노인건강상태별 보건교육 요구도 조사연구

Abstract

Entering into an aging society at a high speed unprecedented in world history, Korea will face the super-aged society and many resultant elderly health problems. Thus it is important to identify problems with elders' health through health examination as a part of health service for elders and execute health education to elders according to their health condition so that elders have appropriate abilities to manage and protect themselves. Thus this study analyzed health examination records of 223 elders aged over 65, who had free health examination at the Seoul Branch of Korea Health Association, and conducted a questionnaire survey through personal and telephone interviews from the 10th to 31st of October 2003 in order to provide basic information about health education by group characteristic by identifying the need of health education according to the health state of the elderly. Collected data were digitized and analyzed using SPSS Win 11.0. For the analysis, the researcher used statistic techniques including frequencies, percentages, means, standard deviations, χ^(2)-test, t-test and ANOVA and obtained results as follows. 1. As for the demographical characteristics of the subjects, 84.3% of them were female and their average age was 72.5. Most of the subjects were elementary school graduates, and 61.9% were bereaved of their spouses. As for monthly income, 37.2% earned no more than 290,000 won, 65.9% were attending local social welfare centers, and 36.1% did not drink nor smoke for heath. Among elders who had received the result of health examination, 47% got re-examination or treatment and 33.6% had counseling or health education after health examination. 2. Among the subjects, 79.8% had one or more diseases and 26.8% of them had arthritis and neuralgia, 21.7% hypertension, 10.7% diabetes, and 8.8% hyperlipemia and arteriosclerosis. As the number of diseases increased, elders' subjective perception on health got worse and the difference was statistically significant (p<0.001). 3. According to the result of analyzing elders' demand for health education according to general characteristics, female elders and those who attended meetings perceived more the necessity of education, and the will to participate in health education was stronger in female elders (p<0.05), those who attended meetings (p<0.001) and those who practiced health-promoting behaviors (p<0.01), and the difference was statistically significant. 4. As for education contents, elders preferred most the area of 'disease prevention and management.' Detailed education contents preferred by elders were in order of dementia, paralysis and apoplexy, arthritis and neuralgia, hypertension, etc. In addition, elders' preference was significantly different according to their academic qualification (p<0.05) and exercise (p<0.05). Elders preferred personal counseling for education method and local community centers for education place, but male elders and those who did not attend meetings preferred hospitals, and the difference was statistically significant (p<0.001). 