• Health Policy and Management
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• v.30 no.2
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• pp.185-191
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• 2020

Background: From January 2018, a policy was applied to differentially apply the co-payment for medical expenses of 15,000 won or more from 30% to 10%-30% for each medical fee. This policy lowers the burden on the medical use of the elderly, and it is necessary to analyze the effect of the policy by confirming changes in medical use and supply behavior after 2 years. Methods: The National Health Insurance Service's national medical use database was used. As for the analysis method, first, the medical use and medical supply behavior change over the age of 65 years were confirmed, and second, in order to check the net effect of the policy, the 66-year-old as the experimental group and the 63-year-old as the control group were selected as the control group. The propensity score matching was performed using the variables of age, living alone, income quartile, residence, disability, chronic disease, and co-morbid disease scores, and then it was analyzed using the difference in difference analysis method. Results: The share of the number of treatments under 15,000 won decreased from 37.0% in 2017 to 20.2% in 2018, while the share of the number of treatments under 15,001-20,000 won increased from 8.0% to 22.7%. It was confirmed that the reason for the increase in the cost of treatment per treatment was the result of the increase in the amount of physical therapy and examination. As a result of the policy effect, the burden of co-payment per person was reduced, and as a result, the number of hospital visits per person and the total medical cost per person increased. Conclusion: The self-pay rate differential policy reduced the burden of medical expenses for the elderly and confirmed the increase in medical use. However, the interpretation of the increase in medical use was not able to distinguish whether the unsatisfactory medical care was satisfied or the inducement demand. Efficient allocation of resources is a more important point in the future when the super-aged society is in front. It is necessary to prepare a plan to induce rational medical use within a range that does not impair the medical accessibility of the elderly.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.155-163
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• 2018

Bilirubin has an anti-inflammatory effect as an endogenous antioxidant and has been reported to be inversely correlated with hypertension, diabetes, metabolic syndrome, and insulin resistance. On the other hand, there is a lack of research evaluating the association between bilirubin and metabolic syndrome compared to liver-specific indicators. This study examined the association between the total bilirubin and metabolic syndrome prevalence in Korean adults who underwent health screening compared to ALT and GGT. This cross sectional study included 22,568 adult males and females aged 20 years or older who underwent a health examination at the General Hospital of Gyeonggi Province from March 2015 to February 2018. Metabolic syndrome was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) guidelines. In both genders, the metabolic syndrome diagnosed group had higher liver enzymes, and the total bilirubin and direct bilirubin were lower than those without the metabolic syndrome risk factors. The serum total bilirubin showed a weak inverse correlation with abdominal obesity (r=-0.066 vs r=-0.055) and triglyceride (r=-0.127 vs r=-0.136) in both males and females, which is weaker than ALT and GGT The data were statistically significant. In addition, total bilirubin as well as ALT and GGT in both men and women were not predictors of the likelihood of developing metabolic syndrome.

• Journal of Oral Medicine and Pain
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• v.34 no.3
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• pp.325-331
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• 2009

The objective of this study was to describe the prevalence of the headache attributed to Temporomandibular disorder(TMD) symptoms and to investigate the relationships of headache and TMD. 66 patients seeking care for signs and symptoms of Temporomandibular disorders(TMD) and Orofacial pain in the department of oral medicine, Dental Hospital, Chosun University, from January, 2008 to June, 2008, were recruited. The obtained results were as follows : 1. A muscle and TMJ origin combined was the most common in study populations(54.55%), grouped as TMD classification. 2. Tension type headache was the most common in study population(89.39%), grouped as headache classification. 3. 36 patients out of 66(54.55%) had headaches which related to TMD. 4. Out of 36 patients who had suffered the headache which were attributed to TMD, 19 patients(52.78%) described that their headache related to TMD was different from their own primary headaches. In conclusion, headache attributed to TMD is relatively common in the patients who had headaches and TMD symptoms together. And the new headache patterns may related to headache and TMD chronification. Larger-scale studies and more specified and controlled comparison study is needed to confirm the relationship between the headache and TMD.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.95-100
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• 2011

