본 연구는 유방암 환자의 진단 및 치료 지연에 영향을 미치는 요인을 확인하고 진단 및 치료 지연의 장애 요인을 파악하여 향후 암 예방 및 개입 방안에 새로운 틀을 제시하는데 목적이 있다. 이를 위해 본 연구는 유방암 환자의 진단 및 치료 지연에 현황 및 원인을 분석하고 인구사회학적, 의학적 요인, 유방암 진단 및 치료 지연 인식 여부, 그리고 사회적 지지체계 등이 진단 및 치료 지연에 얼마나 영향을 미치는지 조사하였다. 연구대상은 287명의 성인 여성으로, 서울 · 경기 지역의 8곳, 지방 1곳의 종합병원을 택하여 설문조사를 통해 수집되었다. 분석 결과, 환자들이 유방 이상 징후를 경험한 이후 유방암 진단을 받기까지의 평균 기간은 약 2.8개월(SD: 8.4), 유방암 진단을 받은 후 치료 기간까지 걸린 평균 기간은 약 2.4개월(SD: 9.7)로, 진단 및 치료지연 모두 경제적인 문제를 가지고 있는 환자들이 상대적으로 오랜 기간동안 지연을 경험하고 있는 것으로 나타났다. 사회적 지지의 경우 사회적 지지가 평균보다 낮은 환자는 진단 지연이 더 긴 것으로 조사되었으나, 치료지연의 차이는 통계적으로 유의미하지 않았다. 진단지연에 가장 영향을 미치는 변수는 진단 지연 인식 여부였으며, 치료 지연은 정서 정보적 지지가 가장 영향력을 미치는 변수로 나타났다. 본 연구는 유방암 환자들의 진단 및 치료지연을 다각적인 측면에서 연구함으로써 향후 유방암 환자의 진단 및 치료지연의 장애요인을 예방하고 개입할 수 있는 기초 자료로 사용할 수 있을 것으로 보인다.;The identification of barriers to diagnostic and therapeutic delays for breast cancer patients can provide a new framework for cancer prevention and control. This study aims to 1) explore current status and causes of diagnostic and therapeutic delays, and 2) investigate how sociodemographic and medical characteristics, perception of delays, and social support influence diagnostic and therapeutic delays for Korean breast cancer patients. A total of 287 adult women were recruited from nine hosptials in Korea. Results indicated that the mean time taken from the discovery of an abnormality to obtaining medical care(diagnositic delay) was 2.8 months (SD=8.4), and the mean time taken from obtaining a diagnosis to cancer treatment (therapeutic delay) was 2.4 months (SD=9.7). Patients with financial difficulties were more likely to report diagnostic and therapeutic delays. In terms of social support, the low social support group was more likely than the high social support group to delay in obtaining medical care; however, the therapeutic delay was not significantly different by the level of social support. The most important factor in the diagnostic delay was perception of diagnositic delay, while emotional and information support was the most important factor in the therapeutic delay. This study will serve as a basis for reducing barriers to diagnostic and therapeutic delays for breast cancer patients.
본 연구는 우리나라 노인들의 장애수준을 파악하고 사회인구학적 특징, 생리학적 요인, 건강행동, 심리사회적 요인에 대해 비장애 노인, 경증장애 노인, 중증장애 노인의 차이를 비교하였으며 이러한 요인들이 노년기 장애수준에 미치는 영향을 검증하였다. 제1차 고령화패널 데이터를 사용하여 65세 이상 노인 4,155명을 대상으로 Chi검증, ANOVA, 다항 로지스틱 회귀분석이 실시되었다. 주요 분석결과는 다음과 같다. 첫째, 일상생활 활동에 도움이 필요한 중증장애 노인은 응답자의 9.6%, 수단적 일상생활 활동에서 도움이 필요한 경증장애 노인은 15.8%에 해당한다. 둘째, 연령, 사회경제적 지위, 만성질환, 감각능력, 건강관련행동, 우울, 건강에 대한 주관적 인식, 사회적 지지 등에서 비장애노인, 경증장애노인, 중증장애노인 간에 차이가 확인되었다. 셋째, 노년기 장애수준의 가장 강력한 결정요인은 뇌혈관질환으로 이 질환을 가진 노인은 중증장애에 속할 확률이 현저하게 높다. 우울과 건강에 대한 주관적 인식도 중증장애의 중요한 예측요인이다. 규칙적인 운동은 중증장애와 경증장애 확률을 다 감소시키지만 친구접촉빈도와 사회활동 참여는 중증장애에 속할 확률을, 배우자 유무와 자녀접촉빈도는 경증장애에 속할 확률을 각각 감소시킨다. 이러한 연구결과에 따라 뇌혈관 질환의 특별관리 체계 확립, 노년기 이전 단계부터 규칙적인 운동습관의 보급, 우울과 주관적 건강에 대한 측정 및 개입, 노년기에 친구로부터의 지지와 사회적 참여를 증가시키기 위한 방안 등 실천적 함의가 제시되었다.;This study explored three issues in regard to disability among Korean older persons. First, prevalence of disability was assessed. Second, differences among no disability, moderate disability, and severe disability were compared. Third, effects of socio-demographic characteristics, chronic conditions, health behaviors, psycho-social constructs on the level of disability were examined. 