• Health Policy and Management
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• v.9 no.2
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• pp.139-156
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• 1999

Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.164-173
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• 2001

Objectives : Fatigue is a common symptom in primary medical care and has nonspecific and highly subjective features. So it has been difficult to define and measure fatigue, especially those present without any organic diseases. This study was conducted to evaluate the validity of the Fatigue severity scale(FSS) in patients with persistent fatigue who were free of any organic diseases or psychiatric disorders of depression or anxiety. Methods : Subjects consisted of 45 controls, 44 fatigued patients and 43 psychiatric patients with depression or anxiety. They all completed the fatigue severity, modified Bepsi stress, and Hospital anxiety and depression scales. Chalder fatigue scale was administrated randomly in 30 of them. Data were analyzed for reliability and validity of the FSS. Results: Cronbach's a coeffient of FSS was 0.929, and the Pearson correlation coefficient for test-retest was 0.916(p<0.01). ANCOVA for discriminant validity revealed that there were significant differences in mean FSS values among the three groups. The fatigue group had significantly higher FSS value than the other two groups. The psychiatric group also had significantly higher FSS value than the control group. The Pearson correlation coefficient for convergent validity by comparing FSS with Chalder fatigue scale was 0.782(p<0.01). Using FSS index 3.22 as the cut-off point, sensitivity was 84.1% and specificity was 85.7% for the fatigue and control groups, respectively. Conclusion : Results suggested the clinical application of the FSS to be a useful measurement for distinguishing fatigue between patients with physiologic fatigue and psychiatric patients with depression or anxiety.

• Journal of agricultural medicine and community health
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• v.13 no.1
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• pp.97-103
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• 1988

산간 농촌지역 19개 행정리 1,151세대, 인구 4,591명, 농가비율 78.4%인 경기도 남양주군 수동면에서 면지역사회 표본추출 세대주 284명의 보건지소 이용에 미치는 요인에 대한 설문조사 자료와 1976년부터 1987년까지 보건지소를 이용한 외래 초진 환자의 진료실적을 분석한 결과 다음과 같은 결과를 얻었다. 1) 농촌지역 주민의 보건지소 이용율은 인구 1,000명당 1987년이 900으로 최고율을 보이다가 1979년 846, 1981년 708, 1985년 618, 1983년 594, 1987년 341로 해가 거듭할수록 감소하는 경향을 보였다. 2) 농촌지역 주민의 연령별 보건지소 이용율은 인구 1,000명당 0~4세군이 1976년 1981년, 1986년 공히 2,067.4, 2,402.7, 2,308.2로 최고율을 보였으며 다른 연령군에서는 별차이가 없었다. 3) 조사대상 세대주의 1차진료기관 선정은 보건지소가 43.3%로 가장 높았고 다음이 병원 29.6%, 일반과의원 15.5%, 전문과 의원 11.6% 순이었다. 4) 조사대상 세대주의 92.6%가 보건지소를 가끔 또는 자주 이용한 적이 있으며 보건지소가 좋다고 생각하는 주민은 21.1%에 불과하였다. 5) 조사대상 세대주의 보건지소나 일반과의원 선정기준은 성실하고 친절한 차이 57.8%로 가장 높고 다음이 가까운 곳(24.6%), 시설이 좋은 곳(9.2%), 치료비가 싼곳(8.4%)순이었다. 6) 농촌지역주민의 보건지소 이용율은 보건지소와의 거리가 가까운 마을 주민일수록 자주 이용하고 있는 경향을 보였다. 7) 조사대상 세대주의 59.8%가 일상농사일이 일차진료에 영향을 미친다고 하였다. 8) 조사대상 세대주의 보건지소 발전 방안을 위해 보건지소에 바라는 소망을 보건지소 직원의 좋은 태도가 28.5%로 가장 높았고 다음이 근무시간 준수나 연장개선(10.9%), 시설 및 장비개선(9.5%), 기타(7.1%) 순이었다.

