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여성노인의 고혈압 유무에 따른 신체활동, 체질량 지수 및 우울이 건강관련 삶의 질에 미치는 영향

Impact of Physical Activity, Body Mass Index and Depression on the Health Related Quality of Life according to the Presence of Hypertension in the Elderly Women

  • 김애실 (영남이공대학교 간호학과) ;
  • 배한주 (계명문화대학교 간호학과)
  • Kim, Ae-Sil (School of Nursing, Yeungnam University College) ;
  • Bea, Han-Ju (Department of Nursing, Keimyung College University)
  • 투고 : 2020.10.07
  • 심사 : 2020.11.06
  • 발행 : 2020.11.30

초록

본 연구는 2018년 제7기 국민건강영양조사 결과를 이용한 2차 자료 분석이었다. 본 연구의 목적은 65세 이상 여성노인의 신체활동, 체질량지수, 우울이 건강관련 삶의 질에 미치는 영향을 파악하고 비교하기 위함이다. 구체적으로 연구대상자는 고혈압 진단을 받은 여성노인 550명, 고혈압 진단을 받지 않은 여성노인 375명으로 구성되었다. SPSS/WIN 22.0 프로그램을 이용하여 기술통계, chi-square test, t-test, multiple linear regression으로 분석하였다. 다중 선형 회귀 분석결과, 고혈압군에서 나이, 교육, 신체활동, 체질량 지수, 우울이 건강관련 삶의 질에 유의한 예측인자로 확인되었고 설명력은 26.9%였다(F=14.30, p<.001). 즉 신체활동량이 많을수록(t=3.02, p=.003), 체질량 지수가 낮을수록(t=-3.12, p=.002), 우울이 낮을수록(t=-7.69, p<.001) 건강관련 삶의 질이 높았다. 반면, 비고혈압군에서 교육과 우울이 건강관련 삶의 질에 유의한 영향인자로 확인되었고 설명력은 31.7%였다(F=5.37, p<.001). 즉, 우울이 낮을수록 (t=-5.53, p<.001) 건강관련 삶의 질이 높았다. 이러한 결과를 바탕으로 향후 고혈압 질환을 갖고 있는 여성노인을 대상으로 다른 구체적 신체활동의 특성을 비교하는 연구와 여성노인의 우울 및 비만 감소를 위한 신체활동 중재 프로그램의 개발이 필요하다.

This study analyzed secondary data using the results of the 7th Korea National Health and Nutrition Survey in 2018. The aim of this study was to identify and compare the effects of physical activity, body mass index, and depression on the health-related quality of life of elderly women. Specifically, the sample consisted of 550 women with hypertension and 375 women without hypertension. The data were analyzed using descriptive statistics, chi-square test, t-test, and multiple linear regression with the IBM SPSS/WIN 22.0 program. Multiple linear regression analysis showed that age, education, physical activity, body mass index, and depression accounted for 26.9% of the health-related quality of life (HRQOL) in the hypertension group (F=14.30, p<.001), followed by physical activity (t=3.02, p=.003), body mass index (t=-3.12, p=.002), and depression (t=-7.69, p<.001). Education and depression accounted for 31.7% of the QoL in the non-hypertension group (F=4.42, p<.001), followed by depression (t=-5.53, p<.001). Based on these results, a physical activity intervention program will be needed to reduce depression and obesity in older women. Moreover, further research comparing the characteristics of other specific physical activities in elderly women with hypertension is recommended.