4,155 older people(65 and over) selected from the data of Korea longitudinal study of aging(KLoSA) were used for chi-square test, ANOVA, and multinomial regression analysis. Findings suggested that 9.6% of the sample were severely disabled, and 15.8% were moderately disabled. It was also found that three groups(no disability, moderate disability, severe disability) showed significant differences regarding to age, socio-economic status, chronic conditions, health behaviors, depression, perceived health, and social support. Finally, stroke was the most salient predictor of severe disability. It was also strongly related with moderate disability. Regular exercise was found to reduce the chances of both severe disability and moderate disability. Among psycho-social variables, depression and perceived health status were related with severe disability. While contacts with friends and social activities reduced the chances of severe disability, living with spouse and contacts with children was found to reduce the chances of moderate disability. According to these results, implications including special attention to cerebrovascular diseases, enhancement of exercise programs, prevention and reduction of depression, increasing social support in later life were discussed.
This study aimed at using design-thinking to surmount globally harmful drinking dynamics, as identified in South Korea and alcohol research-scarce China. The prevalence rate of 12-month diagnoses of the Rapid Alcohol Problem Screen 4 (RAPS4) on alcohol dependence in South Korea and China were compared using the Emergency Department (EDs) surveys, sponsored by the World Health Organization (WHO), conducted on 4,509 adults visiting the Korean and Chinese EDs. Weighted prevalence estimates of alcohol dependence were cross-tabulated using chi-square tests and dependence relationships across sociodemographic characteristics were established using linear logistic regression analysis. Psychiatric disarrays were shown by researchers to indicate alcohol dependence associated with drinking norms, evidencing a higher proportion of alcohol dependence in South Korea (17.5%), as compared to limited alcohol dependence sampling tied to prevalence and correlates of alcohol consumption in China (13.7%). The odds of alcohol dependence for males were statistically significant and high in both countries, being four times higher in South Korea [4.9% (95% CI, 3.6% – 6.8%)] than China [2.6% (95% CI, 1.9% –3.6%)]. In both countries, alcohol dependence was more salient in younger ages (18–24 and 25–34) and extensively greater for males in the oldest age group, along with highest heavy episodic drinking among ages 25–34 in China. Future investigators would benefit by attending precisely to measures for alcohol dependence as well as for alcohol consumption.;본 연구는 한국과 중국의 응급실에 손상으로 내방한 성인을 대상으로 알코올의존의 정도를 측정하고 두 국가 간 알코올의존의 차이를 규명하고자 하는 목적에서 수행되었다. 세계보건기구의 유해음주감소를 위한 응급실연구의 프로토콜의 절차와 방법에 따라 두 국가에서 자료를 수집하였다. 알코올의존에 대한 측정은 RAPS4를 활용하여 지난 12개월동안의 음주 상태를 질문하여 의존을 측정하였다. 분석대상은 모두 4,509명이었으며, 비율의 차이를 검정하기 위해 교차분석을 실시하였으며, 선형 로지스틱 회귀분석을 통해 결론을 유도하였다. 응급실에 손상으로 내방한 환자의 알코올의존의 비율이 한국은 17.5%로 중국의 13.7%보다 통계적으로 유의하게 높았다. 양국 모두에서 남성의 알코올의존에 대한 확률은 높았고 또한 두 나라 사이에 유의한 차이가 나타났다. 즉 한국[4.9% (95%CI, 3.6%-6.8%)]에서 중국[2.6% (95%CI, 1.9%-3.5%)]보다 4배 더 높게 나타났다. 일반적으로 알코올의존은 어린 나이에서 두드러진 특징을 보였으나(한국 18-24세, 중국 25-34세), 남성들의 경우 나이가 가장 많은 그룹에서 알코올의존이 특이하게 높았고, 중국의 경우 25-34세 집단에서는 빈번한 폭음에 의한 알코올의존이 큰 것으로 나타났다. 알코올소비를 감소시킬 대책뿐 아니라 알코올의존에 대한 대책이 필요한 것으로 판단된다.
