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A Study on Hypertensive Patients Compliance to Medical Recommendations (고혈압 환자의 치료지시 이행에 관한 연구)

  • 최영희
    • Journal of Korean Academy of Nursing
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    • v.10 no.2
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    • pp.73-85
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    • 1980
  • The purpose of this study was to investigate the compliance behavior of hypertensive patients in light of their health belief model that explains an individual's compliance with health maintenance or getting well. Although there are many effective regimens and treatments for hypertension nowadays. the most important point to be taken to consideration in their behavioral aspect is their compliance with regard to the control of body weight. eating habits as to salt and cholesterol intake. stresses. activity patterns and smoking as related to their life style. The important reasons for the failure in the control of hypertensive patients are the complexity of regimens to be complied to. irregular medication and the life long restrictions in their own life style. The compliance of patients to medical regimens and rocommendations or failure to do so is an essential factor. Accordingly. the degree of the patient's compliance is an important determinant as to the success or failure of hypertension control. The subjects for this study were 187 hypertensive patients selected from admitted and out patients of the medical department at seven University Hospitals in Seoul. Data was collected from Dec. 1, 1979 to Feb. 15, 1980 using the questionaire method and was analysed by the use of means. standard deviations, coefficient of correlations, analysis of variance and multiple regression analysis. The results obtained are as follows A. Of the seven independent variables in light of health belief model. benefit. barrier and severity are closely related to patient's compliance behavior. Therefore these variables could be used as determinants to predict and modify the hypertensive behavior. 1. Benefit is the most important and significant of the variables for explaining the dependent variables. It accounts for the highest variance of patient's compliance. (23.62%) 2. Then taking the former together with barrier. the variance of compliance showed on increase. (26.59%) 3. And with the addition of severity to the first two. the variance of compliance was also increased. (28.l2 %) B. Except for susceptibility all the independent variables such as severity. benefit, knowledge. motivation and barrier are correlated to dependent variable compliance. C. Sex. marital status and religion appeared to have significant influence on the dependent variables. Therefore one could conclude that the more the patients are aware that hypertension is a threat to health. the more they understand the benefit of taking actions to prevent such a threat. and the less they perceive any barrier when taking action. the more compliant they become in following medical regimens and recommendations. Age. marital status and religion played a significant influence to their compliance. Accordingly. the selected structural variables and demographic variables which have influenced sick role behavior of the hypertensive patient must be integrated to teaching and counselling programs for better hypertension control.

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Cost-Analysis for Social Services: A Case Study of Community-Based Social Service Centers for the Disabled in South Korea (사회복지서비스 원가분석의 방법과 과제: 장애인복지관의 사례를 중심으로)

  • Choi, Jae-Sung;Choi, Sang-Mi
    • Korean Journal of Social Welfare
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    • v.60 no.1
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    • pp.233-250
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    • 2008
  • The purpose of this study is to report a case of cost analysis for community-based social service centers for the disabled. This study analyzed 2002 accounting reports and annual business reports from 20 social service centers for the disabled. To identify weight of each service researchers surveyed each service in terms of significance, difficulty, and emphasis from managers among centers. For cost analysis, this study used TCA(Traditional cost accounting), rather than ABC(Activity-based costing) because of costs, time, and difficulty to find cost drivers. Findings indicate that average annual expenditure is about 1260 million Won. About 65.8% is for labor and another 13.2% is for programs. In addition, the cost for respite care service(1 hour basis) is 26,922 Won and job counselling with job capacity evaluation(2 hour basis) is 143,355 Won. These costs does not count on real estate costs and low labor costs. Thus, market price of those services should be higher than the above. This study analyzed the costs with service bassis rather than costing item basis. This method would provide more useful information to decision makers in relation to program expansion, reducement, and resources allocation etc.

