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In Search of "Excess Competition" (과당경쟁(過當競爭)과 정부규제(政府規制))

  • Nam, II-chong;Kim, Jong-seok
    • KDI Journal of Economic Policy
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    • v.13 no.4
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    • pp.31-57
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    • 1991
  • Korean firms of all sizes, from virtually every industry, have used and are using the term "excessive competition" to describe the state of their industry and to call for government interventions. Moreover, the Korean government has frequently responded to such calls in various ways favorable to the firms, such as controlling entry, curbing capacity investments, or allowing collusion. Despite such interventions' impact on the overall efficiency on the Korean economy as well as on the wealth distribution among diverse groups of economic agents, the term "excessive competition", the basis for the interventions, has so far escaped rigorous scrutiny. The objective of this paper is to clarify the notion of "excessive competition" and "over-investment" which usually accompanies "excessive competition", and to examine the circumstances under which they might occur. We first survey the cases where the terms are most widely used and proceed to examine those cases to determine if competition is indeed excessive, and if so, what causes "excessive competition". Our main concern deals with the case in which the firms must make investment decisions that involve large sunk costs while facing uncertain demand. In order to analyze this case, we developed a two period model of capacity precommitment and the ensuing competition. In the first period, oligopolistic firms make capacity investments that are irreversible. Demand is uncertain in period 1 and only the distribution is known. Thus, firms must make investment decisions under uncertainty. In the second period, demand is realized, and the firms compete with quantity under realized demand and capacity constraints. In the above setting, we find that there is "no over-investment," en ante, and there is "no excessive competition," ex post. As measured by the information available in period 1, expected return from investment of a firm is non-negative, overall industry capacity does not exceed the socially optimal level, and competition in the second period yields an outcome that gives each operating firm a non-negative second period profit. Thus, neither "excessive competition" nor "over-investment" is possible. This result will generally hold true if there is no externality and if the industry is not a natural monopoly. We also extend this result by examining a model in which the government is an active participant in the game with a well defined preference. Analysis of this model shows that over-investment arises if the government cannot credibly precommit itself to non-intervention when ex post idle capacity occurs, due to socio-political reasons. Firms invest in capacities that exceed socially optimal levels in this case because they correctly expect that the government will find it optimal for itself to intervene once over-investment and ensuing financial problems for the firms occur. Such planned over-investment and ensuing government intervention are the generic problems under the current system. These problems are expected to be repeated in many industries in years to come, causing a significant loss of welfare in the long run. As a remedy to this problem, we recommend a non-intervention policy by the government which creates and utilizes uncertainty. Based upon an argument which is essentially the same as that of Kreps and Wilson in the context of a chain-store game, we show that maintaining a consistent non-intervention policy will deter a planned over-investment by firms in the long run. We believe that the results obtained in this paper has a direct bearing on the public policies relating to many industries including the petrochemical industry that is currently in the center of heated debates.

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Development of Education Materials for Healthy Consumption of Milk in a Card News Format for Korean Adults (성인의 바른 우유 섭취를 위한 카드뉴스 형식의 교육자료 개발)

  • Kim, Sun Hyo
    • Journal of Korean Home Economics Education Association
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    • v.32 no.3
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    • pp.97-110
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    • 2020
  • The purpose of this study is to develop milk education materials for adults based on the scientific basis of right milk consumption in the format of card news that can be easily accessed on a mobile phone or the internet and has high impact. The topics to be included in the card news were selected based on the findings from literature analysis and focus group interviews with 10 adults(32.0±6.4 years). For the eight selected topics, effective communication was made by suggesting some information that users want to know while reflecting adult eating habits, lifestyle habits, and nutrition and health interests. The card news draft was reviewed by researcher and consulting experts, and then questionnaire survey was conducted using Likert 5-point scales by 50 adults(42.7±10.2 years). Based on the results of the review, consultation and questionnaire survey, a final draft of the card news consisting of 11 cuts was completed. Card news proposal is expected to produce educational effects, since the respondents showed high satisfaction with the card news (higher than 4 on the 5-point scales) according to the questionnaire survey. Adults can easily access and use the card news developed in this study, and thus this card news is expected to increase milk consumption in adulthood and improve nutrition and health through friendly and systematic milk education.

