Clinical study J Sasang Constitut Med 2019;31(2):12-21 https://doi.org/10.7730/jscm.2019.31.2.12 1 년간검사 - 재검사법을통한단축형사상체질진단설문 (KS-15) 의신뢰도평가 배광호 1* 김상혁 1* 고호연 2 박기현 1 이시우 1 이수진 3 1 한국한의학연구원미래의학부, 2 세명대학교한의과대학한방내과학교실, 3 상지대학교한의과대학생리학교실 Abstract One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students Kwang-Ho Bae 1* Sang-Hyuk Kim 1* Ho-Yeon Go 2 Ki-Hyun Park 1 Siwoo Lee 1 Soojin Lee 3 1 Future Medicine Division, Korea Institute of Oriental Medicine, 2 Department of Internal Medicine, College of Korean Medicine, Semyung University, 3 Department of Physiology, College of Korean Medicine, Sangji University Objectives This study was aimed to evaluate the one-year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students. Methods In March 2017, and March 2018, a survey was sent by email to 583 Korean medicine students in two universities. Of these, 149 (25.6%) participated and completed the first survey (test) and second survey (retest). Participants responded to the KS-15 questionnaire and the general characteristics including their age, sex, height, and weight. Cohen s kappa Spearman s rank correlation coefficient and agreement rate (%) were used for the test-retest reliability for each question item and the diagnosis of the Sasang constitution. The independent T-test was used to determine the difference in BMI between Sasang constitutional accordance and discordance groups obtained from the test-retest results of KS-15. Results The agreement of Sasang constitutional diagnosis was 75.8% (Kappa = 0.618), indicating that KS-15 had a certain level (substantial) of test-retest reliability. However, the kappa of each item was 0.161 ~ 0.620, which showed a large difference between the items. The agreements of each Sasang constitution were 85.1% for Taeeumin, 73.6% for Soeumin, and 58.6% for Soyangin. There was no significant difference in the BMI change between Sasang constitutional accordance and discordance groups in the test-retest. Conclusions These results indicate KS-15 has a reliable one-year test-retest reliability. However, further studies will be required to improve reliability, validity and application across different age ranges for the practical utilization of KS-15. Key Words : Sasang Constitution, Questionnaire, KS-15, Reliability, test-retest