• Title/Summary/Keyword: Health care surveys

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Challenges in fibromyalgia diagnosis: from meaning of symptoms to fibromyalgia labeling

  • Bidari, Ali;Parsa, Banafsheh Ghavidel;Ghalehbaghi, Babak
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.147-154
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    • 2018
  • Fibromyalgia (FM) is a contested illness with ill-defined boundaries. There is no clearly defined cut-point that separates FM from non-FM. Diagnosis of FM has been faced with several challenges that occur, including patients' health care-seeking behavior, symptoms recognition, and FM labeling by physicians. This review focuses on important but less visible factors that have a profound influence on under- or over-diagnosis of FM. FM shows different phenotypes and disease expression in patients and even in one patient over time. Psychosocial and cultural factors seem to be a contemporary ferment in FM which play a major role in physician diagnosis even more than having severe symptom levels in FM patients. Although the FM criteria are the only current methods which can be used for classification of FM patients in surveys, research, and clinical settings, there are several key pieces missing in the fibromyalgia diagnostic puzzle, such as invalidation, psychosocial factors, and heterogeneous disease expression. Regarding the complex nature of FM, as well as the arbitrary and illusory constructs of the existing FM criteria, FM diagnosis frequently fails to provide a clinical diagnosis fit to reality. A physicians' judgment, obtained in real communicative environments with patients, beyond the existing constructional scores, seems the only reliable way for more valid diagnoses. It plays a pivotal role in the meaning and conceptualization of symptoms and psychosocial factors, making diagnoses and labeling of FM. It is better to see FM as a whole, not as a medical specialty or constructional scores.

Survey on the Treatment of Postherpetic Neuralgia in Korea: Multicenter Study of 1,414 Patients

  • Nahm, Francis Sahngun;Kim, Sang Hun;Kim, Hong Soon;Shin, Jin Woo;Yoo, Sie Hyeon;Yoon, Myung Ha;Lee, Doo Ik;Lee, Youn Woo;Lee, Jun Hak;Jeon, Young Hoon;Jo, Dae Hyun
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.21-26
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    • 2013
  • Background: Postherpetic neuralgia (PHN) is a serious complication resulting from herpes zoster infections, and it can impair the quality of life. In order to relieve pain from PHN, various treatments, including pharmacological and interventional methods have been used. However, little information on the recommendations for the interventional treatment of PHN, along with a lack of nation-wide surveys on the current status of PHN treatment exists. This multicenter study is the first survey on the treatment status of PHN in Korea. Methods: Retrospective chart reviews were conducted on the entire patients who visited the pain clinics of 11 teaching hospitals from January to December of 2011. Co-morbid disease, affected site of PHN, routes to pain clinic visits, parenteral/topical medications for treatment, drugs used for nerve block, types and frequency of nerve blocks were investigated. Results: A total of 1,414 patients' medical records were reviewed. The most commonly affected site was the thoracic area. The anticonvulsants and interlaminar epidural blocks were the most frequently used pharmacological and interventional methods for PHN treatment. For the interval of epidural block, intervals of 5 or more-weeks were the most popular. The proportion of PHN patients who get information from the mass media or the internet was only 0.8%.The incidence of suspected zoster sine herpete was only 0.1%. Conclusions: The treatment methods for PHN vary among hospitals. The establishment of treatment recommendation for PHN treatment is necessary. In addition, public relations activities are required in order to inform the patients of PHN treatments by pain clinicians.

Effects of Oral Health Education for Occupational Health Nurses (산업간호사를 대상으로 한 구강보건교육의 효과 평가)

  • Lee, Hyo-Jin;Paik, Dai-Il
    • Journal of dental hygiene science
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    • v.16 no.1
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    • pp.77-83
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    • 2016
  • The purpose of this study was to evaluate effects of oral health education for occupational health nurses. The subjects were 300 occupational health nurses which participated in continuing education of Korean Association of Occupational Health Nurses. Oral health education contents consisted of basic knowledge about oral health, prevention of periodontal disease, oral health care for workers, and oral health program for workers. In order to evaluate the effects of oral health education, we performed questionnaire surveys before and after the education regarding their perceived oral health status and concern for oral health, knowledge about prevention of periodontal disease, attitude about oral health promotion, and needs for implementation of oral health promotion program. The data were analyzed by paired t-test to compare the change of knowledge and attitude according to the education. Linear regression analysis was carried out to assess the factors related to the improvement of their knowledge and attitude. The findings indicated that oral health knowledge and attitude of occupational health nurses were significantly improved by oral health education. A factor of the improvement of knowledge and attitude was concern for oral health. And they would like to be provided primarily oral health education for occupational health nurses. Finally, this study suggested that oral health education for occupational health nurses had significantly effects on improving oral health knowledge and attitude.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Research on the status of children's dental health following mothers' dental health knowledge and behavior (일부 어머니의 구강보건지식 및 행태에 따른 자녀의 구강건강상태에 관한 연구)

