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Structural Equation Analysis of Social Support, Impaired Fasting Glucose, and Type 2 Diabetes
Biomed Sci Letters 2019;25:357-366
Published online December 31, 2019;  https://doi.org/10.15616/BSL.2019.25.4.357
© 2019 The Korean Society For Biomedical Laboratory Sciences.

Yun-Jung Kang1,,*, Sang-Nam Park2,* and Ki Nam Yoon3,*

1Department of Clinical Laboratory Science, Sang-ji University, Wonju 26339, Korea
2Department of Clinical Laboratory Science, Kyungdong University, Wonju 26495, Korea
3Department of Clinical Laboratory Science, Ansan University, Ansan 15651, Korea
Correspondence to: Yun-Jung Kang. Department of Clinical Laboratory Science, Sang-ji University, Wonju 26339, Korea.
Tel: +82-33-738-8081, Fax: +82-33-738-8082, e-mail: lvpig@naver.com
*Professor.
Received November 1, 2019; Revised November 18, 2019; Accepted November 25, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

This study is to identify how the social support influences the impaired fasting glucose and type 2 diabetes as structural equation analysis reflects the health behavior and psychological path. It investigates participants who give consents to participate in the Korean Health Examine Cohort (KOEX), which collects surveys and biological samples at eight university hospitals nationwide. Of the 53,767 adults over 30 years of age enrolled in the 2nd to 7th KOEX study from 2004 to 2010 (1st to 7th), 18,618 participants with a history of chronic diseases related to type 2 diabetes, the main variable, were excluded. The number of participants were 34,316 with enough data on social support and diabetes, which are the main variables. The results show that social support affects health behaviors and lowers fasting blood sugar. Therefore, not only the management of risk factors of individuals, but also the practice of healthy behavior with the attention of social relations such as social support, etc., can prevent type 2 diabetes.

Keywords : Social support, Impaired fasting glucose, Type 2 diabetes, Structural equation analysis
꽌 濡

슦由щ굹씪뒗 1970뀈遺꽣 湲됱냽븳 寃쎌젣諛쒖쟾怨 쓽猷뚭린닠쓽 諛쒕떖怨 깮솢닔以쓽 뼢긽쑝濡 씤빐 留뚯꽦吏덊솚씠 몢뱶윭吏寃 利앷븯뒗 寃쏀뼢쓣 蹂댁씠怨 엳떎(Ryu et al., 2006). 留뚯꽦吏덊솚 媛쒖씤쓽 떊泥댁쟻 怨좏넻肉먮쭔 븘땲씪, 옣湲곗쟻씤 닾蹂묒깮솢濡 씤븳 떖由ъ쟻씤 臾몄젣 굹븘媛꽌뒗 媛쒖씤怨 洹 媛議깆쓽 궣쓽 吏덉뿉 쁺뼢쓣 誘몄튇떎(Kim et al., 2008) 洹 以묒뿉꽌룄 듅엳 떦눊蹂묒 궗쉶 · 寃쎌젣쟻 닔以쓽 뼢긽怨 뜑遺덉뼱 洹 諛쒖깮씠 利앷븯뒗 寃껋쑝濡 븣젮吏 몴쟻씤 꽦씤蹂 以묒쓽 븯굹씠떎. 떦눊蹂묒 씤뒓由 샇瑜대が쓽 遺議 샊 寃고븤쑝濡 씤븳 젣1삎 떦눊蹂묎낵 씤뒓由 빆꽦뿉 쓽빐 諛쒕퀝릺뒗 젣2삎 떦눊蹂묒쑝濡 遺꾨쪟릺硫, 씠 以 젣2삎 떦눊蹂묒 쟾泥 떦눊蹂 솚옄쓽 95% 씠긽쓣 李⑥븯怨 엳떎(Kim et al., 2011) 떦눊蹂묒쓣 삁떦 떒怨꾨줈 遺꾨쪟븳떎硫, 젙긽 삁떦닔以, 떦눊蹂 삁떦닔以怨 씠 몮 궗씠뿉 엳뒗 떦눊蹂 쟾떒怨(pre-diabetes) 利 怨듬났삁떦옣븷 닔以씠떎. 씠 닔以 젣2삎 떦눊蹂묒쑝濡 諛쒕퀝 媛뒫꽦씠 넂 怨좎쐞뿕뿉 빐떦븯湲 븣臾몄뿉 떦눊蹂묒쓣 삁諛⑺븯湲 쐞븳 몴쟻쑝濡 理쒓렐뿉 留롮 愿떖쓣 諛쏅뒗 떒怨꾩씠떎. 꽭怨꾨낫嫄 湲곌뎄議곗궗뿉 쓽븯硫 떦눊蹂묒쓽 꽭怨꾩쟻씤 異붿씠뒗 씠誘 젣븳맂 뼱뼡 듅젙 吏뿭쓽 吏덊솚 븳怨꾨 꽆뼱 꽭怨 쟾뿭쓽 쑀뻾蹂 긽깭源뚯 씠瑜 寃껋쑝濡 蹂닿퀬븯떎. 듅엳 二쇰ぉ빐빞 맆 궡슜 遺덊뻾엳룄 떦눊蹂 솚옄媛 븘떆븘 吏뿭뿉꽌 媛옣 留롮씠 利앷맆 寃껋씠씪뒗 삁痢≪씠떎. 븘떆븘 吏뿭쓽 떦눊蹂 솚옄닔뒗 2000뀈 8,450留 紐낆뿉꽌 2010뀈 57%媛 利앷맂 1뼲 3,230留 紐낆쑝濡 쟾 꽭怨 떦눊蹂 씤援ъ쓽 빟 60%瑜 李⑥븯寃 맆 寃 씠씪뒗 궡슜씠떎(Kim et al., 2005). 굹븘媛 2025뀈源뚯 쟾 꽭怨꾩쟻쑝濡 3뼲 3,300留 紐낆뿉 떖븷 寃껋쑝濡 삁긽릺뒗 젣2삎 떦눊蹂묒쓽 湲됱냽븳 솗궛 쓽猷뚭퀎 젙移섍퀎 뼇履쎌뿉 遺덉븞쓣 빞湲고븳떎(Van Dam et al., 2005). 씤援ъ쓽 怨좊졊솕뿉 뵲씪 젣2삎 떦눊蹂묒쓽 쑀蹂묒옄닔뒗 뜑슧 利앷븷 寃껋쑝濡 삁긽릺뒗 媛슫뜲, 씠뿉 븳 궗쉶쟻 · 援媛쟻쑝濡 슦젮瑜 븯뒗 씠쑀 以 븯굹뒗 닔諛섎릺뒗 빀蹂묒쬆 諛쒕퀝瑜좎씠 넂떎뒗 듅꽦쓣 媛吏怨 엳湲 븣臾몄씠떎(Choi and Jo, 2013). 떦눊蹂묒쑝濡 씤븳 怨좏삁떦 利앹긽 삁愿 넀긽쓣 媛졇 떦눊蹂묒꽦 誘몄꽭삁愿怨 삁愿 빀蹂묒쬆쓣 쑀諛쒖떆耳 愿긽룞留 吏덊솚, 뇤議몄쨷, 븞援ъ쭏솚, 떦눊蹂묒꽦 議깅吏덊솚, 떦눊蹂묒꽦 떊利 벑쓣 쑀諛쒗븷 닔 엳쑝硫(Winocour, 2002), 떖삁愿吏덊솚쓽 쐞뿕씤옄씠떎(Klein et al., 1984). 젣2삎 떦눊蹂묒 쑀쟾쟻 슂씤怨 솚寃쎌쟻 슂씤쓣 紐⑤몢 媛뽯뒗 吏덈퀝씠떎(Bi et al., 2012). 吏덈퀝쓽 삁諛⑹쓣 쐞빐꽌뒗 紐⑤뱺 슂씤쓽 뿰援ш 씠猷⑥뼱졇빞 븳떎. 븯吏留, 쑀쟾쟻 슂씤怨 媛쒖씤쓽 깮솢뒿愿 諛 媛쒖씤쟻 뻾룞뿉 珥덉젏쓣 몢뒗 뿰援щ뒗 留롮쑝굹 궗쉶쟻 留λ씫, 듅엳 궗쉶쟻 愿怨 諛 궗쉶쟻 솚寃쎌쓣 怨좊젮븳 뿰援щ뱾 誘명씉븳 떎젙씠떎. 궗쉶쟻 愿怨꾩뿉뒗 궗쉶쟻 吏吏媛 엳떎. 궗쉶쟻 吏吏 愿묐쾾쐞븳 쓽誘몄뿉꽌 씤뿉 쓽빐 젣怨듬릺뒗 옄썝씠씪 븷 닔 엳쑝硫(Cohen and Wills, 1985), 궗쉶쟻 吏吏뿉뒗 뿬윭 쑀삎씠 엳吏留 몢 媛쒖쓽 꼻 踰붿<濡쒖꽌 湲띿젙쟻 吏吏 遺젙쟻 吏吏媛 엳쑝硫, 湲띿젙쟻 吏吏뿉뒗 젙꽌쟻 吏吏 룄援ъ쟻 吏吏濡 遺꾨쪟븯뒗 寃껋씠 쑀슜븯떎. 젙꽌쟻 吏吏뒗 븷젙, 愿떖, 議닿꼍 벑쓽 吏吏瑜 룷븿븯硫, 룄援ъ쟻 吏吏뒗 蹂묎컙샇, 떊泥댁쟻 룄, 吏묒븞씪 룙湲, 臾쇱쭏쟻 吏썝 벑怨 媛숈 吏곸젒쟻씤 룄쓽 뻾룞쓣 룷븿븳떎(Berkman and Syme, 1979). 궗쉶쟻 吏吏媛 떊泥 嫄닿컯寃곌낵뿉 쁺뼢쓣 誘몄튂뒗 寃쎈줈뒗 겕寃 3媛吏 利 嫄닿컯뻾룞 寃쎈줈, 떖由ъ쟻 寃쎈줈, 깮由ъ쟻 寃쎈줈濡 슂빟맂떎. 泥レ㎏ 嫄닿컯뻾룞 寃쎈줈뒗 궗쉶쟻 吏吏湲곕뒫쓣 넻븯뿬 씉뿰씠굹, 쓬二, 떊泥댄솢룞, 떇씠뒿愿 媛숈 嫄닿컯利앹쭊 샊 쑀빐뻾룞뿉 쁺뼢쓣 以떎(Lewis and Rook, 1999). 몮吏 떖由ъ쟻 寃쎈줈뒗 궗쉶쟻 吏吏뒗 옄議닿컧, 궗쉶쟻 뒫젰, 옄湲고슚뒫媛, 슦슱, 媛먯젙怨 媛숈 씤吏쟻 · 젙꽌쟻 긽깭뿉 쁺뼢쓣 以떎(Cohen, 1988). 留덉留됱쑝濡 깮由ъ쟻 寃쎈줈뒗 뒪듃젅뒪 諛섏쓳怨 愿젴맂 삁븬긽듅, 떖諛뺤텧웾 利앷, 移댄뀒肄쒕씪誘 긽듅怨 媛숈 怨쇰떎븳 옄洹밴낵 硫댁뿭諛섏쓳쓽 뼲젣 媛숈 굹걶 쁺뼢쓣 궗쉶쟻 吏吏媛 셿異⑹옉슜쓣 븯怨, 떊寃 궡遺꾨퉬 샇瑜대が 삦떆넗떊 삁븬쓣 궙異붽퀬 빆 뒪듃젅뒪 옉슜쓣 븿쑝濡쒖뜥 嫄닿컯寃곌낵뿉 吏곸젒쟻씤 쁺뼢쓣 誘몄튌 닔 엳떎(Uchino et al., 1996).