Root Uptake of $^{54}Mn,\;^{60}Co,\;^{85}Sr\;and\;^{137}Cs$ Deposited at Different Times during the Growing Season of Rice (벼 재배 기간중 침적시기에 따른 Root Uptake of $^{54}Mn,\;^{60}Co,\;^{85}Sr,\;^{137}Cs$의 뿌리흡수)

  • Choi, Yong-Ho;Jo, Jae-Seong;Lee, Chang-Woo;Hong, Kwang-Hee;Lee, Jeong-Ho
    • Journal of Radiation Protection and Research
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    • v.20 no.4
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    • pp.255-263
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    • 1995
  • Root uptakes of $^{54}Mn,\;^{60}Co,\;^{85}Sr\;and\;^{137}Cs$ by rice were studied through a greenhouse experiment in which the upper 20 cm of the culture box was filled with an acidic loamy-sandy soil and a mixed solution of the radionuclides was applied to the surface water on the soil 2 days before, and 5 different times after, transplanting. Percent uptakes of the radionuclides to rice tops varied $3.4{\sim}13.7%,\;0.03{\sim}0.1%,\;0.6{\sim}1.5%,\;0.02{\sim}0.15%$, respectively, with application time. Among radionuclides, soil-to-plant transfer factors decreased, on the whole, in the order of $^{54}Mn>^{85}Sr>^{60}Co{\geq}^{137}Cs$, and among plant parts, in the order of straw > chaff > hulled seed. Transfer factors $(m^2/kg-dry)$ in hulled seed were, depending on application time, $1.2{\times}10^3{\sim}5.0{{\times}10^3\;for\;^{54}Mn,\;1.6{\times}10^5{\sim}2.6{\times}10^4\;for\;^{60}Co,\;1.1{\times}10^4{\sim}7.6{\times}10^4\;for\;^{85}Sr\;and\;5.2{\times}10^5{\sim}7.0{\times}10^4\;for\;^{137}Cs$. The highest factors of all the radionuclides in straw came from the application at 67 days after transplanting while those of $^{54}Mn,\;^{60}Co\;and\;^{85}Sr$ in hulled seed appeared at later applications. The data from this studv can be referred to in assessing the radiological impact of an accidental contamination during the rice growth.

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THE POSSIBLE IMPACT OF EUROPEAN COMMUNITY AIR TRANSPORT POLICY ON AVIATION INDUSTRY IN ASIA (EC항공운송정책(航空運送政策)이 아시아 항공산업(航空産業)에 미치는 영향(影響))

