• 농촌의학ㆍ지역보건
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• 제18권1호
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• pp.43-54
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• 1993

In order to find the factors associated with the death of hypertensives, 12 year follow-up study for 267 hypertensives whose average blood pressure were 140/90 mmHg or above during their first health screening in 1979-1980 at YongJin Township, Wanju Country, North Cholla Province by the Community Health Team of Chonju Presbyterian Medical Center. The study results are as follows : 1. Initial general characteristics of hypertensives were studied. The age distribution of studied hypertensives showed 27.3% in 40-49 years, 25.8% in 50-59 years, 29.6% in 60-69 years and 17.2% In 70 + years old group. Marital status showed that 82.8% of hypertensives had their wife or husband. 74. 5% were employed on agriculture. 56.5% of hypertensives were illiterate. 2. Among the hypertensives, 91.6% of male and 22.8% of female reported that they were smokers. 82.6% of hypertensives had body mass index lower than 25 Kg/$m^2$. 46.8% of average systolic blood pressure were 160mmHg or above and 54.3% of average diastolic blood pressure were 95mmHg or above. 3. Twenty percent of hypertensives reported that they were treating hypertension at the beginning of follow up, while 68.5% reported that they were not treated. 28.1% reported that they were treating hypertension within 6 months before last follow-up. but 69.3% reported that they were not treated for hypertension within Ii months before last follow up. So 50.6% were classified as never treated group and 41.2% as treated group. 4. Average blood pressure for initial 3 years were calculated. The change of average systolic blood pressure was observed as $161.3{\pm}19.4mmHg$ at the first year, $145.6{\pm}28.0mmHg$ at the second year and $141.4{\pm}37.2mmHg$ at the third year. Average diastolic blood pressure were changed from $96.2{\pm}14.4mmHg$ at the first year to $90.6{\pm}18.6mmHg$ at the second year and $86.4{\pm}22.9mmHg$ at the third year. 5. By the follow-up of hypertensives, 54 hypertensives (46.2%) among 117 male hypertensives and 50 hypertensives (33.3%) among 150 female hypertensives died for 12 years. 42.6% of male death and 52.0% of female death were caused by cerebrovascular diseases. 6. Through univariate statistical test about the association between general characteristics or cardiovascular risk factors of hypertensives and mortality for 12 years, age variable among male and among female age, marital status, occupation. educational level. systolic blood pressure and treatment status were shown as significant variable to influence upon the mortality. 7. By multiple logistic regression analysis, among male age and systolic blood pressure were selected as significant variable to be associated with the total mortality for 12 years. Among female age, systolic blood pressure and treatment status were selected as statistically significant variable to be associated with the total mortality for 12 years.

• 지역사회간호학회지
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• 제12권1호
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• pp.202-213
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• 2001

This study was conducted to identify the changes of the relationship among general characteristics, self-efficacy. and self-care of the hypertensives in rural area. For this purpose, self-regulation program was carried at two Community Health Practitioner Post located in the suburbs of Daejeon City from September to November. 1999. Data were analyzed with non-parametric statistics, t-test, pearson correlation. The results were as follows; 1. The level of self-care was significantly different according to sex, status of smoking, and the level of self-efficacy of non-smoker was significantly higher than smoker. 2. After self-regulation program, there were significant positive relationship among self-efficacy, self-care, internal locus control, and negative relationship between perceived barrier and self-care. From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area, and this program can be recommended for the management of hypertensives.

• 지역사회간호학회지
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• 제8권1호
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• pp.45-60
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• 1997

Essential hypertension is a typical chronic disease requiring adequate and continuous management. Many studies supported that self-care was the essential factor to promote the wellbeing of hypertensives and self-efficacy increased healthy, behavior. The comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care performance for hypertensives in company. And this self-regulation program was recommended to apply for hypertensives in rural area. The purpose of this study is to identify the general characteristics affecting self-care and interrelationship among the factors including self-care, self-efficacy, HLOC, perceived benefits, barriers and family support. 40 subjects were interviewed from Dec. 1996 to Jan. 1997 and the data was analyzed by the SPSS PC+ program with t-test and multiple correlation to determine the variables affecting the self-care behavior. The results were as follows: 1) Level of self-care was significant difference according to sex(t= -2.27, p=.0l9). religion (t=1.57, p=.055) and smoking habit (t=4.42, P=.000). Perceived self-efficacy was more significantly high among the non-smoking group (t=3.25, P=.000) and female group (t=-2.534, p=.0l3). 2) There were significant positive correlation among the variables: self-care and self-efficacy (r=.5460, p=.000), external-LOC and self-care(r=.2548, p=.056), external-LOC and self-efficacy(r =. 2901, p=.035), self-efficacy and perceived benefits (r=3307, p=.019). And there were significant negative correlation between self-care and barriers (r=-.5438, p=. 000), self-efficacy and barriers (r= - .4153, p=.004). From the above results, it can be concluded that the self-care is more required in male hypertensives and self-efficacy is one of the important factors to increase healthy behavior in cluding self-care. Thus self-regulation program can be recommended in the management of the hypertensives in community settings.

