고혈압, 당뇨병 성인의 뇌졸중 및 심근경색증 조기 증상 비인지 : 관련 요인질병 관리 관련 특성을 중심으로 = Factors Associated with Unawareness of Early Symptoms of Stroke and Myocardial Infarction in Adults with Hypertension and Diabetes: Focused on Management related to Disease

국문 초록 (Abstract)

본 연구의 목적은 고혈압 및 당뇨병을 진단 받은 성인의 뇌졸중 및 심근경색증의 조기 증상 인지 정도를 파악하고 비인지와 관련된 요인을 분석하기 위함이다. 2017년 지역사회건강조사 원시자료를 활용하여;40세 이상 성인 12,277명의 자료를 분석하였다. 뇌졸중 및 심근경색증의 조기 증상 인지율은 각각 53.6%와 46.8%였다. 뇌졸중 및 심근경색증 조기 증상 비인지 요인을 평가하기 위해 로지스틱 분석을 수행하였다. 고혈압 관리 교육;혈압 수치 및 당화혈색소 수치 인식은 다변량 분석에서 인구사회학적 변수를 보정한 후에도 뇌졸중 조기 증상 비인지와 유의한 관련이 있었다. 혈압 수치 및 당화혈색소 수치 인식은 심근경색증 조기 증상 비인지와 유의한 관련이 있었다. 그러므로 고혈압과 당뇨병을 모두 관리해야 하는 고위험군에 대한 홍보 촉진 및 교육 강화 등 심뇌혈관질환 조기 증상 인지 수준 개선을 위한 중재 및 전략의 개발이 요구된다.

다국어 초록 (Multilingual Abstract)

The purpose of this research was to determine the degree of awareness of early symptoms of stroke and myocardial infarction in adults diagnosed with hypertension and diabetes;and to analyze factors related to unawareness. Raw data from the 2017 Community Health Survey were utilized. A total 12,277 adults older than 40 years were included in analysis finally. The early symptom awareness rates of stroke and myocardial infarction were 53.6% and 46.8%;respectively. Logistic analysis was performed to assess factors associated with unawareness of early symptom of stroke and myocardial infarction. After correcting for socio-demographic variables;education for the management of hypertension;recognition of blood pressure level and HbA1c level were significantly related to stroke early symptom unawareness on multivariate analysis. (Education for the management of hypertension;recognition of blood pressure level and HbA1c level were significantly related to the unawareness of early stroke symptoms even after socio-demographic variables were corrected in multivariate analysis.) Recognition of blood pressure level and HbA1c level were also significantly associated with unawareness of early symptoms of myocardial infarction. Therefore;it is required to interventions and strategies to improve the level of awareness of early symptoms of cardio-cerebrovascular disease;such as accelerating promotion and strengthening education for high-risk groups who must manage both hypertension and diabetes.

목차 (Table of Contents)

• 1. 서론 2. 연구방법 3. 결과 및 고찰 4. 논의 5. 결론

참고문헌 (Reference)

• 1 김미나, "지역사회 당뇨병 유병자와 비유병자의 심근경색증 및 뇌졸중 조기증상과 대처방안 인지도 비교: 성향점수매칭분석" 한국보건행정학회 30 (30): 386-398, 2020
• 2 이영훈, "지역사회 교육홍보사업이 지역주민의 뇌졸중 경고증상 및 골든타임인지도에 미치는 효과" 한국보건교육건강증진학회 32 (32): 1-10, 2015
• 3 이유미, "일개 광역시 지역주민의 뇌졸중 조기증상 인식도와 관련요인" 한국산학기술학회 15 (15): 5116-5123, 2014
• 4 조미래, "뇌졸중 고위험 환자의 뇌졸중 경고증상 인지율 및 비인지 영향요인: 2017년 전국 지역사회건강조사 자료 활용" 한국성인간호학회 31 (31): 403-413, 2019
• 5 Hee Sung Kim, "고혈압을 동반한 당뇨병에서 유병기간에 따른 뇌졸중 위험도" 대한임상검사과학회 52 (52): 188-193, 2020
• 6 S. Mahagan, "Variation and Disparities in Awareness of Myocardial Infarction Syndromes Among Adults in the United States" 2 (2): e1917885-, 2019
• 7 Korean Diabetes Association, "Treatment and Management"
• 8 Korea National Diabetes Program (KNDP), "Treatment Guidelines for Cardiovascular Complications in Diabetes"
• 9 K. Thygesen, "Third Universal Definition of Myocardial Infarction" 60 (60): 1581-1598, 2012
• 10 S. H. Lee, "Symptoms Awareness of Acute Myocardial Infarction and Stroke and Related Factors in Ulsan" Ulsan University 2020
• 11 V. Bhat, "Stroke Awareness among Elderly Hypertensives in a Rural Area of Bangalore District, India" 30 (30): 105467-, 2020
• 12 J. M. Ramírez-Moreno, "Stroke Awareness Is Worse among the Old and Poorly Educated : A Population-Based Survey" 24 (24): 1038-1046, 2015
• 13 Statistics Korea, "Statistics of the Elderly in 2020" Statistics Korea
• 14 D. K. Moser, "Reducing Delay in Seeking Treatment by Patients with Acute Coronary Syndrome and Stroke : A Scientific Statement from the American Heart Association Council on Cardiovascular Nursing and Stroke Council" 114 (114): 168-182, 2006
• 15 S. Whitaker, "Public Knowledge of the Symptoms of Myocardial Infarction : A Street Survey in Birmingham, England" 29 (29): 168-173, 2012
• 16 J. C. Finn, "Patient Delay in Responding to Symptoms of Possible Heart Attack : Can We Reduce Time to Care?" 187 (187): 293-298, 2007
• 17 P. Goldstein, "Management of Prehospital Thrombolytic Therapy in ST-segment Elevation Acute Coronary Syndrome(<12 Hours)" 71 (71): 297-302, 2005
• 18 Medical Times, "Hypercholesterolemia in Adults Steadily Increases...Hypertension Decreases"
• 19 박경실, "Factors affecting awareness of myocardial infarction symptoms among the general public in Korea" 한국역학회 42 : 1-7, 2020
• 20 J. Sim, "Factors Associated With the Hospital Arrival Time in Patients With Ischemic Stroke in Korea" 31 (31): E10-E16, 2016
• 21 I. S. Ko, "Effects of Health Education on the Knowledge and Self-care of Hypertension for Visiting Nursing Clients" 21 (21): 134-145, 2007
• 22 Centers for Disease Control and Prevention (CDC), "Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms --- 14 States, 2005" 57 (57): 175-179, 2008
• 23 A. Gonzalez-Aquines, "Contribution of Onset-to-Alarm Time to Prehospital Delay in Patients with Ischemic Stroke" 28 (28): 104331-, 2019
• 24 Inha University Hospital, "Complication of Hypertension"
• 25 Korea Centers for Disease Control and Prevention, "Community Health Survey, 2017" Korea Centers for Disease Control and Prevention
• 26 Statistics Korea, "Cause of Death Statistics in 2019" Statistics Korea
• 27 J. M. Barnhart, "Awareness of Heart Attack Symptoms and Lifesaving Actions among New York City Area Residents" 82 (82): 207-215, 2005
• 28 J. E. Bray, "Australian Public’s Awareness of Stroke Warning Signs Improves after National Multimedia Campaigns" 44 (44): 3540-3543, 2013
• 29 H. S. Kim, "Acute Myocardial Infarction Symptoms and Factors related to Prehospital Delay among Korean Patients with ST-elevation MI" Seoul National University 2016