DOI QR코드

DOI QR Code

Relations of Stroke Literacy, Health Literacy, Stroke Knowledge, and Self-Management among Middle-Aged and Older Adults

중노년기 성인의 뇌졸중 문해력, 건강정보 문해력, 뇌졸중 지식과 자기관리간의 관계

  • Received : 2020.08.04
  • Accepted : 2020.12.04
  • Published : 2020.12.31

Abstract

This study examined the degree and relations of stroke literacy, health literacy, stroke knowledge, and self-management to identify the significant determining factors affecting stroke prevention among middle-aged and older adults with a high incidence of stroke. Data on the sociodemographic characteristics, stroke literacy, health literacy, stroke knowledge, and self-management of 198 participants were collected from December 5, 2019, to March 31, 2020, using a structured questionnaire. The data were analyzed using the SPSS/WIN 23.0 program. The determining factors affecting self-management in middle-aged and older adults were age (β=.190. p=.015), followed in order by smoking (β=-.226, p=.001), self-rated health status (β=.297, p<.001), and stroke knowledge (β=-.168, p=.014); the explanation power was approximately 20.3%. The results suggest that the self-rated health status and stroke knowledge should be considered when developing nursing interventions to improve self-management among middle-aged and older adults. Furthermore, it will be necessary to find the intervening variable between stroke knowledge and self-management for community-dwelling middle-aged and older adults in the community. Overall, these findings underscore the importance of systematic and ongoing education on stroke prevention.

본 연구는 중노년기 성인의 뇌졸중 문해력, 건강정보 문해력, 뇌졸중 지식과 자기관리의 정도를 비교하고 그 관계를 확인함으로써 뇌졸중 발병률이 높은 중노년기 성인의 뇌졸중 예방을 위한 자기관리의 유의한 영향요인을 파악하고자 수행되었다. 2019년 12월 5일부터 2020년 3월 31일까지 198명을 대상으로 인구사회학적 특성, 뇌졸중 문해력, 건강정도 문해력, 뇌졸중 지식 및 자기관리에 관한 자료를 체계적인 설문지를 통해 수집되었다. 자료분석은 독립표본 t 검정, 일원배치 분산분석, Pearson 상관계수, 다중회귀분석을 사용하여 기술 통계량에 대해 SPSS/WIN 23.0 프로그램을 사용하였다. 중노년기 성인의 자기관리에 영향을 미치는 요인은 연령(β=.190. p=.015), 흡연을 할 때(β=-.226, p=.001), 주관적 건강상태(β=.297, p<.001)와 뇌졸중 지식(β=-.168, p=.014)으로, 이들의 설명력은 약 20.3%였다. 본 연구 결과를 볼 때, 중노년기 성인의 자기관리를 향상시키기 위한 간호 중재를 개발할 때 주관적 건강상태 및 뇌졸중 관련 지식을 고려해야 함을 알 수 있다. 또한, 지역사회에 거주 중인 중노년기 성인들의 뇌졸중 지식과 자기관리 사이의 매개변수 탐색이 필요하며, 뇌졸중 예방에 대한 체계적이고 지속적인 교육의 중요성이 강조된다.

