Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.
Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.
Purpose: The purpose of this study was to analyze the effects of aromatherapy on stress using meta-analysis. Methods: Meta-analysis was done with 21 published studies, and data were analyzed with the SAS 9.1 program. Results: Fifty eight effect size was estimated with data from 21 published studies. Overall mean effect size (ES), and mean effect size of dependence variables according to the type of intervention and subject and according to the total amount of time spent in aromatherapy were estimated. Overall mean effect size of the effects of aromatherapy was .593, and the subjective stress (.983) was most effective in the physiological faculty, followed by mean effect size of cortisol (.648) and pulse (.40). On the other hand, mean effect size of systolic blood pressure (.490) was moderate, and that of diastolic blood pressure (.401) was not large. Mean effect size of elderly (.706) cancer patients was considerable(.337). There were significant differences depending on the subjects. With regards to the types of aromatherapy, the effect size of aroma massage combined with inhalation therapy was .590, and there were no significant differences between the intervention methods. With regards to the time of intervention, $20{\sim}30$ minutes spent in aromatherapy was .730, and there were no significant differences between the times of intervention. The relationship between the effect size and intervention frequency was r=.349 and showed significant difference. Conclusion: This result suggests that aromatherapy is an effective intervention to reduce stress for subjects. Nursing intervention protocol by using aromatherapy should be developed and applied in clinical and community settings. Further studies on the effects of aromatherapy on stress should be done by using meta-analysis.
Purpose: The purpose of this study was to investigate factors associated with sexual debut among Korean middle school students. Methods: From the database of the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researchers selected 37,297 middle school students aged 12-15 years. Data were analyzed using $x^2$ test and multiple logistic regression with the SPSS WIN 18.0 program. Results: The proportion of middle school students who had a sexual debut was 2.1% of boys and 1.5% of girls. In multiple regression analysis, economic status, experience of part time work, smoking, drug use and depression were associated with an increased proportion of sexual intercourse for both boys and girls. Living with parents, drinking alcohol and suicidal ideation were associated with sexual debut for boys only. By contrast, formal sexual education was associated with a reduced risk of sexual debut. Conclusion: The results of this study show the factors associated with sexual debut among Korean middle school students. Gender-related interventions should be taken into consideration in school sexual education programmes, because of differences in related factors according to gender.
Kim, Chul-Woung;Moon, Ok-Ryun;Lee, Sang-Yi;Yoo, Jae-Won;Yi, Sang-Gu
Journal of Preventive Medicine and Public Health
/
v.31
no.3
s.62
/
pp.564-578
/
1998
Most extended care facilities have admitted both the healthy and unhealthy elderly, among which members' average caring demand vary. The Aged Welfare Law, however, currently provides no reasonable basis on the staffing policy for extended care facilities. It just reflects the admitted number of the elderly rather than differences in members' average caring demand among facilities. This study is designed to estimate the need for caring staff on the basis of the correlation between the individual health status measured by various tools including Activities of Daily Living and caring demand by actual service time for each one. The sample included all of the admitted elderly(187 persons) in 4 extended care facilities, two in Seoul and the other two in Kangwon-Do over the survey period October 5 through October 20, 1996. The survey process consisted of 3 stages. (1) The current staffing information was collected through self-completed written questionnaires left for head of official in each facility. (2) Six graduate students at School of Public Health interviewed all residents to collect information on their health status and sociodemographics. The response rate for the interview was relatively high(85%). (3) Information on direct and indirect caring time consumed for each residents came from self-completed written questionnaires given to nurses and helpers in each target facilities. Analysis of the data was made using Pearson's correlation and multiple regression technique through SAS program. Based on this procedure, the following was found. 1. No facility meet the staffing standard in the Aged Welfare Law completely. 2. It is actual service time that is most correlated with ADL(Activities of daily living). 3. When all of the elderly are divided by four groups based on the level of ADL, the mean values of needed caring time in each group are 15, 21, 36 and 88 minutes respectively. 4. There is no significant difference among facilities in distribution of elderly person by group. 5. No facility meets the estimated number of nurses and helpers which reflects health status of the admitted elderly. Therefore, it is required that severity of the admitted elderly be considered in establishing staffing standard for extended care facility.
