• Journal of Nutrition and Health
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• v.55 no.3
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• pp.406-417
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• 2022

Purpose: The incidence of chronic diseases is increasing and the age of onset is decreasing in South Korea. Healthy eating habits to prevent chronic diseases are established in adolescence. This study verified the identified factors and dynamics that affect diet self-assessment for sustainable adolescent health and the prevention of chronic diseases. Methods: Data were collected from 492 middle and high school students in South Korea from June to July 2018, and the participants answered a questionnaire on dietary safety management competency for sustainable health. Results: The healthy dietary self-assessment scores of overweight/obese adolescents and adolescents who perceived their health as normal were significantly lower than those of other groups. Factor analysis verified the validity of the items that comprised each study area before a multiple regression analysis was used to investigate the factors affecting healthy dietary self-assessment. Sweet and salty diets, anxiety, food and nutrition knowledge, weight management knowledge, stress management, exercise, basic eating habits, and healthy eating habits significantly affected healthy dietary assessment among adolescents. A higher perception of one's health indicated a higher healthy dietary self-assessment, dietary safety knowledge, and health management practice scores (p < 0.01). Factors like healthy dietary self-assessment, food and nutrition knowledge, and weight management knowledge appear to have a significant correlation with other identified factors, except overeating. The adolescents' awareness, knowledge, and dietary safety practices influenced healthy dietary self-assessment, which can prevent chronic diseases and achieve sustainable health. Conclusion: This study illustrated how the adolescents' awareness, knowledge, and practices of dietary safety influenced their healthy diet self-assessment. The results indicate that diet-based health management competency education relative to the adolescents' self-perception and weight levels should be implemented.

• Korean Journal of Community Nutrition
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• v.25 no.2
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• pp.112-125
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• 2020

Objectives: Diet and incidence of chronic diseases are highly related. This study examined the characteristics of dietary safety awareness and competency for chronic disease prevention among adults. Methods: Data were collected from 247 adults in Daegu and Gyeongbuk areas using a self-administered questionnaire in May and June of 2018. Data were analyzed by frequency analysis, χ²-test, factor analysis, reliability analysis, t-test, one-way analysis of variances, and correlation. Results: The results of the factor analysis indicate that dietary safety awareness of health management was classified into chronic disease anxiety and obsession. Awareness of dietary safety management was sub-grouped into difficulty in acquiring knowledge, lack of awareness of over and malnutrition, food safety anxiety, importance of weight management, education requirement for cancer prevention, and knowledge. Dietary safety behavior composed of a balanced diet, unhealthy diet, and health-functional pursuit. Dietary safety management competency was comprised of health management, food management, and cooking. The competency scores of dietary safety management factors were significantly different according to sex, age, and education level (P < 0.05). Balanced diet factor was significantly correlated with knowledge, health-functional pursuit, health management, food management, and cooking capacity factors (P < 0.01). Conclusions: Active education for dietary safety management competency according to age, gender, and education level should provide dietary safety education to reduce anxiety and obsession regarding chronic diseases and sustainable health management.

• 재활복지
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• v.22 no.4
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• pp.83-102
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• 2018

The purpose of this study is to provide basic data for effective management and prevention of chronic diseases and secondary complications as elderly spinal cord injuries(SCI). The subjects were 200 spinal cord injuries admitted to S hospital from April, 2013 to April, 2018. We investigated the occurrence of chronic diseases and secondary complication through medical records. The results showed that SCI were affected chronic diseases and secondary complications over 50years. The prevalence of chronic diseases and secondary complications over 50 years of age had the odds ratio 11.8 times higher in hypertension and 6.7 times diabetes mellitus. Secondary complications had the odds ratio Osteoporosis 7.5 times, Pneumonia 5.2 times, and central pain 0.4 times. We suggest that continuous management and service of chronic diseases and secondary complications of elderly SCI are necessary. It will be necessary to expand the target population and to study various characteristics including.

