, 1, 1, 2, 1, 1, 1, 1, 1 1 2 = Ab st ra c t = Re la tio ns hip o f Le v e l o f Stre ss, Life Sty le, Subje c tiv e Sy m pto ms a nd C linic a l Dia g no s is in C lie nts ta ke n Multip ha s ic Sc re e ning Pro g ra m J un- H an P ark 1, J in- H o Chun 1, Jang - M i K ang 2, By ung - Chul S on 1, Dae- H wan K im 1, Chang - H ee L ee 1, K ui- W on J eong 1, Sang - H wa Urm 1, D ep artm ent of P reventive M edicine, Colleg e of M edicine, I nj e Univers ity 1 Graduate S chool of P ublic H ealth, I nj e Univers ity 2 T o impr ov e w ellnes s an d quality of life by r ecognizin g the health effect s of str es s, the auth or estim ated the relation ship s betw een stress, subjectiv e symptom s an d clinical diagn osis throu gh a qu estionnaire and a battery of specified laboratory test s - electrocardiography, blood pres sure, cholesterol, aspartate amin otran sferase (A ST ), alanine amin otran sferase (A LT ), g amm a glutamyl tran sferase (- GT P ), fasting blood sug ar, gastro- endoscopy or UGI, abdomin al sonography, etc. T he data w as gathered from 337 client s w ho w ere underg oing multiph asic screening program at a Univ ersity Hospital from Janu ary to M arch 1998. T he m ean ag e of subjects w as 46.511.2 y ear s and th e m ean of body m ass index w as 24.03.7kg/ m 2. T he m ean lev el of stress w a s 18.56.0 expressed as the score out of 40. By g eneral characteristics and life style am on g m ale, mean lev el of stres s w as significantly high er in case of low er socioeconomic statu s, habitual drug u se, long er daily w orking tim e (> 10 hour s ), no regular ex ercise, drinker s, irregular m eal, skippin g breakfa st (p< 0.05). In case of fem ale, that w as significantly higher in case of low er edu cation, low er socioeconom ic statu s, lon ger daily w orkin g tim e (> 10 hour s ), n o regular ex ercise, drinkers, smoker s, irregular m eal, skippin g breakfast (p< 0.05). Significant correlation s w ere ob serv ed betw een stres s and subjectiv e symptom s in all kinds of organ sy stem (p< 0.01). Correlation coefficient s of stress am ong m ale w ere relativ ely high w ith n euro- psy chiatric symptom (=0.476) and cardio- v ascular symptom (=0.361) in order, an d correlation coefficients of stress am ong fem ale w a s highest w ith neuro- psy chiatric symptom (=0.371). T he prev alence of the diagnosis through the battery of laboratory test s w as high in upper g astrointestinal disorder s an d hypercholesterolemia in order in both sex group. A mong male the m ean score of stress w as significantly high in ulcer ativ e peptic disor der of upper g astr oint estin e an d hepatopathy in order (p < 0.05). Am ong fem ale that w as significantly high in diabetes m ellitu s. In summ ary, it is likely that there are association s betw een stress, subjectiv e symptom s an d clinical diagn osis. T o prom ote w ellness and qu ality of life through, therefore, it w ould be of v alu e that periodic stress ev aluation program an d stres s m an agement in cludin g apropriate control of sm oking and drinkin g, regular ex ercise an d m eal. key w ords : stress, subjectiv e symptom s, life style 1997.
.... -,,,. (homeostasis ) (Chrou sosgold, 1992)., (stressor ). (Lipow ski, 1985). (Lazaru s, 1978; Reiser, 1984;, 1996). (, 1996) (Uhlenhuth, 1973;, 1989) (KolbBrodie, 1982;, 1996). (p sy chosom atic disease)(cobb Rose, 1973;, 1996;, 1996), (Jenkin s, 1971; Hayn es, 1978) (M atthew s, 1987; Hu dson, 1988), (Bak erbarcai, 1970; CobbRose, 1973; Robin sonfuller, 1985;, 1992), (, 1989;, 1997), (LintonKam w en do, 1989), (, 1986), (, 1998).,,,,, (BreslowEn strom, 1980; W iley Cam ach o, 1980; M etzner, 1983;, 1990;, 1994;, 1998).,,,,.
. 1. 1998111998331 3 1 337( 175, 162). 2..,,.,,,,,,.,,,,,,,,,,,,,,,,,,,,,,, 44 100. 1 2,,,,. (1997) 10 045 0-14, 15-22, 23-40.,,..,,,,,,. 0.1cm 0.1 (Body M ass Index, BMI=W t ()/ Ht (m 2 )), 20.0, 20.0 25.0, 25.0 (T alleyphillips, 1988; Garrow, 1991). 102 8. 3..