Received June 10, 2019 Revised June 12, 2019 Accepted June 25, 2019 Corresponding author Soojin Lee College of Korean Medicine, 83 Sangjidae-gil Wonju-si Gangwon-do, 220-702, Republic of Korea Tel:+82-33-730-0673, Fax:+82-33-730-0653, E-mail:jinlee@sangji.ac.kr C The Society of Sasang Constitutional Medicine. All rights reserved. This is an open acess article distributed under the terms of the Creative Commons attribution Non-commercial License (http:// creativecommons.org/licenses/by-nc/3.0/)
KH Bae et al 13 Ⅰ. 緖論 사상의학에서는체질에따라인체의소증 ( 素證 ) 과질병의발현이다르고, 이에따라건강관리및치료방법역시다르게적용하기때문에, 체질진단은매우중요한과정이라고할수있다 1,2. 하지만전통적인사상체질진단은대상자의체형기상 ( 體形氣像 ), 용모사기 ( 容貌詞氣 ), 성질재간 ( 性質材幹 ), 병증약리 ( 病證藥理 ) 를근거로한의사의주관적판단에의하여이루어지기때문에일반인혹은다른분야연구자들이사상체질진단에접근하기에는어려움이있었다 3. 이러한한계를보완하고, 체질진단의객관성을위해진단도구개발연구가이루어져왔는데그중에는한의사의체질진단방법과유사하면서도기기를활용하여체형, 안면, 음성, 소증등을정량화한체질진단도구가연구개발되기도하였으나 4, 많은연구들은설문도구만을활용하는방식으로수행되었다. 사상체질설문도구는 1987년사상체질변증방법론연구에서변증을위한기초설문을시작으로 5, 사상체질분류검사지 (QSCC) 6, 개정된사상체질분류검사지 Ⅱ(QSCCⅡ+) 7 와의사용, 전문가용체질진단지 (SDQ) 8,9, 사상체질진단을위한 2단계설문지 (TS-QSCD) 10 등이개발되었으며, 2015년에는문항을간소화하여짧은시간에체질을판별할수있는단축형사상체질진단설문지 (Korea Sasang Constitutional Diagnostic Questionnaire, KS-15) 11 가개발되었다. KS-15 는외형, 심성, 소증을기반으로실용성과활용도가제고된설문으로, 외형을반영하는체질량지수 (Body mass index, BMI) 와심성을반영하는 6문항, 소증을반영하는 8문항으로구성되어있으며, 그중대소변관련문항은성별에따라차이가있도록구성되어있다 11. 2015년백등에의해서 KS-15 설문개발과타당도와관련한연구결과가발표된이후, 신뢰도연구 12, 웹기반시스템연구 13, 일본인적용가능성을위한추가연구 14 등후속연구가수행되었으며, 또한 KS-15 를이용한임상연구들이수행된바있다 15,16. 이러한점에미루어볼때, KS-15 설문은신뢰도와 타당도, 실용성을갖추었다고볼수있으나, 사상체질진단은시간이경과하여도변동이적은체형기상, 용모사기, 성질재간, 병증약리를토대로이루어지기때문에체질진단설문도구역시시간경과에도진단결과가어느정도유지되는지를살펴보는것역시중요하다고할수있다. 이전에 303 명의 20대성인을대상으로하여 14일간격으로검사- 재검사를수행한연구에서는 87.1% 의일치도를보여신뢰도가확보되었으나, 그보다장기간시간경과시일치도에대해서는연구된바가없었다 12. 이에본연구에서는 KS-15 설문후약 1년뒤재검사를시행하여어느정도의일치도를나타내는지확인하고자하였다. Ⅱ. 硏究對象및方法 1. 연구대상자및자료수집온라인설문조사업체 SurveyMonkey(https://ko.surveymonkey.com/) 에의뢰하여, 2017년 3월과 2018년 3월, 2회에걸쳐 2개한의과대학의 6개학년학생들을대상으로설문조사를실시하였다. 2개한의과대학학생수는총 583명이었으며, 이중 523 명이 1차조사에응답하였다. 그중 19세미만인자 7명, 자발적연구참여에동의하지않은자 57명, 재검사 (2차) 미응답자 160명, 설문문항중미입력문항이있는자 150 명을제외하여총 149명을최종분석대상으로하였다. 본연구는세명대학교충주한방병원생명윤리위원회의승인 ( 승인번호 SMCJ-1702-02) 을받아진행되었다. 2. 설문도구본연구에서 KS-15 설문과함께대상자의일반적특성파악을위해연령, 성별, 신장, 체중이조사되었다. KS-15 는체형 (BMI), 성격, 소증의중요항목을선별하여체질을분류하는설문도구로, 성격관련