• Health Policy and Management
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• v.31 no.3
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• pp.301-311
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• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

• Tuberculosis and Respiratory Diseases
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• v.76 no.2
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• pp.53-58
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• 2014

Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

• Health Policy and Management
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• v.24 no.2
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• pp.128-135
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• 2014

Background: With ageing and growing importance of disease management system, it is necessary to investigate the extent of regional difference in service utilization for chronic diseases among the elderly and to reflect it in designing the system. Methods: A multiple regression analysis and descriptive statistics analyses were employed using patient survey, which covers nationwide health facilities and their users. Results: While the differences in the rate of service utilization/utilization outside living area between urban and rural areas or between income levels are not large, considerable variations are observed within urban or rural areas and within income groups. Conclusion: This results suggest that it is important to subsidize economically disadvantaged segments of the population and residents of less-favored areas to be better-equipped for chronic disease management in order to prevent the development of severe ailments and the need for treatment at higher-level medical institutions. Improvements to the service infrastructure in vulnerable regions are essential.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.22-34
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• 2021

The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.

• Health Policy and Management
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• v.30 no.3
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• Health Policy and Management
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• v.33 no.4
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• pp.389-399
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• 2023

Background: The purpose of this study is to analyze the factors affecting the unmet healthcare needs of older people with chronic diseases in Korea and provide a basic research report to strengthen their access to medical care. Methods: In the 2020 older people survey data, 8,182 older people aged 65 or older who were diagnosed with one or more chronic diseases were the final subjects of the study. According to Andersen's behavioral model used in unmet healthcare needs, independent variables were composed of predisposing factors, possible factors, and necessary factors, and whether or not unmet healthcare needs was set as dependent variable. Results: Of the older people with chronic diseases, 1.6% experienced unmet healthcare needs, of which 55.9% experienced unmet healthcare needs for reasons related to economic burden, 31.6% physical constraints, and 12.5% time constraints. As a result of the analysis, older people with chronic diseases were more likely to experience unmet healthcare needs if they were relatively low in age, low in education level, no spouse, low in household income, poor subjective health, complex chronic diseases, and functional restrictions. However, by major reasons for experiencing unmet healthcare needs, living in rural areas were more likely to experience unmet healthcare needs due to physical constraints, and those who participated in economic activities and who had were more likely to experience unmet healthcare needs due to time burden. These results were not derived when only unmet healthcare needs was set as the dependent variable. Conclusion: This study emphasizes the need for an approach by cause of unmet medical occurrence by suggesting that there are differences in influencing factors by reason for experiencing unmet healthcare needs.

• Health Policy and Management
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• v.30 no.2
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• pp.231-244
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• 2020

Background: As the population is aging, chronic diseases and depression are becoming the main problems in a country's healthcare system. In this study, we aimed to explore the associations between chronic diseases and depression among the elderly in South Korea. Methods: We analyzed 9,975 (men, 4,147; women, 5,828) respondents obtained from the 2014 National Survey of Living Conditions and Welfare Needs of Korean Older Persons. Our dependent variable was either 1 or 0 according to whether a respondent had depression or not, where depression was defined when the Short Form of Geriatric Depression Scale score was 8 or more points. Variables of interest were 24 types of chronic diseases and covariates included various socio-demographic and health behavior characteristics. We performed Rao-Scott chi-square tests and hierarchal logistic regression analyses by gender, reflecting the characteristics of the survey. Results: A significant difference was found in the proportion of having depression between genders (men 18.9% vs. women 23.4%). According to fully adjusted, multivariable analyses, for elderly men, relative to those without any chronic disease, the odds ratio of depression was 1.56 (95% confidence interval [CI], 1.10-2.22) in the stroke patients group and 1.82 (95% CI, 1.01-3.25) in the osteoporosis patients group. For elderly women, the odds ratio was 1.96 (95% CI, 1.28-3.00) in the fracture/dislocation and aftereffects patients group and 1.30 (95% CI, 1.03-1.64) in the group of patients with other diseases. Conclusion: Even after being adjusted for diverse characteristics, some chronic diseases were significantly associated with depression in the elderly and the association differed between genders. Therefore, public health and medical interventions are needed to manage such chronic diseases together with curing depression symptoms.