• Title/Summary/Keyword: Family physician

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Relationships between the diabetes awareness and clinical indices/nutrient intakes in Korean adults: Based on the 2012-2013 Korea National Health and Nutrition Examination Survey Data

  • Lee, Seul;Park, Haeryun;Lee, Youngmi;Choi, Onjeong;Kim, Jiwon;Gray, Heewon L;Song, Kyunghee
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.240-246
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    • 2019
  • BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

Factors Influencing Influenza Vaccination Intention among Health Personnel in General Hospitals: An Application of the Theory of Planned Behavior (종합병원 보건의료인의 독감 예방접종 의도와 영향요인: 계획된 행위이론의 적용)

  • You, Jiyoung;Yang, Jinhyang
    • Research in Community and Public Health Nursing
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    • v.32 no.2
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    • pp.175-185
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    • 2021
  • Purpose: Influenza immunization among health personnel is of particular importance given their elevated risk of influenza infection, role in transmission and influence on patients' immunization status. The purpose of this study is to identify factors associated with the influenza vaccination intention among health personnel based on the theory of planned behavior. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 131 health personnel in five general hospitals in two cities in South Korea. The data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with the SPSS 26.0 program. Results: There were statistically significant differences in influenza vaccination intention according to the high-risk group in the family, occupation, length of employment, and influenza vaccination status within a year. The influenza vaccination intention of these health personnel showed significant positive correlations with attitude, subjective norms, and perceived behavioral control towards influenza vaccination. Multiple regression analysis for influenza vaccination intention revealed that the significant predictors were attitude, subjective norms, influenza vaccination within a year and physician in occupation. These factors explained 41.4% of the variance. Conclusion: The results suggest a need to strengthen attitude and subjective norms. The findings also suggest that their characteristics through influenza vaccination status within a year and occupation should be considered for tailored interventions related to the intention. Furthermore, it is necessary to develop programs strengthening attitude and subjective norms to enhance influenza vaccination intention among health personnel.

Patient-Centered Doctor's Competency Framework in Korea (한국의 환자중심 의사 역량 연구)

  • Jeon, Woo-Taek;Jung, Hanna;Kim, Young-Jon;Kim, Chanwoong;Yune, Sojung;Lee, Geon Ho;Im, Sunju;Lee, Sun-Woo
    • Korean Medical Education Review
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    • v.24 no.2
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    • pp.79-92
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    • 2022
  • With increasing demands for medical care by society, the medical system, and general citizens and rapid changes in doctor's awareness, the competencies required of doctors are also changing. The goal of this study was to develop a doctor's competency framework from the patient's perspective, and to make it the basis for the development of milestones and entrustable professional activities for each period of medical student education and resident training. To this end, a big data analysis using topic modeling was performed on domestic and international research papers (2011-2020), domestic newspaper articles (2016-2020), and domestic social networking service data (2016-2020) related to doctor's competencies. Delphi surveys were conducted twice with 28 medical education experts. In addition, a survey was conducted on doctor's competencies among 1,000 citizens, 407 nurses, 237 medical students, 361 majors, and 200 specialists. Through the above process, six core competencies, 16 sub-competencies, and 47 competencies were derived as subject-oriented doctor's competencies. The core competencies were: (1) competency related to disease and health as an expert; (2) competency related to patients as a communicator; (3) competency related to colleagues as a collaborator; (4) competency related to society as a health care leader (5) competency related to oneself as a professional, and (6) competency related to academics as a scholar who contributes to the development of medicine.

ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

Attitude, Beliefs, and Intentions to Care for SARS Patients among Korean Clinical Nurses: An Application of Theory of Planned Behavior

  • Kim Cho-Ja;Yoo Hye-Ra;Yoo Myung-Sook;Kwon Bo-Eun;Hwang Kyung-Ja
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.596-603
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    • 2006
  • Purpose. This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. Methods. A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. Results. Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, 'SARS-patient caring would be a new experience', 'during SARS-patient caring, I should be apart from my family', 'after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event' and 'with my SARS-patient caring, patients could recover from SARS' were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, 'SARS-patient caring would be a challenge' 'SARS-patient caring is a professional responsibility', 'tension during the care of SARS patients' and 'support from team members' were the significant determinants of the intentions. Conclusions. Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

Prevalence and environmental risk factors for respiratory symptoms among elementary school children in a city (도시지역 초등학교 저학년 학생들의 호흡기계 증상 유병률에 영향을 주는 환경위험요인)

  • Park, Hye-Sook;Lee, Bo-Eun;Ha, Eun-Hee;Kim, Nam-Hee;Hong, Yun-Chul;Lee, Youn-Kyung;Cho, Yong-Sung
    • 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.

Health Status in Urban Slum Area (일부(一部) 도시(都市) 영세지역(零細地域)의 보건실태(保健實態))

  • Chang, Im-Won;Chung, Kyou-Chull
    • Journal of Preventive Medicine and Public Health
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    • v.10 no.1
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    • pp.3-15
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    • 1977
  • In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.

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Chronic Fatigue Syndrome (만성 피로증후군)

  • Jung, Seung-Pil;Lee, Keun-Mi
    • Journal of Yeungnam Medical Science
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    • v.24 no.1
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    • pp.1-10
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    • 2007
  • The chronic fatigue immune dysfunction syndrome (abbreviated CFIDS or CFS) is a disorder characterized by debilitating fatigue(over 6 months.), along with cognitive, musculoskeletal, and sleep abnormalities. The etiology of this illness is unlikely to be a single agent. Findings to date suggest that physiological and psychological factors work together to predispose and perpetuate the illness. Diagnosis is made difficult by the nonspecific clinical findings and no available diagnostic testing. With no known cause or cure for the chronic fatigue and immune dysfunction syndrome, treatment is based on relieving symptoms and improving the quality of life of affected patients. There is emerging evidence that chronic fatigue syndrome may be familial. In the future, studies will examine the extent to which genetic and environmental factors play a role in the development of chronic fatigue syndrome. Most patients with CFS have psychiatric problems such as a generalized anxiety disorder, or major or minor depression, therefore, these mental health disorders may be correlated with the pathophysiology of the CFS. The treatment for CFS must be individualized, due to the heterogeneity of the CFS population. Also the treatment of CFS is built on a foundation of patient-physician relationship, respect and advocacy.

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An Analysis or the Medical problems of the Medical Aid Patients Registered in a Health Center in Seoul (Relationships Between the Findings Of the Routine Urinalysis and Hypertensive Symptoms) (1차진료기관(次診療機關) 이용환자(利用患者)의 질병양상(疾病樣相) 및 고혈압(高血壓)과 요검사소견(尿檢査所見)에 관(關)한 연구(硏究))