14 One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students 6문항과소화, 식욕관련 2문항, 땀관련 2문항, 추위 / 더위관련 1문항, 음수관련 1문항과남성에게적용되는야간소변 1문항, 여성에게적용되는대변긴박 1문항, 그리고연령대별 BMI 로구성되어있다 11 (Appendix 1). KS-15 의체질진단결과는 KDC(Korean medicine Data Center) 17 에서수집된체질확진자들의데이터를바탕으로얻은문항별체질가중치를적용하여이루어진다. 각문항의가중치는사상체질전문가의진단을받고일정기준이상의체질처방에호전반응을보인자들을체질확진자 (gold standard) 로설정하고, 카이제곱검정을통해각문항의응답차이에대한 p-value를구하여이값을로그로치환해각문항별체질가중치를구한다. 이값은성별에따라다르게적용하며, 14문항의가중치를더한대상자의태음인, 소음인, 소양인점수 3개와연령대별가중치가적용된 BMI 값을독립변수로설정하고체질을종속변수로하는로지스틱회귀분석을수행한다. 이회귀식을통해체질별확률값을구하여이중가장높은확률값을나타내는체질을대상자의체질로판정하게된다 11. 3. 자료분석방법대상자들의성별, 연령, BMI, 체질분포중범주형데이터는빈도분석 (frequency analysis) 을이용하여 number와 % 로표시하였고, 연속형데이터는평균 (mean) 과표준편차 (standard deviation, SD) 로표시하였다. 검사- 재검사법신뢰도는각문항별 Spearman s rank correlation analysis( 서열척도로구성되지않은 10, 13, 14번문항제외 ), 일치도 (%), 측정수준간의일치도를나타내는 Cohen's kappa 18 를사용하였으며, 체질진단결과에대한신뢰도또한일치도와 Cohen's kappa를사용하였다. 검사- 재검사결과를통해얻어진체질일치군과불일치군간의 BMI 변화량차이는 independent t-test를사용하였다. 통계프로그램은 SPSS Statistics 25.0(KoreaPlus Statistics for Public Service) 를이용하였으며, 유의수준은 P < 0.05로하였다. Ⅲ. 硏究結果 1. 일반적특성전체 149 명의대상자중남성은 97명 (65.1%), 여성은 52명 (34.9%) 이었다. 평균연령은 22.7 세였으며평균BMI 는 21.9 였다. KS-15 1차결과에따른체질분포는태음인이 67명 (45.0%), 소음인 53명 (35.6%), 소양인 29명 (19.5%) 이었다. 남성에서는태음인이가장많았고 (53.6%), 여성에서는소음인이가장많아 (44.2%), 남녀모두소양인의비율이가장적었다 ( 남 : 15.5%, 여 : 26.9%) (Table 1). 2. KS-15 문항별검사- 재검사신뢰도남성에서 11번문항을제외한 1~14 번문항의일치도 (%) 는 72.2, 63.9, 70.1, 71.1, 68.0, 66.0, 53.6, 62.9, Table 1. Participants General Characteristics at the Baseline (2017) Variables Men (n = 97) Women (n = 52) Total (n = 149) Age (years) 22.9 ± 2.2 22.2 ± 1.9 22.7 ± 2.2 Height (cm) 174.8 ± 5.5 161.8 ± 5.3 170.2 ± 8.2 Body weight (kg) 70.1 ± 9.3 52.2 ± 6.5 63.9 ± 12.0 Body mass index (kg/m 2 ) 22.9 ± 2.7 20.0 ± 2.7 21.9 ± 3.0 Constitution Taeeumin 52 (53.6%) 15 (28.8%) 67 (45.0%) Soeumin 30 (30.9%) 23 (44.2%) 53 (35.6%) Soyangin 15 (15.5%) 14 (26.9%) 29 (19.5%) Results are presented as n (%) or mean ± standard deviation.
KH Bae et al 15 71.1, 54.6, 66.0, 67.0, 80.4 로나타났으며 Kappa 값은 0.501, 0.402, 0.413, 0.533, 0.390, 0.465, 0.259, 0.263, 여성에서 0.408~0.743, 전체에서 0.246~0.669 사이의값을나타냈다 (Table 3). 0.525, 0.325, 0.172, 0.458, 0.484 로나타났다. 