  • Kwun, Hyeon-Sook;Lee, Eun-Gyeong;Cho, Gab-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.4
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    • pp.670-684
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    • 2009
  • Objectives : This research analyzed the general characteristics that closely affect the children's dental health and the mothers' dental health knowledge and dental health behavior to identify the correlation of the latter with the status of children's dental health in order to provide the basic data for the development of dental health business that would target children. Methods : Research subjects were selected arbitrarily from three nursery schools located in Busan metropolitan city, targeting 186 children between the ages of four to six and their mothers. The children were subjected to dental Inspection, and the status of their dental caries was studied whereas the mothers were subjected to the surveys on the general characteristics, dental health knowledge and dental health behavior. Results : 1. Level of mothers' dental health knowledge is higher when the mothers' educational level is higher(p=0.02) and when the household's monthly income is higher(p=0.009). 2. When the level of mothers' dental health knowledge is higher, children tended to brush their toothbrushing using proper method(p=0.025). Moreover, when the level of mothers' dental health knowledge is higher, they tended to take their children to dental clinic mostly for preventive measures than for treating cavity(p=0.023). 3. When the level of mothers' dental health knowledge is higher, children's dmft index was significantly low(p=0.02). When the mothers use fluoride-containing toothpaste, children's children' dmft index was even lower(p=0.02). 4. As the children tended to brush their teeth more often, dmft index was lower(p=0.003). When the reason that the children visited dental clinic was more to prevent, than to treat cavity, dmft index was even lower(p=0.000) Conclusions : When the above mentioned results are summarized, it is possible to know that the mothers' dental health knowledge and dental health behavior significantly affect children's dental health. Accordingly, it is necessary to develop maternal and child dental health program that factors in both the mothers and children in order to prevent children's dental caries and to increase their dental health, and continued care is required to discover and treat dental caries early on.

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Development of Performance Indicators in Public Health Center Based Home Healthcare (방문보건사업 평가지표 개발)

  • Chang, Hyun-Sook;Lee, Tae-Bum;Nam, So-Young;Chin, Young-Ran
    • Health Policy and Management
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    • v.16 no.4
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    • pp.112-127
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    • 2006
  • The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

A Study on the Prediction Model of the Elderly Depression

  • SEO, Beom-Seok;SUH, Eung-Kyo;KIM, Tae-Hyeong
    • The Journal of Industrial Distribution & Business
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    • v.11 no.7
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    • pp.29-40
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    • 2020
  • Purpose: In modern society, many urban problems are occurring, such as aging, hollowing out old city centers and polarization within cities. In this study, we intend to apply big data and machine learning methodologies to predict depression symptoms in the elderly population early on, thus contributing to solving the problem of elderly depression. Research design, data and methodology: Machine learning techniques used random forest and analyzed the correlation between CES-D10 and other variables, which are widely used worldwide, to estimate important variables. Dependent variables were set up as two variables that distinguish normal/depression from moderate/severe depression, and a total of 106 independent variables were included, including subjective health conditions, cognitive abilities, and daily life quality surveys, as well as the objective characteristics of the elderly as well as the subjective health, health, employment, household background, income, consumption, assets, subjective expectations, and quality of life surveys. Results: Studies have shown that satisfaction with residential areas and quality of life and cognitive ability scores have important effects in classifying elderly depression, satisfaction with living quality and economic conditions, and number of outpatient care in living areas and clinics have been important variables. In addition, the results of a random forest performance evaluation, the accuracy of classification model that classify whether elderly depression or not was 86.3%, the sensitivity 79.5%, and the specificity 93.3%. And the accuracy of classification model the degree of elderly depression was 86.1%, sensitivity 93.9% and specificity 74.7%. Conclusions: In this study, the important variables of the estimated predictive model were identified using the random forest technique and the study was conducted with a focus on the predictive performance itself. Although there are limitations in research, such as the lack of clear criteria for the classification of depression levels and the failure to reflect variables other than KLoSA data, it is expected that if additional variables are secured in the future and high-performance predictive models are estimated and utilized through various machine learning techniques, it will be able to consider ways to improve the quality of life of senior citizens through early detection of depression and thus help them make public policy decisions.

