• Journal of Yeungnam Medical Science
• /
• v.40 no.2
• /
• pp.218-222
• /
• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• Nutrition Research and Practice
• /
• v.17 no.5
• /
• pp.1007-1018
• /
• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS: Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ² test to validate the test. RESULTS: There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS: The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

• Journal of the Korean Society of Child Welfare
• /
• no.59
• /
• pp.209-234
• /
• 2017

This study viewed schools as a cause of students dropping out and posited that dropping out of high school would vary depending on the characteristics and influencing factors of the school from which students were dropping out. Therefore, focusing on schools, we longitudinally investigated the change patterns of school dropout across high schools in the country, and the types of changes in dropping out of high school. In addition, we predicted the general characteristics of schools according to the type of school students were dropping out from, looked at the changes in the major factors (i.e., school violence and school counseling) affecting school dropout, and reviewed schools' long-term efforts and outcomes in relation to school dropout. For this purpose, KERIS EDSS's "Secondary School Information Disclosure Data" were used. The final model included data collected five years20122016) from high schools across the country. The results were as follows. First, in order to examine the longitudinal change patterns of dropping out of high schools, a latent growth models analysis was conducted, and it revealed that, as time passed, the dropout rate decreased. Second, growth mixture modeling was used to explore types according to the change patterns of the school students were dropping out from. The results showed three types: the "remaining in school" type, the "gradually decreasing school dropout" type, and the "increasing school dropping out". Third, the multinomial logistic regression was conducted to predict the general characteristics of schools by type. The results showed that public schools, vocational schools, and schools with a large number of students who have below the basic levels in Korean, English and mathematics were more likely to belong to the "increasing school dropout" type. Further, the larger the total number of students, the higher the probability of belonging to the "remaining in school" type or the "gradually decreasing school dropout" type. Lastly, growth mixture modeling was used to analyze the trend of school violence and school counseling according to the three types. The focus was on the "gradually decreasing school dropout" type. In the case of the "gradually decreasing school dropout" type, it was found that as time passed, the number of school violence cases and the number of offenders gradually decreased. In addition, in terms of change in school counseling the results revealed that the number of placement of professional counselors in schools increased every year and peer counseling was continuously promoted, which may account for the "gradually decreasing school dropout" type.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.36 no.4
• /
• pp.78-95
• /
• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.

• Journal of Korean Academy of Nursing
• /
• v.30 no.5
• /
• pp.1195-1206
• /
• 2000

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

• Journal of Nutrition and Health
• /
• v.43 no.3
• /
• pp.273-284
• /
• 2010

The purpose of this study was to investigate the effects of weight control program on dietary habits and blood composition in obese middle-aged women. The program consisted of nutrition education, physical exercise and nutrition counseling was conducted for 12 weeks. Participants of the preliminary study were 255 obese women, among which 82 women participated in the nutrition education program. We evaluated the anthropometry, blood lipid profiles, dietary habits of obese women before and after the nutrition education. Dietary habits of the subjects were significantly improved in regularity of having breakfast (p < .05), the frequency of eating snack after dinner (p < .001), eating out (p < .01) and the speed of meal (p < .05) after the program. There was significant decrease in total cholesterol, triglyceride, LDL-cholesterol and systolic pressure of the subjects after nutrition education. Changes of atherogenic index and diastolic pressure were not significant, but had a tendency to decrease. All of the anthropometric outcomes except lean body mass such as BMI, percent body fat, fat mass, and WHR were significantly decreased after weight control program. These findings show that weight control program including nutrition education and counseling can improve dietary habits and weight control pattern, and lead the authors to recommend that public health organizations and dietetic professionals should educate obese women on practical strategies for an effective weight management.

• Clinical and Experimental Pediatrics
• /
• v.54 no.6
• /
• pp.246-252
• /
• 2011

Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

• Journal of Nutrition and Health
• /
• v.46 no.2
• /
• pp.156-165
• /
• 2013

This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged $47.2{\pm}6.6$ years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, < 59%), medium-compliance group (MC, 59-70%), and high-compliance group (HC, > 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p < 0.05, p < 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p < 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p < 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p < 0.05). The change of fruit serving size showed a significant increase in the HC group (p < 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p < 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group.

• Journal of Korean Biological Nursing Science
• /
• v.22 no.4
• /
• pp.232-248
• /
• 2020

Purpose: The purpose of this study was to develop and apply a motivation-strengthening obesity management program for obese subjects with visual impairment and evaluate its effects. Methods: The program development and evaluation periods were from March to August 2018. The study design was an experimental study of non-equality, control repeat design. 25 subjects in the experimental group participated in the 12-week obesity management program and the 26 people in the control group did not. Results: The motivation-strengthening obesity management program included stretching exercises for 30 minutes in the morning five times a week. In addition, counseling, education, and group discussions were continued once a week for motivational strengthening. Special custom exercises for blind patients were also completed once a week simultaneously. Both of these activities were continued for 50 minutes a week for a total of 12 weeks. Measurements were recorded periodically to identify the sustained effects of the program. The obese subjects with visual impairment improved their knowledge of obesity, perceived disability, self-efficacy of exercise, and quality of life related to obesity through the motivational obesity management program. Waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood sugar were also improved in obese subjects. Conclusion: The study findings indicate that this program could be an active intervention for the control of weight gain in participants with visual impairment. Therefore, the motivation-strengthening program based on the ADDIE (Analysis, Design, Development, Implementation& Evaluation) model could be an effective strategy for better health outcomes of obese subjects with visual impairment.

• The Korean Journal of Elementary Counseling
• /
• v.5 no.1
• /
• pp.205-226
• /
• 2006

The purpose of this study was to find out the relations between 6th graders' negative cognitive process and anger experience and aggressiveness. To achieve the goal, it conducted a test to examine children's negative cognitive process, anger experience, aggressiveness targeting 100 children of 6th grade in C elementary school, Gyeonggj province. Then it conducted SPSS 12.0 statistical program to get the results of correlation analysis and regression analysis. The outcomes were as follows. First, there was a meaningfully positive relation between a negative cognitive process and anger experience. In other words, children having more negative cognitive process seemed to experience the feelings of anger more often, this presented the important role of cognition while getting into a temper Second, it reported a positive relation between anger experience and aggressiveness. Children who have experienced anger more often showed more violent behaviors, especially there were more significant positive relations between trait-anger and aggressiveness compared to state-anger and aggressiveness. This could explain some possibilities that children with high level of trait-anger might outrage more often than others by recognizing the situations as anger stimulants. Third, when conducting a regression analysis, a negative cognitive process made an effect on anger experience which affected aggressiveness. However, it did not show a negative cognitive process making a direct effect on aggressiveness. This is considered that children could experience an anger while evaluating an event or object in a negative way based on individual belief, and emotional linguistic behavioral aggressiveness would be formalized as they express the sparked fury either internally or externally. In conclusion, this study proved that there were close relations between children's negative cognitive process and anger experience and aggressiveness. A negative cognitive process affects anger experience, and anger experience affects aggressiveness afterwards. A negative cognitive process affects aggressiveness through anger experience indirectly, and especially trait-anger among anger experience is the main factor to influence on aggressiveness. With consideration of these results, it is believed that mediation is important key to moderate the negative cognition and trait-anger in order to diminish children's aggressive behaviors. This study has a meaning to provide searching for manifold mediating methods between negative cognition and trait anger, with a fundamental resource.