• Title/Summary/Keyword: Health behavior change

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Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Current status, perception and practicability of restaurant staffs related to reducing sodium use in Seongnam, Korea (성남 지역 외식업소의 나트륨 저감화 현황과 종사자의 저감화 실행에 대한 인식 및 실천용이도)

  • Ahn, So-Hyun;Kwon, Jong Sook;Kim, Kyungmin;Lee, Yoonna;Kim, Hye-Kyeong
    • Journal of Nutrition and Health
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    • v.52 no.5
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    • pp.475-487
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    • 2019
  • Purpose: With the increase of going out to eat, reducing the sodium in restaurant foods has a crucial impact on reducing sodium intake. This study aimed to assess the current status and perceptions of restaurant staffs related to reducing sodium use in restaurants. Methods: Restaurant managers and chefs (n = 312) in Seongnam area completed a questionnaire on the current status related to sodium use, the barriers to practice for reducing sodium use, support needs, and the practicability of methods for reducing sodium use in restaurants. Results: The percentage of restaurants in the preaction stage (including the precontemplation, contemplation, and preparation stages) for reducing sodium use was 79.7%. Logistic regression analysis showed that measuring salinity while cooking was associated with measuring seasoning (OR, 4.761; 95% CI, 2.325 ~ 9.751), action/maintenance stages of behavior change (OR, 2.829; 95% CI, 1.449 ~ 5.525) and providing salinity information of restaurant foods (OR, 6.314; 95% CI, 2.964 ~ 13.45). Maintaining taste and hindering the cooking process were the main barriers to reduce sodium use. The total practicability of actions for reducing sodium was higher in staffs who worked in restaurants that measured seasoning and salinity while cooking (p < 0.05 and p < 0.01, respectively). The hardest item to practice was 'purchase foods after comparing sodium content in the nutrition labeling'. 'Avoid serving salt-fermented foods as side dishes', 'serve small portions of kimchi and less salty kimchi', and 'put up promotional materials for reducing sodium intake' were selected as easy items to perform. The majority (82%) was willing to reduce sodium in restaurant foods under the support of local government and they desired the promotion of participating restaurants and education on cooking skills to reduce sodium. Conclusion: Measuring seasoning and salinity while cooking is a meaningful practice that is associated with stages of behavior change and the practicability of actions for reducing sodium. It is necessary to provide support and education with a gradual approach to staffs for reducing sodium in restaurant foods.

The Association Between Socioeconomic Changes and Adolescent Mental Health After COVID-19 Pandemic (코로나19이후 사회 경제적 변화와 청소년 정신건강의 연관성)

  • Kim, Hi-Ju;Kim, Min-Hyuk;Min, Seongho;Lee, Jinhee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.1
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    • pp.16-21
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    • 2022
  • Objectives : The purpose of this study is to investigate depression and suicide ideation according to socioeconomic changes after COVID-19 among Korean adolescent. Methods : Data on the study population were obtained from the 16th Korea Youth Risk Behavior Web-based Survey (KYRBS). The KYRBS is a nationally representative sample of Korean adolescents (aged 12-18 years) that originally included over 103 questions in 15 domains of health-risk behaviors. In the 16th KYRBS, a total 54,948 students from 793 schools responded to the survey. Chi-square test and logistic regression analysis were conducted regarding depression and suicide ideation. Results : This study suggests that changes in the family household before and after COVID-19 pandemic are also affecting the mental health of the adolescents. The study shows that worse change of family household is significant associations with suicidal ideation and depression. Adolescents reporting worse (AOR 1.38; 95% CI 1.38-1.57) and much worse (AOR 2.07; 95% CI 1.87-2.29) were significantly more likely to report depression. Adolescents reporting worse (AOR 1.34; 95% CI 1.34-1.60) and much worse (AOR 2.01; 95% CI 1.76-2.29) were significantly more likely to report suicide ideation. Conclusions : In this study, it was confirmed that young people from socially disadvantaged backgrounds are at high risk of suicide ideation and more depression. The results of this study suggest that we should consider improving the screening and prevention of mental health problems for adolescents with poor socioeconomic changes of COVID-19.

Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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A study on usage status of auxiliary oral hygiene devices in service workers behavior (일부 서비스 종사자들의 구강위생보조용품의 사용실태에 관한 조사 연구)

  • Kim, Myung-Eun
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.3
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    • pp.37-52
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    • 2008
  • The purpose of this study was to provide basic data for oral health promotion of service worker and their effective interpersonal relationships forming through the evaluation about service workers' awareness of the auxiliary oral hygiene devices and using behavior of it. The survey was carried out questionnaire research targeting 400(service group 200, non-service group 200) and compared the two groups. The obtained results were as follow: 1. brushing behavior showed the highest ratio of 3~4 times/day(53.4%) in brushing frequency, up-down method(50.8%) in brushing method, after 5 minutes after the meals(45.0%) in brushing time, shape brush(56.6%) in brush change time. 2. service group used a lot more auxiliary oral hygiene devices than non-service group(50.9%). the frequency of use was toothpick(30.9%), gargle(29.9%), floss(13.5%), tongue cleaner(10.1%). 3. In comparison of two group about state of use, service group showed more higher ratio of floss(66.1%), tongue cleaner(64.4%), gargle(56.6%) than non-service group. non-service group showed more higher ratio of toothpick(54.6%) than service group 4. Service group used auxiliary oral hygiene devices by suggestions of dental clinic(53.6%) and didn't use them because of uncomfortable to use(45.4%) or didn't know how to use(21.6%). 5. As result of the awareness-related using rate of auxiliary oral hygiene devices, service group showed higher using ratio except toothpick than non-service group. especially gargle(54.8%), tongue cleaner(43.3%), floss(35.8%) were showed high. 6. service group took a regular checkups more than non-service group and showed the highest ratio of each 1 year(43.5%) in checkup period.

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Effect-Evaluation on Nutrition Education in Related Curriculums for Elementary School Children -Focused on Change of Dietary Habits- (초등학생의 올바른 식습관 형성을 위한 연관교과 내 식생활교육의 효과판정 -식습관 변화를 중심으로-)

  • Her Eun-Sil;Lee Sang-Gyun;Park Hye-Jin;Lee Kyune-Hea
    • Korean Journal of Community Nutrition
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    • v.10 no.6
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    • pp.795-804
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    • 2005
  • The purpose of this study was to develop of nutritional education activities and effect evaluation in related curriculums for all Dongbu Elementary School children in Jinhae by the teacher in charge. This educational purpose was to build a desirable dietary behavior for optimal growth and health in elementary school children. The educational program contents were developed according to 1) selection of content related curriculums 2) analysis of contents related on dietary habits by grade 3) preparation teaching plans to build desirable dietary habits 4) development of teaching manual by turns. Twelve hours of nutrition education at all school classes were done from March 2 to December 10 2004 in Dongbu Elementary School in Jinhae, Gyeongnam. The education effects were evaluated through the questionnaire surveys before and after the education and their comparative analysis. The results of this study were summarized as follows : Forty percent of the underweight group, $22.8\%$ of the normal group, $42.2\%$ of the obese group had the wrong perceptions on their body figures, but after nutrition education $80.5\%$ of the underweight group, $94.3\%$ of the normal group, $97.9\%$ of the obese group gleaned the correct perceptions on their body figures (p < 0.001). As the effects of the education, the subjects who exercise more than 3 times in a week increased in all groups (p < 0.01-0.001), notably in the obese group. Meal regularity (p < 0.001) , skipping meals (p < 0.001), eating rate and snack selection patterns (p < 0.01-p < 0.001) also improved by nutrition education. We could also observe the effects of the nutrition education through the affirmative statements which appeared in their dietary records. These results showed a possibility of nutrition education activities in related curriculums to improve in dietary habits of school children. Next year, we will start with the system of nutrition teachers in elementary school, but nutrition teacher cannot undertake the task of teaching and food service management alone. Because of that, we intend to develop this program as an alternative proposal for the nutrition education in elementary schools. (Korean J Community Nutrition 10(6) $795\∼804$, 2005)