Keywords

References

  1. Adebayo, O. D., & Culpan, G. "Diagnostic accuracy of computed tomography perfusion in the prediction of haemorrhagic transformation and patient outcome in acute ischaemic stroke: A systematic review and meta-analysis" European stroke journal, Vol.5, No.1, pp.4-16, 2020. DOI: https://doi.org/10.1177/2396987319883461
  2. Korean Statistical Information Service (KOSIS) Korea national health and nutrition examination survey. (2018). Available From: http://kostat.go.kr/portal/korea/kor_nw/1/6/2/index.board?bmode=read&bSeq=&aSeq=377606&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt= (accessed Jul. 1, 2020)
  3. Kim. J. Y., Bea. H. J., & Park. J. M. "Stroke Statistics in Korea, 2018" Public Health Weekly Report, Vol.12, No.43, pp.1845-1860, 2019.
  4. Kang, J. H., Jeong, B. G., Cho, Y. G., Song, H. R., & Kim, K. A. "Medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke in Korea" Korean Journal of Health Education and Promotion, Vol.27, No.4, pp.83-90, 2010.
  5. Niewada, M., & Michel, P. "Lifestyle modification for stroke prevention: facts and fiction" Current opinion in neurology, Vol.29, No.1, pp.9-13, 2016 DOI: https://doi.org/10.1097/WCO.0000000000000285
  6. Bae, S. G., Lee, S. K., & Han, C. H. "Influencing and mediating factors in stroke: Based on 2007-2012 Korea national health and nutrition examination survey" Journal of the Korea Academia-Industrial cooperation Society, Vol.16, No.1, pp.418-428, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.1.418
  7. Kim, E. J., & Kong, J. H. "The Effects of Primary Stroke Prevention Program on the Knowledge of Stroke, Stroke Symptom Coping Behavior and Self Management of Stroke Risk Group" Journal of the Korea Academia-Industrial cooperation Society, Vol.16, No.11, pp.7925-7933, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.11.7925
  8. Howe, M. D., & McCullough, L. D. "Prevention and management of stroke in women" Expert Review of Cardiovascular Therapy, Vol.13, No.4, pp.403-415, 2015. DOI: https://doi.org/10.1586/14779072.2015.1020300
  9. Kindig, D. A., Panzer, A. M., & Nielsen-Bohlman, L. Health literacy: a prescription to end confusion. pp.368, National Academies Press, 2004, pp.31.
  10. Lee, J. E., Lee, S. Y., Noh, H. K., & Lee, E. "The influence of functional health literacy on health promotion behavior" Journal of the Korean Data and Information Science Society, Vol.26, No.6, pp.1427-1438, 2015. DOI: https://doi.org/10.7465/jkdi.2015.26.6.1427
  11. Chesser, A. K., Woods, N. K., Smothers, K., & Rogers, N. Health literacy and older adults: a systematic review. Gerontology and Geriatric Medicine, Vol.2, pp.1-13, 2016. DOI: https://doi.org/10.1177/2333721416630492
  12. Kim. J. H., Park. C. Y., & Kang. S. H. "A Survey on the Level and Related Factors of Health Literacy in Korean People" Korean Academy of Health Policy and Management, Vol.29, No.2, pp.146-159, 2019. DOI: https://doi.org/10.4332/KJHPA.2019.29.2.146
  13. Jeong, J. H., & Kim, J. S. "Health Literacy, Health Risk Perception and Health Behavior of Elders" Journal of Korean Academy of Community Health Nursing, Vol.25, No.1, pp.65-73, 2014. DOI: https://doi.org/10.12799/jkachn.2014.25.1.65
  14. Gumbinger, C., Reuter, B., Stock, C., Sauer, T., Wietholter, H., Bruder, I., ... & Hacke, W. "Time to treatment with recombinant tissue plasminogen activator and outcome of strokein clinical practice: retrospective analysis of hospital quality assurance data with comparison with results from randomised clinical trials" British Medical Journal, Vol.348, pp.1-12, 2014. DOI: https://doi.org/10.1136/bmj.g3429
