Objectives: The purpose of this study was to evaluate the feeling of distance of social work practitioners for people living with HIV/AIDS(PLWHA) and to identify related factors. Methods: A total of 409 data were collected as convenience sampling from social welfare service providers. Independent variables were socio-demographic data, AIDS related knowledge, authoritarian personality, prejudice for minority(handicapped, women, foreigner, old aged), cultural competency. Data were analyzed by t-test, ANOVA, multiple regression analysis were conducted. Results: Multiple regression model was developed by integrating the significant variables from univariate analysis. Significant factors of physical distance were social prejudice against handicapped, knowledge about AIDS and critical awareness/knowledge about other culture. And significant factors of social distance were social prejudice against handicapped, knowledge about AIDS, authoritarian personality, critical awareness/knowledge about other culture. At last, we found that social prejudice against handicapped was the biggest factor for physical distance and authoritarian personality was the biggest factor for social distance of social work practitioners. Conclusions: The area of social services for PLWHA have to be expanded. Physical and social distance of professionals to provide services to PLWHA and factors affecting it is necessary to continue research. In addition, on the basis of these findings, specific training programs is need to be developed.
Purpose: To find out whether the self-care ability measurement used for visiting health care provide an appropriate standard to select service methods using a Delphi survey and to offer basic data that can improve the measurement. Method: A Delphi survey was done with 39 people consisting of theoretical professionals, field managers, and practitioners engaged in visiting health care. Result: It was found that items and weighted points in the currently used self-care ability measurement needed adjustment. Therefore, a modified evaluation standard was presented by domains, items and detailed items. Finally, the self-care ability measurement is composed of 4 domains, 11 items and 19 detailed items. Conclusion: This study is significant in that it presented an evaluation standard applicable directly to business practice by supplementing problems in the existing self-care ability measurement. This study suggests the need to develop various measurements for elderly households based on community.
Objectives: This study aims to investigate the psychological factors associated with abstention following a smoking cessation program, and to suggest useful information for those who want to stop . smoking and health practitioners who help them Methods: Participants were 73 smokers (65 males, 8 females) that participated in a hospitalized smoking cessation program, whose mean age was 44.89 (SD=9.61). Participants completed questionnaires and psychological tests including: Demographic sheet, Eysenck's Personality Questionnaire, Multidimensional Coping Scale, Fagerstrom Test for Nicotine Dependence, and Jerusalem and Schwarzer's Self-Efficacy Scale. To identify whether the subjects abstained or not and to encourage them to abstain, the researcher called them on the telephone once a week for three months. After three months, they were contacted every other week till six months passed since they had left the smoking cessation program Tthey were THEN contacted once a month for another six months. The data was analyzed by using ANCOVAs with SPSS 10.0 for Windows. Results: 42 (57.5%) out of 73 abstained for one month and 26 (35.6%) abstained for one year. People who failed to abstain within a month showed a higher psychoticism and introversion personality trait than those who abstained for one month, while people who abstained for one month were coping actively in most situations, showed a higher self-efficacy and lower nicotine dependence than those who failed to abstain within a month, and people who failed to abstain within a year showed a higher psychoticism than those who abstained for one year. While people who abstained for one year were coping actively, obstinate, and interpreting positively most situations, they showed a higher self-efficacy than those who failed to abstain within a year. Conclusion: These findings reiterate the roles of personality, self-esteem, nicotine dependence in smoking and suggest the roles for smoking cessation. And it was found the roles of coping styles ,in smoking cessation. It might help smokers who want to stop smoking and health practitioners who help them
The purpose of this study was to evaluate the program for the control of acute respiratory infections(ARI) in children in a Korean rural area(Yonchon county). Evaluating the program, we focused on the pattern of prescription and appropriateness of antibiotics prescribed by the health personnel who had participated in the ARI Control Program. It was implemented at the primary health care setting in rural area, such as district hospital, health subcenters, and health posts. During six-months programme monitoring period, medical records were reviewed and collected data were analysed by the pediatrician, research coordinator of this study. The baseline data were collected from medical records of the same period(six months) of one year before the implementation of the ARI programme. The study results were as follow : 1. Common cold was the most prevalent disease(78.7%. 594 cases) among the all ARI cases (755 cases). The less frequent cases were bronchitis(11.9%), acute pharyngitis(5.2%), and pneumonia(1.8%). 2. Significant reduction in the use of antibiotics was observed after the programme implementation. Ninety three(15.7%) of 594 common cold cases were received antibiotics compared with 282(35.2%) of 802 in the baseline period. In the cases of bronchitis and acute pharyngitis, the reduction rates were 15.1% and 23.2% respectively compared to the baseline period. 3. Mean duration of antibiotics prescription was 1.81-1.75 days, similar to the baseline data. 4. The appropriateness rate of antibiotics prescriptions were 84.3%(common cold), 35.6% (bronchitis) and 28.2%(acute pharyngitis). In the case of pneumonia, the antibiotics prescription was compatible to the criteria developed. 5. Pediatrician prescribed antibiotics more appropriately for all cases than general practitioners in health sub-center, and nurse practitioners in health posts. 6. Antibiotics therapy was shown to be of no effect in the treatment of the all ARI cases. At the 5 and 10 days check-up of common cold cases after visits, proportion of improved patients were 58.3% in the antibiotics-used group and 51.4% in the control group. In the other cases of ARI, the patterns of response were similar to common cold. None of the differences in outcome between the antibiotics-used and control group was statistically significant. This ARI programme may have substantial a substantial impact on antibiotics use at the public health institutions(district hospital, health subcenters, health posts) which are of major domain for primary health care in Korean rural areas.