Identifying the Subjects of Nutrition Education for Junior and Senior High School Students (중.고등학생 대상 영양교육 현황 분석을 통한 영양교육 주제 도출)

  • Kang Yeo-Hwa;Yang Il-Sun;Kim Hye-Young;Lee Hae-Young
    • Journal of Nutrition and Health
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    • v.37 no.10
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    • pp.938-945
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    • 2004
  • The purposes of this study were to survey the present situation of nutrition education in junior/senior high school, to analyze the difference between the favorite subjects on students and the existing subject done by dietitians on nutrition education, and then to identify the subjects of nutritional education for junior/senior high school students. Self-administered questionnaires were given to dietitians and students and 142 of the 200 dietitians (71.0%) and 479 of the 564 students (84.9%) responded to the questionnaire on the nutritional education. According to the survey results, 76.1 % of school dietitians currently were doing nutrition education for students while the other 23.9% didn't have such education programs even though they recognized the necessity strongly. The target of nutrition education was student rather than parents or teacher generally and the principal measuring method for nutrition education effect was change of plate waste and leftover'. It was found that significant difference in the collector and source of nutritional education information between junior and senior high school dietitians (p< .05) . About ninety-eight percentage of dietitians felt that nutrition education should keep pace with meal service and this meant that almost respondent recognized the necessity of nutrition education for students. Because the most serious one among operational problems of nutrition education program was lack of enough time owing to too many affairs as dietitian, junior and senior high schools should support so that dietitians would share enough time for nutrition education. And also, a gap was existed between actual and favorite subjects on nutrition education. Significant differences existed in the following subjects; 'basic concept of food and nutrition', 'disease and nutrition', 'food culture in the world', 'cooking and culinary art', 'food of the 24 divisions of the year in the lunar calendar', 'food waste and environmental issue', 'food habit and food behavior', 'exercise and nutrition' (p< .001) 'table manner', 'food and individual sanitation', 'recommended dietary allowance' (p < .01) and 'menu planning' (p< .05) .Finally, 24 subjects of nutritional education were selected based on the survey results. These subjects would be expected to be able to contribute the effective and interesting nutrition education program for junior and senior high school students.

The Effects of Treadmill Exercise on Inhibition of Soleus Muscle Atrophy and Improvement Functional Recovery after Spinal Cord Contusion in the Rats (척수타박손상 후 트레드밀운동이 근 위축지연과 기능적 회복에 미치는 효과)

  • Oh, Myung-Jin;Jang, Moon-Nyeo;Seo, Tae-Beom;Kim, Jong-Oh;Byun, Jae-Jong;Yoon, Jin-Hwan;Jeong, Il-Gyu
    • Journal of Life Science
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    • v.19 no.11
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    • pp.1651-1657
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    • 2009
  • Physical activity and exercise can promote sensorimotor recovery from central nerve injury. It has been suggested that the functional recovery promoted by exercise training after spinal cord injury might be associated with insulin-like growth factor-I in the inflicted muscle. To investigate morphological and biochemical change of the soleus muscle after spinal cord injury, all tissues were used for H&E, immunofluorescence staining and Western blot. Also, BBB-test was used to evaluate behavioral improvement after spinal cord contusion. Thirty male Sprague-Dawley rats ($230{\pm}10\;g$; 7week in age) were assigned equally to three different groups; Normal (n=10), SCI (n=10), SCI+TMT (n=10). Every rat in SCI and SCI+TMT groups underwent laminectomy at T9 level and then contusion on the exposed spinal cord site in anesthetized condition. After one week-recovery from contusion, every rat in the SCI+TMT group exercised on a motorized treadmill for 30min/d, 5d/wk for 7wks. TMT followed by injury increased IGF-I induction levels in the soleus muscle and inhibited muscle atrophy. Behavioral scales for 4 and 8 weeks after spinal cord injury were improved in the SCI+TMT group compared to the SCI group. These results suggest that treadmill exercise after spinal cord injury might promote functional recovery along with muscle regrowth through the up-regulation of IGF-1 in muscle tissue.