  15. Kim, J., Hwang, Y. H., Kim, J. T., Choi, N. C., Kang, S. Y., Cha, J. K., ... & Lim, B. H. "Establishment of government-initiated comprehensive stroke centers for acute ischemic stroke management in South Korea" Stroke, Vol.45, No.8, pp.2391-2396, 2014. DOI: https://doi.org/10.1161/STROKEAHA.114.006134
  16. Lee. Y. H., Kim. Y. T., Oh. G. J., Kim. N. H., ... & Kim. H. S. "Effects of community-based education and advocacy intervention on public awareness about the warning signs of stroke and the golden window of time" Korean J Health Educ Promot, Vol.32, No.1, pp.1-10, 2015. DOI: https://doi.org/10.14367/kjhep.2015.32.1.1
  17. Brice, J. H., Griswell, J. K., Delbridge, T. R., & Key, C. B. Stroke: from recognition by the public to management by emergency medical services. Prehospital Emergency Care, Vol.6, No.1, pp.99-106, 2002. DOI: https://doi.org/10.1080/10903120290938904
  18. Willey, J. Z., Williams, O., & Boden-Albala, B. Stroke literacy in Central Harlem: a high-risk stroke population. Neurology, Vol.73, No.23, pp.1950-1956, 2009. DOI: https://doi.org/10.1212/WNL.0b013e3181c51a7d
  19. Kim, Y. S., Park, S. S., Bae, H. J., Cho, A. H., ... & Kim, G. M. "Stroke awareness decreases prehospital delay after acute ischemic stroke in Korea" BMC Neurology, Vol.11, No.1, pp.1-8, 2011. DOI: https://doi.org/10.1186/1471-2377-11-2
  20. Lee, Y. M., Kim, K. Y., & Kim, K. S. "Awareness of stroke warning symptoms and related factors among residents in a province" Journal of the Korea Academia-Industrial cooperation Society, Vol.15, No.8, pp.5116-5123, 2014. DOI: https://doi.org/10.5762/KAIS.2014.15.8.5116
  21. Lee, Y. H., Kim, Y. T., Oh, G. J., Kim, N. H., ... & Lee, K. S. "Effects of community-based education and advocacy intervention on public awareness about the warning signs of stroke and the golden window of time" Korean Journal of Health Education and Promotion, Vol.32, No.1, pp.1-10, 2015. DOI: https://doi.org/10.14367/kjhep.2015.32.1.1
  22. Yang, J., Zheng, M., Cheng, S., Ou, S., Zhang, J., Wang, N., et al. "Knowledge of stroke symptoms and treatment among community residents in western urban China" Journal of Stroke and Cerebrovascular Diseases, Vol.23, No.5, pp.1216-1224, 2014. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.10. 019
  23. Sallar, A. M., Williams, P. B., Omishakin, A. M., & Lloyd, D. P. "Stroke prevention: awareness of risk factors for stroke among African American residents in the Mississippi delta region" Journal of the National Medical Association, Vol.102, No.2, pp.84-94, 2010. DOI: https://doi.org/10.1016/S0027-9684(15)30495-8
  24. Miyamatsu, N., Okamura, T., Nakayama, H., Toyoda, K., Suzuki, K., Toyota, A., et al. "Public awareness of early symptoms of stroke and information sources about stroke among the general Japanese population: the acquisition of stroke knowledge study" Cerebrovascular Diseases, Vol.35, No.3, pp.241-249, 2013. DOI: https://doi.org/10.1159/000347066
  25. Waltz, C., Strickland, O. L., Lenz, E. Measurement in nursing and health research. 4th ed. New York, NY: Springer Publishing Company; 2010. p. 453
  26. Lee, T. W., & Kang, S. J. "Development of the short form of the Korean health literacy scale for the elderly" Research in nursing & health, Vol.36, No.5, pp.524-534, 2013. DOI: https://doi.org/10.1002/nur.21556
  27. Lee, T. W., & Kang, S. J. "Health Literacy in the Korean Elderly and Influencing Factors" Journal of Korea Gerontological Society, Vol.28, No.4, pp.847-863, 2008.
  28. Yoon, S. S., Heller, R. F., Levi, C., Wiggers, J., & Fitzgerald, P. E. "Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population" Stroke, Vol.32, pp.1926-1930, 2001. https://doi.org/10.1161/01.STR.32.8.1926