최근 자원으로서의 시간에 대한 개인의 인식은 인간의 생활을 영위하는 기초적 단위로서 시간의 가치활용도를 높이고 인간관계의 맥락을 심화시키며, 그들의 「삶의 질」을 극대화하는 핵심적인 가치를 부여하는데 초점을 맞추고 있다. 그렇지만 어느 누구에게나 정해져 있는 시간의 양(quantity)을 어떻게 효율적으로 사용하고, 필요한 분야 및 항목에 얼마나 배분하는가에 따라 시간의 질(quality)을 증대시킬 수 있다. 본 연구는 1999년 통계청에서 처음으로 실시한 자료를 심층 분석하는 것이다. 연구목적은 기혼여성의 혼인상태 및 사회경제적 특성에 따라 생활시간 배분이 어떻게 상이한지를 분석하고 문제점을 찾으며, 아울러 효율적 시간활용방안을 제시하고 정책적 지원방안도 함께 모색하는데 있다. 주요 결과는 우리나라 기혼여성의 생활시간 배분은 혼인상태에 따라 현저한 차이가 있었다는 점이다. 아울러 기혼여성의 경제활동여부도 생활시간 배분에 영향을 크게 미치고 있었다. 특히 이혼부인은 생계유지를 위하여 경제활동에 적극 참여해야 하기 때문에 적절한 시간배분에 문제점을 노출시키고 있었다. 이와 같은 일련의 분석연구는 우리나라 부인의 혼인상태, 연령, 경제활동참여 및 직업유형 등의 특성에 따라 생활방식과 삶의 질을 파악하고, 시간자원을 효율적으로 활용하는 데 필요한 기초자료로 제공될 수 있을 것이며, 궁극적으로 여성의 「삶의 질」을 향상시키는 데 기여할 것으로 사료된다.;Individual's view of time as resource has recently been geared toward making the best use of time as the basic unit of human life in order to deepen the context of interpersonal relationships and maximize quality of life. The quality of one's time can be enhanced depending on how efficiently one allocate, manage, and spend the quantity of time. The present study aims to conduct an in depth examination of the first time-allocation survey carried out in Korea by the National Statistical Office in 1999 and analyze differences and identify problems in time allocation among married women according to their marital status and socioeconomic characteristics. Along the way, strategic plans and policy implications are suggested for improving the efficiency of time allocation. Major findings can be summarized as follows. Patterns of time allocation among married women in Korea vary widely depending on their marital status. The largest portion of their time in general is spent on ‘self-care’ which includes time allocated for sleep. However, divorced women are found to spend the next largest portion of their time on work, while widowed women and women with spouse spend the second largest portion their time on 'leisure and friends/acquaintances'. Divorced women are found to spend significantly more time at work than widowed women and women with spouse do. This is presumably a result stemming from the fact that divorced women, unlike women with spouse present, are highly responsible for household livelihood not only because they do not have income-earning husbands, but also because they are generally younger than their widowed counterparts and therefore are less likely to have income-earning children. Divorced and widowed women in their thirties/forties as compared with other groups are found to spend much more time on work. This may be not only because they unlike women with spouse present－must fulfill their responsibilities and role as the main breadwinner for the family, but also because they are more likely to have school-aged children and are responsible for earning money for bringing up and educating them. Unemployed women, regardless of their marital status, are found to spend more time on household and family care than employed women. This implies that there is an accentuated policy need for paying particular heed to social support toward helping divorced women balance their work and family lives. Koreans in general－irrespective of socio-demographic factors such as gender, age, educational level, marital status, and employment status－are found to devote little time to voluntary activities, even during weekends or holidays. Non-working women and elderly people, in particular, spend very limited amount of time participating in voluntary activities despite having relatively much spare time. Divorced and widowed women as compared to women with spouse are found to suffer from lack of time to care for their preschool children due to other obligations. This calls for more policy attention to be placed on the protection of physical and emotional health of children in these female-headed households. For instance, the availability/accessibility of desired services should be ensured through the expansion of home-helper programs, educare centers, and financial aid programs. Based on these results, the following time management strategies and policy options can be considered. First, more time needs to be allocated, especially in the case of married non-working women, to voluntary activities. This can be made possible by reducing time spent on friends/acquaintances, leisure activities, and self-care. Second, it is hard for many divorced and widowed women to allocate much time to household and family care because they are responsible for engaging in income-earning activities. Therefore, social support should be provided to enhance the availability and accessibility of home-helper programs and daycare services. Third, cultural/leisure programs should be developed for working married women who generally have little or no time for leisure and interpersonal relationships. Forth, the longstanding inequalities in gender roles must be redressed. To do this would require men to escape from their traditional ‘male gender role’ and assume an increased, if not equal, role in household tasks and family care.