• Journal of the Korean Society of School Health
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• v.12 no.2
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• pp.243-262
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• 1999

Today, obesity is not recognized as a disease itself but is known to be the indirect cause of much chronic illness. Obesity has an impact on psychological disorders including severe inferiority, damage of body self-image, low self-esteem, personality disorders. The results in an increase of the mortality rate. Therefore, this study attempts to discover and evaluate stressful experience in obese teenagers. For this study, 21 girl students and 19 boy students in Pusan middle or high school located were selected. The data were collected from March to May at 1999. A tape-recorder was used under the permission of the subjects to prevent the loss of spoken information and communication. This study consisted of 563 reponses from girls and 461 responses from boys which were then classified with descriptive expressions and priority classifications. The results generated 72 common elements in girls and 54 common elements in boys. From these elements 24 syntheses of hypothetical definitions and 8 identifications of the structural definitions in both girls and boys were developed. The structural and hypothetical definitions were as follows: The analysis of the data was made through a phenomenological analytic method suggested by Van kamm, which is as follows: 1. Maladjustment to school life; lack of understanding of the teacher, insufficient exercise ability, and a feeling of burden in attending the school obesity program. 2. Conflict in family relationships; lack of understanding from the family, a feeling of alienation. 3. Conflict in friend relationships; lack of understanding among friends, constant comparisons in appearance and body with friends (in girls) and estrangement from friends (in boys). 4. Conflict in acquaintance of the opposite sex; hoping to meet the opposite sex, lack of understanding of boy friends (in girls), feelings of pain, feelings of anxiety (in girls) feelings of burden (in girls) feelings of envy (in boys). 5. Negative body image: shape of body; feelings of pain; feelings of powerlessness; feelings of discomfort, and reception; emotional disorders (in boys), and change of personality (in boys). 6. Health disorder: Physical and psychological discomfort. 7. Feelings of burden in weight control; negative experiences in weight control, interference with family and friends, the difficulty in diet therapy, feelings of burden in exercise (in girls), to be teased by the public through mass media (in boys).

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.45-51
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• 1993

Stress perception was investigated in 53 outpatients with extrinsic type of bronchial asthma, using GARS scale and other questionnaires. 40% of the patients were found to be psychosomatic. The patients were more likely to consider their physical symptoms as severe than the allergist Severity of symptoms rated by the allergist had significantly positive correlation with scores of stress perception related to changes in relationship. However, no significant correlation was found between severity of symptoms rated by patients and scores of stress perception. Psychosomatic group was significantly higher in scores of stress perception related to illness and injury, financial burden, and change or no change in routine than non-psychosomatic group. Female. older age, higher education. presence of religion. and presence of psychological stressors at onset and/or aggravation of the illness were found to increase stress perception. These findings indicate ant extrinsic asthmatics an less likely to perceive psychological stress than physical symptoms, and that they are less vulnerable to psychological stressors than patients with other diseases.

• Child Health Nursing Research
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• v.7 no.3
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• pp.280-297
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• 2001

The purpose of the study was to develop and test the model for the quality of life in mothers of children with nephrotic syndrome. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around ten constructs. Exogenous variables included in this model were mother's health, father's health, marital intimacy, mother's attitude on children, economic state, side effect of steroid, severity of illness and social support. Endogenous variables were mother's burden and quality of life. Empirical data for testing the hypothetical model were collected by using a self-report questionnaire from 152 mothers of children with nephrotic syndrom at the outpatient clinics and in the hospital. The data was collected from May, 1999 to August, 1999.Reliability of the seven instruments was tested with Cronbach's alpha which ranged from 0.71 - 0.92.For the data analysis, SPSS 8.0 WIN program and LISREL 8.20 WIN program were used for descriptive statistics and covariance structural analysis. The results of covariance structural analysis were as follow :1. The hypothetical model showed a good fit with the empirical data. [x2 = .56, df = 3, p = .90(p>.05 ), GFI = .99, AGFI = .99, RMSR = .005.] 2. For the parsimony of model, a modified model was constructed by deleting 1 variable and excluding 2 paths according to the criteria of statistical significance and meaning.3. The modified model also showed a good fit with the data[x2 = 2.83, df = 7, p = .90( p>.05 ), GFI = 1.00, AGFI = .97, RMSR = .011].The result of the testing of the hypothesis were as follows : 1. Mother's health(γ21 = .26, t = 4.16), father's health(γ22 = .19, t = 2.92), marital intimacy(γ23 = .26, t = 4.13) and social support(γ28 = .12, t = 2.03) had a significant direct effect on the quality of life.2. Mother's burden(β21 = -.20, t = -3.10) had a significant negative direct effect on the quality of life.3. Mother's attitude on children(γ14 = -.34, t = .-4.57), mother's health(γ11 = -.22, t = -2.96) and side effect of steroid (γ16 = -.23, t = .-2.69) had a significant direct negative effect on the burden. The result of this study showed that mother's health, marital intimacy, mother's burden, father's health, and social support had a significant direct effect on the quality of life. Mother's attitude on children, mother's health, and side effect of steroid had a significant direct effect on mother's burden. These six variables, mother's health, marital intimacy, father's health, social support, mother's attitude on children and side effect of steroid were identified as relatively important variables. The results of this study suggest, it needed to determine the nursing intervention will alleviate mother's burden and promote a greater quality of life in mothers of children with nephrotic syndrom.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.1
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• pp.50-61
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• 2001