5. According to the result of analyzing elders' demand for health education according to their health condition, their will to participate was weaker when their subjective perception on their health was low, and stronger when the number of diseases increased but if the number of diseases was 3 or more elders' will to participate in health education rather went down, and these were statistically significant (p<0.05). 6. The most preferred content of education was 'disease prevention and management' for all elders regardless of their health condition, and the next was 'exercise and weight control.' Elders with three or more symptoms demanded relatively high for 'mental health and stress control' and 'how to use medical institutions' than healthy elders and those with only one symptom, but the difference was not significant statistically. 7 . As for education methods, elders who were not healthy subjectively and had two composite diseases preferred personal counseling most, and next specialists' lectures. There was a statistically significant difference in preferred education method according to the number of diseases (p<0.05). Elders who were not healthy subjectively and had two composite diseases preferred local community centers as education place, and those with a single disease relatively preferred hospitals. In addition, there as a statistically significant difference in preferred education place according to the number of diseases (p<0.05).;고령화 사회로의 진입속도가 세계적으로도 그 유례를 찾아볼 수 없이 빠른 우리나라는 곧 초고령 사회를 맞이하게 될 것이며 그에 따른 노인보건문제를 예측 가능케 한다. 이에 따라 노인보건사업의 하나인 건강검진으로 노인의 건강문제를 발견하고 적합한 자기관리·자기보호 능력을 함양시킬 수 있도록 건강상태에 따라 보건교육을 실시하는 것이 중요하다. 이에 본 연구에서는 노인건강상태별 보건교육 요구도를 파악하여 특성별 집단보건교육의 기초자료를 제공하고자 한국건강관리협회 서울시지부 건강증진센터에서 무료건강검진을 받은 일부 65세 이상 노인의 수검자료 335부를 1차분석한 후 이를 근거로 223명의 노인을 선별하여 2003년 10월 10일부터 31일까지 방문 및 전화면접으로 설문조사를 직접 실시하였다. 조사된 자료는 모두 전산부호화하여 SPSS Win 11.0을 이용하였고, 빈도, 백분율, 평균 및 표준편차, χ^(2)-test, t-test, ANOVA의 통계기법에 의해 분석하였으며 결과는 다음과 같다. 1. 대상자의 인구학적 특성은 여성노인이 84.3%이었고 평균연령이 72.5세로 교육수준은 초졸 이하이며, 61.9%가 사별상태이었다. 월수입은 29만원 이하가 37.2%이고, 65.9%가 지역사회복지관에 참석하며 건강관리행위는 금연·금주의 실천이 36.1%이었다. 검진결과를 통보 받은 노인의 47%만 재검 또는 치료를 받았으며 검진 후 상담 또는 보건교육을 받은 노인은 33.6%이었다. 2. 대상자의 79.8%가 하나 이상의 질병을 가지고 있었고 관절염 및 신경통 26.8%, 고혈압 21.7%, 당뇨병 10.7%, 고지혈증 및 동맥경화 8.8% 등의 순이었으며, 질병수가 증가할수록 주관적 건강인식도 나빠져 통계적으로도 유의한 차이가 있었다(p<0.001). 3. 일반적 특성별 보건교육 요구도를 분석한 결과, 여성노인과 모임에 참석하는 노인의 경우 교육의 필요성을 더 인식하고 있었으며 여성노인의 경우(p<0.05), 모임에 참석하는 경우(p<0.001), 건강행위를 실천하는 노인에게서(p<0.01) 참여의지가 더 높았고 이는 통계적으로 유의하였다. 4. 교육내용은 '질병예방 및 관리' 영역의 요구도가 가장 높았으며 그 세부내용으로는 치매, 중풍 및 뇌졸중, 관절염 및 신경통, 고혈압 등의 순이었다. 또한 교육수준(p<0.05)과 운동여부(p<0.05)에 따라 유의한 차이가 있었다. 교육방법은 개인상담을, 교육장소는 지역사회복지관을 가장 선호하였으나 남성노인의 경우와 모임에 참석하지 않는 노인의 경우 병의원을 선호했으며 통계적으로 유의하였다(p<0.001). 5. 건강상태별 보건교육 요구도를 분석한 결과, 참여의지는 주관적으로 건강하지 못한 경우 상대적으로 낮았으며 질병수가 증가할수록 높았으나 3개 이상인 경우 오히려 낮았으며 이는 통계적으로 유의하였다(p<0.05). 6. 교육내용의 요구는 어떠한 건강상태에서도 '질병예방 및 관리' 영역이 가장 높았으며 다음으로 '운동 및 체중관리'를 선호하였으며, 3개 이상의 복합소견을 가진 노인의 경우 정상이거나 단일소견인 노인보다 '정신건강 및 스트레스 관리'와 '의료기관 이용법' 영역에서 상대적으로 요구도가 높았으나 유의하지는 않았다. 7. 교육방법에서는 주관적으로 건강하지 않고 2개의 복합질병을 가진 노인이 개인상담 다음으로 전문가의 강의를 선호하였으며 질병수와 교육방법 간에는 통계적으로 유의한 차이가 있었다(p<0.05). 교육장소로 지역사회복지관을 가장 선호하는 노인은 주관적으로 건강하지 못하고 2개의 복합질병을 가졌으며, 단일질병을 가진 경우 상대적으로 병의원을 선호하였다. 또한 질병수와 교육장소 간에는 통계적으로 유의한 차이가 있었다(p<0.05).