폐경 여성의 신체활동이 정신건강에 미치는 영향 : 2010년 국민건강영양조사 자료 이용

다국어 초록 (Multilingual Abstract)

As a secondary analysis, this study was conducted to investigate the effect of each physical activity on entire Korean natural-menopause women's mental health according to their life process divided into middle age and old age and to provide basic data for the development of a nursing intervention program likely to enhance menopause women's physical activities and mental health. By using the data from Korea National Health and Nutrition Examination Survey conducted in the first year (2010) of the fifth period, this study selected a total of 1,470 natural menopause women as research subjects, 810 at the age between 40 and 64 and 660 over 65. The health survey questionnaire of the first year of the fifth period was used as a research tool, and the questionnaire used for this analysis was composed of 4 domains, general characteristics, menopausal characteristics, physical activities and mental health. As for the physical activity tool, this study adopted IPAQ (International Physical Activity Questionnaire) for adults suggested by WHO, and it was used to measure the degrees of physical activities of the research subjects divided into a physical activity practice group and a non-practice group. As for the analysis of data, this study carried out a complex sample analysis to estimate the entire Korean natural menopause women through the parent population by using SPSS 19.0 Complex Samples Module in addition to general analyses, such as descriptive statistical analyses for percentage and frequency, Chi-square test, correlation analysis and multiple logistic regression. The interpretation of survey results was conducted mainly with the complex sample analysis, and when additional explanation was required for statistical differences, it was supplemented through the results of general analyses.
The results of this survey can be summarized as below.
Firstly, it was found that menopause women were less likely to get engaged in physical activities in their daily lives, neither vigorous (highly intense) nor moderate ones, such as walking, muscular movements, and stretching exercises. As for their mental health, there were more women suffering stress and depression or even thinking of committing suicide in this group in general, but the stress recognition rate was 29.1% in women at the age between 40 and 64, and the suicide thought rate was 32.4% in women over 65, which were found to be highest in their mental health rates.
Secondly, as a result of analyzing their mental health by their physical activity practice through Chi-square test, it was found that when doing stretching exercise, both the stress recognition rate and the suicide thought rate became lower in all the research subjects. On the contrary, when doing highly-intense physical activities, they were more likely to get stressed out, with a higher depression recognition rate. Even in women over 65, the depression recognition rate was higher when being engaged in moderate physical activities, and in the general analysis, both walking and stretching exercise helped lower both the stress recognition rate and the suicide thought rate as well.
Thirdly, as a result of analyzing their physical activities by their general characteristics through Chi-square test, there were statistically significant differences found in moderate physical activities, muscular strength and stretching exercise. When living with their spouses by marriage, they were found to get more engaged in moderate physical activities, especially in women at the age between 40 and 64 (p=.016) and over 65 (p=.014). The results of general analyses show that research subjects whose educational background was below elementary school had low muscular strength and low stretching exercise practice rate, so they showed the necessary of proper exercise.
Fourthly, as a result of analyzing their mental health by their general characteristics through Chi-square test, there was no significant difference found between stress and depression, and both the two age groups had low suicide thought rates when living with their spouses by marriage.
Fifthly, as a result of analyzing the correlation between stress, depression and suicide in menopause women, it was found that there was a relatively high positive correlation in both the two age groups.
Sixthly, as a result of carrying out multiple logistic regression to find out the effect of their physical activities and general characteristics on their mental health, it was found that out of all the factors having effect on their stress, highly-intense physical activities made stress increase by 4.823 (95% CI:1.328-17.520) in women at the age between 40 and 64, and moderate physical activities helped them decrease stress by 0.175 (95% CI:0.036-0.854). In women over 65, stretching exercise was found to help them decrease stress by 0.572 (95% CI:0.327-0.998). Meanwhile, out of all the factors having effect on their depression, vigorous physical activities were found to make their depression recognition rate increase by 3.757 (95% CI:1.324-10.664) in women at the age between 40 and 64. Out of all the factors having effect on their thought of committing suicide, stretching exercise was found to help women at the age between 40 and 64 decrease the suicide thought rate by 0.200 (95% CI:0.068-0.589). In women over 65, however, living with their spouses by marriage helped them decrease the suicide thought rate by 0.888 (95% CI:1.256-2.839), compared to those who didn't live with their spouses through divorce, bereavement or separation.
It is expected that the results of this study can be used as evidentiary data when a nursing intervention program is developed to enhance menopause women's mental health through physical activities, and this study also suggests that further studies should make multilateral approaches with various different criteria.