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A study on categories of questions when holding counselling on learning math in regards to grounded theoretical approaches (근거이론적 접근에 따른 수학학습 상담 발문 유형에 대한 연구)

  • Ko, Ho Kyoung;Kim, Dong Won;Lee, Hwan Chul;Choi, Tae Young
    • Journal of the Korean School Mathematics Society
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    • v.17 no.1
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    • pp.73-92
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    • 2014
  • This study was performed in part with the task to find measures to improve the defining characteristics of feelings, value, interest, self-efficacy, and others aspects in regards to learning math among elementary and middle school students. For this study, it was essential to understand the appropriate questions that are needed to be asked during a consultation at a math clinic, for students that are having a hard time learning math. As a method for performing this study, the content of scheduled counseling over 2 years from a math clinic were collected and the questions that were given and taken were analyzed in order to figure out the types of questions needed in order to effectively examine students that are facing difficulty with learning math. The analysis was performed using Grounded theory analysis by Strauss & Corbin(1998) and went through the process of open coding, axial coding, and selective coding. For the paradigm in the categorical analysis stage, 'attitude towards learning math' was set as the casual condition, 'feelings towards learning math' was set as the contextual condition, 'confidence in one's ability to learn math' was set as the phenomenon, 'individual tendencies when learning math' was set as the intervening condition, 'self-management of learning math' was set as the action/interaction strategy, and 'method of learning' was set as the consequence. Through this, the questions that appeared during counseling were linked into categories and subcategories. Through this process, 81 concepts were deducted, which were grouped into 31 categories. I believe that this data can be used as grounded theory for standardization of consultation in clinics.

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A Study on the Establishment of Clinical Nurse Specialist (우리나라 전문간호사제도 개선방안에 관한 연구)

  • Byun, Young-Soon;Kim, Young-Im;Song, Mi-Sook
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.130-146
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    • 1994
  • Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.

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A Comparative Study on the Temporomandibular Joint Sounds before and after Occlusal Splint Therapy Using Electrovibratography (두개하악장애환자의 교합안정장치에 의한 치료후 Sonopak을 이용한 악관절음 변화)

  • Hye-Sook Park;Jong-Hoon Choi;Chang-Seo Park
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.67-78
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    • 1996
  • This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

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A Study on Improvement of Specialized High School of Electrical Field-to-Work Transition by SWOT Analysis (전기·전자·통신 분야 특성화고등학교의 SWOT 분석을 이용한 학교에서 일터로의 전이 개선 방안)

  • Kim, Jinkwon;Woo, Sangho;Lee, Yongjin;Kim, Jinsoo
    • 대한공업교육학회지
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    • v.32 no.1
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    • pp.55-72
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    • 2007
  • The purpose of this study is to improve specialized high school of electrical field-to-work transition by a SWOT Analysis. The subject analyzed the curricula of 12 special highschool and surveyed 192 vocational teachers of them. In this study, a SWOT matrix was filled to improve transition from electric special high school to work, and the results was gotten as follows: First, the government should offer the military service special case for students of electric special high school, strengthen the course of CEO for the school master, and make the system to expand job training. Second, the provincial office of education should aid a functional training with a administrative ability and financial support, offer a list of industry visiting teachers to specialized high school, and promote a modification of the department according to a growth industry of the area. Third, each school should present a school education goal agreed with the purpose of specialized department and intensify the counselling of job selection and the application of the approved textbook.

Influences of Demographic, Smoking, and Smoking Cessation Factors on Smoking Cessation Success in Adolescent Smokers (인구학적, 흡연 및 금연관련 요인이 청소년 흡연자의 금연성공에 미치는 영향)

  • Yi, Yeo-Jin;Lee, Kun-Ja;Kim, Young-Sook
    • The Journal of the Korea Contents Association
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    • v.11 no.4
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    • pp.303-311
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    • 2011
  • This study aimed to identify success factors of smoking cessation for 6 months in Adolescent smokers. Data were collected from January to December, 2008. The 925 adolescent smokers were registered smoking cessation clinic at public health center in Incheon. Data(demographic, smoking, smoking cessation) were analyzed by logistic regression. Major factors are attempting to quit smoking(no trial, OR=9.48), alcohol drinking(yes, OR=4.61), information source for registration(family, friends's ask, OR=3.94), cessation methods(cognitive+behavior+ nicotine alternative therapy, OR=2.45), gender(male, OR=1.78), grade in school(high schooler, OR=1.65), expiration CO concentration (OR=0.95), and nicotine dependency(OR=0.76). Therefore, smoking cessation policy for adolescence should be emphasized on smoking prevention as well as smoking cessation. We have to help the adolescent to succeed in smoking cessation when they attempt to quit smoking at first time. Female student smokers and middle school smokers should be given advice for smoking cessation motives and more times of counselling for smoking cessation. If adolescent smokers have high expiration CO concentration and high nicotine dependency, they should not only take cognitive-behavior therapy but also nicotine alternative therapy.