여성에서 12번문항을제외한 1~14 번문항의일치도 (%) 는 71.2, 75.0, 59.6, 67.3, 57.7, 61.5, 63.5, 69.2, 67.3, 44.2, 63.5, 86.5, 75.0 이었으며, Kappa 값은 0.477, 0.620, 0.316, 0.465, 0.259, 0.389, 0.459, 0.363, 0.517, 0.161, 0.320, 0.780, 0.582로나타났다 (Table 2). KS-15 의 Spearman 상관계수는남성에서 0.217~0.676, 3. KS-15 검사- 재검사체질진단및체질별일치도 KS-15 의체질진단결과일치도는남성에서 75.3%, 여성에서 76.9%, 전체 75.8% 였으며, Kappa 값은남성에서 0.581, 여성에서 0.644, 전체 0.618이었다 (Table 2). Table 2. Test-Retest Agreements and Kappa Reliability Analysis of KS-15 Items Men Women Total Agreement Kappa Agreement Kappa Agreement Kappa 1 72.2% 0.501 71.2% 0.477 71.8% 0.493 2 63.9% 0.402 75.0% 0.620 67.8% 0.490 3 70.1% 0.413 59.6% 0.316 66.4% 0.379 4 71.1% 0.533 67.3% 0.465 69.8% 0.510 5 68.0% 0.390 57.7% 0.259 64.4% 0.362 6 66.0% 0.465 61.5% 0.389 64.4% 0.441 7 53.6% 0.259 63.5% 0.459 57.0% 0.335 8 62.9% 0.263 69.2% 0.363 65.1% 0.302 9 71.1% 0.525 67.3% 0.517 69.8% 0.536 10 54.6% 0.325 44.2% 0.161 51.0% 0.271 11(F), 12(M) 66.0% 0.172 63.5% 0.320 58.4%, 72.5% 0.253, 0.206 13 67.0% 0.458 86.5% 0.780 73.8% 0.578 14 80.4% 0.484 75.0% 0.582 78.5% 0.544 Constitution 75.3% 0.581 76.9% 0.644 75.8% 0.618 Item 11 applies only to women, and 12 applies only to men. Table 3. Test-Retest Rank Correlation Coefficients of KS-15 Items Men Women Total Coefficient P-value Coefficient P-value Coefficient P-value 1 0.614 < 0.001 0.482 < 0.001 0.568 < 0.001 2 0.572 < 0.001 0.743 < 0.001 0.645 < 0.001 3 0.522 < 0.001 0.542 < 0.001 0.530 < 0.001 4 0.676 < 0.001 0.663 < 0.001 0.669 < 0.001 5 0.487 < 0.001 0.528 < 0.001 0.525 < 0.001 6 0.590 < 0.001 0.571 < 0.001 0.584 < 0.001 7 0.431 < 0.001 0.684 < 0.001 0.543 < 0.001 8 0.400 < 0.001 0.408 0.003 0.401 < 0.001 9 0.653 < 0.001 0.680 < 0.001 0.669 < 0.001 11(F), 12(M) 0.217 0.033 0.445 0.001 0.330, 0.246 < 0.001, 0.003 Items were analyzed using the Spearman rank correlation. Item 11 applies only to women while item 12 applies only to men. The Spearman rank correlation was not used on items 10, 13, and 14 as it would not aptly measure these questions.
16 One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students 체질별검사- 재검사체질진단결과일치도는태음인 85.1%, 소음인 73.6%, 소양인 58.6% 로나타났다. 남성에서일치도는태음인 86.5%, 소음인 66.7%, 소양인 53.3% 였으며, 여성에서일치도는태음인 80.0%, 소음인 82.6%, 소양인 64.3% 로나타났다 (Table 4). Test(baseline) 에서 KS-15 를이용하여도출된체질판정확률값 (%) 분포에따른검사 -재검사 Kappa 값은, 체질확률값이 50% 미만이었던경우 Kappa 값은 0.416이었으며, 50~60% 미만은 0.718, 60~70% 미만 은 0.662, 70~80% 미만은 0.881, 80% 이상은 1.0으로나타났다 (Figure 1). 4. 