, (complete bundle branch block ), (My ocardial isch emia or infarction ), Joint National Committee on Detection, Ev alu ation and T reatm ent of High Blood Pressure (JNC )(1978)140Hg 90 Hg, 221/ (, 1996), 57 (1997) 120/. Alanine amin otran sferase (A LT )46U/ L A spartate aminotran sferase (A ST ) 51U/ L - Glutamyl tran sferase (- GT P ) 78U/ L, 46U/ L (, 1998),. (UGI),. 4. PC SA S (v er 6.12), 2 - test,,, t - ANOVA..
. 1. 46.511.240 42.9%. 24.03.7 42.3%, 23.5%. 40 18.56.0 22.9%27.1%. 22.9% 20.0%, 79.1%80.8%.,,,, (1). p - () 0.014 < 39 40-49 50-59 60 48 (27.4) 75 (42.9) 30(17.1) 22(12.6) 47(29.0) 44(27.2) 39(24.1) 32(19.7) 95 (28.2) 119 (35.3) 69 (20.5) 54 (16.0) 46.511.2 (/ ) 0.001 < 20 20-25 25 12( 6.9) 89 (50.9) 74 (42.3) 22(13.6) 102(63.0) 38(23.5) 34 (10.1) 191(56.7) 112(33.2) 24.03.7 0.564 48 (27.4) 87 (49.7) 40(22.9) 38(23.5) 80(49.4) 44(27.1) 86 (25.5) 167 (49.5) 84 (25.0) 18.26.1 19.05.9 18.56.0 0.523 39 (22.9) 131(77.1) 30(20.0) 120(80.0) 69 (21.6) 251(78.4) 0.001 125 (79.1) 33 (20.9) 20(16.7) 120(83.3) 145 (47.8) 153 (52.2) * 19.713.8 0.001 130(80.8) 31(19.2) 45(36.9) 77(63.1) 175 (61.8) 108 (38.2) 2. (, ),,,,., (2).
N p - N p - () 0.054 0.2 74 < 39 48 20.25.1 47 19.06.1 40-49 75 17.46.3 44 17.65.8 50-59 30 17.25.8 39 19.36.3 60 22 17.56.8 32 20.35.3 (/ ) 0.543 0.651 < 20 12 20.05.9 22 20.08.1 20-25 89 17.96.4 102 18.85.7 25 74 18.15.7 38 18.85.4 0.088 0.001 21 20.04.6 27 20.05.3 61 18.07.0 47 19.26.3 66 17.55.4 38 15.05.5 0.007 0.003 118 17.65.9 100 18.15.8 37 20.66.0 40 21.36.0 0.329 0.208 140 17.85.8 110 18.55.9 35 18.18.6 52 19.86.1 0.054 0.85 7 55 17.16.1 102 18.96.2 96 19.16.0 40 18.75.5 3.,, 1,,. 1,.,, 1,,,, 1, (3).
N p - N p - 0.000 0.000 4 8.307.5 4 14.85.6 60 15.64.8 33 15.75.7 60 18.95.7 49 18.15.3 45 21.46.0 66 21.65.4 0.001 0.447 88 18.88.1 98 19.20.6 53 15.85.4 26 18.26.1 1 ( ) 0.023 0.003 <8 49 16.95.7 34 17.66.3 8-10 64 17.86.1 31 20.84.8 10 45 20.26.3 24 22.95.7 1 ( ) 0.841 0.918 2 15 17.33.2 18 18.77.2 3-4 63 17.86.8 49 19.36.5 5-10 64 18.56.2 32 19.85.8 10 14 18.66.7 9 20.35.2 ( ) 0.077 0.2 78 <6 14 21.15.7 24 20.55.1 6-8 85 18.66.3 66 18.86.1 8 65 17.25.8 58 18.26.2 0.000 0.000 38 13.85.1 30 14.75.6 131 18.55.8 120 19.95.6 0.207 0.001 125 18.55.9 20 22.84.9 33 17.08.5 100 17.85.9 0.012 0.001 130 18.95.4 45 20.76.5 31 14.87.8 77 18.36.0 4.,,, 1.,.,, 1 (4).
N p - N p - 0.000 0.103 87 16.55.6 67 17.86.4 37 18.45.4 38 20.25.6 47 21.66.1 54 19.85.4 0.001 0.003 105 16.95.7 92 17.75.9 41 19.45.3 38 21.44.8 28 21.37.0 28 19.86.5 0.568 0.716 34 17.26.8 58 19.05.7 113 18.56.2 94 19.15.9 21 18.35.0 8 17.38.3 1 () 0.425 0.855 55 17.35.6 68 19.16.2 1-2 84 18.66.7 72 19.05.8 3 34 18.75.1 18 18.66.3 5.. (=0.476), (=0.361) (=0.371)(5).