With the improvement of current medicine, the number of the chronicly ill children are increasing. The illness of the child drives all of the family to despair. especially it is a burden on the mother who takes care of the ill child. She's faced with many emergencies and feels powerless. The home care for a child is for finding a child's problems early and mediating them. The purpose of this study was to investigate the mother's reaction following their chronicly ill child's discharge and to investigate the supporting needs for caring for an ill child. The subjects of this study were mothers with a chronicly ill child being discharged from a general hospital in Seoul and the data was collected from July 20 to September 30. Data was collected by using questionnaires which were developed by the researcher. (The questionnaires were composed of the average 5 points - Likert's method). The Mother's reaction means that the higher the score, the more negative the mother's thoughts about discharge are. Supporting need for caring for ill an child means that the higher the score, the higher the demand of nursing is. The statistical analysis used the SPSS program for t-test. ANOVA, and Pearson Correlation. The results of this study were as follows: 1. The mother's reaction scores following discharge were the lowest. 19 and the highest 72 so that the total average was 43.15. The answer, 'I worry that my baby will be troubled with illness again after discharge gained the high points (3.94 of 5 points). The answer. 'The discharge of my baby makes me gloomy' gained 2.05-it was the lowest points. Their were significant differences according to religion (p=.006). salary (p=.050). the burden of the medical fee (p = .005) and caregiver (p=.027). 2. Supporting Need for caring for ill an child was the lowest 15 and the highest 67. the total average was 47.87. The answer. 'I'd be glad to get a person whom I could always get counsel about the health of my baby with' scored the high point (average 4.04 of 5). The answer. 'Caring for my baby at home makes me exhausted' gained the lowest point. 2.49. Their were significant differences according to religion (p=.019) and diagnosis (p=.019). 3. The relationship between the reaction of the mother and supporting need for caring for an ill child was a positive correlation (r=0.585). In conclusion. this study revealed that mothers weren't positive about their chronicly ill child's discharge and they wanted to get support for caring for an ill child. Through this study. I proposed that the program to support the chronicly ill child at home and home care by continuous counselling after discharge should be develop.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.53-61
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• 2013

Purpose: The purpose of the study was to identify the levels of anxiety, depression and uncertainty of patients who participated in the clinical trials for anticancer drug, and to identify correlations among these variables. Methods: Cross-sectional survey used the Symptom Check List-90-Revision and the Mishel Uncertainty in Illness Scale from 106 subjects in 2011. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients. Results: The mean score of anxiety was 2.06, that of depression 2.35, and that of uncertainty 2.61. Anxiety and depression (r=.70), anxiety and uncertainty (r=.44), depression and uncertainty (r=.60) were significantly correlated each other. The levels of anxiety, depression and uncertainty were different in various characteristics of the subjects, such as education, recurrence, and economic burden. Conclusion: The results of the study indicate that when implementing psychosocial interventions for cancer patients who participate in clinical trial, factors such as education, economic burden, and recurrence should be integrated into the intervention. Further studies applying theoretical model would be helpful to identify directional relationships among the variables that are important in psychosocial well-being of cancer patients undergoing clinical trial.

• Health Policy and Management
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• v.31 no.4
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• pp.423-436
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• 2021

This article summarizes the structure of China's current social health insurance system and reviews the development status of China's private health insurance (PHI). China's medical security system is mainly composed of two parts: basic medical insurance (BMI) and PHI. Among them, the BMI provides reimbursement of basic medical expenses for the insured persons according to different proportions. PHI is a necessary supplement to the BMI and provides assistance to the insured persons in the event of illness or accident. By having PHI, people can obtain medical protection outside the coverage of BMI. In the development of PHI in China, the total medical cost is high and the insurance market size is large, but the proportion of PHI expenditure is low and the personal burden is high. Through this Chinese case, it will be helpful for mutual development between Korean PHI and national health insurance, for Korean insurance companies to enter the Chinese market, and for removing the medical burden on the people.

