시력과 삶의 질: 제4기 국민건강영양조사자료
Visual Acuity and Quality of Life: KNHANES IV
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목적: 시력과 삶의 질의 연관성을 고찰하였다. 대상과 방법: 11,022명의 제4기 국민건강영양조사를 완료한 군에서 시력과 표준화된 삶의 질 평가방법인 EQ-5D을 이용하여 이들간관계를 선형회귀분석을 통해 비교하였다. 결과: 시력이 감소할수록 삶의 질이 떨어지며 운동능력, 일상활동, 통증/불편에 영향이 크고, 특히나 일상 활동 측면에서 삶의 질 저하가 두드러졌다. 자기관리, 불안/우울에 미치는 영향은 크게 나타나지 않았다. 일상 활동과 관련하여 logMAR 시력이 0.0부터 0.5인군을기준으로 1.6에서 3.0인군의 삶의 질이 adjusted Odds Ratio = 23.6 (95% Confidence interval, 4.8-115.5)만큼 낮았다. 삶의 질은65세 이상의 고령, 저소득층, 낮은 교육수준, 독신으로 사는 군에서 유의하게 낮았다. 결론: 시력이 감소할수록 운동능력, 일상활동, 통증/불편의 삶의 질이 낮아지며, 이는 낮은 시력에 의한 활동제한이 원인으로 생각된다. 고령, 저소득, 낮은 교육 수준, 독신 등의 취약점을 동시에 가진다면 삶의 질이 더욱 낮을 수 있고, 이러한 면을 고려하여 활동 제한을줄임으로써 삶의 질 향상을 기대할 수 있다.
Abstract
Purpose: To evaluate the health-related quality of life (QOL) in Koreans according to visual acuity. Methods: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. The present study included 11,022 Koreans who completed the KNHANES IV. The relation of visual acuity and QOL was verified,and EuroQoL 5D (EQ-5D) was identified using the adjusted mean based on linear regression analysis. Results: As visual acuity decreased, QOL decreased. QOL in mobility, usual activities, and pain/discomfort were affected by the vision gradient, while self-care and anxiety/depression were less influenced by the vision gradient. In particular,QOL in usual activities was significantly affected by the visual gradient. Subjects with a visual acuity of 1.6-3.0 were less likely to have a low QOL in usual activities compared to subjects with a visual acuity of 0.0-0.5 as a reference group (adjusted Odds Ratio = 23.6, 95% CI, 4.8-115.5). QOL in usual activities was statistically low in subjects older than 65years of age, with low household monthly income, low education, and living without a spouse. Conclusions: As visual acuity decreased, QOL in the aspect of mobility, usual activities, and pain/discomfort decreased severely, which resulted from activity limitation. Considering that the risk group with increasing age, low income, low education,and living without a spouse had lower QOL, the most important is to increase activity, which can induce the improvement of QOL in Koreans who have low visual acuity and related risk factors is.
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