  • Cheng, Chia Jui
    • The Korean Journal of Air & Space Law and Policy
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    • v.4
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    • pp.167-176
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    • 1992
  • 1957년에 서명된 로마조약(條約)을 처음 개정한 단일(單一)유럽법(法)이 1987년 7월 1일에 발효(發效)되었을 때 유럽공동체(共同體) 12개 회원국(會員國)들은 공동정책(共同政策)에 의거 상업(商業), 농업(農業), 운송(運送), 금융(金融) 및 기타 관련부분에 있어 단일역내시장(單一域內市場)을 형성하기로 약속했다. 물론 완전한 역내공동시장(域內共同市場)은 자유로운 운송시장(運送市場)을 전제로 한다. 따라서 EC조약(條約)은 모든 회원국(會員國)들이 서어비스의 자유에 근거하여 공동운송정책(共同運送政策)을 따를 것을 강제하고 있다. 항공운송(航空運送)에 있어서의 목표도 역시 다른 모든 경제활동의 목표와 마찬가지로 로마조약(條約)이 적용되는 공동운송정책(共同運送政策)의 일부를 구성하고 있다. 종합적인 공동체항공정책(共同體航空政策)의 작업에는 운임(運賃), 공급량(供給量), 시장진출(市場進出) 및 경쟁상(競爭上)의 일괄적인 자유화 조치 이상의 것을 내포하고 있다. 그것은 국가장벽으로 방해되지 않는 공동체(共同體)의 항공운송망(航空運送網)의 개발과 확장뿐만 아니라 경제(經濟), 안전(安全), 환경(環境) 및 사회적(社會的) 요인(要因)들 간에 합리적인 균형을 이루는 공동체항공운송정책(共同體航空運送政策)의 개발을 위한 공동항공운송정책(共同航空運送政策)의 공식화(公式化)를 요한다. 1987년의 항공(航空)에 관한 일괄입법조치, 1989년의 제 2 차 항공(航空)에 관한 일괄입법조치 및 1992년 이후로 예정된 제 3 차 일괄입법조치에 따라 EC는 초국가적(超國家的)인 항공운송(航空運送) 분야에 있어서의 개방적인 국제경쟁(國際競爭)을 본격적으로 추구하고 있다. 결국 이러한 일괄규칙은 EC와 제(第) 3 국(國)들간의 관계에 중대한 의미를 가지게 될 것이다. EC항공운송정책(航空運送政策)이 아시아 항공산업(航空産業)의 상업운선(商業運船)에 어떠한 영향을 미칠 것인가는 모든 아시아 국가들이 알아야 할 중요한 문제이다. 이론적으로 말해서, 역내공동체(域內共同體) 항공운송(航空運送)의 자유화는 아시아 국가들에 대한 치외법권적(治外法權的) 효과를 일으킬 수 있는 로마조약(條約)과 유럽사법재판소(司法裁判所)에 의해 형성된 원칙들에 필연적으로 영향을 미칠 것이다. 이와 관련하여 아시아 항공산업(航空産業)은 무차별원칙(無差別原則), 설립(設立)의 자유(自由), 서어비스의 자유(自由) 및 EEC 경쟁법(競爭法)과 같은 제(第) 3 국(國)의 국제항공운송에 영향을 미치는 일련의 새로운 원칙과 법률의 출현에 큰 관심을 갖고 있다. 실무적인 관점에서, 1992년 이후의 종합적인 공동체항공운송정책(共同體航空運送政策)의 작업에는 항공운화(航空運貨), 시장진출(市場進出), 제(第)3 및 제(第)4의 운륜자유권(運輪自由權), 복수지정(複數指定), 제(第)5의 자유(自由), 캐보타지(cabotage), 손상(損傷)(derogation), 공급량(供給量), 편수(便數), 불정기운항(不定期運航) 및 기타 부문항공기소음(部門航空機騷音), 최저(最低) 안전(安全) 및 사회적(社會的) 조치(措置), 항공종사자면허(航空從事者免許), 감항증명(堪航證明), 운항시간제도(運航時間制度), 컴퓨터 예약제도(豫約制度), 탑승거절보상의 공동최저기준(共同最低基準), 공중혼잡(空中混雜), 공항이착륙시간할당법(空港離着陸時間割當法), 공항시설(空港施設), 정부지원(政府支援 등). 이와 같은 모든 공동체항공운송정책(共同體航空運送政策)의 주요문제들은 아시아 항공산업(航空産業)에 여러 각도로 영향을 미치게 될 것이다. 위와 같은 문제들 가운데, 제(第) 3국(國) 항공사(航空社)들의 역내공동체(域內共同體) 항로(航路)의 접근, 공급량(供給量), 운임(運賃), 제(第)5의 자유(自由) 및 캐보타지가 아시아 항공산업(航空産業)에 관심이 큰 문제가 되고 있다. 아시아 항공사(航空社)들의 EEC시장(市場)에로의 상업운항(商業運航)이 다소 영향을 받게 될 것이다. 첫째, 복수(複數) 목적지(目的地) 문제이다. 둘째, 항공(航空)서어비스의 운임(運賃) 및 료솔(料率)문제이다. 셋째, 항공운송구역(航空運送區域)에서의 사업에 대한 경쟁원칙의 적용 문제이다. 넷째, 제(第)5 자유(自由) 운륜권(運輪權) 문제이다. 다섯째, 캐보타지(cabotage)문제이다. 끝으로, 유럽 항공사(航空社)들간의 합병(合倂)의 문제이다. 결론적으로 유럽공동체항공운송(共同體航空運送)의 자유화는 1993년까지 공동체(共同體) 역내(域內)와 역외(域外)의 항공운송법제(航空運送法制)의 현재의 모습을 극적으로 바꾸어 놓을 정도로 가속화(加速化)되고 있다. 한편 항공운송(航空運送)의 자유화(自由化)에 대한 EC의 제의는 대담하고 급진적이다. 반면에 그것이 아시아 항공산업(航空産業)에 미칠 영향 또한 중대하다. 의심할 여지없이 항공사(航空社)와 고객들의 이익면에서 EEC와 비(非)EEC국가들의 항공운송산업(航空運送産業)에서 더욱 경제적으로 경쟁적이 되도록 할 필요가 있다. 전세계 항공운송산업(航空運送産業) 운영(運營)의 대부분을 정부가 소유하거나 통제하는 것은 정말로 국제항공운송(國際航空運送)의 발전에 불필요한 장애를 일으킨다. 따라서 國內航空社와 전세계 항공사(航空社)들간의 이해관계의 조화를 협상하는 것이 중요하다. 아마도 아시아 항공사(航空社)들간의 지역적 협조가 미국(美國)뿐만 아니라 유럽으로 부터의 압력 증가에 대해 균형을 이루는 힘이 될 수 있을 것이다.