• The Journal of Health Technology Assessment
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• v.6 no.2
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• pp.123-132
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• 2018

Objectives: Maternal morbidity and mortality are important healthcare issues. However there have been few studies on cost of illness (COI) from maternal disorders. This study aimed to estimate the COI due to maternal disorders in Korea. Methods: By reviewing previous studies and consulting expert we determined the scope of maternal disorders. We operationally defined maternal disorders as maternal hemorrhage, maternal sepsis, hypertensive disorders of pregnancy, obstructed labor, and abortion for maternal disorders. The reference period of this study is the year 2015. Main source of data were the National Health Insurance Service claims data, cause of death statistics from the Korea National Statistical Office, and the Korea Health Panel study. We classified the total costs into direct and indirect costs. The direct costs cover healthcare costs and non-healthcare costs. The indirect costs consist of productivity losses due to morbidity and premature death. Results: The cost of maternal disorders in 2015 was 229.7 billion won. The direct and indirect costs of maternal disorders were 165.2 billion won and 64.5 billion won respectively. The largest cost item for maternal disorders was healthcare cost (138.3 billion won, 60.2%). By age groups, the COI in 30-39 years old women were the highest (165.1 billion won, 71.9%). Abortion was the disorder with the highest COI among maternal disorders (71.9 billion won, 31.3%). Conclusion: The COI due to maternal disorders in Korea is quite substantial. Economic burden of maternal disorder increased when being compared with the year 2012 data despite the continued low birth rate in Korea. Therefore, it is necessary to continuously monitor the social costs of the maternal disorders in Korea.

• Journal of Korean Academy of Nursing
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• v.49 no.3
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• pp.349-360
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• 2019

Purpose: This study was conducted to derive a substantive theory on lived experiences of elderly cancer patients. Methods: The data were collected from February to March 2018 through in-depth personal interviews with 14 elderly cancer patients. The collected data were analyzed based on Corbin and Strauss's grounded theory. Results: The core category was "the journey to find balance in daily lives as a cancer patient by recovering disturbed ego integrity." The core phenomenon was "shattered by suffering from cancer," and the causal conditions were "physical change" and "limitations in daily life." The contextual conditions were "decreased self-esteem," "feelings of guilt toward the family," and the sense of "economic burden." The participants' action and interaction strategies were "maintaining or avoiding social relations," "seeking meaning of the illness," "falling into despair," and "strengthening the willingness to battle the cancer." The intervening conditions were "support from health care providers and family," "dissatisfaction with health care providers," "spiritual help from religion," and "the improvement or worsening of health conditions." The consequences were "having a new insight for life," "living positively along with cancer illness," and "the loss of willingness to live." A summary of the series of processes includes the "crisis stage," "reorganizing stage," and the "ego integration stage." Conclusion: This study explored the holistic process of ego integrity impairment and the recovery experience of elderly cancer patients. This study is expected to be used as a basis for the development of nursing interventions that can support patients when coping with all stages of their cancer illness trajectory.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• Journal of Preventive Medicine and Public Health
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• v.45 no.5
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• pp.291-300
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• 2012

Objectives: We aimed to estimate the annual socioeconomic burden of coronary heart disease (CHD) in Korea in 2005, using the National Health Insurance (NHI) claims data. Methods: A prevalence-based, top-down, cost-of-treatment method was used to assess the direct and indirect costs of CHD (International Classification of Diseases, 10th revision codes of I20-I25), angina pectoris (I20), and myocardial infarction (MI, I21-I23) from a societal perspective. Results: Estimated national spending on CHD in 2005 was $2.52 billion. The majority of the spending was attributable to medical costs (53.3%), followed by productivity loss due to morbidity and premature death (33.6%), transportation (8.1%), and informal caregiver costs (4.9%). While medical cost was the predominant cost attribute in treating angina (74.3% of the total cost), premature death was the largest cost attribute for patients with MI (66.9%). Annual per-capita cost of treating MI, excluding premature death cost, was $3183, which is about 2 times higher than the cost for angina ($1556). Conclusions: The total insurance-covered medical cost ($1.13 billion) of CHD accounted for approximately 6.02% of the total annual NHI expenditure. These findings suggest that the current burden of CHD on society is tremendous and that more effective prevention strategies are required in Korea.