The purpose of this study was to examine the relationship between self-perceived benefits from singing and the quality of life of older adults aged 75 years and older. A total of 231 older adults participated in this study with 141 of them living alone and 90 of them living with others. Each participant was instructed to complete the investigator-constructed questionnaire and the Quality of Life scale. The questionnaire consisted of 49 items on demographic information, involvement in leisure activities and singing-related experiences, and perceived benefits from singing. The results showed that the amount of involvement in leisure activities and the measured quality of life were found to differ between the two subgroups of older adults living with and without others. The number of older adults who had singing-related experiences was also differed between the groups. A positive correlation was found between the amount of self-perceived benefit from singing and quality of life. These results indicate that self-perceived benefits from singing could be an important factor for the quality of life of older adults. This study supports the potential benefits of incorporating singing as an active leisure activity into interventions for older adults, expanding the research that has been extensively based on listening-based interventions. Also, it presents clinical implications for how singing interventions and programs could be designed and suggested to support this population to better cope with their life issues and enhance the quality of life.
Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.
Objectives: Despite the importance of human immunodeficiency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. Methods: 169 HIV-infected males and their female sex partners were recruited from 1985 to tune 1998. We examined female sex partner's HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. Results: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell courts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) Conclusion: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.
Adolescence is vulnerable to various Health Risk Behaviors (HRB). These behaviors can affect his remaining life as well as adolescence, thus prevention of HRB is a critical issue in health education. This study is aimed to provide basic information for prevention of HRB. Thus, this study was conducted to analyze the impact of peer group's health risk behaviors on health risk perception (HRP) and that of health risk perception on health risk behaviors based on 832 respondents. The 852 subjects were selected in six middle and high schools in Seoul through random sampling. Data were collected from September, 18-October, 21, 1998, and the 832 data were analyzed after excluding the 20 incomplete and inaccurate data. Questionnaire items and measures are based on an instrument to measure Perceived Health Risk Perception, which Hodge B.C. developed in 1992. Cronbach alpha is used to test the reliability. The reliability of HRP and HRB is 0.9473, 0.8768 in this study, Statistical analysis divided into four phases. First, the impact of socio-demographic characteristics on HRP is analyzed by oneway ANOV A. Male students have lower HRP than female students. As grade goes up, HRP is getting lower. Perceived higher concern of parents and HRP are correlated. And the experience of school health education and HRP are correlated. Second, the impact of peer group's HRB on the HRP is analyzed by linear regression. Peer group's HRB and HRP are negatively correlated, Third, the impact of HRP on HRB is analyzed by linear regression. There is a correlation between high HRP and low HRB. Fourth, Powerful impact factors on HRB are analyzed by stepwise multiple regression. Grade, gender, peer group's HRB, and related HRP is entered as independent variables. Because of correlation between entered variables, three interaction variables between grade, gender, peer group's HRB and related HRP also entered, In general, peer group's HRB is the most accountable factor to HRB. And Interaction variable between HRP and peer group's HRB and HRB are negatively correlated. These results indicate that HRP may reduce the impact of peer group's HRB on HRB. Some recommendations are as follows: First, health educational programs suitable for gender and grade are required. Second, a systematic cooperation between school and home is necessary for effective prevention of HRB. Third, the educational effect for decreasing HRB by increasing HRP is statistically assisted. However, peer group has much stronger impact on HRB than subjective HRP, thus special consideration and management are necessary for peer group which does HRB more frequently.
Shin, Dong Gyo;Lee, Chun Kyoon;Lee, Sang Gyu;Kang, Jung Gu;Sun, Young Kyu;Park, Eun-Cheol
Health Policy and Management
/
v.23
no.1
/
pp.35-43
/
2013
Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.2
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pp.497-507
/
2018
Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.
Journal of the Korea Academia-Industrial cooperation Society
/
v.19
no.2
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pp.125-136
/
2018
Heavy snowfall disasters are the third most serious natural disasters, after typhoon and heavy rainfall disasters, in terms of economic disaster damage in South Korea. The average annual economic damage of heavy snowfall disasters was approximately eighty-eight billion won during the period of 2005-2014. In spite of significant economic damage, there have been few economic studies regarding heavy snowfall disasters in South Korea. The objective of this research is to identify the association between economic damage of heavy snowfall disasters and damage effect factors of snowfall amounts, snowfall days, population densities, and non-urban area ratios using a regression analysis model. Economic damage data sets of heavy snowfall disasters during the period of 2005-2014 were obtained from the Natural Disaster Yearbook published by the Ministry of Public Safety and Security. Weather-related data sets, such as snowfall amounts and snowfall days were collected from the Korea Meteorological Administration. Demographic and urban data sets, including population densities and non-urban area ratios, were provided by the Local Government Yearbook. Outcomes of this study can assist with heavy snowfall disaster management policies of South Korea.
Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: $61{\pm}15$), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p<.0001), self efficacy (t=4.13, p<.0001) and compliance with sick role behavior(t=5.66, p<.0001) were significantly higher in the patients who got the follow-up coronary angiogram than in those who did not get it. But there was not any relative factor in demographic variables (p>.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3. The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.
Background: Capecitabine is an oral fluoropyrimidine derivative which is frequently used alone or in combination regimens for the treatment of metastatic breast cancer. Although overall and progression free survivals have increased in recent years with the use of new generation drugs, predictive factors that would further improve the outcomes are needed. Previous studies have demonstrated the relation between post-treatment increase in mean corpuscular volume (MCV) and predicting therapy response as well as survival. The present study investigated the clinical impact of MCV elevation in metastatic breast cancer patients treated with capecitabine. Materials and Methods: The data of a total of 82 patients from three centers followed between June 2005 and June 2013 were retrospectively analyzed. The demographic data and hormone receptor status of the patients, as well as initial examination before and after treatment and data concerning progression were recorded. MCV ${\geq}100$ fl was considered as macrocytosis. Capecitabine was given at a dose of $2500mg/m^2$ daily for 14 days every three weeks. Pre-treatment and post-treatment MCV and other parameters of complete blood count were recorded. Post-treatment initial evaluation was performed after 2 cycles of therapy. Results: The median age of the patients was 46.5 years (range 26-72 years) and 54% were premenopausal. Performance status was ECOG 0 and 1 in 81 (99%) patients. The median number of cycles for capecitabine therapy was 5 (min-max: 2-18). The median ${\Delta}MCV$ level (post-treatment values at sixth week - baseline) was 6.4. Whilst ${\Delta}MCV$ was ${\geq}6.4$ in 42 patients, it was <6.4 in 40 patients. Clinical benefit (complete response+partial response+stable disease) was observed in 37 (88%) of 42 patients with a median ${\Delta}MCV$${\geq}6.4$ and in 30 (75%) of 40 patients with ${\Delta}MCV$ <6.4 with no statistically significant difference (p=0.158). No significant difference was determined between the group with ${\Delta}MCV$${\geq}6.4$ and the group with ${\Delta}MCV$ <6.4 in terms of progression-free survival (11 vs 12 months) (p=0.55) and overall survival (20 months vs. 24 months) (p=0.11). Conclusions: The identification of new predictive markers in metastatic breast cancer is very important. In some recent studies, increase in MCV has been suggested as a marker in tumor response. In the present study, however, no significant difference was determined between tumor response and increase in MCV. Further studies including higher numbers of patients are needed to determine whether increase in MCV is a predictive marker or not.
Jung, Saim;Ju, Gawon;Lee, Sang Ick;Shin, Chul-Jin;Son, Jung-Woo;Kim, Siekyeong
Korean Journal of Psychosomatic Medicine
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v.25
no.2
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pp.193-199
/
2017
Objectives : Insomnia may be one of the risk factor for suicidal ideation, but little is known about the mechanism by which sleep disturbances confer risk for suicide. The aim of this study was to investigate examine whether insomnia severity would be associated with resilience and suicidal ideation, and whether resilience would mediate the relationship between insomnia and suicidal ideation. Methods : A total of 432 community-dwelling adults(227 male, 205 female,) completed the self-report questionnaire that covered basic socio-demographic data. To assess the psychological variables, the following instruments were applied: Insomnia Severity Index(ISI), Korean Version of the Connor-Davidson Resilience Scale(K-CD-RISC), Beck Hopelessness Scale(BHOP) and Scale for Suicidal Ideation(SSI-Beck). People with an ISI score of 8 or higher were defined as insomnia. Results : Greater insomnia symptom severity was significantly associated with higher level of suicidal ideation and lower level of resilience, adjusting for hopelessness, age, sex, presence of family members living together, and household income. Additional analysis revealed that disturbance of sleep initiation and disturbance of sleep maintenance were significantly associated with suicidal ideation. Mediation analyses revealed that resilience significantly accounted for the relationship between insomnia symptom severity and suicidal ideation. Conclusions : These findings suggest that the evaluation and control of insomnia and resilience may be needed to reduce the risk of suicide.
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