체질진단결과일치군과불일치군간 BMI 변화량차이검사- 재검사에서체질진단결과가일치한그룹과불일치한그룹간 BMI 변화량은남, 여, 전체모두에서유의한차이가존재하지않았다 (Table 5). Table 4. Test-retest Agreements According to Sasang Constitution Retest Taeeumin Soeumin Soyangin Total Taeeumin 45 (86.5) 5 (9.6) 2 (3.8) 52 (100) Men Soeumin 5 (16.7) 20 (66.7) 5 (16.7) 30 (100) Soyangin 3 (20.0) 4 (26.7) 8 (53.3) 15 (100) Total 53 (54.6) 29 (29.9) 15 (15.5) 97 (100) Taeeumin 12 (80.0) 2 (13.3) 1 (6.7) 15 (100) Test Women Soeumin 0 (0.0) 19 (82.6) 4 (17.4) 23 (100) Soyangin 3 (21.4) 2 (14.3) 9 (64.3) 14 (100) Total 15 (28.8) 23 (44.2) 14 (26.9) 52 (100) Taeeumin 57 (85.1) 7 (10.4) 3 (4.5) 67 (100) Total Soeumin 5 (9.4) 39 (73.6) 9 (17.0) 53 (100) Soyangin 6 (20.7) 6 (20.7) 17 (58.6) 29 (100) Total 68 (45.6) 52 (34.9) 29 (19.5) 149 (100) Results are presented as n (%). Figure 1. The test-retest reliability according to sasang constitutional probability score
KH Bae et al 17 Table 5. BMI Changes between Sasang Constitutional Accordance and Discordance Group Accordance Discordance Total P-value Men N (%) 73 (75.3) 24 (24.7) 97 (100) BMI change 1.15 ± 1.91 1.21 ± 1.40 1.17 ± 1.79 0.897 Women N (%) 40 (76.9) 12 (23.1) 52 (100) BMI change 0.90 ± 1.73 0.98 ± 0.68 0.92 ± 1.55 0.873 Total N (%) 113 (75.8) 36 (24.2) 149 (100) BMI change 1.06 ± 1.84 1.13 ± 1.20 1.08 ± 1.71 0.832 Results are presented as n (%) or mean ± standard deviation. Ⅳ. 考察 본연구에서는 2개한의대학생 149 명을대상으로 1년의기간을두고단축형사상체질진단설문지 (KS-15) 의신뢰도를평가하기위해검사 -재검사법을수행하였으며, 그결과 75.8% 의체질진단결과일치율과 0.618의 Kappa 값을보여 KS-15 가일정수준의신뢰도를가지고있음을확인할수있었다. KS-15 는기존에개발된사상체질설문이문항수가많아임상에서활용하기에시간적제약이있음을고려하여, 적은문항이면서도일정수준의타당도를확보하여임상에서용이하게사용할수있도록개발된설문이다 11. 그구성에대해살펴보면, 성격과소증에대하여 KDC 자료의 54문항을검토하여체질별가중치와전문가 3인의논의를통해 14문항을도출하였고, 체형에대해서는기존연구에서활용되었던 5부위, 8부위에대한체형지표대신 10세단위평균체질량지수대비대상자의체질량지수를평가하는방법을사용하였다 11,19. 현재까지 KS-15 설문에대한몇개의신뢰도, 타당도연구들이수행되었다. 백의연구에서는 222명을대상으로사상체질전문가와의일치도를평가하여태음인 63.0%, 소음인 83.3%, 소양인 27.8%, 전체 63.1% 의일치율을보였으며 11, 박의연구에서는일본인 50 명을대상으로전문가와의일치도를평가하여태음인 61.9%, 소음인 60.0%, 소양인 57.9% 의일치율을보였다 14. 신뢰도에있어서는 303명의 20대성인들을대상으로 2주후재검사를통해신뢰도를평가하였는데, 87.1% 의일치율과 0.794의 Kappa 값을보였다 12. 본연구역시신뢰도를평가하기위한연구로이전신뢰도연구 12 와유사하지만검사와재검사사이의기간이 1년으로기간에서그차이가있다. 일반적으로검사 -재검사의신뢰도가있다는것은한번의검사로얻은측정값이시간의변화가있음에도안정적이고대표적이라는것을말하며, 반대로신뢰도가떨어진다는것은측정값이환경, 정신적, 방법론적프로세스의변화등으로인해대상자의상태를정확히반영하지못한다는것을의미한다. 보통검사 -재검사방법은측정도구의노후와피험자의상태변화로인한영향을피하기위해검사시점과재검사시점사이의기간을상대적으로짧게하는편이다. 