considerations of environmental constraints and subsequent personal and social changes post-illness. Consequently, the research aims to reconstruct the experiences of secondary health conditions within the illness narrative framework proposed by Bury (2001), drawing insights from the narratives of nine individuals with disabilities. First, the main cause of the secondary health conditions reconstructed by the participants was the stress of disability discrimination, and the timing of discovery and diagnosis was delayed due to the combination of each life history reason and the medical staff's incomprehension of disability. After the onset of secondary health conditions, the participants reconstructed and recovered their daily lives with public support and support from the disability network. In this process, participants developed an awareness that individuals’ health problems are a social concern and attempted to turn the changes they had experienced into social changes. The study concludes by suggesting that medical staff should actively listen to the narratives of patients with disabilities and implement targeted health education and health literacy initiatives for individuals with disabilities.

장애 유형별 의료서비스 이용의 차이

윤태호 ( Tae Ho Yoon ),정백근 ( Baek Geun Jeong ),강윤식 ( Yune Sik Kang ),이상이 ( Sang Yi Lee ),김철웅 ( Chul Woung Kim ) 한국보건행정학회 2007 보건행정학회지 Vol.17 No.2

The disabled population is a vulnerable group, having very complex medical conditions, but little is known about differences in the level of access by type of disability. This study was performed to investigate the differences of health care utilization by the type of disability. The database was constructed from registry of the disabled and health insurance and medical aid claims data submitted to the Korea Health Insurance Cooperation during in the year 2003. The disability classified three groups according to the Disabled Welfare Act; physically disability with external dysfunction, physically disability with organic disease, and mentally disability. There were huge differences in health care utilization by the type of disability. For the inpatient care, those with a mental disability were more likely to utilize health care services in terms of average visit number of medical facilities and visit days per case, but the treatment amount per case was the highest in physically disabled with organic disease. For the outpatient care, those who the physically disabled with organic disease were more likely to utilize health care services in terms of average visit number of medical facilities, treatment amount per case, and the treatment days per case. Also, those who physically disbled with organic disease were more likely to utilize general hospital for both inpatient and outpatient care, and spent more out-of-pocket expenditure. As the number of persons with disabilities rises, the need to consider new approaches to protecting their health grows increasingly. Especially, Korean health care system should be refined to be more responsive to the needs of the type of disability.

시각 장애인의 예방적 건강검진, 건강행태와 정신 건강에 대한 분석

심종우,한승한,Jong Woo Shim,Seung Han Han 대한안과학회 2012 대한안과학회지 Vol.53 No.12

Purpose: To better understand visual disabilities via preventative health examination, health behavior, and psychological health. Methods: The preventative health examination, health behavior, and psychological health records of 4,724 participants over the age of 40 who completed the third Korean National Health and Nutrition Examination Survey (KNHANES III) were analyzed. The participants were divided into 3 groups for analysis: subjects without disabilities, subjects with disabilities but without visual disabilities, and subjects with visual disabilities. The unadjusted mean and the adjusted mean for which socioeconomic factors were adjusted were calculated. Results: In the preventative health examination there were no differences between the 3 groups except for a statistically significant increase in the number of cholesterol check-ups in the visual disability group. In the health-related behavior analysis, lifetime smoking and routine physical activity were similar between the visual disability and no disability group, however, these factors were greater in the disability without visual disability group. The analysis of psychological health revealed that major depressive symptoms, suicidal ideation, suicidal attempts and psychological consultations were greater in the disability without visual disability and the visual disability groups compared to the participants without disability. However the overall number of psychological consultations was low. Conclusions: There was no difference in the frequency of preventative health examinations between each group. However, there was an increase in the prevalence of psychological problems in subjects with visual disabilities compared to subjects without disabilities and subjects with disabilities but without visual disabilities. Thus, ophthalmologists should consider psychological aspects when dealing with patients with visual disturbances.

