• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.29-44
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• 1989

A household survey was conducted to determine the utilization rate of medical facilities and to identify the factors related with the utilization in the South District of Taegu from July 3 to July 15, 1988. Study population included 1,723 family members of 431 households which were selected by one-stage simple cluster random sampling. Well trained medical college students interviewed mainly housewives with a structurized questionnaire. Morbidity rate of acute illness during the 2-week period was 101 per 1,000 persons and it was highest in the age group of 9 years below. The rate for chronic illness was 77 per 1,000 persons, increasing with age, low income and medicaid benefit. During the 2-week period, 689 of 1,000 persons utilized the medical facilities. Of the facilities, most number, 294, used hospital and clinic, and the order ran as pharmacy, health center, and herb medical clinic. The utilization rate was higher in the female, 70-year and older group, medicaid group, the lowest income class and self-employed group than other groups. The average number of visits among users of medical facilities during the 2-week period was 3.25. those who visited medical facilities most frequently were females, the 70-year and older group, the lowest income class and blue collar worker group. During one-year period, admission rate of 1,000 persons was 27.6 and that of female was 38.9, higher than that of male. the eldest group had the highest admission rate. Admission rate of medical insurance beneficiaries was twice or higher than non-beneficiaries. The higher the family monthly income, the more frequently they admitted. During one-year period, average admission days of the persons hospitalized were 22.5 days and males were hospitalized longer than females. The groups which were hospitalized longest were those between the ages of 40 and 49, medical insurance beneficiaries, the lowest income group and unemployed group. During one-year period, average admission days of 1,000 persons were 560 days and those of female were 661 days, more than those of male. The guoups which had the longest admission days were those above 70 years of age, the lowest income and unemployed groups. The medical insurance beneficiaries were three times or longer than non-beneficiaries. In logistic regression analysis of utilization of physician significant independent variables were the 9-year and younger group(+), the 70-year and older group(+), acute illness episode(+), chronic illness episode(+), medical insurance beneficiary(+) and white collar workers(-). Acute and chronic illness episode(+), and medical insurance for government employees and private school teacher(-) were significant variables in analysis of utilization of pharmacy. In multiple regression analysis of the number of physician visits, siginificant variables were acute illnes episode(+), chronic illness episode(+), industrial, occupational and regional medical insurance beneficiary(+), white collar workers(-). Acute and chronic illness episode(+), and medical insurance beneficiary(-) were significant variables in analysis of the number of pharmacy visits. In logistic regression analysis of admission event, significant independent variables were the 9-year and younger group(+), the 70-year and older group(+) , chronic illness episode(+), and medical insurance beneficiary(+).

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.1
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• pp.6-18
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• 2011

Purpose: This study was done to explore the meaning and nature of life world for adolescents with epilepsy. The hermeneutic phenomenological method which was developed by van Manen was used. Methods: Participants were four boys and five girls, ages 13 to 18 being seen in a neurology outpatient department. Data were collected from iterative work with in-depth interviews from during the period from February to September, 2010. Contents of the interviews were tape-recorded with participant consent. Results: Essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were: an illness that makes a hurt in one's heart rather than one's body, a change in the body that is not controllable, a future like thick fog, everyday life trapped in illness, a change of relationships, learning how to live with an illness. Conclusion: Findings reveal the life world of the adolescents is affected to varying degrees by the epilepsy. It is important for nurses to identify and address developmental issues and effects of the illness and to support reorientation in a disintegrated life situation. The result of this study will provide nurses with insights into these experiences and should help promote empathetic care.