Nutritional status of 3~5 year old children attending kindergarten and childcare facilities: Using data from the 2010 and 2014 Korea National Health and Nutrition Examination Surveys (유치원 및 보육시설 이용 3~5세 원아들의 영양상태 : 2010, 2014년 국민건강영양 조사 자료 이용)

  • Park, Mi Yeon;Park, Pil Sook
    • Journal of Nutrition and Health
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    • v.50 no.4
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    • pp.361-375
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    • 2017
  • Purpose: The purpose of this study was to investigate the nutritional status of 3~5 year old children attending kindergarten and childcare facilities in 2010 and 2014. Methods: Data were obtained from the 2010 and 2014 Korea National Health and Nutrition Examination Surveys (KNHANES) and included 509 subjects aged 3~5 years old attending kindergarten and childcare facilities. Results: In 2014, rate of skipping meals by children was 16.2%, an increase of 5.5% compared with the rate of skipping meals by children in 2010. Calcium intake in 2014 was 397.41 mg at 3 years old, 419.27 mg at 4 years old, and 414.01 mg at 5 years old. For the mean nutrient adequacy ratio (MAR) of subjects in 2010 and 2014, MAR at 3 years old (0.86) was significantly lower than those at 4 and 5 years old (0.90, 0.91) (p < 0.01). In 2010 and 2014, EAR intake at 3 years old (2.72) was significantly higher than those at 4 years old (2.14) and 5 years olds (1.92) (p < 0.01). Conclusion: As a result, compared with 2010 before establishment of the Children's foodservice management center, there was no improvement in the polarization of nutrient intake of children in 2014. Therefore, researchers believe that a continuous monitoring system developed by nutrition experts and children's foodservice management center are needed to improve the nutritional status of children. Of children between the ages of 3~5 years old, those with intakes under EAR were mostly 3 years old. Therefore, researchers suggest that the infant age group of KDRIs, which is classified as 1~2 years old and 3~5 years old, needs to be reestablished considering the growth and development of infants.

A Study on the Relationships of Oral Status and Self-perceived Oral Health Status in Elderly (일부 노인의 구강내 상태와 자가인지 구강건강상태와의 관련성)

  • Park, Jong-Hee
    • Journal of Technologic Dentistry
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    • v.35 no.2
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    • pp.145-155
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    • 2013
  • Purpose: The recent proliferation of the aging population, oral health care is closely related to the mental health of the elderly is very important being recognized. Provide basic data for improving the quality of life for the elderly, to determine whether the oral health of the elderly whether oral self-perception of health and any related wish. Methods: Surveys to May 20 from April 15, 2011, subjects were elderly and living in Daejeon and Chungnam 277 people were examined. All the statistics using SPSS 18.0 for the determination of statistical significance, and the significance level was 0.05. Results: 1. Recognized, the most common oral health, self-aware bad the state (46.2%) there was no significant difference in the general characteristics according to self-Oral health status, remaining natural dimensions or the intra-oral prosthetic, there was no significant difference. More teeth, residual phase, in accordance with intra-oral prosthetic mandibular Not all dentures, partial dentures, full dentures net self-perception of oral health status better recognized. 2. According to the type of partial dentures, oral health status self-phase, mixed mandibular removable, fixed, fixed, removable partial dentures in order to recognize that good oral health, self-aware state, showed between them, there was no significant difference. 3. Of variable dimension that has nothing to do with the remaining natural maxillary and mandibular prosthetic maxillary prosthetic mandibular partial dentures, age income, a positive correlation was negatively correlated. The case of the mandible, the mandibular prosthetic mandibular partial denture, maxillary prosthetic, the amount of income were correlated. 4. Intra-oral Prosthetics correlation variables in the maxillary, mandibular prosthesis, the positive correlation between income, age was negatively correlated, if the income of the mandible. Maxillary partial denture has nothing to do with the variable portion of the mandibular denture, age was a negative correlation was found. Conclusion: Satisfaction and how now it is important simply to live as long, but you need to pay attention to the quality of life, sometimes with an aging population and the increase of soybean To buy the loss of teeth causes the typical health problems of the elderly. Elderly people of any relevant oral health and the oral cavity by the state to determine whether to provide the basic data for oral health education was more residual value, intra-oral prosthetics there is no more self-aware, the oral health status is good to recognize that appeared. Strengthen the oral health education to improve the quality of life of the elderly, and is thought to be necessary to increase the number of residual.

A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development (국내 근거기반 임상간호실무지침 주제의 우선순위 결정)

  • Gu, Mee Ock;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Eun, Young;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.