씠뿉 蹂 뿰援щ뒗 嫄닿컯뻾룞 寃쎈줈 떖由ъ쟻 寃쎈줈, 깮由ъ쟻 寃쎈줈瑜 諛섏쁺븳 援ъ“諛⑹젙떇 遺꾩꽍쑝濡 궗쉶쟻 吏吏媛 怨듬났삁떦옣븷 諛 젣2삎 떦눊蹂묒뿉 誘몄튂뒗 쁺뼢쓣 뙆븙븯怨 슂씤쓣 솗씤븯뿬 媛쒖씤쓽 吏덈퀝씠 궗쉶愿怨꾩 긽샇옉슜뿉 湲곗씤븳 寃껋엫쓣 洹쒕챸븯怨 吏덈퀝쓽 썝씤쓣 媛쒖씤뿉꽌 궗쉶쟻 愿怨꾨줈 룷愿꾪븯뿬 깘援ы븯怨좎옄 븳떎.

긽 諛 諛⑸쾿

蹂닔쓽 젙쓽

寃곌낵蹂닔: 떦눊蹂묒쓽 湲곗 誘멸뎅떦눊蹂묓븰쉶(American Diabetes Association, ADA)쓽 湲곗쑝濡 젙쓽븯떎(ADA, 1997). 씠뿉 怨듬났삁떦 100 mg/dL 誘몃쭔쓣 젙긽쑝濡, 떦눊蹂 쟾떒怨(怨듬났삁떦옣븷)瑜 100~125 mg/dL濡 遺꾨쪟븯쑝硫, 떦눊蹂 吏꾨떒쓽 湲곗쓣 126 mg/dL 씠긽 삉뒗 쓽궗쓽 吏꾨떒 뿬遺, 씤뒓由 샊 寃쎄뎄삁떦媛뺥븯젣瑜 蹂듭슜븯怨 엳뒗 寃쎌슦濡 젙쓽븯떎.

二쇱슂 끂異쒕닔: 궗쉶쟻 吏吏쓽 議곗궗 泥숇룄뒗 He (He, 2000)쓽 泥숇룄瑜 궗슜븯떎. 湲띿젙쟻 吏吏 6臾명빆怨 遺젙쟻 吏吏 6臾명빆쑝濡 굹늻뼱 援ъ꽦븯떎. 湲띿젙쟻 吏吏쓽 6빆紐 Kuder-Richardson Formula 20 (KR-20)쓽 怨꾩닔媛믪 0.80씠뿀怨, 遺젙쟻 吏吏쓽 6빆紐 KR-20 怨꾩닔媛믪 0.72濡 궗쉶쟻 吏吏쓽 湲곕뒫 젏닔 泥숇룄뒗 넂 떊猶곕룄瑜 蹂댁떎. 湲띿젙쟻 吏吏뿉 븳 議곗궗뒗 '냽궗젙쓣 꽭뼱넃쓣 닔 엳뒗 궗엺씠 엳떎', '굹뿉寃 뒛 愿떖쓣 媛뽮퀬 嫄깆젙쓣 빐二쇰뒗 궗엺씠 엳떎', '以묒슂븳 씪씠굹 뼱젮슫 씪씠 엳쓣 븣 쓽끉긽媛 릺뼱 二쇰뒗 궗엺씠 엳떎'쓽 젙꽌쟻 吏吏 3臾명빆怨 '궡媛 븘뵆 븣 蹂묎컙샇瑜 빐二쇨굅굹 吏묒븞씪쓣 룄二쇰뒗 궗엺씠 엳떎', '븘슂븳 寃껋씠 엳쑝硫 蹂댄깭二쇨굅굹 鍮뚮젮二쇰뒗 궗엺씠 엳떎', '궡媛 슂泥븷 븣留덈떎 湲곌볼씠 떆媛꾩쓣 궡二쇨퀬 吏묒븞씪쓣 룄二쇰뒗 궗엺씠 엳떎'쓽 룄援ъ쟻 吏吏 3臾명빆쑝濡 援ъ꽦븯뿬, 湲띿젙쟻 吏吏뒗 珥 6臾명빆씠떎. 빐떦 吏吏쓽 젣怨 諛쏆 뿬遺瑜 븘땲슂 (1), 삁 (2)쑝濡 쓳떟븯寃 븯뿬 젏닔瑜 遺뿬븯怨 洹 빀쓣 怨꾩궛븯떎. 湲띿젙쟻 吏吏 젏닔쓽 踰붿쐞뒗 6~12젏씠硫, 젏닔媛 넂쓣닔濡 궗쉶쟻 吏吏媛 넂쓬쓣 쓽誘명븯硫, 궗쉶쟻 吏吏 룄援 궗슜踰(Berkman and Syme, 1979)쓣 李멸퀬븯뿬 룊洹좉컪쓣 湲곗쑝濡 긽 · 븯 吏묐떒쑝濡 굹늻뿀떎.