• Research in Community and Public Health Nursing
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• v.32 no.2
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• pp.131-139
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• 2021

Purpose: In adults with chronic diseases, unmet healthcare needs are likely to increase the risk of worsening the illness and complications. This study was conducted to explore factors affecting unmet healthcare needs among adults with chronic diseases. Methods: A cross sectional study was performed using the data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2017. The sample of this study consisted of 6,104 adults with chronic diseases. The data were analyzed by Rao-Scott 𝑥² test and logistic regression using complex samples analysis. Results: The proportion of subjects who experienced unmet healthcare needs was 10.9% of adults with chronic diseases. The factors affecting unmet healthcare needs of adults with chronic diseases were age, gender, employment status, household income, subjective health status, activity limitation, and perceived stress. Conclusion: The findings of this study suggest that various factors may be associated with their unmet healthcare needs. Finally, the development of strategies to reduce unmet healthcare needs for people with chronic diseases should consider the associated factors presented in the study.

• Clinical and Experimental Pediatrics
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• v.65 no.5
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• pp.222-229
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• 2022

Pediatric chronic kidney disease (CKD) is a chronic illness that affects the overall quality of life of patients during childhood. This article highlights the psychological and social burden of CKD in patients and their families. Patients with CKD and their families require comprehensive treatment for psychosocial problems. Therefore, it is crucial for pediatricians to screen for these issues and refer patients and their families for therapy. Tools that are short, easy to administer, and easy to score, such as the Pediatric Quality of Life Inventory or the Childhood Depression Inventory, can be utilized during routine clinical appointments. Reducing the negative impact of CKD on the family will improve the well-being and coping skills of patients and their families.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.1 no.1
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• pp.138-143
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• 1998

Chronic diarrhea in children is a common problem with numerous causes. Although most of these causes are benign, critical illness may present as chronic diarrhea. In a patient of chronic diarrhea, gastrointestinal infections are the most common causes in children of all ages and antibiotics may cause chronic diarrhea by altering intestinal microflora, which can result in the emergence of bacterial overgrowth. Overgrowth of Clostridium difficile may cause pseudomembranous colitis. We experienced 25-month-old boy who suffered from chronic diarrhea and partially treated with antibiotics irregularly. Colonoscopic findings of this child showed multiple plaques with white to yellowish exudate which adhere to the mucosal surface of a variable length of rectum. Histollogically, each plaque comprised a pseudomembrane of mucous debris, inflammatory cells, and exudate overlying groups of partially disrupted glands. A latex agglutination test on patient's stool was positive to toxin A of Clostridium difficile. He was recovered after stopping the antibiotics he has been prescribed, and being given vancomycin for 2 weeks. We report this case with brief review of literature.

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• Journal of muscle and joint health
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• v.5 no.1
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• pp.7-25
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• 1998

Rheumatoid arthritis, unlike other chronic diseases, causes the patients to experience uncertainty in their daily lives and thus to feel threat on their emotional comfort because of inconsistent and unpredictable symptoms such as pain. Therefore, a theoretical framework is needed for explanation of uncertainty in patients having rheumatoid arthritis. A hypothetical model was constructed on the basis of Mishel's Uncertainty Theory and other literature review. The model included 9 theoretical concepts and 19 paths. Subjects of the study constituted 330 partients who visited outpatient clinics of two university hospitals and one general hospital in Seoul. Self report questionnaires were used to measure the variables affecting uncertainty. Reliability coefficients of these instruments were found Cronbach's Alpha=$.70{\sim}.94$. In data analysis, SAS program and PC-LISREL 8.03 computer program were utilized for descriptive statistics and covariance structure analysis. The results of covariance structure analysis for model fitness were as follows : 1) Hypothetical model showed a good fit to the empirical data : Chi-square($X^2$)=41.81 (df=11, P=.000), Goodness of Fit Index=.974, Root Mean Square Residual=.049, Normed Fit Index=.928, Non Normed Fit Index=.814. 2) For the validity and the parcimony of model, a modified model was constructed by appending 2 paths and deleting 5 paths according to the criteria of statistical significance and meaningfulness. 3) The results of hypothesis testing were as follows : (1) Educational level, event familiarity and severity of illness had a direct effect on uncertainty : Event congruency had both direct and indirect effect on uncertainty : Credible authority and symptom consistency had a nonsignificant direct effect on uncertainty, (2) Illness duration, symptom consistency, and event congruency had a direct effect on severity of illness ; Credible authority had a both direct and indirect effect on severity of illness ; Event congruency had the greatest effect on severity of illness, and event familiarity had a nonsignificant direct effect on severity of illness.