Recent changes in the health care environment have directed increasing attention to the number and specialty mix of practicing physicians. A major concern identified in Korean health care system is the serious oversupply of specialists and a relative lack of primary care physicians. Currently only 21% of Korean physicians are primary care physicians(general practitioners and family physicians), and less than 10% of recent medical school graduates are choosing to enter primary care. More primary care physicians are needed to deal with major problems in the current health care system, such as cost and access. The infrastructure that relies on primary care physicians is needed to deliver cost-effective and efficient care. To achieve a better balance of primary care to non-primary care physicians. more medical students need to choose careers in one of the primary care specialties(family medicine. internal medicine and pediatrics). This paper suggests the necessity of reforming the Korean graduate medical education system, that is, establishing the path of training primary care physicians in internal medicine and pediatrics residency training programs.
Traditional, complementary, and alternative medicine(CAM) constitutes a major source of health care in developing countries. Its therapies, products and practices are increasing used in industrialized countries, typically by around 50% of the population. However, controls on the provider of CAM services and supply and promotion of complementary medicines are weak in these countries. These trends evoke important public health questions relating to benefits and detriments, safety and quality from medical, financial, and social perspectives. In the western counties, investment in research is increasing, and some guideline is now available for ensuring their quality, efficacy, and safety according to the criteria of evidence-based medicine as legally demanded. National policies and legislation are being developed in many countries and often include partnerships between biomedical and traditional health practitioners. The purposes of the study were to review the policies on CAM, to examine the responses of the government to cope with use of CAM in industrialized countries. Lastly, some implications and recommendation are suggested.
Objectives: The purpose of this study is to examine and explain the extent of income-related inequity in health care utilization and expenditures to compare the extent in 2005 and 2010 in Korea. Methods: We employed the concentration indices and the horizontal inequity index proposed by Wagstaff and van Doorslaer based on one- and two-part models. This study was conducted using data from the 2005 and 2010 Korean National Health and Nutrition Examination Survey. We examined health care utilization and expenditures for different types of health care providers, including health centers, physician clinics, hospitals, general hospitals, dental care, and licensed traditional medical practitioners. Results: The results show the equitable distribution of overall health care utilization with pro-poor tendencies and modest pro-rich inequity in the amount of medical expenditures in 2010. For the decomposition analysis, non-need variables such as income, education, private insurance, and occupational status have contributed considerably to pro-rich inequality in health care over the period between 2005 and 2010. Conclusions: We found that health care utilization in Korea in 2010 was fairly equitable, but the poor still have some barriers to accessing primary care and continuing to receive medical care.
Purpose: The purpose of this study was to identify health promotion services in rural areas and factors influencing this service. Method: From March to April, 2007, a structured questionnaire on services in 2006 was used to collect data from community health practitioners in all of the Primary Health Care Posts (PHCP) in North Chungchong Province. Collected data were analyzed using SPSS 12.0 Win program. Results: The most frequently offered programs were health gymnastics, walking exercise, bathing and vaccination service, and hypertension management. The main obstacles to these health services were lack of adequate space, insufficient budget, and overwork. The most frequently offered health education programs were education on hypertension, exercise, diabetes, volunteer work, and smoking cessation. The main obstacles to health education were lack of adequate space, insufficient education materials and equipment, and lack of cooperation from the citizens. Improvement and reinforcement of health promotion programs should include support of specialist, development of appropriate methods of service delivery, and education materials, and increase ease in using community resources. Conclusions: The research results show that a new model of health promotion must be developed for efficient health promotion programs in rural PHCP.