遺젙쟻 吏吏 臾명빆 '留롮 궗엺씠 궡媛 븯뒗 씪뿉 媛꾩꽠븯嫄곕굹 諛섎븳떎', '쁽옱 궡媛 媛뽮퀬 엳뒗 臾몄젣媛 紐⑤몢 궡 깛씠씪怨 鍮꾨궃븯뒗 궗엺씠 엳떎', '굹瑜 臾댁떆븯뒗 뒓굦쓣 二쇰뒗 궗엺씠 엳떎', '궡媛 썝븯吏룄 븡뒗 룄쓣 以섏꽌 留덉쓬쓣 遺덊렪븯寃 븯뒗 궗엺씠 엳떎', '궡 二쇰뿉 굹 궡 씪뿉 臾닿떖븳 궗엺씠 엳떎', '궡媛 룄쓣 슂泥븯硫 遺遺 嫄곗젅쓣 븯뒗 궗엺씠 엳떎'쓽 6臾명빆쑝濡 援ъ꽦븯쑝硫, 빐떦 吏吏쓽 젣怨듬컺쓬 뿬遺瑜 븘땲삤 (1), 洹몃젃떎 (2) 쑝濡 쓳떟븯寃 븯뿬 젏닔瑜 遺뿬븯怨 洹 빀쓣 怨꾩궛븯떎. 遺젙쟻 吏吏쓽 젏닔 踰붿쐞뒗 6~12젏씠硫, 젏닔媛 넂쓣닔濡 遺젙쟻 吏吏媛 넂쓬쓣 쓽誘명븯硫, 궗쉶쟻 吏吏 룄援 궗슜踰(Berkman and Syme, 1979)쓣 李멸퀬븯뿬 룊洹좉컪쓣 湲곗쑝濡 긽 · 븯 吏묐떒쑝濡 굹늻뿀떎.

怨듬웾 蹂닔: 蹂 뿰援ъ뿉꽌 궗슜맂 援먮蹂닔 諛 怨듬웾 蹂씤 씪諛섏쟻 듅꽦怨 嫄닿컯뒿愿 벑씠硫, 蹂 뿰援 4옣쓽 Table 3뿉꽌 媛숇떎. 꽦蹂꾩 궓꽦怨, 뿬꽦쑝濡 遺꾨쪟븯怨, 뿰졊 30遺꽣 40, 50, 60, 洹몃━怨 70 씠긽쑝濡 遺꾨쪟븯떎. 援먯쑁닔以 珥덈벑븰援 議몄뾽, 以묓븰援 議몄뾽, 怨좊벑븰援 議몄뾽, 쟾臾몃븰援 씠긽쑝濡 遺꾨쪟븯쑝硫, 냼뱷 썡 룊洹 媛援ъ냼뱷쓣 쓽誘명븯硫, 200留 썝 誘몃쭔怨 200留 썝 씠긽 400留 썝 誘몃쭔, 400留 썝 씠긽 600留 썝 誘몃쭔, 600留 썝 씠긽쑝濡 遺꾨쪟븯떎. 諛곗슦옄 쑀臾대뒗 踰뺣쪧쟻 愿怨꾨낫떎뒗 궗떎긽쓽 愿怨꾨 以묒떆븯뿬, 湲고샎옄씪룄 蹂꾧굅 以묒씪 븣뿉뒗 諛곗슦옄 뾾쓬쑝濡 援щ텇븯떎. 二쇨쟻 嫄닿컯긽깭뒗 뼇샇, 蹂댄넻, 굹겏쑝濡 援щ텇븯怨, 씉뿰怨 쓬二쇰뒗 쟾 뾾쓬, 씠쟾뿉뒗 씉뿰씠굹 쓬二쇱뒿愿씠 엳뿀쑝굹 쁽옱뒗 뾾쓬, 洹몃━怨 쁽옱 洹몃윭븳 뒿愿씠 엳쓬쓽 꽭 踰붿<濡 援щ텇븯떎. 泥댁쭏웾吏닔뒗 泥댁쨷(BMI<18.5), 젙긽(18.5≤BMI<23), 怨쇱껜以(23≤BMI<25), 鍮꾨쭔(BMI≥25)쑝濡 援щ텇븯쑝硫, 떖由ъ궗쉶쟻 쎇鍮숈닔(PWI)뒗 젏닔媛 궙쓣닔濡 떖由ъ궗쉶쟻 뒪듃젅뒪쓽 젙룄媛 궙 寃껋쑝濡 빐꽍릺硫 쐞뿕援(0~27)怨 怨좎쐞뿕援(28~54)쑝濡 遺꾨쪟븯떎. 洹몃━怨 뒪듃젅뒪뒗 뒪듃젅뒪 긽솴쓽 끂異쒕퉰룄瑜 痢≪젙븯뒗 寃껋쑝濡쒖꽌 쟾 뾾쓬, 媛걫, 옄二쇱쓽 꽭 踰붿<濡 굹돏떎. 留덉留됱쑝濡 洹쒖튃쟻 슫룞 븞 븳떎 븳떎쓽 2媛 踰붿<濡 援щ텇맂떎.

Construct reliability and average variance extracted of variables

Variables SRE ME CR AVE
SES Educational level 0.849 0.305 0.68 0.53
Household income 0.545 0.590
Social support Positive support 0.559 0.167 0.78 0.64
Negative support 0.542 0.175
Psychological factors PWI 0.578 0.303 0.69 0.53
Stress 0.568 0.278
Behavioral factors Smoking 0.614 0.249 0.79 0.56
Drinking 0.629 0.258
Physical exercise 0.536 0.325


옄猷 닔吏

紐⑤뱺 뿰援 李몄뿬옄뿉 븯뿬 꽦蹂, 뿰졊, 援먯쑁, 닔엯, 寃고샎긽깭 벑쓽 궗쉶씤援 넻怨꾪븰쟻 듅꽦怨 씉뿰, 쓬二, 떊泥댄솢룞, 二쇨쟻 嫄닿컯긽깭, 떖由ъ궗쉶쟻 쎇鍮숈닔 벑쓽 嫄닿컯愿젴 깮솢뒿愿, 怨쇨굅吏덈퀝젰, 빟臾쇰났슜 뿬遺 諛 吏덈퀝쓽 媛議깅젰 벑뿉 빐 닕젴맂 議곗궗옄뱾씠 吏곸젒 씤꽣酉곕 넻븯뿬 꽕臾몄瑜 옉꽦븯떎.

떊泥닿퀎痢: 떊泥닿퀎痢(궎, 泥댁쨷, 뿀由щ몮젅) 뻼 샆쓣 엯 긽깭뿉꽌 痢≪젙븯怨, 泥댁쭏웾吏닔(Body Mass Index)뒗 泥댁쨷쓣 떊옣쓽 젣怨깆쑝濡 굹늻뼱 怨꾩궛븯쑝硫, 泥댁쭏웾吏닔뿉 뵲씪 18.5 (m/kg2) 誘몃쭔쓣 泥댁쨷, 18.5~23 (m/kg2) 誘몃쭔 援곗쓣 젙긽, 23~25 (m/kg2) 誘몃쭔 援곗쓣 怨쇱껜以, 25 (m/kg2) 씠긽 援곗쓣 鍮꾨쭔쑝濡 遺꾨쪟븯떎(Wen et al., 2009).