Fibrodysplasia ossificans progressiva(FOP) is characterized by episodes of permanent heterotopic ossifications of soft tissues throughout the body. FOP is inherited in an autosomal dominant pattern, but most cases result from new mutations in the ACVR1 gene. Even minimal trauma can cause permanent ossifications of soft tissues and give rise to complications following routine dental care. Dental block anesthesia, severe stretching of the jaw and biopsies are all contraindicated in children with FOP. There is no effective treatment. Since the prevalence of FOP is very low and most patients with FOP are misdiagnosed during childhood, they undergo dangerous and unnecessary treatment that can lead to permanent harm. For patients with FOP, early diagnosis and prevention of complications are most important. This study aims at contemplating the characteristic features and consideration factors for the dental treatment of FOP patients in relation to the case of an eight years-and-one month old boy who was referred to Pediatric Dentistry due to prolonged retention of mandibular right and left deciduous central incisors after being diagnosed with sporadic FOP at Pediatric Orthopaedics, Seoul National University Hospital, and received dental treatment without the exacerbation of the FOP symptoms.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.333-348
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• 2001

The study was intended to investigate the degree of satisfaction and experiences of maternity nursing practice and to examine the relationships between satisfaction and experiences. Data were collected from a college located in Inchon from April 2, 2001 to October 30, 2001. A general characteristics questionnaires, questionnaire for clinical practice satisfaction and maternity nursing clinical checklist were used to measure the satisfaction and experiences of maternity nursing practice. The subject were supposed to record their clinical experience in maternity clinical practice checklist. 153 questionnaires for satisfaction of clinical practice and 178 maternity nursing clinical practice checklists used for analysis. The data were analyzed by SPSS-PC+ program. The results of this study were as follows ; 1) The mean score of satisfaction of clinical practice was 3.34(a perfect score 5) and among the 4 categorial components from the questionnaire of satisfaction the score of 'clinical practice teaching' was high(3.85) and 'clinical practice environment(2.91)' and 'clinical practice contents(2.90)' was relatively low. 2) There was significant value between place of clinical practice and clinical practice satisfaction among 7 clinical practice hospital and the most high score of clinical practice satisfaction is 3.70 and the low score is 2.91(F=7.706, p<.001). The score of delivery room was significantly higher than the OBGY room and there was significant value among the place of clinical practice(DR : F= 6.441, p<.001, OBGY room : F=7.908, p<.001). 3) In delivery room, the frequency of observation are 2.61 day, the frequency of practice are 1.33 day and in OBGY room the frequency of observation are 1.73 day, the frequency of practice are 1.31 day for 2 week of maternity clinical practice and the most frequent practice of maternity nursing care was checking vital sign. 4) There were significant relationships between the ranking score of clinical satisfaction and clinical experiences in maternity nursing practice. Based on the results, it is suggested that the satisfaction of clinical practice was related to environment of clinical practice and it is necessary to improve environment of clinical practice and make a strategies to enhance the quality of maternity clinical experience.

• The Journal of Korean Academic Society of Nursing Education
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• v.8 no.1
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• pp.95-107
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• 2002