Analysis of Health Promotion Behaviors according to Physical Activity Participation Patterns of Physically Handicapped People: Application and Supplementation of Health Belief Model

김현륜,백재근 사단법인 한국융합기술연구학회 2022 아시아태평양융합연구교류논문지 Vol.8 No.4

This paper analyzes the health promotion behavior model on the physical activity participation pattern of the physically disabled individuals. To achieve the research purpose, 1,579 people with physical disabilities from five districts (Seoul, Gyeonggi, Chungcheong, Jeolla, and Gyeongsang) were surveyed for 8 weeks from January to March 2021. First, the researcher and assistant researcher directly visited and conducted the athletic meet in order to collect data on the participants in the athletic meet for the physically disabled. Second, in cooperation with welfare centers for the disabled, the size of welfare centers for the disabled by region was identified, and research objectives and research data were collected. For the collected data, K-means cluster analysis, independent t-test, and structural equation model were applied using SPSS 23.0 and AMOS 23.0 programs, and the results are as follows. First, it was found that the full participation group was statistically significantly higher than the incomplete participation group in the participation period, participation frequency, and frequency of participation in the difference according to the cluster classification results according to the physical activity participation type of the physically disabled. Second, the difference in health beliefs according to the physical activity participation type of the physically disabled was statistically significantly higher in the full participation group than in the incomplete participation group in severity(p<.05). Third, in the difference in health promotion behavior according to the physical activity participation type of the physically disabled, the group that did not participate in the health promotion activity was found to be statistically significantly higher than the fully participated group(p<.05). Finally, the relationship between sensitivity and health promotion showed a positive (+)significant effect(p<.01), the relationship between sensitivity and health promotion activity(p<.001), and the relationship between severity and health promotion was significant(p<.001). was found to have an effect(p<.001). In addition, the relationship between benefit and health promotion was found to have a significant effect on benefit (+)(p<.001), benefit and internal/external factors(p<.001), and benefit and health promotion activity(p<.001). Also, the relationship between disability and internal/external factors was found to have a significant positive (+)effect(p<.01). Through the above results, it was possible to know the structural relationship between health beliefs and health promotion behaviors according to the physical activity participation type of the physically disabled.

보건소의 장애인 구강보건사업에 관한 연구

우승희 ( Seung Hee Woo ),김윤정 ( Youn Jung Kim ),곽정숙 ( Jung Suk Gkuk ) 한국치위생학회 2008 한국치위생학회지 Vol.8 No.3

Oral health projects that cater to the disabled should be more prevailing in order to ensure the maintenance and successful promotion of the oral health of disabled people. 70 public dental clinics that conducted oral health projects geared toward the disabled were examined to get a precise grip on their oral health projects. The findings of the study were as follows: 1. 31 out of 70 public dental clinics investigated(44.3%) were equipped with two or more dental hygienists who were professional human resources in charge of the oral health projects for the disabled. As for the age and disability type of the beneficiaries of the oral health projects, adolescents(74.3%) and people with mental retardation(87.1%) benefited most from the oral health projects. Concerning the most common implementation frequency of the projects, the projects were carried out once to three times a week(62.9%). 2. The most dominant oral disease treatment provided to disabled people was amalgam treatment and resin treatment(68.6%), which were the early dental caries treatment. The most common preventive treatment that was offered to improve their oral health was oral prophylaxis (82.9%). As for reform measures for the oral health projects, education of personnels in charge of the projects and their specialization(58.6%) were most emphasized. 3. Regarding factors related to the preventive oral health projects for the disabled, the implementation of oral prophylaxis and toothbrushing education was linked to the age of the beneficiaries. More oral prophylaxis was offered to teens, and more toothbrushing education was provided to preschoolers and adolescents. The age of the beneficiaries and the number of dental hygienists responsible for the projects had something to do with the application of fluorides.4. Concerning the relationship of the preventive oral health projects for the disabled to the number of dental hygienists, one of the personnels in charge of the projects, the application of fluorides(54.4%) and pit & fissure sealing(56.8%) were more prevalent when there were two or more dental hygienists. There was a statistically significant disparity in that regard(p<0.05). The above-mentioned findings illustrated that in order to boost the oral health of the disabled, dental hygienists who are responsible for the oral health projects for the disabled should put ceaseless efforts into fostering their professional knowledge and ability and offering quality service to disabled patients. Every public dental clinic should be equipped with plenty of professional personnels to enlarge the scope of treatment and ensure the efficiency of treatment and the preventive projects.