• 대한간호학회지
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• 제30권5호
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• pp.1303-1317
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• 2000

This study was conducted to identify a effect of the comprehensive self-regulation program for hypertensives as a nursing intervention on self-care performance and the physiologic parameters in rural areas. For this purpose, a nonequivalent control group and a pre and post-test quasi- experimental design was used. Fifty-four were evaluated subjects from two Community Health Practitioner Posts in the suburbs of Taejon City. The subjects of the control and experimental groups were matched for age and sex. The self-regulation program developed by author given to the experimental group. The program consisted of group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring, recording of self-care activities, and encouraging and reinforcing self-efficacy. The whole program was carried out from September to November of 1999. The data were analyzed by repeated measure ANCOVA, t-test, and ANCOVA. The results were as follows ; There was significant improvement in the scores on knowledge (F=.68, P=.004), perceived self-efficacy (F=26.39, P=.000), self-care performance (F=26.11, P=.000) of the experimental group compared with those of the control group. There was no significant change on the score of locus of control, perceived benefits and perceived barrier, blood cholesterol level, body weight between two groups (P>.05). From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area.

• Journal of Preventive Medicine and Public Health
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• 제33권2호
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• pp.215-225
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• 2000

Objective : The purpose of this study was to examine the therapeutic compliance and its related factors in the rural hypertensives. Method : A questionnaire survey and blood pressure measurement were performed to 3,876 residents of a rural area, and 660 hypertensives were selected as subjects of study. The study employed a hypothetical model which was composed of constructs from the health belief model and KAP model. The analysis techniques employed included contingency table analysis and structural equation modeling. Result : The proportion of those who were compliant to the treatment of hypertension was 44.2% of subjects. As the result of structural equation modeling, when patients had more favorable attitude toward treatment, higher perceived benefit, or lower perceived barriers to treatment, the therapeutic compliance was significantly higher(T>2.0). When patients had more knowledge about hypertension, or higher perceived severity of hypertension, the attitude toward the treatment of hypertension was more favorable significantly(T>2.0). And when patients had the support for treatment from family or neighbor, the attitude toward treatment was more favorable(T>2.0). When patients had experience of health education, they had more knowledge, higher perceived susceptibility of complication, perceived severity for hypertension, and perceived benefit of treatment, compare to patients without health education(T>2.0). Conclusion : In consideration of above findings, in order to improve the therapeutic compliance in the rural hypertensives, it would be necessary to change attitude, perception, knowledge about hypertension and its treatment, by various methods such as effective health education and programs for maintaining the supportive environment for hypertension treatment.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.56-68
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• 2000

Objectives : To describe health behaviors related to hypertension in rural population of Korea and focused to identify inappropriate awareness, treatment, and control of hypertension. Methods : We surveyed 5,517 adults (2,288 males, 3,229 females) older than 30 years in 58 rural areas, purposely sampled nationwide from December 1996 to February 1997. Blood Pressure was checked twice af the time of the first visit. For those who showed high blood pressure using the JNC-6 criteria at their initial visit, we followed up their blood pressure one week later. Also information on the health behavior related to hypertension was collected through the person-to-person interview using structured questionnaire at the first visit. Results : For the past one year, females had more experiences of checking their blood pressure than males (77.3% versus 69.5%, p=0.001). Through the results of consecutively checked blood pressure, only 51.7% of the hypertensives were aware of their condition. Of the hypertensives who aware of their condition, 44.4% did not receive any medication and/or recommendation. And 50.4% of the hypertensives who had anti-hypertensive medication were classified as still having hypertensive blood pressure by 160/95 mmHg criteria. Of the medicated, 54.8% were found to take medication regularly for the past six months. Among the medicated, only 11.4% knew the name of anti-hypertensive drug they had. Conclusions : 'Rule of halves', which works in the situation of no special efforts for hypertension control, was identified. This study showed that much efforts to control hypertension would be required in the rural population of Korea.

• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.133-146
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• 2001

본 연구는 경상북도 도농 복합형 1개 시의 건강증진사업 일환으로 1998년 12월에서 1999년 4월 초 사이에 농촌지역 주민 6,977명을 대상으로 실시된 고혈압사업을 통해, 새로이 발견된 고혈압 환자 282명을 대상으로 추적하여 1개월간의 치료 실태와 고혈압 환자로 판명되기 이전에 가지고 있던 고혈압에 대한 건강신념과 고혈압 환자로 판명된 후의 치료순응과의 관계를 알아보고자 하였다. 고혈압으로 진단받고 1개월간 지속적으로 치료한 사람은 11.7%였으며, 간헐적 치료군은 11.4%로 치료경험군은 23.1%였다. 연령이 증가할수록 치료경험률이 높았으며, 학력이 낮을수록 치료경험률이 높았다(p<0.01). 미치료군의 미치료 이유는 아픈데가 없어 치료할 필요를 느끼지 못했다가 45.6%로 가장 높았고, 혈압이 크게 높지 않아 치료할 필요가 없었다가 43.2%였다. 연령이 증가할수록 아픈데가 없어 치료할 필요를 느끼지 못했다라는 응답의 비율이 높았다(p<0.01). 치료경험군의 주 치료기관은 보건기관(보건소, 보건지소)이 57.9%로 가장 높았고, 병의원이 29.8%, 약국과 한의원 등의 기타 기관이 12.3%였다. 환자의 일반적 특성에 따라 주 치료기관의 차이는 없었다. 고혈압이라는 질환이 심각하다고 느끼는 사람의 치료경험률이 27.7%로 그렇지 않은 사람의 20.4%에 비해 높았지만 유의한 차이는 아니었다. 치료의 부작용이 없을 것이라고 생각할수록, 치료 비용이 적게 들것이라고 생각할수록 치료경험률이 높았으나 유의한 차이는 아니었다. 고혈압으로 진단 받기 이전에 두통과 같은 고혈압 증상을 경험한 사람일수록 고혈압 치료를 경험하는 비율이 높았다(p<0.05). 주위에 고혈압으로 인해 중풍 등의 합병증을 앓고 있는 사람이 있는 경우 지속적 치료율이 14.3%, 간헐적 치료율이 20.6%인 반면, 없는 경우는 지속적 치료율 11.4%, 간헐적 치료율 8.7%로 차이가 있었으며 (p<0.05), 고혈압에 대해 지난 1년간 보건교육을 받은 경험이 있는 경우 지속적 치료율이 17.0%, 간헐적 치료율이 20.8%로 고혈압에 대해 보건교육을 받은 경험이 없는 경우의 지속적 치료율 10.6%, 간헐적 치료율 7.8%에 비해 고혈압 치료경험률이 유의하게 높았다(p<0.01). 지속적 치료와 간헐적 치료를 합하여 치료경험으로 한 후 치료경험유무를 종속변수로 한 다중 로지스틱 회귀분석 결과, 치료경험에 유의한 영향을 미치는 변수는 보건교육 경험유무와 주위에 고혈압으로 인해 중풍 등의 합병증을 앓고 있는 사람 유무로 보건교육경험이 있는 경우, 주위에 고혈압으로 인해 중풍 등의 합병증을 앓고 있는 사람이 있는 경우 치료경험률이 유의하게 높았다(p<0.05). 이상의 결과 고혈압 환자에게 본인이 고혈압 환자임을 주지시키고, 평소에 보건교육을 통해 고혈압에 대한 정확한 지식과 합병증에 대한 위험을 알리고, 고혈압 환자에 대한 지속적인 관찰과 관심이 중요할 것으로 생각된다.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.93-106
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• 2003