A study on analysis of daily activities and time allocations of Community health Practitioners(CHP) and Community Health Aids(CHA) who assigned to Ocku Demonstration Health Project of the Korean Health Development Institute was conducted for one week from 3rd through 8th December 1979. The purpose of this study was to determine the efficacy including productivity of the community Health Workers developed by KHDI for rural areas. Five Community Health Practitioners and eight Community Health Aids were selected for the studies and their activities and time allocations were measured by designed format for one week. The following are the summary of the findings. 1. The mean age of the CHPs was 34.4 years with standard deviation 4.8 years, while that of CHAs was 26.9 years with standard deviation 3.1 years. 2. On educational background, all of the CHPs were graduated from Junior Nursing College, six CHAs were from high school and the rest of them from middle school. 3. On marital status, all CHPs were married, meanwhile four CHAs were married and the rest of them were single. 4. On service duration in public health fields, all of the CHPs have worked for less than three years, meanwhile five CHAs for 5 to 9 years and one CHA for more than 10 years. 5. Only one CHP lives in the myon where she works, and the rest of them live in other areas. Three CHAs live in the same myon where they work, and five live in other areas. 6. On types of work, the CHPs have worked on technical areas for 3.6 hours per day and on supportive and administrative activities for 2.7 hours and other activities for 1.8 hours on average. 7. The CHAs have spent 2.9 hours a day on technical activities, 4.2 hours on supportive and administrative activities and 1.6 hours on other activities in terms of time spent on average. 8. The average hours per day spent by CHPs on functional areas were 2.2 hours for clinic activities, 13.7 minutes for maternal health, 30.1 minutes for infant and child health, 13.4 minutes for family planning, 1.1 hours for supporting activities and 1.7 hours for administrative affairs. 9. The average hours per day spent by CHAs on functional areas were 4.1 hours for administrative affairs, 2.6 hours for supportive activities and only 2.9 for maternal health, infant and child health an family planning, and other technical works. 10. The average time spent by CHPs on clinical works were 1.0 minutes for history takings on disease, 2.6 minutes for physical examinations, 1.1 minutes for measurements, 3.8 minutes for administration of medications, 1.5 minutes for educations and 0.9 minutes for others. 11. On the average 92.8 percent of whole working hours of CHPs were spent in the substations, meanwhile 70.4 percent of CHAs were spent in the substations. 12. 17.8 percent of field working hours of CHAs were spent on the roal for their transportations. 13. The average time for unit service performance by CHPs were 10.9 minutes on clinical case, 18.1 minutes on maternal health, 14.8 minutes on infant and child health, 20.5 minutes on family planning and 29.9 minutes on tuberculosis control. 14. The average time for unit service performance by CHAs were 19.4 minutes on clinical work, 19.9 minutes on maternal health, 20.1 minutes on infant and child health, 17.2 minutes on family planning, 22.2 minutes on tuberculosis control.
During the month of October, 1990, 676 practicing physicians in Taegu City were surveyed by mail questionnaires about their general characteristics and the reasons why they chose Taegu as a practice location and 331 out of them responded completely. Collected data were analyzed to provide basic reference data for future health manpower policy which intends to solve the problem of geographical maldistribution of physicians, The major findings are as follows: For the question asking why Taegu area is favored, following lists are as the order of their magnitude of the reasons replied by more than 20% of the respondents: 1) Taegu is a foundation of life until now(81.3%) 2) Better educational environments are available for their offsprings(73.7%) 3) They can have intimate relationship with acquaintances or friends sharing same or similar interests(61.0%) 4) Due to characteristics of their specialty, metropolitan seems to fit better(52.0%), 5) They graduated from the medical school in Taegu(49.8%) 6) Never thought of selecting practice location in other area than Taegu without any specific reasons(45.9%) 7) Intelligent communications are available with other physicians(39.9%) 8) More opportunities to participate in social life, such as medical, or alumni association etc., can be given(33.2%) 9) No specific knowledge or relationships with other area are available(32.6%) 10) They finished internship or residency training in Taegu area(31.4%) 11) Facilitation of transferring patients including emergent patients can be obtained (30.8%) 12) Continuing medical educational programs are available(29.9%) 13) Sufficient medical demands are provided because of the large population(28.1%) 14) More chances to be grown up as a medical professionals can be achieved(25.7%) 15) More leizure time can be utilized for cultural activities(23.9%) 16) They had experiences to work in hospitals or facilities in Taegu area(23.3%) 17) Medical facilities of fellow physicians or alumni can be used(20.5%) In addition, 37% of female physicians answered that their spouse strongly influenced them to choose Taegu, and 33.3% of physicians with age of thirty replied that parents did so. Physicians of specialty in radiology, clinical pathology, anatomical pathology, and anesthesiology considered that patients from other hospitals and medical facilities would be referred often to them and that less competition seemed to be expected in their specialty (30.8%). In contrast, general practitioners anticipated that larger population would increase the medical demand(62.5%). 28.6% of medical practitioners who graduated medical schools in other are than Taegu and 22.0% of medical practitioners who were trained in hospitals of other area than Taegu were influenced to choose Taegu by their spouses. In consideration of above findings, we may conclude that long term and rational manpower policies should be implemented to solve the problem of geographical maldistribution of physicians as well as short term physician-inducing policies, and they have to be incorporated with equitable community development.
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