This research has been accomplished to build up the growth strategies of Kangwon district's small & medium-sized construction firms. For this purpose, we made an investigation of the present situation and status for existing regional small & medium construction firms by analyzing data. Based on the results from this study, the following growth strategies are suggested to gain their competitive advantages. Firstly, most of all, the role of the top manager is the most important factor since most of the top manager for the small & medium-sized construction firms coincide with the owner the firms. Secondly, the specialization strategy is to establish. Above all they concentrate their business capacities on core business. Then, this growth strategy should be based on the selective escalation of functions in order to maintain an appropriate level of construction works. Thirdly, the specialized skills and skilled workers are ensured for competitive advantages. For human resource development, they should train workers to be multi-functioned on the assumption the they could stay at firm until they wish to retire. Finally, the government must also spare no effort to encourage the small & medium-sized construction firms to build up it's competitive power and cultivate it's spontaneous generation power though the reformation of system related whit the small and medium construction industry.
Journal of agricultural medicine and community health
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v.27
no.2
/
pp.127-136
/
2002
This study was taken to provide data for the approaches of day care service for the elderly in community health practitioner's post through the study on the utilization rate, characteristics and health promotion that the elderly used the day care services. Data collection used three records that case management in take sheet, dementia check list and ADL record during the one year, from June 21, 2001 to June 30, 2002. During the one year, the elderly used day care services were 119 persons that 26.9% of the total elderly population, 1.5 time per used the elderly, and female elderly(88.9%) more used than male elderly. 39.5%of the elderly user have chronic diseases that was arthritis and hypertension and etc. 41.2% of the elderly users have dementia state that score was $17.39{\pm}7.17$(handicapped elderly), $18.43{\pm}7.36$(healthy elderly), but statistically not significant PADL score was $2.18{\pm}0.55$(handicapped elderly), $2.78{\pm}0.30$(healthy elderly), IADL score was $1.78{\pm}0.51$(handicapped elderly), $2.47{\pm}0.60$(healthy elderly) that were statistically significant. One year later, PADL and IADL of the elderly users were improved that statistically significant(p=0.01). The elderly users were wanted rehabilitation service(22.2%), talking service(20.6%), bath service(12.7%), food service(9.5%) of day care services in CHP's post. We are recommended that day care service for the elderly in CHP's post was very useful and contributed to promote ADL functions.
Kim, Jae-Soog;Park, Jong;Ryu, So-Yeon;Lee, Chul-Gab;Kim, Hak-Ryul;Kim, Yang-Ok
Journal of agricultural medicine and community health
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v.24
no.1
/
pp.131-143
/
1999
This study was attempted to find the mutual relationship between leisure activities and life satisfaction by the aged persons in a rural area. The data was obtained by interview with questionnaire and the data from 209 persons aged over 65, residing in Dohwa-myeon and Podu-myeon, Koheung-kun, Chollanam-do were analysed. The survey was carried out from Feb. 16th to May 3rd in 1998 and the results are as follows: 1. The survey showed that the major leisure activities were TV watching followed by talking with friends, club activities, taking a walk, visiting friends' or relatives' home and breeding domestic animals. 2. The types of leisure activities were classified into 8 patterns as active self-enlightenment, passive self-enlightenment, temporal amusements, passive self-activities, cozy introspective activities, friend oriented activities, family oriented activities and religious activities. Among the above 8 patterns active self-enlightenment type contributed most to the life satisfaction. 3. The major factors affecting leisure activities were sex, age, average income, religion and educational status. And the major factors affecting life satisfaction were sex, age average income, educational status and a state of health. In conclusion the more the aged persons participated in leisure activities, the better they felt life satisfaction.
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.15
no.2
/
pp.143-151
/
2004
Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.
Journal of agricultural medicine and community health
/
v.35
no.2
/
pp.111-123
/
2010
Objectives: The purpose of the present study is to examine the effects of the Field Management Training Program for home care services personnel on their understanding and professional competences. Methods: The subjects were 373 team managers of public home care services who participated in the training program. Data was collected with a self-administered questionnaire in April and September, 2007. The subjects' level of understanding of home care was measured by 35 questions divided into 8 categories while their professional competence was measured by 15 questions divided into 5 categories. Result: After attending the training, the subjects' understanding improved from 20.90 points (possible range: 4~32) to 26.11 points. The most improvement was evident in the Planning and Public Health Education categories. Their professional competences improved from 10.81 points (possible range: 4~16) to 12.51 points. The improvement of their understanding and professional competences differed across to training places. It was also evident that an increase in understanding brought about an increase in professional competence. Conclusion: The Field Management Training Program needs to be continued with efforts to reduce the differences of training effects between training places. And additional recommendations should be made through further evaluation of subsequent training programs.
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