경상남도 거창군 관내 17개 보건진료소에서 지역사회진단을 통해 고혈압이 있는 것으로 파악된 618명을 대상으로 2002년 9월에 고혈압관리 행태에 대해 설문조사를 실시한 결과는 다음과 같다. 대상자 618명 중 고혈압 약을 처방대로 규칙적으로 복용하고 있는 고혈압 환자는 68.9%, 고혈압 약을 복용은 하나 불규칙적으로 복용하는 환자는 23.5%였고, 고혈압 약을 복용하지 않는 환자는 7.6%였다. 여자가 처방전대로 복용한다는 응답이 71.4%로 남자의 62.2%에 비해 높았고(p<0.05), 경제상태에서 잘산다라고 응답한 경우 처방전대로 복용하는 율이 높았다(p<0.01). 고혈압관련 특성과 고혈압에 대해 어떻게 설명하고 있는가에 따라서는 고혈압에 대한 지식수준이 높을수록 처방전대로 고혈압 약을 복용하고 있었고, 고혈압이 생긴 원인을 의학적으로 설명하는 경우와 본인의 고혈압을 심각하다고 느낄수록, 그리고 고혈압은 평생 치료해야 한다고 응답한 경우 고혈압 약을 처방전대로 복용하고 있었다(p<0.01). 지난 1년간 고혈압 치료를 위해 한약재, 조약 등 고혈압 약 이외의 다른 약을 사용해본 경험이 있는 고혈압환자는 12.5%였다. 고혈압치료의 부작용을 경험 한 경우(p<0.01), 고혈압약을 불규칙적으로 복용하는 경우(p<0.01), 본인의 고혈압이 심하다고 느낄 수록(p<0.05), 고혈압은 일정 기간 치료하면 완전히 나을 수 있다고 생각하거나 고혈압약으로 치료해도 소용이 없다고 생각하는 경우(p<0.05) 기타 약 복용률이 높았다. 고혈압 약 이외의 약을 사용한 이유로는 신약보다 부작용이 적을 것 같아서가 36.4%로 가장 높았고, 신약만으로는 효과가 없어서(19.5%), 체력을 보강하기 위하여(14.3%) 등이었다. 기타 약을 복용한 방법은 고혈압 약을 잠시 중단하고 복용한 경우가 53.2%로 가장 높았고, 고혈압 약과 시차를 두고 먹은 경우가 33.8%였다. 기타 약을 구입하게된 동기는 주위의 권유가 49.4%로 가장 높았고, 그 다음이 자식이 사주어서(26.0%) 였다. 기타 약의 효과에 대해서는 16.9%가 효과가 있었다고 하였다. 일반 의료기기 판매점에서 판매하는 게르마늄, 옥매트 등의 의료기기를 사용한 경험이 있는 대상자는 18.9%였는데, 연령에 따라 사용률에 차이가 있었고(p<0.05), 고혈압치료의 부작용 경험이 없는 경우(p<0.01), 고혈압약을 복용하지 않는 경우(p<0.01), 고혈압이 왜 생겼는지 모르겠다고 답한 경우(p<0.01), 본인의 고혈압이 심하지 않다고 생각할수록 낮았다(p<0.05). 게르마늄, 옥매트 등의 의료기기를 사용한 이유로는 단기간의 치료로 나을 수 있을 것 같아서가 50.4%로 가장 높았다. 구입하게 된 동기는 자식이 사 주어서가 53.8%로 가장 높았고, 그 다음이 주위 사람의 권유로 20.5%였다. 효과에 대해서는 12.0%가 효과가 있었다고 하였다. 고혈압 치료를 위해 민간요법을 사용한 경험이 있는 대상자는 16.2%였는데, 가족이 없는 경우에 민간요법 사용률이 높았고(p<0.05), 고혈압에 대한 지식이 보통이거나 고혈압 이환기간이 10년 이상인 경우(p<0.05), 고혈압치료의 부작용 경험이 있는 경우, 고혈압 약을 불규칙적으로 복용하는 경우, 본인의 고혈압이 심각하다고 느낄수록, 고혈압 치료에 대한 생각이 단기간의 치료로 완치될 수 있다고 생각하거나 고혈압약으로 치료해도 소용이 없다고 생각하는 경우 민간요법 사용률이 높았다(p<0.01). 민간요법을 사용한 동기는 주위 사람의 권유로가 70.0%로 가장 높았다. 사용한 이유는 단기간의 치료로 나을 수 있을 것 같아서(34.0%), 고혈압 약의 부작용을 우려해서(32.0%) 등이었고, 사용자의 22.0%가 효과가 있었다고 하였다. 사용한 민간요법으로는 사용자의 12.4%가 돌미나리즙을 사용한 적이 있다고 하여 가장 높았고, 여러 민간한약재(11.2%)와 감잎차(11.2%), 감식초(9.0%)와 솔잎가루(9.0%)의 순이었다. 이상의 결과, 고혈압 환자의 고혈압관리를 제대로 하도록 하기 위하여는 평소에 보건교육을 통해 고혈압에 대한 정확한 지식을 습득하도록 하고 고혈압을 정확하게 설명할 수 있도록 하여야 할 것으로 생각된다.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.155-164
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• 2002