깮솕븰쟻 寃궗: 怨듬났삁떦 FBS (fasting blood sugar)濡 痢≪젙븯쑝硫, FBS 遺꾩꽍諛⑸쾿 SST 5 mL 뒠釉(Sekisui Chemical Co, Osaka, Japan)濡 梨꾪삁븳 삁븸쓣 30遺 씠궡 삁泥遺꾨━ 썑 Modular analytics P800 (Hitachi/Japan) 옣鍮꾨 씠슜븯뿬 UV test (Hexokinase Assay)쑝濡 痢≪젙븯떎.

뿰援 긽옄

蹂 뿰援щ뒗 떦눊蹂, 怨좏삁븬, 怨⑤떎怨듭쬆, 샇씉湲곗쭏솚, 궗利앺썑援 벑쓽 留뚯꽦吏덊솚쓽 삁諛⑹쓣 쐞빐꽌 諛쒕퀝怨 愿젴븳 쐞뿕슂씤쓣 븣怨 씠瑜 궗쟾뿉 愿由ы븯湲 쐞븯뿬 쟾援 8媛 븰蹂묒썝뿉꽌 꽕臾몄“궗 깮泥댁떆猷뚮 룞떆뿉 닔吏묓븯뒗 "嫄닿컯寃吏 닔吏꾩옄 肄뷀샇듃(Korean Health Examine Cohort, KOEX)" 뿰援ъ뿉 李몄뿬 룞쓽 썑 벑濡앺븳 李몄뿬옄瑜 긽쑝濡 븯怨 엳떎. 2004~2010뀈(1~7李) 룞븞 2~7李 KOEX 뿰援ъ뿉 벑濡앺븳 30꽭 씠긽쓽 꽦씤 53,767紐 以 二쇱슂 蹂닔씤 젣2삎 떦눊蹂묎낵 愿젴씠 엳뒗 留뚯꽦吏덊솚(뇤議몄쨷, 삊떖利/떖洹쇨꼍깋, 怨좏삁븬, 怨좎삁利, 吏諛⑷컙, 留뚯꽦媛꾩뿼/媛꾧꼍蹂, 븫)뿉 븳 吏덈퀝젰씠 엳뒗 몴蹂 18,618紐낆쓣 젣쇅븯떎. 씠뱾 以 뿰援щぉ쟻쓽 二쇱슂蹂닔씤 궗쉶쟻 吏吏, 떦눊蹂묒뿉 븳 옄猷뚭 異⑹떎븳 긽옄 珥 34,316紐낆쓣 긽쑝濡 븳떎. 씠 뿰援щ뒗 泥쒖븞 떒援븰援 쑄由ш린愿 寃넗쐞썝쉶 쓽빐 듅씤릺뿀떎(IRB No. 2014-04-006).

옄猷뚮텇꽍 諛⑸쾿

理쒖쥌뜲씠꽣뒗 SPSS 18.0 Windows ver.怨 AMOS 18.0 봽濡쒓렇옩쓣 씠슜빐 遺꾩꽍븯쑝硫, 씪諛섏쟻 듅꽦쓣 븣븘蹂닿린 쐞빐 鍮덈룄遺꾩꽍 諛 湲곗닠넻怨꾨 떎떆븯怨, 씪諛섏쟻 듅꽦怨 怨듬났삁떦怨쇱쓽 愿怨꾨 븣븘蹂닿린 쐞빐 移댁씠뒪섏뼱寃젙쓣 넻빐 P 媛믪쓣 룄異쒗븯떎. 吏덈퀝뿉 븳 궗쉶쟻 吏吏쓽 뿭븷쓣 븣븘蹂닿린 쐞빐, 꽑뻾뿰援щ 넻빐 援ъ“紐⑦삎쓣 異붿젙븯怨 씠瑜 寃利앺븯떎.

寃 怨

긽옄쓽 씪諛섏쟻 듅꽦

몴蹂 듅꽦 Table 1怨 媛숇떎. 쟾泥댄몴蹂몄쓽 닔뒗 34,316씠硫, 씠以 쑀슚몴蹂몄쓽 닔뒗 媛 듅꽦蹂꾨줈 議곌툑뵫 李⑥씠媛 엳떎. 씪諛섏쟻 듅꽦쓣 궡렣蹂대㈃, 癒쇱 꽦蹂꾩뿉 뵲씪꽌뒗 궓꽦(33.1%)蹂대떎 뿬꽦(66.9%)쓽 鍮꾩쑉씠 넂븯怨, 뿰졊 52.5±8.1씠쑝硫, 援먯쑁닔以 怨좎「옄(37.2%)媛 媛옣 留롮 寃껋쑝濡 굹궗떎. 냼뱷닔以 200~400留 썝 洹몃9(41.8%)씠 媛옣 留롮븯怨, 諛곗슦옄 쑀臾대뒗 諛곗슦옄媛 엳뒗 洹몃9(89.9%)씠 븬룄쟻쑝濡 留롮븯떎. 二쇨쟻 嫄닿컯긽깭뒗 蹂댄넻(44.1%)씠 媛옣 留롮븯怨, 뼇샇(39.7%)媛 洹 떎쓬씠뿀쑝硫, 嫄닿컯븯吏 븡떎怨 쓳떟븳 긽옄뒗 16.2%뿉 遺덇낵뻽떎. 쁽옱 씉뿰쑉 12.5%쑝硫, 鍮꾨쭔 쑀蹂묐쪧 33.5%씠뿀떎. 떖由ъ궗쉶쟻 쎇鍮숈닔뒗 룊洹 씠븯濡 궙 吏묐떒씠 臾대젮 90.3%뿉 떖뻽쑝硫, 뒪듃젅뒪뒗 뾾떎怨 쓳떟븳 吏묐떒씠 56.0%, 媛걫 뒪듃젅뒪瑜 寃る뒗떎怨 쓳떟븳 吏묐떒씠 35.7%뿉 빐떦븯떎. 洹몃━怨 洹쒖튃쟻 슫룞쓣 븳떎怨 쓳떟븳 吏묐떒씠 53.0%濡 굹궗떎. 湲띿젙쟻 吏吏뒗 몴蹂 쟾泥댁쓽 룊洹좊낫떎 넂 吏묐떒(69.7%)씠 뜑 留롮븯怨, 諛섎濡 遺젙쟻吏吏뒗 몴蹂 쟾泥댁쓽 룊洹좊낫떎 궙 吏묐떒(68.0%)씠 뜑 留롮 寃껋쑝濡 굹굹 쟾諛섏쟻쑝濡 쓳떟옄쓽 궗쉶쟻 吏吏뒗 넂 寃껋쑝濡 뙆븙맂떎(Table 1).