A Study on Status of Student Health Service in Universities and Colleges in Korea (우리나라 대학(大學) 학생보건관리실태(學生保健管理實態)에 관(關)한 조사연구(調査硏究))

  • Kwun, Byung-Nim;Choi, Sam-Sop
    • Journal of Preventive Medicine and Public Health
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    • v.12 no.1
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    • pp.3-12
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    • 1979
  • A survery was carried out in order to know the status of student health service and student medical insurance of universities and colleges in Korea from 1 July to 30 September. 1978. And the following results were obtained; 1. Out of seventy universities and colleges, 54.8% of them had student health service facility such as student health conte. (30.0%) or health room (24.8%). 2. Out of twenty-seven national and public universities and colleges, 44.4% of them had student health service facility and out of forty-three private universities and colleges, 60.5% of them had student health service facilities. 3. Each of 80.0% of 25 universities, 43.3% of 30 colleges and 33.3% of 15 junior colleges had student health service facility. 4. Major roles of student health service were physical examination (92.1%), health counselling (86.8%), primary medical care (78.9%), tuberculosis control (68.4%), insect and rodent control (52.6%), parasite control(47.4%), water source sanitation (44.7%), and dental health care (28.9%). 5. Out of 21 universities and colleges, 66.7% of them had full time doctor and 81.0% of them had full time nurse for student health center. And out of 17 universites and colleges, 5.9% of them had full time doctor and 33.3% of then had full time nurse for student health room. 6. The range of health fee was varied from 100 won to 1,400 won per student per semester and the average was 520 won. 7. Among 55 universities and colleges, 78.6% of them had carried out annual physical examination in 1977 and the rate of physical examination was 57.4%. 8. Out of 70 universities and colleges. 45.7% of them had tuberculosis control program and the prevalence rate was 6.0 per 1,000 students. 9. Student medical insurance program was developed by ten universities and one college among 25 universities and 45 colleges. 10. Student medical insurance benefit was varied according to university and college; the reduction rate of medical fee was 20% to 80% for not only in-patient but also out-patient. 11. The upper limit of pay claim was varied according to the university and college from 5,000 won to no-limitation for out-patient and from 30,000 won to no-limitation for in-patient. 12. The highest utility rate of student medical insurance program was found in university 'F' with the rate of 791 for out-patient and 12 for admitted patient per 1,000 students.

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Current Trends in Intervention Studies of Hwabyung in Korean Medicine (화병의 한의학적 치료에 대한 연구동향)

  • Suh, Hyo-Weon;Choi, Eun-Ji;Kim, Sang-Ho;Kim, Dong Hee;Kim, Lak-Hyung;Kim, Jong-Woo;Lee, Jae-Hyok;Lim, Jae-Hwan;Choi, Woo-Jin;Chung, Sun-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.261-274
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    • 2016
  • Objectives: To determine the general characteristics of clinical studies about Hwabyung and assess their limitations and alternatives. Methods: Clinical studies that examined the effects of traditional Korean medicine intervention on Hwabyung were included in this study. A systematic search of English, Chinese, Japanese, and Korean databases was performed. The characteristics of included articles were described and those articles were assessed by Risk of Bias (RoB) tool or Risk of Bias for Nonrandomized Studies (RoBANS) tool. Results: Sixteen articles were selected from 1,826 articles. Most clinical studies about Hwabyung were published in Korea. The number of conducted trials was insufficient. The prevailing study design was randomized controlled trial. Traditional Korean medicine intervention used in the trials were acupuncture, herbal medicine, counselling, meditation, emotional freedom technique (EFT), music therapy, art therapy, and multi intervention program. Herbal medicine study used placebo as control while non-pharmacological intervention study mostly used no treatment as control. Most of the trials were supported by the government. Therefore, financial conflict of interest might not exist for results. We judged that some studies had a high risk of bias. In general, most of the studies with a high risk of bias were non-pharmacological intervention studies, and the risk of bias was mainly due to lack of blinding. Conclusions: More clinical studies of Hwabyung are needed. There are some issues about a suitable comparison and effective blinding strategy for non-pharmacological study. Improving methodological quality is required.

Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City (한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 -)

  • Yoo Wang-Keun;Ryu Kyung-A
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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