키워드

참고문헌

  1. World Health Organization. 2020. Hypertension. [cited 2020 April 24]. Available from: https://www.who.int/health-topics/hypertension/#tab=tab-1
  2. H. C. Kim, M. C. Cho, "Korea hypertension fact sheet 2018", Clinical hypertension, Vol.24, No.13, pp.1-4, October, 2018. DOI: https://doi.org/10.1186/s40885-018-0098-0
  3. Statistical information report for users of the Ministry of Health and Welfare - Survey on the status of the elderly; 2018. [cited 2020 April 24]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=DT-35001-A667421&vw-cd=MT-ZTITLE&list-id=350-35001-6&seqNo=&lang-mode=ko&language=kor&obj-var-id=&itm-id=&conn-path=MT-ZTITLE
  4. Korea Centers for Disease Control and Prevention National Information Portal. 2016. [cited 2020 October 2].
  5. J. H. Kim, A. Ebinger, J. E. Niiranen, T. J. Claggett, B. L. Merz, C. N. B., S. Cheng, (2020). "Sex differences in blood pressure trajectories over the life course", JAMA cardiology, Vol.5, No.3, pp.19-26, January, 2020. DOI: http://doi.org/10.1001/jamacardio.2019.5306
  6. National Statistical Office, Life Table, National Approval Statistics No. 101035. 2019 https://www.index.go.kr/potal/info/idxKoreaView.do?idx-cd=2758
  7. disease control center. 2020. [cited 2020 April 24]. Available from: http://www.cdc.go.kr/board.es?mid=a20602010000&bid=0034&act=view&list-no=367214
  8. N. L. Marpillat, I. Macquin-Mavier, A. I. Tropeano, A. C. Bachoud-Levi, P. Maison, "Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis", Journal of hypertension, Vol.31, No.6, pp.1073-1082, 2013. https://doi.org/10.1097/HJH.0b013e3283603f53
  9. M. J. Calvert, N. Freemantle, "Use of health‐related quality of life in prescribing research. Part 1: why evaluate health‐related quality of life?". Journal of clinical pharmacy and therapeutics, Vol.28, No.6, pp.513-521, 2003. https://doi.org/10.1046/j.0269-4727.2003.00521.x
  10. H. Y. Ko, J. K. Lee, J. Y. Shin, E. Jo, "Health-related quality of life and cardiovascular disease risk in Korean adults", Korean journal of family medicine, Vol.36, No.6, pp.349-356, November, 2015. DOI: https://doi.org/10.4082/kjfm.2015.36.6.349
  11. B. Langhammer, A. Bergland, Rydwik, E. "The importance of physical activity exercise among older people". BioMed research international, Special Issue, pp.1-3, October, 2018. DOI: https://doi.org/10.1155/2018/7856823
  12. G. Cardenas Fuentes, R. A. Bawaked, M. A. Martinez Gonzalez, D. Corella, I. Subirana Cachinero, J. Salas-Salvado, M. Fiol, "Association of physical activity with body mass index, waist circumference and incidence of obesity in older adults". European journal of public health, Vol.28, No.5, pp.944-950, October, 2018. DOI: https://doi.org/10.1093/eurpub/cky030
  13. A. C. Goulart, K. M. Rexrode, "Health consequences of obesity in the elderly: a review". Current Cardiovascular Risk Reports, Vol.1, No.4, pp.340-347, August, 2007. DOI: https://doi.org/10.1038/sj.ijo.0803005
  14. A. Pandey, M. LaMonte, L. Klein, C. Ayers, B. M. Psaty, C. B. Eaton, J. D. Berry, "Relationship between physical activity, body mass index, and risk of heart failure". Journal of the American College of Cardiology, Vol.69, No.9, pp.1129-1142, March, 2017. DOI: https://doi.org/10.1016/j.jacc.2016.11.081
  15. J. R. Banegas, E. López-Garcia, A. Graciani, P. Guallar-Castillon, J. L. Gutierrez-Fisac, J. Alonso, F. Rodriguez-Artalejo,"Relationship between obesity, hypertension and diabetes, and health-related quality of life among the elderly". European Journal of Cardiovascular Prevention & Rehabilitation, Vol.14, No.3, pp.456-462, January, 2007. DOI: https://doi.org/10.1097/HJR.0b013e3280803f29