General characteristics

Characteristics & variables All (n=34,316) %
Sex Male 11,367 33.1
Female 22,949 66.9

Age (years) Mean ± SD 52.5±8.1
30~39 123 0.4
40~49 13,421 39.1
50~59 13,396 39.0
60~69 6,787 19.8
>70 589 1.7

Educational level (years) Elementary 5,924 17.5
Middle 5,858 17.3
High 12,607 37.2
College 9,491 28.0
Unknown 436

Household income (10 thousand KW/month) <200 9,477 31.9
200~400 12,426 41.8
400~600 5,309 17.9
≥600 2,517 8.4
Unknown 4,587

Marita status Single 3,443 10.1
Married 30,746 89.9
Unknown 127

Self-rated health Good 13,542 39.7
Medium 15,049 44.1
Bad 5,541 16.2
Unknown 184

Smoking Never 25,302 74.0
Former 4,619 13.5
Current 4,279 12.5
Unknown 116

Drinking Never 18,383 53.7
Former 1,056 3.1
Current 14,773 43.2
Unknown 104

BMIa Under weight 576 1.7
Normal 12,350 36.0
Over weight 9,845 28.7
Obesity 11,495 33.6
Unknown 50

PWIb Low 30,135 90.3
High 3,219 9.7
Unknown 962

Stress Never 18,997 56.0
Sometimes 12,109 35.7
Often 2,829 8.3
Unknown 381

Physical exercise No 16,118 47.0
Yes 18,160 53.0
Unknown 38

Positive support Mean ± SD 11.3±1.3
High 23,931 69.7
Low 10,385 30.3

Negative support Mean ± SD 6.6±1.2
Low 23,321 68.0
High 10,995 32.0

a: body mass index; Underweight (BMI <18.5), Normal (18.5 ≤ BMI<23), Overweight (23 ≤BMI<25), Obesity (BMI ≥25)

b: psychosocial well-being index; Low risk group (PWI ≤27), High risk group (PWI ≥28)



긽옄쓽 씪諛섏쟻 듅꽦뿉 뵲瑜 怨듬났삁떦옣븷 諛 젣2삎 떦눊蹂

씪諛섏쟻 듅꽦怨 怨듬났삁떦怨쇱쓽 愿怨꾨 遺꾩꽍븳 寃곌낵뒗 Table 2怨 媛숇떎. 諛곗슦옄 쑀臾댁 떖由ъ궗쉶쟻 쎇鍮숈닔(PWI: Psychosocial Well-being Index)瑜 젣쇅븯怨, 꽦蹂, 뿰졊, 援먯쑁닔以, 媛援ъ냼뱷, 二쇨쟻 嫄닿컯긽깭, 씉뿰뒿愿, 쓬二쇱뒿愿, 泥댁쭏웾吏닔(BMI; Body Mass Index), 뒪듃젅뒪, 洹몃━怨 洹쒖튃쟻 슫룞뿉 뵲씪 쑀쓽誘명븳 李⑥씠媛 엳뒗 寃껋쑝濡 굹궗떎. 뿬꽦蹂대떎 궓꽦뿉꽌 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧씠 뜑 넂 鍮꾩쑉濡 諛쒓껄릺뿀쑝硫, 뿰졊씠 利앷븷닔濡 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧씠 利앷븯뒗 寃껋쑝濡 굹궗떎. 삉븳 援먯쑁닔以怨 냼뱷씠 궙쓣닔濡 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧씠 쑀쓽誘명븯寃 뜑 넂 鍮꾩쑉濡 굹궗떎. 二쇨쟻 嫄닿컯긽깭뒗 嫄닿컯븯吏 븡떎怨 씤떇븯뒗 吏묐떒뿉꽌 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧씠 뜑 넂븘吏뒗 寃껋쓣 븣 닔 엳떎. 쓬二쇱뒿愿 諛 씉뿰뒿愿쓽 寃쎌슦, 臾닿꼍뿕옄뿉 鍮꾪빐 씠쟾 삉뒗 쁽옱뿉 쓬二쇰굹 씉뿰뒿愿쓣 媛吏 吏묐떒뿉꽌 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧씠 넂 寃껋쑝濡 굹궗떎. 삉븳 泥댁쭏웾吏닔媛 利앷븷닔濡 怨듬났삁떦옣븷 삉뒗 떦눊蹂 쑀蹂묐쪧씠 뜑 利앷븯쑝硫, 떖由ъ궗쉶쟻 쎇鍮숈닔媛 궙 吏묐떒뿉꽌 怨듬났삁떦옣븷 떦눊蹂 쑀蹂묐쪧 뜑 넂寃 諛쒓껄릺뿀떎(Table 2).

Fast blood sugar according to general characteristics

Characteristics all (n=34,316) FBS, n (%) P-value

Normal IFG DM



25,079 5,647 3,590
Gender Male 7,261 (63.9) 2,654 (23.3) 1,452 (12.8) <0.001
Female 17,818 (77.6) 2,993 (13.0) 2,138 (9.3)

Age (years) 30~39 109 (88.6) 6 (4.9) 8 (6.5) <0.001
40~49 10,559 (78.7) 1,702 (12.7) 1,160 (8.6)
50~59 8,585 (71.6) 2,367 (17.7) 1,444 (10.8)
60~69 4,465 (65.8) 1,432 (21.1) 890 (13.1)
>70 361 (61.3) 140 (23.8) 88 (14.9)

Educational level (years) Elementary 4,096 (69.1) 1,098 (18.5) 730 (12.3) <0.001
Middle 4,169 (71.2) 1,033 (17.6) 656 (11.2)
High 8,429 (74.8) 1,967 (15.6) 1,211 (9.6)
College 7,072 (74.5) 1,478 (15.6) 941 (9.9)
Unknown 436 (1.3)

Household income (10 thousand KW/month) <200 6,675 (70.4) 1,736 (18.3) 1,066 (11.2) <0.001
200~400 9,213 (74.1) 1,953 (15.7) 1,260 (10.1)
400~600 3,987 (75.1) 798 (15.0) 524 (9.9)
≥600 1,936 (76.9) 356 (14.1) 225 (8.9)
Unknown 4,587 (13.4)

Marital status Single 2,522 (73.3) 556 (16.1) 365 (10.6) 0.840
Married 22,455 (73.0) 5,079 (16.5) 3,212 (10.4)
Unknown 127 (0.4)

Self-rated health Good 10,013 (73.9) 2,225 (16.4) 1,304 (9.6) <0.001
Medium 11,051 (73.4) 2,437 (16.2) 1,561 (10.4)
Bad 3,889 (70.2) 948 (17.1) 704 (12.7)
Unknown 184 (0.5)

Smoking Never 19,293 (76.3) 3,575 (14.1) 2,434 (9.6) <0.001
Former 2,868 (62.1) 1,151 (24.9) 600 (13.0)
Current 2,819 (65.9) 910 (21.3) 550 (12.9)
Unknown 116 (0.3)

Drinking Never 13,893 (75.6) 2,619 (14.2) 1,871 (10.2) <0.001
Former 711 (67.3) 217 (20.5) 128 (12.1)
Current 10,390 (70.3) 2,799 (18.9) 1,584 (10.7)
Unknown 104 (0.3)

BMIa Under weight 484 (84.0) 52 (9.0) 40 (6.9) <0.001
Normal 9,808 (79.4) 1,476 (12.0) 1,066 (8.6)
Over weight 7,145 (72.6) 1,666 (16.9) 1,034 (10.5)
Obesity 7,608 (66.2) 2,444 (21.3) 1,443 (12.6)
Unknown 50 (0.1)

PWIb Low 22,009 (73.0) 4,969 (16.5) 3,157 (10.5) 0.648
High 2,373 (73.7) 511 (15.9) 335 (10.4)
Unknown 962 (2.8)

Stress Never 13,803 (72.7) 3,233 (17.0) 1,961 (10.3) 0.002
Sometimes 8,934 (73.8) 1,913 (15.8) 1,262 (10.4)
Often 2,083 (73.6) 419 (14.8) 327 (11.6)
Unknown 381 (1.1)

Physical exercise No 11,895 (73.8) 2,619 (16.2) 1,604 (10.0) 0.005
Yes 13,156 (72.4) 3,022 (16.6) 1,982 (10.9)
Unknown 38 (0.1)

a: body mass index; Underweight (BMI <18.5), Normal (18.5 ≤BMI<23), Overweight (23 ≤BMI<25), Obesity (BMI ≥25)

b: psychosocial well-being index; Low risk group (PWI <27), High risk group (PWI ≥27)