그러나선천적영향이있고, 변하기어렵다는체질을진단하기위한도구로서의 KS-15 는비교적오랜기간을두고신뢰도를평가하는것또한중요하다고생각되어, 본연구에서는검사- 재검사사이의기간을 1년으로하여수행하였다 20,21. 사상체질설문도구의검사- 재검사신뢰도연구들을살펴보면, 이는 Sasang constitutional analysis tool (SCAT) 를가지고 4주뒤의재검사를통해서분석하여, Spearman s rank correlation coefficients 0.448~0.828의값을보고하였으며 22, 김은몽고인들을대상으로사상체질분류검사지의문항에대한 1년- 검사- 재검사연구를수행하여종속성 40%, 일치율 92% 를보고하였고 23, 황은사상체질분류검사 (QSCC Ⅱ) 를가지고 2년, 3년재검사를통해 56.88%, 55.56% 의일치율을보고하였다 24. 본연구에서관찰된 75.8% 의일치율과 0.618 의 Kappa 값은이전 KS-15 검사의검사 -재검사신뢰도연구 12 에서관찰된 87.1% 의일치율과 0.794의 Kappa
18 One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students 값보다는다소낮은결과이나, 다른사상체질설문도구의검사 -재검사신뢰도에비해서는낮지않은수치이며, Kappa 값또한상당한수준 (substantial) 18 으로나타나일정수준의신뢰도를갖추었다고생각된다. 문항별신뢰도를살펴보면, 0.161~0.620의 Kappa 값, 0.246~0.669의상관계수값을보였는데, 그중낮은 Kappa 값 (Slight, Fair) 과상관계수값을보인문항들은주로땀, 대변, 소변관련문항들 (10, 11, 12번문항 ) 이었다. 이는해당문항이건강상태에따라자주바뀔수있는증상이기때문이거나, 대상자들이 20대로구성되어있어답변이한쪽으로크게치우쳤기때문이라생각된다. 일례로 12번문항의경우 72.5% 의일치율을보였으나 Kappa 값은 0.206으로낮았는데전체대상자중약 80% 가야간소변이없다고응답하였다. Table 4는체질별체질진단결과일치율을보여주고있는데, 남, 여, 전체모두소양인이가장낮은일치율을보였으며, 남성에서는태음인이, 여성에서는소음인이가장높은일치율을보였다. 이전연구에서도소양인의일치율이가장낮은경향을보였으며 12, 또한다른사상체질진단연구들을살펴보았을때에도소양인진단의타당도가다른체질에비해낮은경향을보이고있다 25,26. 이는기존연구에서태음인, 소음인에비해소양인에대한척도가안정적이지않다는것과같은결과를보여주는것이라고할수있으며 27,28, 본연구에사용된 KS-15 역시체질설문지가가지는이러한약점을공유하고있음을보여주고있다. 이러한점을보완하기위해서, 설문지만사용한소양인체질결과는그것을해석함에있어임상적인고려가더많이이루어져야할것이며, 장기적으로는체질진단설문의소양인문항개정및개발이필요할것이다. KS-15 는체형에대한값으로 BMI 를이용하고있는데, 본연구에서는검사- 재검사에서 BMI 의변동이체질진단불일치에영향을주었는지를 independent t-test 를이용하여알아보고자하였다. Table 5에서제시한바와같이남, 여, 전체에서그룹간 BMI 변화량은유의한차이가없었으며, 이를통해검사- 재검사시의체질 진단결과불일치를 BMI 변동의영향으로설명할수없다는것을확인할수있었다. Figure 1에서는 1차검사의체질확률값에따른재검사에서의 Kappa 값분포를보여주고있는데, 대체로 1차검사시점에높은체질확률값을기록할수록재검사시높은 Kappa 값을나타내는것을확인할수있었다. 이는이전연구와유사한결과이며 12, 임상에서 KS-15 를이용할때, 단순한체질진단결과뿐만아니라체질확률값을고려하여대상자를평가하는것이더나을것이라는것을보여준다. 본연구는 1년이라는기간을두고수행된검사- 재검사법에서 KS-15 가일정수준의신뢰도를보였다는것에그의의가있으나, 대상자가 20대학생으로국한되어있어본연구의신뢰도를전체성인으로확대하여적용하기에는어렵다는한계점이있다. 추후다양한연령층을대상으로연구가진행되어야할것으로생각되며, 더불어신뢰도와타당도를올리기위한개별문항의재검토및민감도와특이도절단값등에대한연구역시필요하리라생각된다. Ⅴ. 結論 본연구는 20대대학생 149 명을대상으로두차례의인터넷설문조사 (2017년 3월, 2018년 3월 ) 를통해단축형사상체질진단설문지 (Korea Sasang constitutional diagnostic questionnaire, KS-15) 의신뢰도를검사- 재검사법으로평가하였다. KS-15 의체질진단결과일치도는 75.8%(Kappa = 0.618) 로나타나일정수준이상의신뢰도 (substantial) 가있음을확인할수있었으나, 각문항의 Kappa 값은 0.161~0.620 로문항간큰차이를보였다. 체질별체질진단결과일치도는태음인 85.1%, 소음인 73.6%, 소양인 58.6% 로관찰되었다. 향후외적타당도를높이기위한보다다양한연령층을대상으로한후속연구가필요하다.