The purpose of this study is to determine the clinical nurses' knowledge of DM and diabetes patient education aptitude so as to provide a basis for clinical nurse training with respect to diabetes patient education program. The data has been collected through the questionnaires of 42 items from the Knowledge on DM and each 16 item from the Importance on the elements of diabetes patient and the Recognition for clinical nurses, respectfully. 166 nurses from a general hospital who had participated in clinical nurse training in Sep. 28 and Oct. 4, 2001 were subject to respond the questionnaires. Analysis has been done by using statistical method such as percentage, average, standard deviation, t-test, ANOVA, Duncan test and Pearson correlation coefficients. The findings are as follows: 1. Clinical nurses' knowledge levels of diabetes 1) The average level of nurses' knowledge about diabetes is 29.37 (right answer- finding rate: 70%), which is intermediate. 2) Amongst the nurses classified by their knowledge levels about diabetes, the group with less than one year career and that with more than 5 year careers are found to have higher knowledge levels. The item with the highest right answer-finding rate was 'Please find the wrong out of the following examples about foot care'. Meanwhile, the item with highest incorrect answer-finding rate was 'what does blood sugar control aims for amongst gestational diabetes?'. 2. Clinical nurses' importance and perception levels of educational training about diabetes 1) There were no differences amongst nurses' importance level about diabetes. 2) Nurses usually had high scores(4.30) in terms of the items related to the importances about educational training. 3) There were quite high recognitions of general characteristics and symptoms about diabetes, amongst the nurse cohorts working more than one year and less than 5 years, and over 5 years, the group belonging to the internal department, that having the previous experiences of dealing with diabetes, and that having their diabetic relatives and other close people. Meanwhile, strangely, the group who identified themselves as 'not good at treating diabetes' had a high recognition level of educational training about diabetes. 3. Relationship between knowledge levels and importance & perception levels of diabetes 1) The higher knowledge about diabetes nurses had, the more importance they recognized. 2) It is found that there was no relationship between knowledge and perception of diabetes. 3) The more importance about diabetes nurses had, the higher perception they obtained. In conclusion, there is an urgent need for systematic educational programs about diabetes including technical aspects, in order to upgrade and improve nurses knowledge levels. In addition, re-educational training should be provided at regular intervals. Further, we believe the nurses with high knowledge about diabetes and interests in the provision of educations for patients can be far more confident, and in return, patients can have better self-management about diabetes obtained through educations. Based on the above-mentioned findings, we would like to make the suggestion: re-evaluation about nurses' knowledge and cognition levels should be carried out after job training programs about diabetes.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.141-153
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• 2000

The several Chinese herbs such as Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, So-Hap-Hyang-Won and O-Yak-Soon-Ki-San were extracted with water and then lyophilized. For identification of the effect of extracted herbs, they were medicated to 103 patients of cerebrovascular accident for 4 week. They were hospitalized in D-Oriental Medical Hospital from April to August in 1999. The herbs were extracted with water and lyophilized and then, used as samples. The medical history of each patient was detected and analyzed from their medical records. The results were as follows; 1) Each sample (Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-Ki-San) was statistically significant differences of systolic blood pressure(t=4.22, P=0.0004; t=3.44, P=0.0028; t=2.11, P=0.0463; t=3.23, P=0.0052). The statistically significant difference of diastolic blood pressure showed by medicated with Soon-Ki-Hwal-Hyal-Tang, Seong-Hyang-Jeong-Ki-San, and O-Yak-Soon-ki-San (t=2.13, P=0.0459; t=2.68, P=0.0136; t=3.12, P=0.0066). 2) The statistically significant difference of the arm/leg-ROM showed by medicated with Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O Tang, So-Hap-Hyang-Won(t=4.74/4.95, P=0.0002/0.0001; t=2.25/2.44, P=0.0368/0.0248; t=5.85/6.76, P=0.0001/0.0001). 3) In the verbal disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang had statistically significant differences(t=4.50, P=0.0002; t=3.32, P=0.0036). 4) In the conscious disorder, Soon-Ki-Hwal-Hyul-Tang, Bo-Yang-Hwan-O-Tang, Seong-Hyang-Jeong-Ki-San, and So-Hap-Hyang-Won had statistically significant differences(t=6.32, P =0.0001; t=8.32, P=0.0001; t=3.74, P=0.0012; t=5.14, P=0.0001). 5) Bovine aortic endothelial cell (BAEC) were cultured in DMEM treating 0.01mg/ml, and 0.1mg/ml of each lyophilized samples for 24 hours. In BAECs were treated by 5 kinds of samples, the effect of So-Hyap-Hyang-Won induced syncytium of adjacent endothelial cells. It may induce the recovering of the damaged blood vessels in cerebrovascular accidental patient by angiogensis of endothelial cells. Therefore, it suggests that the medication of So-Hap-Hyang-Won will help to nursing care for cerebrovascular accidental patients.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.2
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• pp.196-211
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• 2000