援ъ“紐⑦삎쓽 寃利

紐⑦삎쓽 異붿젙 諛 媛꽕: 꽑뻾뿰援ъ쓽 씠濡좉퀬李곗쓣 넗濡 궗쉶쟻 吏吏쓽 嫄닿컯 삉뒗 吏덈퀝뿉 븳 꽕紐낅え뜽濡쒖꽌 떖由ъ쟻 寃쎈줈 뻾룞쟻 寃쎈줈瑜 諛섏쁺븯뿬 Fig. 1怨 媛숈 援ъ“紐⑦삎쓣 꽕젙븯떎. 援ъ“紐⑦삎 쉶洹遺꾩꽍怨 떖由 痢≪젙蹂닔瑜 넻빐 媛꽕쟻 媛쒕뀗씤 옞옱蹂씤쓣 깮꽦븯怨, 怨듬웾 遺꾪빐瑜 넻빐 옞옱蹂닔뱾 媛꾩쓽 蹂듭옟븳 씤怨쇨怨꾨 泥닿퀎쟻쑝濡 돺寃 씠빐븯뒗 뜲 겙 룄쓣 以떎. 삉븳, 紐⑦삎뿉 궡옱맂 痢≪젙삤李⑤ 븣 닔 엳怨, 굹븘媛 痢≪젙紐⑦삎怨 씠濡 紐⑦삎 媛꾩쓽 愿怨꾨 쟾泥댁쟻씤 愿젏뿉꽌 寃利앺븷 닔 엳떎뒗 젏뿉꽌 겙 쓽쓽媛 엳떎. 痢≪젙蹂씤뱾 븵쓽 遺꾩꽍뿉꽌 궗슜븳 蹂닔 룞씪븯硫, 빐떦 蹂닔뱾쓣 궗슜빐 궗쉶寃쎌젣쟻 吏쐞(SES), 궗쉶쟻 吏吏, 떖由ъ쟻 슂씤, 뻾룞쟻 슂씤, 吏덈퀝쓽 옞옱蹂씤뱾쓣 룄異쒗븯怨, 옞옱蹂씤뱾 媛꾩쓽 愿怨꾨 븣븘蹂닿퀬옄 븯떎. 씠븣 愿痢〓닔濡 궗슜븳 蹂씤뱾 옞옱蹂씤쓽 媛쒕뀗怨 씪移섑븯룄濡 遺젙쟻 吏吏, 떖由ъ궗쉶쟻 쎇鍮숈닔, 뒪듃젅뒪, 씉뿰뒿愿, 쓬二쇱뒿愿쓣 뿭諛⑺뼢쑝濡 怨꾩륫븯쑝硫 궗쉶쟻 吏吏뒗 湲띿젙쟻 吏吏뒗 젙諛⑺뼢쑝濡 怨꾩륫븳 媛믨낵 遺젙쟻 吏吏뒗 뿭諛⑺뼢쑝濡 怨꾩륫븳 媛믪쓣 빀궛븯뿬 怨꾩륫븯떎(Fig. 1).

Fig. 1.

Hypothetical model of social support to disease.



紐⑦삎쓽 쟻빀꽦 寃利:

(1) 옞옱蹂씤쓽 媛쒕뀗떊猶곕룄 諛 뙋蹂꾪떦룄

異붿젙紐⑦삎쓽 옞옱蹂씤 愿痢〓씤쓽 닔媛 쟻뼱 솗씤슂씤遺꾩꽍쓣 떎떆븯湲곗뿉 쟻빀븯吏 븡떎. 뵲씪꽌 媛쒕뀗떊猶곕룄 遺꾩궛異붿텧吏닔, 洹몃━怨 뙋蹂꾪떦룄 寃利앹쓣 넻빐 媛꽕쟻 媛쒕뀗씠 삱諛붾Ⅴ寃 꽕젙릺뿀뒗吏 솗씤빐蹂댁븯떎. 媛쒕뀗떊猶곕룄(CR: Construct Reliability)뒗 옞옱蹂씤뿉 븳 痢≪젙蹂씤뱾쓽 궡쟻 씪愿꽦쓣 痢≪젙븯뒗 뜲 씠슜맂떎. 媛쒕뀗떊猶곕룄쓽 怨꾩궛諛⑸쾿 떎쓬怨 媛숇떎.

CR=(Σ몴以쟻옱移)2[몴以쟻옱移)2痢≪젙삤李]

삉븳 룊洹좊텇궛異붿텧(AVE: Average Variance Extracted)쓣 寃利앺븯뿬 떊猶곗꽦 룊媛瑜 븯떎. AVE뒗 痢≪젙삤李⑥뿉 湲곗씤븳 蹂웾怨 鍮꾧탳뻽쓣 븣 꽕紐낅릺뒗 蹂웾쓽 겕湲곕 굹궡硫, 떎쓬怨 媛숈씠 怨꾩궛맂떎.

AVE=(Σ몴以쟻옱移)2[몴以쟻옱移)2痢≪젙삤李]

씠윭븳 怨듭떇뿉 뵲씪 媛쒕뀗떊猶곕룄 룊洹좊텇궛異붿텧吏닔瑜 Table 3뿉 굹궡뿀떎. 遺꾩꽍寃곌낵, 媛 슂씤쓽 몴以쟻옱移섍 0.5 씠긽씠誘濡 媛쒕뀗떦꽦 솗蹂대릺뿀떎. 삉븳 씠뿉 븳 媛쒕뀗떊猶곕룄뒗 0.68~0.79濡 궡쟻 씪愿꽦씠 엳떎怨 븷 닔 엳떎. 洹몃━怨 룊洹좊텇궛異붿텧吏닔뒗 紐⑤몢 0.53~0.64濡 굹굹 닔졃떦꽦룄 솗씤릺뿀떎(Table 3).

떎쓬쑝濡 뙋蹂꾪떦꽦쓣 솗씤븯떎. 媛쒕뀗떊猶곕룄媛 옞옱蹂씤怨 痢≪젙蹂씤씠 꽌濡 뼹留덈굹 씪移섑븯뒗媛瑜 蹂대뒗 寃껋씠씪硫, 뙋蹂꾪떦룄뒗 옞옱蹂씤뱾씠 꽌濡 뼹留덈굹 긽씠븳媛瑜 蹂대뒗 寃껋씠떎. 뙋蹂꾪떦꽦쓣 媛옣 뾼寃⑺븯寃 뙋떒븯뒗 湲곗 룊洹좊텇궛異붿텧吏닔媛 긽愿怨꾩닔쓽 젣怨(2) 媛믪쓣 긽쉶븯뒗吏 뿬遺(Fornell & Larcker, 1981)濡 뙋떒븯뒗 寃껋씠떎. 癒쇱 옞옱蹂씤뱾 媛꾩쓽 긽愿愿怨꾨 遺꾩꽍븳 寃곌낵뒗 Table 4 媛숇떎. 긽愿愿怨꾨텇꽍 븯굹쓽 냽꽦씠굹 媛쒕뀗쓽 긽깭뿉 븳 痢≪젙씠 떎瑜 냽꽦씠굹 媛쒕뀗쓽 긽깭蹂솕瑜 삁痢≫븯뒗吏瑜 뙋떒븯뒗 뜲 쓽쓽媛 엳떎. 蹂 뿰援ъ뿉꽌 긽젙븳 援ъ“紐⑦삎쓽 愿怨꾩뿉꽌 궗쉶쟻 吏吏 吏덈퀝, 떖由ъ쟻 슂씤怨 吏덈퀝 媛꾩뿉뒗 긽샇 媛꾩쓣 쑀쓽誘명븯寃 삁痢≫븯吏 紐삵븯뒗 寃 쑝濡 굹궗쑝굹, 洹 쇅쓽 紐⑤뱺 愿怨꾩뿉꽌뒗 옞옱蹂씤뱾 媛 쑀쓽誘명븳 긽愿愿怨꾧 엳뒗 寃껋쑝濡 굹궗떎(Table 4).