  29. Song. H. Y. "Stroke Risk and Knowledge in Women with Prehypertension" Journal of Korean Biological Nursing Science, Vol.10, No.2, pp.121-130, 2008.
  30. Nedeltchev, K., Fischer, U., Arnold, M., Kappeler, L., & Mattle, H. P. "Low awareness of transient ischemic attacks and risk factors of stroke in a Swiss urban community" Journal of Neurology, Vol.254, pp.179-184, 2007. https://doi.org/10.1007/s00415-006-0313-x
  31. Walker, S. N., Sechrist, K. R., & Pender, N. J. "The health-promoting lifestyle profile: development and psychometric characteristics" Nursing Research, Vol.36, No.2, pp.76-81, 1987. DOI: https://doi.org/10.1097/00006199-198703000-00002
  32. Seo, H. M. Constructing of health promoting behaviors model in elderly Ph.D dissertation. Seoul National University, Seoul, Korea, p. 54-55, 2000.
  33. Kwon, M. S., Noh G. Y., & Jang, J. H. "A Study on Relationships between Health Literacy, Disease-related Knowledge and Compliance to Medical Recommendations in Patients with Hypertension" Journal of Korean Public Health Nursing, Vol27, No.1, pp.190-202, 2013. DOI: https://doi.org/10.5932/JKPHN.2013.27.1.190
  34. Kang, S. J., Lee, T. W., Kim, G. S., & Lee, J. H. "The Levels of Health Literacy and Related Factors among Middle-aged Adults in Seoul, Korea" Korean Journal of Health Education and Promotion, Vol.29, No.3, pp.75-89, 2012.
  35. Kim, J. H., Kwon, M. J., & Jung, S. K. "The Influence of Health Locus of Control, Social Support, and Self-Efficacy on Health Promoting Behavior in Middle-Aged Adults" Journal of the Korea Academia-Industrial cooperation Society, Vol.18, No.4, pp.494-503, 2017. DOI: https://doi.org/10.5762/KAIS.2017.18.4.494
  36. Choi, S. S. "Impact of Hospital Admission Times on Acute Ischemic Stroke Patients Protector Stroke-related knowledge Score" Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, Vol.6, No.9, pp.495-504, 2016. DOI: https://dx.doi.org/10.14257/AJMAHS.2016.09.05
  37. Jeong, Y. J., & Park, J. H. "The Effects of the Stroke on the Health Knowledge, Optimistic Bias and Health-Promoting Lifestyle in Middle-Aged Adults" Journal of the Korea Academia-Industrial cooperation Society, Vol.17, No.9, pp.141-155, 2016. DOI: https://doi.org/10.5762/KAIS.2016.17.9.141
  38. Yang, S. Y., & Park, K. O. "Associations between community residents perceived acceptance of health information and their health behaviors in Incheon" Journal of Regional Studies, Vol.26, No.2, pp.65-80, 2018. DOI: https://doi.org/10.31324/JRS.2018.06.26.2.65
  39. Oh, J. H., & Park, E. O. "The impact of health literacy on self-care behaviors among hypertensive elderly" Korean Journal of Health Education and Promotion, Vol.34, No.1, pp.35-45, 2017. DOI: https://doi.org/10.14367/kjhep.2017.34.1.35
  40. Kim, Y. M., & Yoo, K. H. "A Correlational Study on the Knowledge, Stress and Self-care Performance among Tuberculosis Patients" The Journal of Korean Academic Society of Nursing Education, Vol.25, No.3, pp.366-377, 2019. DOI: https://doi.org/10.5977/jkasne.2019.25.3.366
  41. Yang, I. S. "Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure" Korean Journal of Adult Nursing, Vol.28, No.3, pp.302-313, 2016. DOI: https://doi.org/10.7475/kjan.2016.28.3.302
  42. Chang, K. O., & Oh, M. J. "Effects of Stroke Prevention Education Program of Oriental Nursing on Self-Health Perception Change, Health Behavior Change, Self-Care and Physiological Index of adult and elderly people" Journal of the Korea Academia-Industrial cooperation Society, Vol.20, No.1, pp.111-120, 2019. DOI: https://doi.org/10.5762/KAIS.2019.20.1.111