• Journal of the Korean Society of School Health
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• v.16 no.2
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• pp.1-11
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• 2003

PURPOSE: The aim of our study was to assess the prevalence of respiratory symptoms and to determine their environmental risk factors in school children living in a city where traffic is particularly heavy. METHODS: From November 12th to November 19th, 2002, we sent questionnaires to parents for children's health and environmental factors, and ninety eight percent (516) of parents responded. RESULTS: The lifetime prevalence of chronic respiratory illness was 12.2% and 13.2% for wheeze, and 6.6% for physician diagnosed asthma. Using multiple logistic regression model, we found that family history of asthma(OR=3.47, 95% CI 1.36-8.78), atopy dermatitis(OR=5.48, 95% CI 2.37-12.66), and pets at home(OR=3.22, 95% CI 1.26-8.23) were associated with chronic respiratory illness in last 12 months. We also found that family history of asthma(OR=3.28, 95% CI 1.16-9.31), atopy dermatitis(OR=2.89, 95% CI 1.11-7.54), and short distance between the house and road(OR=2.85, 95% CI 1.03-7.87) were associated with asthma in last 12 months. CONCLUSIONS: Elementary school children in a city had a relatively high prevalence of chronic respiratory illness and symptoms. In addition to genetic factors, pets at home and outdoor air pollution are associated with respiratory illness and Symptoms in school children.

• Journal of Korean Academy of Rural Health Nursing
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• v.10 no.1
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• pp.31-41
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• 2015

Purpose: The study was performed to identify factors influencing suicidal ideation in patients with chronic mental health problems and who live in the community. Methods: Data were collected using questionnaires and participants were 140 people with mental illness living in Y-si, Gyeonggi-do. The study was carried out from May 15 to September 30, 2014. Data were analyzed using descriptive statistics, Pearson Correlation Coefficients, and Logistic Regression with the SPSS/WIN 18.0 statistical program. Results: The number of persons who attempted suicide was 47(33.6%) and the number who had suicide ideation was 22(15.7%). The mean score for depression was $6.4{\pm}6.45$. The mean score for life satisfaction was $16.5{\pm}8.21$. Depression had a significant negative correlation with life satisfaction. Odds ratio of suicide ideation was 1.19. The significant factor influencing suicidal ideation was depression. Conclusion: The results of this study can be used in the development and practice of programs to decrease suicide in people with mental illness.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.14 no.1
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• pp.33-44
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• 2011

The influence of nutrition during early life on physical growth as well as mental development has been thoroughly discussed in the literature. The physical dimensions of the body are greatly influenced by nutrition, particularly during the period of rapid growth in early childhood. Nutritional status affects every pediatric patient's response toillness. Good nutrition is important for achieving normal growth and development. It is indicated that permanent impairment of the central nervous system may result from dietary restriction of imbalance during certain periods of life. If children under 3 years of age show a good nutritional status, it may be assumed that they are well nourished. Several common diseases of children such as iron deficiency, chronic constipation and atopic dermatitis are known food related diseases. Patients with chronic illness and those at risk of malnutrition should have detailed nutritional assessments done. Components of a complete nutritional assessment include a medical history, nutritional history including dietary intake, physical examination, anthropometrics (weight, length or stature, head circumference, midarm circumference, and triceps skinfold thickness), pubertal staging, skeletal maturity staging, and biochemical tests of nutritional status. The use of age, gender, and disease-specific growth charts is essential in assessing nutritional status and monitoring nutrition interventions. Nutrition assessment and dietary counseling is helpful for the cure of disease, and moreover, the prevention of illness.