Correlations among latent variables

Variables Correlation coefficient P
SES Social support 0.136 <0.001
SES Behavioral factors -0.214 <0.001
Psychological Social support 0.597 <0.001
factors
Psychological Behavioral factors -0.079 <0.001
factors
Psychological SES 0.213 <0.001
factors
Social support Behavioral factors 0.018 0.048
Disease Behavioral factors -0.106 <0.001
Disease Psychological 0.006 0.473
factors
Disease SES -0.054 <0.001
Disease Social support 0.004 0.659


씠윭븳 긽愿怨꾩닔瑜 씠슜빐 뙋蹂꾪떦꽦쓣 寃利앺븯쑝硫 遺꾩꽍寃곌낵뒗 떎쓬 Table 5 媛숇떎. 痢≪젙蹂씤씠 븯굹濡쒕쭔 援ъ꽦맂 吏덈퀝쓣 젣쇅븯怨, 紐⑤뱺 李⑥썝뿉꽌 옞옱蹂씤뱾 媛꾩쓽r-square (2) 媛믪 0.5 誘몃쭔쑝濡 媛 옞옱蹂씤쓽 AVE 媛믩낫떎 옉湲 븣臾몄뿉 뙋蹂꾪떦꽦 솗蹂대릺뿀떎怨 븷 닔 엳떎(Table 5).

Discriminant validity among latent variables

a b c d
a: SES AVE=0.53
b: Social support 0.02 AVE=0.64
c: Psychological factors 0.05 0.36 AVE=0.53
d: Behavioral factors 0.05 0.00 0.01 AVE=.0.56

(2) 紐⑦삎쟻빀룄

蹂 뿰援ъ뿉꽌 긽젙븳 媛꽕 寃利앹뿉 븵꽌 援ъ“紐⑦삎쓽 쟻빀꽦(model fit)쓣 寃利앺븯쑝硫, 洹 寃곌낵뒗 Table 6 媛숇떎. 떎留 愿痢〓닔뿉 寃곗륫媛믪씠 룷븿맂 뜲씠꽣 뀑쓣 궗슜빐 遺꾩꽍븯湲 븣臾몄뿉, 쟻빀吏닔 以 GFI 諛 AGFI뒗 怨꾩궛븯吏 紐삵븯떎. 癒쇱 젅쟻빀吏닔 以 移댁씠옄듅(χ2) 넻怨꾨웾씠 74.50쑝濡 넂寃 굹굹 젙洹쒕텇룷瑜 씠猷⑤뒗 洹臾닿꽕쓣 梨꾪깮븯吏 紐삵븯떎. 洹몃윭굹 RMSEA=0.04濡 굹굹 쟻빀꽦 슂嫄댁쓣 異⑹”븯떎. 利앸텇쟻빀吏닔 以 NFI=0.95, CFI=0.94쑝濡 쟻빀븳 寃껋쑝濡 굹궗怨, 媛꾨챸쟻빀吏닔씤 TLI=0.90쑝濡 굹굹 理쒖쥌쟻쑝濡 紐⑦삎 쟻빀븳 寃껋쑝濡 뙋젙븯떎.

Model fit for the hypothetical model

Indices Absolute fit measures Incremental fit measures Parsimonious fit measures
χ2 (P) RMSEA NFI CFI TLI
Values 74.50 (<0.05) 0.04 0.95 0.94 0.90


紐⑦삎쓽 媛꽕 寃利: 紐⑦삎뿉 븳 遺꾩꽍寃곌낵뒗 Table 7怨 媛숈쑝硫, 긽쟻씤 쁺뼢젰쓽 겕湲곕 븣븘蹂닿린 쐞빐 몴以솕 빐瑜 넻빐 젣떆븯떎. 紐⑦삎뿉꽌 긽젙븳 珥 9媛쒖쓽 寃쎈줈뿉 븯뿬 P<0.05 닔以뿉꽌 넻怨꾩쟻쑝濡 쑀쓽誘명븳 寃쎈줈뒗

Standardized regression weights

Endogenous variables Exogenous variables Estimate P-value SMC
Psychological factors SES 0.112 <0.001 0.496
Social support 0.679 <0.001

Behavioral factors SES -0.205 <0.001 0.158
Social support 0.140 <0.001
Psychological factors -0.139 <0.001

Disease SES -0.088 <0.001 0.119
Social support -0.011 0.589
Psychological factors 0.021 0.300
Behavioral factors -0.124 <0.001


7媛쒕줈 굹궗떎. 援ъ껜쟻쑝濡 궡렣蹂대㈃ 떎쓬怨 媛숇떎. 癒쇱, 떖由ъ쟻 슂씤쓽 蹂웾뿉 븳 쇅깮蹂닔뱾쓽 꽕紐낅젰 49.6%濡 鍮꾧탳쟻 넂寃 굹궗떎. 利, 궗쉶쟻 吏吏(γ=0.68) 궗쉶寃쎌젣쟻 吏쐞(γ=0.11)뒗 떖由ъ쟻 슂씤쓣 쑀쓽誘명븯寃 利앷떆궎뒗 寃껋쑝濡 굹궗떎. 뻾룞쟻 슂씤뿉 븳 쇅깮蹂닔뱾쓽 꽕紐낅젰 15.8%濡 굹궗쑝硫, 궗쉶쟻 吏吏(γ=0.14)媛 뻾룞쟻 슂씤쓣 쑀쓽誘명븯寃 利앷떆궎硫, 떖由ъ쟻 슂씤(γ=-0.14)怨 궗쉶寃쎌젣쟻 吏쐞(γ=-0.21)뒗 뻾룞쟻 슂씤쓣 쑀쓽誘명븯寃 媛먯냼떆궎뒗 寃껋쑝濡 굹궗떎. 吏덈퀝뿉 븳 쇅깮 蹂닔뱾쓽 꽕紐낅젰 11.9%濡 굹궗쑝硫, 뻾룞쟻 슂씤(γ=-0.12)怨 궗쉶寃쎌젣쟻 吏쐞(γ=-0.09)媛 吏덈퀝쓣 쑀쓽誘명븯寃 媛먯냼떆궎뒗 寃껋쑝濡 굹궗떎(Table 7). 遺꾩꽍寃곌낵뿉 븳 紐⑦삎쓽 寃쎈줈룄빐瑜 Fig. 2뿉 굹궡뿀떎.

Fig. 2.

Path diagram for model.