  • Park, Seung-Key
    • Journal of Preventive Medicine and Public Health
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    • v.17 no.1
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    • pp.259-268
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    • 1984
  • The Korean government launched the medicaid program for the poor people as a wing of the social development and welfare programs beginning in 1977 when the fourth 5-year national economic development program started. The charts of the medicaid recipients who visited Jonglo-Gu Health Center for the period from 1981 to 1983 were reviewed and analysed. Major findings from the analysis are as follows. 1. The medicaid recipients occupied 5.19% in 1981, 2.90% in 1982 and 2.00% among the total residents of Jonglo district in 1983, respectively. 2. The mean number of physician visits per person year of medicaid recipients who visited the Jonglo-Gu Health Center was 4.73 in 1981, 4.90 in 1982 and 4.41 in 1983, respectively. 3. The consultation/referral rate at the Jonglo-Gu Health Center was 2.65% in 1981, 1.77% in 1982 and 2.18% in 1983 while the rate at the department of family practice, Seoul National University Hospital was 3.18% in 1983. 4. Classifying into 17 major categories, the pattern of diseases of the poor outpatients who visited the Hallym College Medical Center both in 1981 and 1982 showed a statistically similar pattern of the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981 and 401 patients in 1983. 5. Classifying into 17 major categories, the disease of outpatient visits at the department of family practice, Seoul National University Hospital from 1st May, 1983 to 31s1 Oct., 1983 revealed statistically significant similarity with both the 5,169 medicaid patients in 1981 and the 401 patients sampled in 1983. 6. Classifying into 17 major categories, the diseases of community diagnosis at the Ihwa Dong, Jonglo-Gu also showed a statistically significant similarity with the 5,169 medicaid patients who visited the Jonglo-Gu Health Center in 1981. 7. Classifying into 17 major categories, the diseases of 5,169 medicaid patients at Jonglo-Gu Health Center in 1981 showed a statistically significant similar distribution with that of the 401 sampled medicaid patients at this center in 1983. 8. Among the medicaid patients who utilized the Jonglo-Gu Health Center in 1983, 401 sampled patients who are practicable routine urinalysis composed of 131 indigent group and 270 low-income group. The sample composed of 127 males and 274 females. There were more old patients than the young ones among the 401 sampled patients. 9. Age-adjusted prevalence rate of the hypertension computed by the direct method using estimated of midyear population of 1980 year as the standard is the highest in the Yonsei area and the lowest in the Shindongmyun. Furthermore age-adjusted prevalence rate was higher for males than that of females. 10. The group of hypertension patients using routine urinalysis profile composed of pyuria, hematuria, proteinuria and glycosuria is the most statistical significant, the pyuria alone is very significant, hematuria is significant and proteinuria is also significant.

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Awareness, Treatment, and Control Rates of Hypertension and Related Factors of Awareness among Middle Aged Adult and Elderly in Chuncheon : Hallym Aging Study(HAS) (춘천지역 중년과 노인의 고혈압 인지율, 치료율, 조절률 및 인지율 관련 요인: 한림노년연구(HAS))

  • Jeong, Jin-Young;Choi, Yong-Jun;Jang, Soong-Nang;Hong, Kyung-Soon;Choi, Young-Ho;Choi, Moon-Ki;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.4
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    • pp.305-312
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    • 2007
  • Objectives : To estimate the awareness, treatment and control rate, as well as to identify the awareness-related factors for hypertension. Methods : The study participants were 482 adults (men 206, women 276), aged 45 or over, diagnosed with hypertension and living in Chuncheon. The awareness rate was defined as the proportion of persons among those with hypertension who had previously been diagnosed by a physician. The treatment rate was defined as the proportion of persons who had used anti-hypertensive medication, among those who were aware of their hypertension. The control rate was defined as the proportion of persons who kept blood pressure normal, among those who had been treated for their hypertension. Multivariable logistic regression analysis was carried out for the awareness-related factors using SAS VER 8.1. Results : The awareness, treatment, and control rate were 55,8% (53.4% for men; 57.6% for women), 89.6% (87,2% for men; 91.2% for women), and 34.4% (28.1 % for men; 38.6% for women), respectively. The awareness-related factors included a family history of hypertension (odds ratio[OR], 5.63; 95% confidence interval[95% CI]=1.53-20.72), smoking([Ex; OR 0.38, 95% CI= 0.15-0.96)], [Current; OR 0.28, 95% CI=0.10-0.80]), and alcohol intake ([Ex; OR 3.22, 95% CI 1.03-10.09],[Current; OR 3.36, 95% CI=1.30-8.71]) for men, and education(OR 2.23, 95% CI=1.10-4.53), body mass index(OR 2.72, 95% CI=1.13-6.53), and self-rated health(OR 2.38, 95% CI=1.07-5.30) for women. Conclusions : The awareness rate of hypertension among the middle aged and elderly in Chuncheon was 55.8%. The related factors of awareness were gender specific. Further studies are needed to elucidate the putative reasons for these gender differences.