KH Bae et al 19 Ⅵ. 감사의글 본연구는 2019년도한국한의학연구원기관주요사업인 유전체기반한의건강예측기술개발 (Grant No. KSN1713092) 의지원을받아수행된연구임. Ⅶ. References 1. Kim YY, Kim HS, Baek YH, Yoo JH, Kim SH, Jang ES. A Study on the Constitution Type-Specific Presentation of Physical Symptoms. J Sasang Constitut Med. 2011;23(3):340-350. (Korean) 2. Shin SW, Kim YH, Hwang MW. Diagnosis and treatment principle in Sasang medicine: original symptom. Integr Med Res. 2016;5:99-104. 3. Lee JM. Dong-yi-soo-se-bo-won. Seoul: Daesung. 1998. 4. Do JH, Jang ES, Ku BC, Jang JS, Kim HG, Kim JY. Development of an integrated Sasang constitution diagnosis method using face, body shape, voice, and questionnaire information. BMC Complement Altern Med. 2012;12:85. 5. Ko BH, Song IB. Study on the Methodology of Sasang Constitutional Differentiation of Syndromes (Report 1 & 2). J Korean Med. 1987;8:139-45. 6. Kim SH, Koh BH, Song IB. A Validation Study of Questionnaire of Sasang Constitutional Classifìcation (QSCC). J Sasang Constitut Med. 1993;5:67-85. (Korean) 7. Kim SH, Koh BH, Song IB. A Study on the Standardization of QSCCⅡ(Questionnaire for the Sasang Constitution Classification Ⅱ). J Sasang Constitut Med. 1995;7(1):187-246. (Korean) 8. Choi MO. The Study on Golden standard for Sasang Constitution Diagnosis. Busan: Dong-Eui University. 2006. 9. Pak YS, Kim JS, Park BJ, Yoo JH, Lee JH, Koh BH, et al. The Reliability and Validity Test of Sasangin Diagnostic Questionnaire for Specialist (SDQ_S). J Sasang Constitut Med. 2016;28(2):110-122. (Korean) 10. Kim YW, Shin DY, Kim JH, Choi DS, Lim MK, Lee KL, et al. A Development of the Two Step Questionnaire for the Sasang Constitution Diagnosis (TS-QSCD). J Sasang Constitut Med. 2006;18(1): 75-90. (Korean) 11. Baek YH, Jang ES, Park KH, Yoo JH, Jin HJ, Lee SW. Development and Validation of Brief KS-15 (Korea Sasang Constitutional Diagnostic Questionnaire) Based on Body Shape, Temperament and Symptoms. J Sasang Constitut Med. 2015;27(2):211-221. (Korean) 12. Kim YY, Jang ES. Test-Retest Reliability of Brief KS-15 -Korean Sasang Constitutional Diagnostic Questionnaire. J Physiol & Pathol Korean Med. 2016;30(3):177-183. 13. Park DI, Park KH, Jin HJ. The Web Application to Improve Utilization of Sasang Constitutional Diagnosis Questionnaire - KS-15(Korea Sasang Constitutional Diagnostic Questionnaire). J Sasang Constitut Med. 2017;29(3):224-231. 14. Park KH, Baek YH, Lee SW. Applying KS-15 (Korea Sasang Constitutional Diagnostic Questionnaire) to the Japanese : a Pilot Study. J Physiol & Pathol Korean Med. 2018;32(1):70-74. 15. Jang ES, Kim YY, Baek YH, Lee SW. The Association between Seven Health Practices and Self Rated Health by Sasang Constitution. J Sasang Constitut Med. 2018;30(1):32-42. 16. Bae KH, Park KH, Lee SW. Cold hypersensitivity in the Hands, Feet and Abdomen according to Sasang Constitution. J Sasang Constitut Med. 2018;30(1): 50-57. 17. Jin HJ, Baek YH, Kim HS, Ryu JH, Lee SW. Constitutional multicenter bank linked to Sasang con-