장애인 보호자의 구강보건인식 태도

정화영,김윤신,정미애 한국지체.중복.건강장애교육학회 2009 지체.중복.건강장애연구 Vol.52 No.2

The purpose of this study was to examine the oral health awareness of disabled people's guardians in an effort to help promote the oral health of the disabled, as those people were bound to rely on their guardians for oral health care due to their own poor oral health care skills. The subjects in this study were the guardians of students in Ohseong School and Cheonghae School that were respectively located in Gang- neung and Sokcho, Gangweon province. After a survey was conducted from October 6 to 20, 2008, the answer sheets from 255 respondents were gathered, and 214 answer sheets were analyzed with SPSS (Statistical Package for the Social Science) WIN 13.0 program except incomplete ones. Statistical data on frequency and percentage were obtained to find out their general characteristics, and x2(Chi-square) test and frequency analysis were utilized to check into the oral health awareness of the guardians, their use of dental treatment and the oral health care attitude of the disabled students. The findings of the study were as follows: 92.1 percent of the guardians investigated had an interest in the oral health of the disabled, and 52.8 percent considered them to be in a bad oral health. The majority that accounted for 93.5 percent had never received oral health education for the disabled. They were most interested in the dental caries treatment of the disabled and preferred a medical institution adjacent to their residences. They complained of expensive treatment fee(22.4%), and they also complained that some medical institutions rejected to treat disabled people because of prejudice against them. Since the oral health awareness of guardians who are closely linked to disabled people has a huge impact on the dental care of the disabled, disabled people and their guardians should continue to be motivated to wake up to the importance of oral health, and institutional measures should be taken to let them receive oral health education without any difficulties. And oral health education experts should be nurtured.

Do age, gender, and subjective health-related factors influence health-related life satisfaction in people with disabilities who are physically active?: a secondary analysis

조현석,안숙희 한국여성건강간호학회 2024 여성건강간호학회지 Vol.30 No.1

Purpose: This study explored the factors influencing the health-related life satisfaction of people with disabilities who engaged in physical activity, by age and gender.Methods: A secondary analysis was conducted of the 2020 Third Disability and Life Dynamics Panel (2021). The participants were 2,796 people who performed regular physical activity at least once a week. The variables selected were disability-related factors (degree of disability, multiple disabilities, and type of disability), sociodemographic factors (age, gender, living alone, and mean monthly family income), and health-related factors (amount of physical activity, self-esteem, depression, chronic disease, subjective health, and health-related life satisfaction). Descriptive statistics, the chi-square test, the t-test, two-way analysis of variance, and multiple regression analysis were conducted.Results: In total, 58.0% of participants were male, and 42.0% were female. For age groups, 14.4% were children/adolescents (0–19 years), 42.6% were adults (20–59 years), and 43.0% were seniors (≥60 years). The mean score for health-related life satisfaction was 5.0±2.15 out of 10. Adults and seniors whose level of physical activity met or exceeded recommendations had higher subjective health. Moreover, men had better subjective health than women in seniors. Health-related life satisfaction was higher among those who had higher self-esteem, were not depressed, did not have chronic diseases, and had better subjective health.Conclusion: Gender significantly influenced health-related life satisfaction in children/ adolescents and seniors. Disability-related factors were significant in adults, and health-related factors were significant in all age groups. Therefore, these factors should be considered when designing interventions to promote subjective health and health-related life satisfaction of people with disabilities.