  16. Y. H. Oh, J. H. Moon, M. H. Kong, B. J. Oh, H. J. Kim, "The Association between Sitting Time and Health-Related Quality of Life According to Body Mass Index in Elderly Korean". The Korean Society of Health Promotion and Disease Prevention. Vol.17, No.4, pp.209-218, November, 2017. DOI: https://doi.org/10.15384/kjhp.2017.17.4.209
  17. L. D. S. S. C. B. de Oliveira, E. C. Souza, R. A. S. Rodrigues, C. A. Fett, A. B. Piva, "The effects of physical activity on anxiety, depression, and quality of life in elderly people living in the community". Trends in psychiatry and psychotherapy, Vol.41, No.1, pp.36-42, Jun, 2019. DOI: https://doi.org/10.1590/2237-6089-2017-0129
  18. Y. H. Oh, "The health status of older Koreans and policy considerations". In Health Welf Policy Forum, Vol.223, pp. 29-39, May, 2015.
  19. G. M. Van Dijk, M. Kavousi, J. Troup, O. H. Franco, "Health issues for menopausal women: the top 11 conditions have common solutions". Maturitas, Vol.80, No.1, pp.24-30, September, 2015. DOI: https://doi.org/10.1016/j.maturitas.2014.09.013
  20. K. A. Kim, S. Y. Hwang, "Impact of physical activity, central obesity and depression on the quality of life according to the presence of cardiovascular risk among menopausal middle-aged women: Secondary data analysis". Korean Journal of Adult Nursing, Vol.29, No.4, pp.382-392, August, 2017. DOI: https://doi.org/10.7475/kjan.2017.29.4.382
  21. C. H. Lin, S. L. Chiang, P. Yates, M. S. Lee, Y. J. Hung, W. C. Tzeng, L. C. Chiang, "Moderate physical activity level as a protective factor against metabolic syndrome in middle‐aged and older women". Journal of Clinical Nursing, Vol.24, No.9-10, pp.1234-1245, May, 2015. DOI: https://doi.org/10.1111/jocn.12683
  22. R. C. Weisell, "Body mass index as a indicator of obesity". Asia Pacific journal of clinical nutrition, Vol.11, pp.S681-S684, December, 2002. DOI: https://doi.org/10.1046/j.1440-6047.11.s8.5.x
  23. K. Kroenke, R. L. Spitzer, J. B. Williams, The PHQ‐9: validity of a brief depression severity measure. Journal of general internal medicine, Vol.16, No.9, pp.606-613, 2001. DOI:https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  24. Jeon, J. A. Korean women's mental health indicators. Health and Welfare Forum. Vol.235, pp.47-60, 2016. http://kiss.kstudy.com/thesis/thesis-view.asp?key=3540371
  25. Group, T. E. EuroQol-a new facility for the measurement of health-related quality of life. Health policy. Vol.16, No.3, pp.199-208, 1990. DOI:https://doi.org/10.1016/0168-8510(90)90421-9
  26. S. I. Lee, "Validity and reliability evaluation for EQ-5D in Korea". Cheongju: Korea Centers for Disease Control and Prevention, Vol.40, No.59, pp.1-106, 2011. http://www.ndsl.kr/ndsl/search/detail/report/reportSearchResultDetail.do?cn=TRKO201300000474
  27. Y. C., Kim, J. Paik, "The effects of family conflict, social support and self-esteem on life satisfaction of the aged". Journal of Digital Convergence. Vol.14, No.7, pp.279-287, July, 2016. DOI: https://doi.org/10.14400/jdc.2016.14.7.279
  28. F. Orfila, M. Ferrer, R. Lamarca, C. Tebe, A. Domingo-Salvany, J. Alonso, "Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions". Social science & medicine, Vol.63, No.9, pp.2367-2380, August, 2006. DOI: https://doi.org/doi:10.1016/j.socscimed.2006.06.017
  29. J. An, H. Y. Choi, "Trend of influencing factors on health-related quality of life in Korean elderly". Journal of Korean Public Health Nursing, Vol.32, No.2, pp.149-165, August, 2018. DOI: https://doi.org/10.5932/JKPHN.2018.32.2.275
  30. Y. J. Son, Song E. K. "Impact of health literacy on disease-related knowledge and adherence to self-care in patients with hypertension". Journal of Korean Academy of Fundamentals of Nursing, Vol.19, No.1, pp.6-15, February, 2012. DOI: https://doi.org/doi:10.7739/jkafn.2012.19.1.006