• Journal of Korean Academy of Dental Administration
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• v.5 no.1
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• pp.45-54
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• 2017

The purpose of this article is to cope with the abuse of antibiotics in the clinic, to determine the necessity of antibiotic administration, to share information on the selection and proper use of appropriate antibiotics, and to increase the appropriateness of antibiotic prescription through continuous monitoring. In line with the latest research and guidelines trends of various agencies, we will supplement the antibiotic prescription guidelines and use them for the treatment in Apple Tree Dental Hospital. Specially, by history taking and the penicillin allergy test, amoxicillin is prescribed as a primary selective antibiotic for 1 day. The complaints and treatment effects of the first antibiotic should be evaluated at the next visit. If the primary antibiotic was ineffective, we replaced it with a broad-spectrum antibiotic. If there was no improvement in symptoms, the patient would be referred to upper grade hospital. The staff of the Apple Tree Dental Hospital regularly monitored and educated antibiotic prescriptions. The current guidelines should be supplemented continually and positively affect the abuse of antibiotics and the habit of dental practice.

• Research in Community and Public Health Nursing
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• v.5 no.2
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• pp.162-180
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• 1994

The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.80-98
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• 2022

Posttraumatic stress disorder (PTSD) is well known to have a limited response to drug treatment. Many recently published clinical care guidelines recommend trauma-focused psychotherapies such as cognitive processing therapy (CPT) and prolonged exposure therapy (PE) as first-line treatment and medication such as serotonin reuptake inhibitors and venlafaxine as second-line treatment. Current review introduces the session composition and contents of CPT and presents various CPT studies that show therapeutic effect for civilian and veterans/military with PTSD. In order for clinicians to help effectively patients with PTSD, it is necessary to learn and actively use evidence-based trauma-focused psychotherapies including CPT and PE.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.87-105
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• 2002

In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

• Journal of Korean Academy of Rural Health Nursing
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• v.12 no.2
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• pp.29-44
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• 2017

Purpose: The purpose of this study was to identify community health practitioners' (CHP) perception of barriers to research utilization, current status and competence in evidence-based practice (EBP). Methods: From all over the country, 126 CHP completed an e-mail survey. Results: The items with the highest barrier scores were that it is difficult to understand articles written in English and physicians will not cooperate with implementation. There were statistically significant differences in the scores for attitude toward EBP and knowledge in EBP by education level and nursing academic society membership status. When faced with a problem, the nurses usually use related regulations or asked a colleague for advice. Conclusion: Results indicate an awareness of the necessity of applying EBP, need to improve readiness to use EBP voluntarily and actively, and need to search for various factors that are barriers to research utilization. There is a need to develop and apply EBP training/education programs to find new evidence that might actually support previous practice for which nurses lack confidence. Guidelines that consider CHP task characteristics and barrier factors to research utilization should be developed.

• Clinical and Experimental Pediatrics
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• v.51 no.8
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• pp.792-796
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• 2008

Bone pain in a child could be associated with cancer as an initial manifestation of the disease. The childhood malignancies that frequently present bone pain are leukemia, neuroblastoma, and primary bone tumors such as osteosarcoma and Ewing sarcoma. Persistent bone or joint pain associated with swelling, mass, or limitation of motion implies underlying serious causes. Systemic manifestations such as lymphadenopathy, hepatosplenomegaly, fever, fatigue, night sweat, and laboratory abnormalities are also suggestive of malignancy. The index of suspicion tends to be low since less than 1% of children who complain of bone pain are diagnosed as cancer. Nonetheless, pediatricians should be alert to the possibilities of cancer since early detection and prompt treatment might reduce mortality.

• The Journal of Pediatrics of Korean Medicine
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• v.32 no.2
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• pp.64-71
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• 2018

Objectives The purpose of this study is to examine the correlation of antibiotics administration duration and antimicrobial resistance by reviewing domestic and foreign literatures. Methods We searched literatures dated up to 23 February, 2018 in PubMed and Cochrane Library using terms of "Anti-Bacterial Agents", "Carrier State", "Nasopharynx", "Drug Administration Schedule", and also searched via RISS (Research Information Service System), KISS (Koreanstudies Information Service System), DBpia (DataBase Periodical Information Academic) using terms of antibiotics, resistance, and dose. Results In comparison with shortened and standard antibiotic course, longer treatment duration is associated with greater antimicrobial resistance or non-significant difference, but we cannot find literature that shortened antibiotic course increases antimicrobial resistance on human nasopharyngeal flora. Conclusions Currently, there is no evidence that completing the standard antibiotic course reduces antimicrobial resistance. It can be a strategy for reducing antibiotic use to apply Korean medicine treatment, as well as short-course antibiotic therapy or delayed antibiotic prescription. Additional well-designed trials should be conducted in domestic and foreign settings about the appropriate duration of antibiotic therapy.