* 0.3482 0.1937 (0.0001) (0.0135) 0.3610 0.2876 (0.0001) (0.0002) 0.3386 0.1699 (0.0001) (0.0306) 0.2113 0.2186 (0.0050) (0.0052) 0.4761 0.3707 (0.0001) (0.0001) 0.1826 0.1233 (0.0156) (0.0080) 0.2694 0.2603 (0.0003) (0.0008) 0.2353 0.1677 (0.0017) (0.0330) 6. (81.1% ), (33.1% ), (14.3% ) (85.9% ).,. (85.2% ), (31.5% ), (19.1% ), (14.2% ), (18.0% ), (6.2% )(89.1% ). (6).
N (%) p - N (%) p - 0.668 0.174 19(10.9) 17.83.9 31(19.1) 20.35.7 156(89.1) 18.26.3 131(80.9) 18.66.0 0.718 0.600 58(33.1) 18.46.0 51(31.5) 18.55.7 117(66.9) 18.16.1 111(68.5) 19.06.0 0.129 0.518 19(10.9) 20.24.6 23(14.2) 20.76.5 156(89.1) 17.96.2 139(85.8) 18.85.9 0.304 0.002 12( 6.9) 16.46.2 10( 6.2) 22.63.4 163(63.1) 18.36.1 152(93.8) 18.86.0 0.032 0.722 25(14.3) 20.65.8 13( 8.0) 18.44.7 150(85.7) 17.88.1 149(92.0) 19.06.1 0.060 0.525 142(81.1) 17.88.3 138(85.2) 18.86.0 33(18.9) 18.84.5 24(14.8) 19.75.4 0.006 0.066 122(85.9) 17.26.3 123(89.1) 18.56.0 20(14.1) 21.45.4 15(10.9) 21.55.9
. 20. (H olmesrahe, 1967; Kessler, 1985), (Lipow ski, 1985). (Lazaru s, 1978 ; Reiser, 1984;, 1996), (Hinkle, 1997)., (, 1988;, 1997).,,. 46.5, 24.0. 4018.5 25%. 22.9%, 20.0% 79.1%80.8%. (, 1988;, 1990). 30. (, 1988;, 1996), (, 1988;, 1996). (1989) (1996),,,. (, 1989;, 1994;, 1997). (, 1989;, 1995;, 1996;, 1997).,
.,,,. 1 10, 16,. (, 1994;, 1996), (, 1990;, 1994).,,. BreslowEn strom (1980), W ileycam acho (1980),..,,,,,,, (p< 0.01), (=0.476), ( =0.361)(=0.371),, (1997) (1988).,. (W hiteh ead, 1978; Sh apirolehrer, 1980;, 1995). (81.1% ) (33.1% ) (85.0% ) (31.5% ).,. 53.1%, 57.3%, 71.4% (, 1988).
(Uhlenhuth, 1973;, 1989) (KolbBrodie, 1982;, 1996) (CobbRose, 1973;, 1996;, 1996), (Jenkin s, 1971; H aynes, 1978), (M atth ew s, 1987; Hudson, 1988), (BakerBarcai, 1970; CobbRose, 1973; Robin sonfuller, 1985;, 1992), (, 1989;, 1997), (LintonKamw endo, 1989), (, 1986), (, 1998). (1987),,,, (1996), (1996). KolbBrodie (1982),,,. (W hitehead, 1978). 78% 73%, 58% (, 1992). 8% 65%(Dim sdaleh erd, 1982). (1996). (1988) (1992). (Jenkin s, 1971; H aynes, 1973), (M atthew s, 1987; Hu dson, 1988), (Dim sdaleh erd, 1982),., 1,,,.,,,.
.,,,. 3371998111998 331, PC SA S. 46.511.2, 24.03.7 40 18.56.0, 22.9%27.1%. (, ), 1 (10 ),,,,, ( ), (, ), 1 (10),,,, (p< 0.05).,,,,,,, (p < 0.01), (=0.476), (=0.361) (=0.371).,,.,,,.
,.. 1992;31(6): 1084-1091.. 1988; 27 (3):525-533.. 1996;27 (3):514-521,,,,,.. 1998;19 (1):13-23,,.. 1996;35 (4): 1443-1457,.. 1987;26(3):495-503,,.,. 1988;27 (5):828-833,,.. 1989;28 (2):282-291,.. 1986;25 (3):503-509,,.,. 1997;30(4):791-804,,,.,. 1997;18 (8): 802-813.., 1995, p378-393,,,.. 1998;19 (2);205-214., 1998, pp111-112,,.,. 1994;33 (6);1409-1424,.,, 1996, 122-126.. 1990;23 (1);33-42.., 1997... 1995;3 (2):147-157,,,.. 1996;35(5):997-1005,,.. 1996;35 (5):982-995,,,.. 1998;21(2):365-373
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