The purpose of this study was to determine the effects of 5 weeks self-help management program on reducing depression, promoting Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings(IADLs), grasping power, hope and self-efficacy for post stroke patients visiting public health care centers in Seoul. This was pre-experimental study, and the subjects were 27 post stroke hemiplegic patients. The program was composed of five sessions and each session had health education on stroke, ROM exercise and recreation. Data were collected from May to November, 2000, and all subjects were asked to complete the Questionnaires, be measured vital signs and grasping power. Data were analyzed with frequency, percent, paired t-test, and Pearson's correlation coefficient using SAS(version 6.12) program. The results were as follows : 1) The scores of ADLs were increased from 27.04 to 28.22 after program, and that was statistically significant(p=.005). 2) The scores of IADLs were increased from 18.70 to 19.78 after program, and that was statistically significant(p=.004). 3) The grasping power of right hand were increased from 21.87kg to 26.93kg after program, and that was statistically significant(p=.002). But the grasping power of left hand were statistically insignificant(p=.919). 4) The scores of depression were decreased from 39.63 to 35.30 after program, and that was statistically significant(p=.030). 5) The scores of hope were increased from 30.89 to 34.15 after program, and that was statistically significant(p=.002). 6) The scores of self-efficacy were increased from 67.70 to 76.37 after program, and that was statistically significant(p=.000). According to the results of this study, the scores of Activity of Daily Livings(ADLs), Instrumental Activity of Daily Livings (IADLs), hope, and self-efficacy and the grasping power were improved and depression was reduced in post stroke patients participating in self-help management program. Therefore we recommend to use self-help management programs as a nursing intervention for the post stroke patient.

• Child Health Nursing Research
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• v.9 no.4
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• pp.359-367
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• 2003

Purpose: This study is designed to test the effects of a full body massage on Apgar score, postpartum mother's childbirth experience, and mother-infant attachment for primipara during labor. Method: Data were collected using a quasi-experiment method (nonequivalent control group, pre-post test design) from November 1, 2001 to July 31, 2002. The subjects for this experiment consist of 28 women in the experimental group and 29 in the control group, out of 57 primipara hospitalized at the U OB & GYN hospital in Inchon. A 20 minute full body massage was given to the experimental group on each of three delivery phases (latent, active, and transition), and a conventional delivery care to the control group. The experimental tools for the study are Apgar score scale developed by Apgar(1958), postpartum mother's childbirth experience scale developed by Marut and Mercer(1979), and mother-infant attachment scale developed by Cropley et al(1981). The data collected were analyzed using t-test, χ2 test, and ANCOVA on the SPSS program. Result: The results of the experiment are as follows: One minute(t=6.756, p=.000; F=9.181, p=.004), and five minute(t=6.129, p=.000; F=7.918, p=.007) Apgar score are increased significantly. Postpartum mother's childbirth experience is significantly increased(t=11.691, p=.000; F=11.741, p=.001). Verbal touch score(t=5.256, p=.000; F=7.169, p=.010), skin touch score(t=11.332, p=.000; F=27.073, p=.000), and total score(t=12.105, p=.000; F=30.104, p=.000) of postpartum mother's childbirth experience are significantly increased, but not for eye touch score(t=3.236, p=.002; F=.800, p=.375). Conclusion: This study shows that a full body massage has a significant positive effect on Apgar score, postpartum mother's childbirth experience. and mother-infant attachment. Therefore, it is suggested that the full body massage might be used clinically to help primipara during labor.

• Journal of Digital Convergence
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• v.12 no.11
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• pp.437-449
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• 2014

In this study, we analyzed an effect of area-environmental factor on breast cancer screening rates using multi-level analysis. It was intended for the KNHANES-IV. Total subjects were 14338. Among them, 4143 subjects met the inclusion criteria. When we applied only empty Model, a variance of breast cancer screening rates was 0.061 in each region. When we applied Model with individual level variables, the variance was 0.034. However, when we applied both Model with individual level variables and Model with area level variables, the variance was 0.023. We drew applied only individual level variables parallel applied 3 regional variances which could explain variance of inspection of breast cancer up to 18.04% compared with applied only individual level variables. Area level variables could reduce a variance of region. This means besides individual level variables. The group can share a same thing and can effect to breast cancer screening rates. We need to discover factors which area level variables and suggest that make a standard for inspection of breast cancer.