장애인의 건강불평등(Health Inequality) 개념화를 위한 이론적 고찰

신유리(Shin, Yu-Ri),김정석(Kim, Cheong-Seok),조혜진(Cho, Hye-Jin),유동철(Yoo, Dong-Chul) 비판과 대안을 위한 사회복지학회 2017 비판사회정책 Vol.- No.56

최근 장애인복지에서 장애인의 건강권보장을 위한 구체적인 실현방안을 마련하는데 관심을 기울이고 있다. 이에 본 연구는 장애인의 건강불평등 개념이 어떻게 활용되고 있는지 관련 문헌고찰을 통해 그 개념을 정립하고자 한다. 먼저, 선행연구를 통해 장애인의 건강불평등의 양상을 파악하고자 비장애인과의 건강격차, 또 장애인집단 내부의 다양한 요인에 의한 차이를 살펴보았다. 다음으로 보건의료, 사회학, 노년학, 사회복지학 등의 타학문에서 건강불평등 용어가 사용되는 범위, 구성요소, 내용 등을 고찰하였다. 장애인의 건강불평등 개념의 명확한 속성을 파악하고자 Walker와 Avant(1995)의 개념분석 절차를 활용하였으며 그 결과, 이 개념의 네 가지 속성을 도출하였다. 도출된 속성은 ‘장애인의 건강에 대한 기본권리 박탈’, ‘장애인에 대한 지속적인 사회적 차별의 결과’, ‘불평등한 보건의료서비스 접근 및 이용의 산물’, ‘이차장애(secondary disability) 예방 및 관리지원 체계의 부재’, ‘개인적 사회적 결정요인으로 인한 집단 간이나 장애인집단 내의 건강상태의 차이’로 확인되었다. 이를 통해 장애인의 건강불평등이란 ‘장애인의 건강권의 박탈과 장애에 대한 지속적인 사회적 차별의 결과로 나타나는 불평등한 보건의료서비스 이용과 이차장애 예방 및 관리지원 체계의 부재 등의 결과로써 발생되는 집단 간이나 장애인집단 내의 건강격차’로 개념화된다. 이러한 연구결과는 장애인의 건강불평등 개념정립을 위한 탐색적 수준이지만 장애인의 건강불평등에 대한 기초지식과 개념을 정립하는 데 활용될 것이며, 나아가 이들의 건강권 확보를 위한 사회적 개입에 기초자료를 제공할 것이다. As the interests in guaranteeing health rights and supporting it’s solutions of the disabled are increasing, recently, researchers on conceptualization of health inequality of the disabled in the welfare of the disability positively are being implemented. This research is to be reestablishing concept of their health inequality how to applying it through literature reviews. Firstly, on examines the aspect of health differences between the Non-disabled and the disabled, difference within the same group of people with disabilities. Nextly, on considerate applied contents, elements, scope of health inequality terms in other learning such as Health Medical, Sociology, Gerontology, Social welfare. Besides, fore of a generic character of health inequality were deduced through the method of Walker and Avant theoretical procedure. Generic characters of this concept drew from this research is that there are ‘deprivation of the health right of people with disabilities’, ‘results of consistent social discrimination of people with the disability’, ‘products of inequality approach and using in heath service’, ‘nothing in prevention and management system of secondary disability’, ‘health disparity with both of non-disabled and the disables or in a group of people with disability contributed to individual and social factors. From this generic characters, The concept of health inequality of people with the disability can be confirmed that it’s health disparity with both of non-disabled and the disabled or in a group of the people with disability occurred from products of inequality approach and using in heath service and nothing in prevention and management system of secondary disability showed as results of which are deprivation of the health right of people with disabilities and the result of social discrimination of people with the disability. Even though this results are exploring level for conceptualizing health inequality, provider basic knowledges in conceptualizing it and fundamental resources in social intervention for assuring health rights.