  31. D. P. Guh, W. Zhang, N, Bansback, Z. Amarsi, C. L. Birmingham, A. H. Anis, "The incidence of co-morbidities related to obesityand overweight: A systematic review and meta-analysis". Bio-Med Central Public Health. Vol.9, No.88, pp.382-392, March, 2009. DOI: https://doi.org/10.1186/1471-2458-9-88
  32. K. Lee, "Gender-specific relationships between alcohol drinking patterns and metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2008". Public Health Nutrition. Vol.15, No.10, pp.1917-1924, February, 2012. DOI: https://doi.org/10.1017/S136898001100365X
  33. J. Chung, M. Lee, M. Kim, "A study on the prevalence of chronic diseases, health-related habits and nutrients intakes according to the quality of life in Korean adults". Korean Journal of Community Nutrition, Vol.15, No.4, pp.445-459, August, 2010.
  34. C. Rosendorff, H. R. Black, C. P. Cannon, B. J. Gersh, J. Gore, J. L. Izzo Jr, S. Oparil, "Treatment of hypertension in the prevention and management of ischemic heart disease: A scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention". Circulation, Vol.115, No.21, pp.2761-2788, May, 2007. https://www.ahajournals.org/doi/full/10.1161/circulationaha.107.183885
  35. J. A. Lee, "Relationship between Grip Strength and Prevalence of Hypertension in Korean Adults: the Sixth Korea National Health and Nutrition Examination Survey (2015)". The Official Journal of the Korean Academy of Kinesiology, Vol.19, No.3, pp.53-60, July, 2017. DOI: https://doi.org/10.15758/jkak.2017.19.3.53
  36. M. R. Moraes, R. F. Bacurau, D. E. Casarini, Z. P. Jara, F. A. Ronchi, S. S. Almeida, C. C. Barros, "Chronic conventional resistance exercise reduces blood pressure in stage 1 hypertensive men". The Journal of Strength & Conditioning Research, Vol.26, No.4, pp.1122-1129, 2012. DOI: https://doi.org/10.1519/JSC.0b013e31822dfc5e
  37. J. H. Kim, J. Y. Park, "The influence of anxiety over aging of the elderly group on successful aging and the mediation effect of social support". The Journal of the Korea Contents Association. Vol.15, No.9, pp.210-222, September, 2015. DOI: https://doi.org/10.5392/jkca.2015.15.09.210
  38. Y. C. Kim, J. Paik, "The effects of family conflict, social support and self-esteem on life satisfaction of the aged". Journal of Digital Convergence. Vol.14, No.7, pp.279-287, July, 2016. DOI: https://doi.org/10.14400/jdc.2016.14.7.279
  39. J. I. Kim, "Levels of health-related quality of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas". Journal of Korean Academy of Community Health Nursing. Vol.24, No.1, pp.99-109. January, 2013. DOI: https://doi.org/10.12799/jkachn.2013.24.1.99
  40. M. Haseda, N. Kondo, T. Ashida, Y. Tani, D. Takagi, K. Kondo, "Community social capital, built environment, and income-based inequality in depressive symptoms among older people in Japan: An ecological study from the JAGES project". Journal of epidemiology, pp.1-9, October, 2017. DOI: https://doi.org/10.2188/jea.JE20160216
  41. M. J. Park, M. Y. Chung, "Effects of Anxiety on Health Related Quality of Life of the Elderly: Multiple Mediating Effects of Self-esteem and Social Support". Journal of Korean Academy of Community Health Nursing, Vol.31, No.1, pp.24-33, March, 2020. DOI: https://doi.org/10.12799/jkachn.2020.31.1.24
  42. J. Yeom, J. S. Park, D. H. Kim, "A study offactors affecting self-rated health among Korean elderly: Focusing on gender differences". The Korean Gerontological Society, Vol.32, No.4, pp.1101-1118, November, 2012. https://www.koreascience.or.kr/article/JAKO201235154450014.page