The Development and Implementation of Problem-Based Learning Package in Physical Therapy (물리치료학에서의 PBL 학습교재 개발 및 적용)

  • Hwang, Hyun-Sook;Chung, Jin-Woo;Lim, Jong-Soo
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.83-94
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    • 2002
  • Within physical therapy education, there has been increased attention to curricula and course that emphasize problem solving, clinical reasoning, and synthesis of information across traditional discipline-specific boundaries. This article describes the development implementation, and outcomes of a problem-based learning course in Physical therapy. The course was designed to help students to integrate the various elements of a physical therapy curriculum and to enhance their abilities to respond to an ever-changing health care environment. An evaluation of the course by the first 50 students who completed it revealed both strengths and weaknesses. Students responded that the course enhanced their professional behavior, including interpersonal communication skills, team work, and follow-through with professional responsibilities. The learning package was developed by the authors and implemented to a college students during three weeks of the first semester of 2001. Most studies which conducted PBL module development were short period or temporary PBL package application and evaluation rather than a whole semester's. While, this study carried on partial integrated PBL curriculum development and application with recomposing content of the two subjects to one subject Physical therapy which includes four PBL packages. This package was developed from a simple concept to complex and partial integrated PBL curriculum application systematically variable learning methods such as discussion, practice, lecture, video. There are 2 classes, each class has 25 students, in the college. Each class has 5 small groups consisting 5 students. Two tutors proceeded discussion charging each class also, they used multiple methods and materials like tutorials, self-directed learning, lecture, and video. The package is 5 grades and 5 hours per week and the rate of discussion, lecture is 4, 1 respectively. One of the most change is the increase of interaction between students and tutors. Whenever students need information and suggestion, they can visit tutors who provide reading materials and guide for the direction of self learning. Therefore, this study describes the PBL package development process and application during one semester recomposing contents of two subjects to Physical therapy concepts. Besides, it will contribute to active application of existing each subject to tutors who intend to convert as PBL methods. The study has significant meaning to show potentiality of partially integrated PBL application, using systematic PBL package development from two subjects contents. However, when students' need of yearning is over the extent of Introduction of Physical therapy and Rehabilitation medicine, tutors should set learning extent. So, there is limitation to attain completely integrated PBL education within one subject, therefore, it is high lighted to proceed development of integrated curriculum to maximize learning effects of PBL. It is exected that partial integrated PBL package development and application will distribute to prosper excellent physiotherapist in practice.

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The strategic behaviors of incumbent pharmacy groups in the retail market of pharmaceuticals in response to the entry trials by the online platform firms delivering medicines - A perspective of market entry deference model in game theory (온라인 의약품배송플랫폼기업의 시장 진입 시도에 대한 기존 의약품 공급자의 전략적 행동 - 게임이론의 시장진입 저지 모형 관점)

  • Lee, Jaehee
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.4
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    • pp.303-311
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    • 2022
  • Recently the telemedicine platform firms which have been temporarily permitted since COVID-19 outbreak have increasingly provided online prescription drugs delivery, causing concerns among incumbent providers of medicine, some of whom began to take aggressive actions again them. In this study, using game theoretic market entry - deterrence model, we show that although the incumbent medicine provider can effectively deter entry by the telemedicine platform firms by its preemptive action, accommodation could be a optimal action when telemedicine platform firms already have penetrated the market with their being permitted to do business due to the COVID-19. However, for the incumbent to cooperate for the successful change in the retail market for medicines, policies like placing a ceiling on the maximum number of taking prescriptions by the pharmacists a day in the telemedince platform network, providing favorable exposure of community pharmacists on the telemedicine platform user interface, and allowing community pharmacies to participate as shareholders of the telemedicine platform firms in its initial public opening of capital, are suggested.