20 One year test-retest reliability of the Korea Sasang constitutional diagnostic questionnaire (KS-15) in university students stitutional phenotypic data. BMC Complement Altern Med. 2015;15:46. 18. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33: 159-174. 19. Jang ES. A Development of Sasang Constitution Diagnosis Program based on Characteristics of Body Shape Face Physiological Symptom and Personality. Iksan: Wonkwang University. 2010. 20. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307-310. 21. JCGM. Evaluation of measurement data Guide to the expression of uncertainty in measurement. Geneva : Int. Organ. Stand. 2008;50:134. 22. Lee JY, Yim MH, Kim JY. Test-retest reliability of the questionnaire in the Sasang constitutional analysis tool (SCAT). Integr Med Res. 2018;7:136-140. 23. Kim KS, Lee SK, Shin HK, Koh BH, Song IB, Lee EJ. A Study on the Reliability of the Questionnaire about Sasang Constitution Classification for Mongolians. J Sasang Constitut Med. 2006;18(2): 96-112. (Korean) 24. Hwang DS, Cho JH, Lee CH, Jang JB, Lee KS. A Study on Reproducibility of Responses to the Questionnaire for Sasang Constitution Classification Ⅱ (QSCC Ⅱ). J Korean Med. 2006;27(3):145-150. (Korean) 25. Kim SH. Diagnostic Accuracy of the Questionnaire for Sasang Constitution in Korean Adult Population: Systematic Review. Doctor thesis. Kyunghee univ. 2012. 26. Kim SH, Lee YS, Koh BH, Jang ES. Assessing the diagnostic accuracy of the Questionnaire for Sasang Constitutional Classification II (QSCC II): A systematic review. Eur J Integr Med. 2013;5(5):393-398. 27. Kim SB, Lee JH, Park GS, Jung YJ, Lee SK, Song IB. A Study on responses to the questionnaire based on of revised Sasang Constitution Classification Ⅱ (QSCCⅡ+). J Sasang Constitut Med. 2001;13(3): 15-23.
KH Bae et al 21 [Appendix] 사상체질분류설문지 (Korea Sasang Constitutional Diagnostic Questionnaire 15) 1. 성격이대범하신가요? 섬세하신가요? 대범 중간 섬세 2. 행동이빠른편인가요? 느린편인가요? 빠르다 중간 느리다 성격 3. 모든일에적극적인가요? 소극적인가요? 적극적 중간 소극적 4. 성격이외향적인가요? 내성적인가요? 외향 중간 내성 5. 남성적인편인가요? 여성적인편인가요? 남성적 중간 여성적 6. 가끔흥분하는편인가요? 이성적인편인가요? 흥분 중간 이성 소화 7. 평소소화는어떠한가요? 소화가잘된다 소화가잘안되지만불편하지않다 소화가안되고불편함도느낀다 8. 평소입맛은어떠한가요? 좋은편이다 2 중간이다 3 안좋은편이다 땀 대변 소변 한열음수 9. 평소땀을어느정도흘리는편인가요? 많다 중간 적다 10. 땀을흘리고난뒤기분이어떠한가요? 상쾌하다 피곤하다 아무느낌없다 11. 대변이마려운신호가왔을때참기어려운가요? 자주그렇다 가끔그렇다 없다 ( 어렵지않다 ) 12. 밤 ( 잠을잘때 ) 에소변을몇회보나요? 0 회 1 회 2 회이상 13. 평소추위, 더위어느것이더싫은가요? 추위 더위 모두싫거나모두괜찮다 14. 평소마시는물의온도는어떠한가요? 주로따뜻한물 주로찬물 가리지않고마신다 Height and weight (body type variable) were examined in socio-demographic items.