怨 李

궗쉶쟻 吏吏 궗쉶寃쎌젣쟻 吏쐞뒗 떖由ъ쟻 슂씤쓣 쑀쓽誘명븯寃 利앷떆궎뒗 寃껋쑝濡 굹궗떎. 삉븳 궗쉶쟻 吏吏媛 뻾룞쟻 슂씤쓣 쑀쓽誘명븯寃 利앷떆궎硫, 떖由ъ쟻 슂씤怨 궗쉶寃쎌젣쟻 吏쐞뒗 뻾룞쟻 슂씤쓣 쑀쓽誘명븯寃 媛먯냼떆궎뒗 寃껋쑝濡 굹궗떎. 뻾룞쟻 슂씤怨 궗쉶寃쎌젣쟻 吏쐞媛 吏덈퀝쓣 쑀쓽誘명븯寃 媛먯냼떆궎뒗 寃껋쑝濡 굹궗떎. 利, 궗쉶쟻 吏吏媛 뻾룞쟻 슂씤쓣 利앷떆耳곗쑝硫, 뻾룞쟻 슂씤 吏덈퀝쓣 媛먯냼떆궓 寃곌낵씠떎. 궗쉶쟻 吏吏濡 씤빐 씉뿰怨 쓬二쇰뒗 媛먯냼릺怨 슫룞 利앷떆耳 湲띿젙쟻씤 뻾룞쟻 슂씤쑝濡 옉슜릺뼱 怨듬났삁떦怨 젣2삎 떦눊蹂묒쓣 쑀쓽誘명븯寃 媛먯냼떆耳곕떎. 궗쉶쟻 吏吏媛 嫄닿컯寃곌낵뿉 쁺뼢쓣 二쇰뒗 꽭 媛吏쓽 寃쎈줈 以 嫄닿컯뻾룞 寃쎈줈媛 꽦由쎈맂 寃곌낵씠떎. 嫄닿컯뻾룞 寃쎈줈뒗 궗쉶쟻 吏吏湲곕뒫쓣 넻븯뿬 씉뿰씠굹, 쓬二, 떊泥댄솢룞, 떇씠뒿愿 媛숈 嫄닿컯利앹쭊 샊 쑀빐뻾룞뿉 쁺뼢쓣 以떎(Lewis and Rook, 1999). 궗쉶쟻 吏吏媛 嫄닿컯뻾룞뱾뿉 쁺뼢쓣 誘몄튂뒗 寃껋 뿬윭 媛吏 諛⑸쾿뱾씠 엳떎. 泥レ㎏, 궗쉶쟻 吏吏뒗 뜑 굹 嫄닿컯뻾룞뱾쓣 珥됱쭊떆궗 닔룄 엳떎. 솢깘븯硫 洹멸쾬 媛쒖씤씠 寃쏀뿕븷 닔 엳뒗 뒪듃젅뒪쓽 뼇쓣 媛먯냼떆궗 닔 엳湲 븣臾몄씠떎. 몮吏, 궗쉶쟻 吏吏뒗 媛쒖씤뿉寃 吏곸젒쟻쑝濡 뜑 嫄닿컯븳 떎泥쒗뻾룞뱾뿉 李몄뿬븯룄濡 룞湲 쑀諛쒖쓣 븷 닔룄 엳떎. 삁瑜 뱾뼱, 媛源뚯슫 媛議 援ъ꽦썝뱾 媛쒖씤씠 슫룞쓣 븯嫄곕굹 湲덉뿰븯룄濡 븬젰쓣 媛븷 닔룄 엳떎뒗 寃껋씠떎. 洹몃━怨 쟻젅븳 궗쉶쟻 吏吏瑜 媛吏뒗 寃껋 븳 궗엺씠 궗옉쓣 諛쏅뒗떎뒗 궗떎쓣 븣젮二쇨퀬, 씠寃껋 뒪뒪濡쒕 룎蹂대뒗 룞湲곕 利앷븯寃 留뚮뱾뼱 뜑 굹 嫄닿컯뻾룞뱾쓣 씠걣뼱 굹媛 닔 엳떎. 떖由ъ쟻 寃쎈줈뒗 蹂 뿰援ш껐怨쇱뿉꽌뒗 쑀쓽誘명븯吏 븡븯떎. 떖由ъ쟻 寃쎈줈뒗 옄議닿컧, 궗쉶쟻 뒫젰, 옄湲고슚뒫媛, 슦슱 벑쓽 蹂닔媛 以묒슂븳뜲, 蹂 뿰援щ뒗 蹂닔 痢≪젙쓽 븳怨꾨줈 떖由ъ쟻 寃쎈줈쓽 蹂닔濡 떖由ъ궗쉶쟻 쎇鍮숈닔留 솢슜릺뿀湲 븣臾몄씠씪怨 깮媛곷맂떎. 異뷀썑 뿰援ъ뿉꽌뒗 紐⑤뱺 蹂닔媛 怨좊젮맂 뿰援ш 븘슂븷 寃껋씠떎. 留덉留됱쑝濡 嫄닿컯寃곌낵뿉 吏곸젒쟻씤 쁺뼢쓣 誘몄튌 닔 엳뒗(Uchino et al., 1996) 깮由ъ쟻 寃쎈줈뒗 쑀쓽誘명븯吏 븡븯떎. 궗쉶쟻 吏吏뒗 嫄닿컯뿉 吏곸젒 쁺뼢쓣 二쇰뒗 寃껊낫떎뒗 궗쉶쟻 吏吏濡 씤븯뿬 嫄닿컯뻾룞뱾쓣 떎泥쒗븷 븣 嫄닿컯뿉 쁺뼢쓣 二쇰뒗 寃껋씠씪怨 깮媛곷맂떎. 蹂 뿰援щ뒗 궗쉶쟻 吏吏媛 嫄닿컯뻾룞뿉 쁺뼢쓣 二쇱뼱 怨듬났삁떦쓣 궙異붾뒗 寃껋쑝濡 굹궗떎. 뵲씪꽌, 젣2삎 떦눊蹂묒쓽 삁諛⑹쓣 쐞빐꽌뒗 媛쒖씤쓽 쐞뿕슂씤쓽 愿由 肉먮쭔 븘땲씪, 궗쉶쟻 吏吏 벑怨 媛숈 궗쉶쟻 愿怨꾩쓽 愿떖 媛뽮퀬 嫄닿컯뻾룞쓣 떎泥쒗븯뒗 寃껋씠 吏덈퀝쓣 以꾩씪 닔 엳뒗 諛⑹븞씠씪 븯寃좊떎. 蹂 끉臾몄 젣븳젏씠 엳떎. 泥レ㎏, 떒硫댁뿰援ъ씠誘濡 궗쉶쟻 吏吏 怨듬났삁떦옣븷쓽 愿젴꽦뿉 빐 씤怨쇨怨꾨 끉븯吏 紐삵븯硫, 떦눊蹂 솚옄씪 寃쎌슦, 삤엳젮 二쇰쓽 愿떖쑝濡 궗쉶쟻 吏吏媛 넂쓣 닔 엳뒗 뿭 씤怨쇨怨꾧 議댁옱븷 닔 엳떎. 몮吏, 뿰援ъ쓽 議곗궗긽씠 嫄닿컯寃吏 닔寃옄씪뒗 듅젙 씤援ъ쭛떒쓣 긽쑝濡 씠猷⑥뼱議뚭린 븣臾몄뿉 뿰援ш껐怨쇰 씪諛섑솕 떆궎뒗 뜲뒗 젣븳젏씠 엳떎怨 깮媛곹븳떎. 뀑吏, 떦눊蹂묒쓣 吏꾨떒븯뒗뜲 엳뼱꽌 怨듬났삁떦쑝濡쒕쭔 吏꾨떒릺怨, 떦遺븯寃궗瑜 씠슜븯吏 紐삵븳 젣븳젏씠 엳떎. 꽬吏, 궗쉶쟻 吏吏뒗 늻媛 吏吏瑜 젣怨듯븯뒓깘뿉 뵲씪 洹 슚怨쇨 떎뼇븯寃 굹굹뒗뜲 蹂 뿰援ъ뿉꽌뒗 吏吏 썝泥쒖쓽 룊媛뒗 怨좊젮릺吏 븡븯떎. 뵲씪꽌 씠썑쓽 뿰援ъ뿉꽌뒗 젣븳젏쓣 蹂댁셿븳 뿰援ш 젣떆릺뼱빞 븷 寃껋씠떎. 씠윭븳 젣븳젏씠 엳쓬뿉룄 蹂 뿰援щ뒗 쟾援 8媛 븰蹂묒썝뿉꽌 꽕臾몄“궗 깮泥댁떆猷뚮 룞떆뿉 닔吏묓븳 옄猷뚮 씠슜븯뿬 궗쉶쟻 吏吏 怨듬났삁떦옣븷쓽 愿怨꾨 꽦蹂꾩쓽 李⑥씠瑜 怨좊젮븯뿬 궡렣蹂댁븯쑝硫, 궗쉶쟻 愿怨꾨쭩쓽 湲띿젙쟻 湲곕뒫怨 遺젙쟻 湲곕뒫쓣, 湲띿젙쟻 吏吏 遺젙쟻 吏吏濡 痢≪젙븯뿬 븿猿 怨좊젮븳 뿰援ъ씠硫, 媛쒖씤쓽 嫄닿컯臾몄젣瑜 깮臾쇳븰쟻 젒洹쇱뿉꽌 踰쀬뼱굹 궗쉶쟻 留λ씫뿉꽌 諛붾씪蹂닿퀬옄 吏덈퀝쓽 썝씤쓣 媛쒖씤뿉꽌 궗쉶쟻 愿怨꾨줈 룷愿꾪븯뿬 깘援ы븯떎뒗뜲 쓽쓽媛 엳떎.

ACKNOWLEDGEMENT

None.

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

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