목차 (Table of Contents)

• Ⅰ. 서론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 용어의 정의 4
• 1) 폐경 4
• 2) 신체활동 5
• 3) 정신건강 5
• 4. 연구의 제한점 5
• Ⅱ. 문헌고찰 6
• 1. 폐경 여성의 정신건강 6
• 2. 신체활동 12
• 3. 신체활동과 정신건강간의 관계 15
• Ⅲ. 연구방법 17
• 1. 연구설계 17
• 2. 연구모형 17
• 3. 연구대상 18
• 4. 자료수집방법 18
• 5. 연구도구 19
• 6. 자료분석방법 22
• Ⅳ. 연구결과 24
• 1. 대상자의 일반적 특성 24
• 2. 폐경여성의 신체활동과 정신건강 수준 29
• 3. 신체활동 실천에 따른 폐경여성의 정신건강 34
• 4. 폐경여성의 일반적 특성에 따른 신체활동과 정신건강 39
• 5. 폐경여성의 스트레스, 우울, 자살의 상관관계 50
• 6. 폐경여성의 정신건강에 영향을 미치는 요인 51
• Ⅴ. 논의 58
• Ⅵ. 결론 및 제언 63
• Ⅶ. 참고문헌 67
• 부록(측정지표 및 설문지) 78
• ABSTRACT 87
• 표 목 차
• <표 1> 학력별 특성 24
• <표 2> 결혼상태 25
• <표 3> 주택소유별 특성 25
• <표 4> 주택형태별 특성 26
• <표 5> 가구당 월평균소득별 특성 26
• <표 6> 가구원수별 특성 27
• <표 7> 기초생활 수급여부별 특성 27
• <표 8> 건강보험 종류별 특성 28
• <표 9> 민간의료보험 가입여부별 특성 28
• <표 10> 폐경 여성의 격렬한 신체활동 실천 29
• <표 11> 폐경 여성의 중등도 신체활동 실천 30
• <표 12> 폐경 여성의 걷기활동 실천 30
• <표 13> 폐경 여성의 근력운동 실천 31
• <표 14> 폐경 여성의 유연성 운동 실천 31
• <표 15> 폐경 여성의 스트레스 32
• <표 16> 폐경 여성의 우울 33
• <표 17> 폐경 여성의 자살 33
• <표 18> 신체활동 실천여부에 따른 스트레스 인지 (일반분석) 35
• <표 19> 신체활동 실천여부에 따른 스트레스 인지 (복합표본) 35
• <표 20> 신체활동 실천여부에 따른 우울 인지 (일반분석) 37
• <표 21> 신체활동 실천여부에 따른 우울 인지 (복합표본) 37
• <표 22> 신체활동 실천여부에 따른 자살생각 (일반분석) 38
• <표 23> 신체활동 실천여부에 따른 자살생각 (복합표본) 38
• <표 24> 일반적 특성에 따른 격렬한 신체활동 실천(일반분석) 39
• <표 25> 일반적 특성에 따른 격렬한 신체활동 실천(복합표본) 40
• <표 26> 일반적 특성에 따른 중등도 신체활동 실천(일반분석) 41
• <표 27> 일반적 특성에 따른 중등도 신체활동 실천(복합표본) 41
• <표 28> 일반적 특성에 따른 걷기 실천(일반분석) 42
• <표 29> 일반적 특성에 따른 걷기 실천(복합표본) 42
• <표 30> 일반적 특성에 따른 근력운동 실천(일반분석) 43
• <표 31> 일반적 특성에 따른 근력운동 실천(복합표본) 44
• <표 32> 일반적 특성에 따른 유연성 운동 실천(일반분석) 45
• <표 33> 일반적 특성에 따른 유연성 운동 실천(복합표본) 45
• <표 34> 일반적 특성에 따른 스트레스 인지(일반분석) 46
• <표 35> 일반적 특성에 따른 스트레스 인지(복합표본) 47
• <표 36> 일반적 특성에 따른 우울 인지(일반분석) 47
• <표 37> 일반적 특성에 따른 우울 인지(복합표본) 48
• <표 38> 일반적 특성에 따른 자살생각(일반분석) 49
• <표 39> 일반적 특성에 따른 자살생각(복합표본) 49
• <표 40> 폐경 여성의 스트레스, 우울, 자살의 상관관계 분석 50
• <표 41> 다중 로지스틱회귀분석에 사용된 변수 51
• <표 42> 폐경 여성의 스트레스에 영향을 미치는 요인 53
• <표 43> 폐경 여성의 우울에 영향을 미치는 요인 55
• <표 44> 폐경 여성의 자살생각에 영향을 미치는 요인 57
• 그 림 목 차
• 그림 1. 연구모형 17