본 연구는 일개 보건지소에 등록된 고혈압 환자의 치료율 및 관리율을 구하고 치료지속성과 관련성이 있는 변수를 파악하고 치료중단 이유를 조사하기 위하여 2000년 11월 이전에 군남면 보건지소에 등록되어 치료받고 있는 고혈압 환자 295명을 대상으로 하여, 의무기록조사와 전화설문조사를 병행하여 실시되었다. 그 결과는 다음과 같다. 1. 대상자 295명중 남자가 108명(36.6%), 여자가 187명 (62.7%)이었으며 평균연령은 남자 64.6세, 여자 66.3 세로 여성에서 더 높았다(p<0.05). 2. 대상자의 54.9%가 지속적인 치료를 받는 것으로 조사되었고, 간헐적 치료군이 19.3%, 치료중단군이 25.8%였다. 3. 성, 연령, 의료보장, 거주지 등 연구대상자의 특성중 거주지로부터 보건지소까지 이동시 소요되는 시간만이 치료지속성과 통계적으로 유의한 관련성이 있었다(p<0.01). 3. 치료중단의 이유로는 증상 또는 몸의 불편함이 없어서가 23.9%를 차지하였고 그 다음으로 타의료기관 이용(18.4%), 교통의 불편(17.9%), 약국 이용(14.9%), 거동 불가능(7.5%), 경제적인 이유(6.0%), 보건지소 서비스에 불만족(4.4%) 순이었다. 4. 전체 대상자 295명의 평균 치료혈압은 $144.9{\pm}12.9/86.9{\pm}8.6mmHg$이었고, 이들 중 평균 치료혈압 이 140/90mmHg 미만으로 적절히 조절되는 환자는 32.5%였다. 이러한 연구결과를 종합해 볼 때, 보건지소 고혈압 환자들의 낮은 치료율, 관리율을 개선하기 위해서는, 적극적인 추후관리와 고혈압에 대한 환자의 잘못된 인식을 교정해주는 효과적인 보건교육을 포함하는 보다 체계적인 고혈압 관리 사업이 요구된다고 하겠다.

• 대한예방한의학회지
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• 제5권2호
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• pp.29-39
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• 2001

Purpose: This study was conducted to investigate and compare the growth, blood pressure, and s-cholesterol of urban and rural students in Korea. Methods: April 1999, We examined the students' health of a boys high school and a girls high school in a urban area - Jeonju, Korea.(boys were 317, girls were 343). And we also examined the students' health of a high school in a rural area - Gimje, Korea.(boys were 33, girls wee 36). Height, body-weight, Body Mass Index(BMI)I, blood pressure, and s-cholesterole were checked and compared between two groups. Results and Conclusion: The mean of height in urban students was $165.25{\pm}7.79cm$, and that in rural students was $163.77{\pm}8.72cm$. There was no significant difference stastically between two groups. The mean of body-weight in urban students $(57.78{\pm}10.51kg)$ was significantly higher than that in rural students $(54.71{\pm}10.11kg)$)(p<0.05). The mean of body mass index(BMI) in urban students $(21.12{\pm}3.27kg/m2)$ was significantly higher than that in rural students $(20.30{\pm}2.69kg/m2)$(p<0.05). Obese students $(BMI{\geq}27)$ were 31(4.70%) in urban students, 3(4.35%) in rural students. The mean of systolic blood pressure in rural students $(114.99{\pm}9.50mmHg)$ was significantly higher than that in urban students $(111.89{\pm}12.42mmHg)$(p<0.05) The mean of diastolic blood pressure in rural students$(75.72{\pm}9.90mmHg)$ was very significantly higher than that of urban students $(68.45{\pm}9.40mmHg)$(p<0.001). Hypertensives (${\geq}138/86mmHg\;in\;boys,\;{\geq}130/83mmHg$ in girls) were 28(4.24%) in urban students, 13(18.84%) in rural students. The mean of s-cholesterol in urban students was $174.95{\pm}32.28mg/dL$, and that in rural students was $176.81{\pm}33.18mg/dL$. There was no significant difference stastically between two groups. Hypercholesterolemias (${\geq}198mg/dL$ in boys, ${\geq}212mg/dL$ in girls) were 130(19.70%) in urban students, 14(20.89%) in rural students. These results suggest that there are differences in body weight, BMI, and diastolic blood pressure between urban and rural students and that it is necessary to consider these differences in health examination.