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Fatty Acid Compositions of Fats in Commercial Coffee Creamers and Instant Coffee Mixes and Their Sensory Characteristics (국내 유통되는 커피 크리머와 커피믹스에 함유된 지방의 지방산 조성 및 관능적 특성)

  • Lee, Bom-Ee;Lee, Hee-Jae;Cho, Eun-Ae;Hwang, Keum-Taek
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.3
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    • pp.362-368
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    • 2012
  • This study examined the fatty acid compositions of the fats extracted from 14 commercial coffee creamers and 11 instant coffee mixes, and evaluated the sensory characteristics of the coffees using different coffee creamers. The fat content in the 14 coffee creamers and 11 coffee mixes was 15~28% and 8~14%, respectively. The fats in 12 coffee creamers consisted of 34~45% lauric, 15~19% myristic and 10~18% palmitic acids. The fats in the other 2 coffee creamers consisted of 43% palmitic, 39% oleic and 10% linoleic acids. The fatty acids of the fats in the 11 coffee mixes were almost all saturated with lauric acid being the most abundant (44~45%). Coconut oil or palm kernel oil might have been used to manufacture the 12 coffee creamers and 11 coffee mixes, which had a higher lauric acid content. Palm oil (PO) might be a fat source for the other 2 coffee creamers. The sensory characteristics of five coffee mixes were evaluated based on their fatty acid compositions. The coffees with the creamers, which had a higher lauric acid content, were significantly more acceptable than those with a higher palmitic acid (p<0.05). The sensory evaluation of the coffees made with the creamers composed of hydrogenated coconut oil (HCO) and PO at different ratios showed that the acceptability increased with increasing HCO content. This suggests that PO may have a negative impact on the sensory characteristics.

Spatio-temporal Variations in the Dynamics and Export of Large Wood in Korean Mountain Streams (우리나라 산지계류에 있어서 유목 동태의 시.공간적 다양성과 그에 따른 유출 특성)

  • Seo, Jung Il;Chun, Kun Woo;Kim, Suk Woo;Im, Sangjun
    • Journal of Korean Society of Forest Science
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    • v.101 no.3
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    • pp.333-343
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    • 2012
  • In-stream large wood (LW) has a critical impact on the geomorphic characteristics relevant to ecosystem management and disaster prevention, yet relatively little is known about variations in its dynamics and subsequent export on the watershed-scale perspective in Korea. Here we review variations in the dynamics and subsequent export of LW as a function of stream size, which is appropriate for Korean mountain streams. In upstream channels with narrow bankfull widths and low stream discharges, a massive amount of LW, resulting from forest dynamics and hillslope processes, may persist for several decades on valley floor. These pieces, however, are eventually transported during infrequent debris flows from small tributaries, as well as peak hydrology in main-stem channels. During the transport, these pieces suffer fragmentation caused by frictions with boulders, and stream bank and bed. Although infrequent, these events can be dominant processes in the export of significant amounts of LW from upstream channel networks. In downstream channels with wide bankfull widths and high stream discharges, LW is dominantly recruited by forest dynamics and bank erosion only at locations where the channel is adjacent to mature riparian forests. With the LW pieces that are supplied from the upstream, these pieces are continuously transported downstream during rainfall events. This leads to further fragmentation of the LW pieces, which increases their transportability. With decreasing stream-bed slope, these floated LW pieces, however, can be stored and form logjams at various depositional sites, which were developed by interaction between channel forms and floodplains. These pieces may decay for decades and be subsequently transported as particulate or dissolved organic materials, resulting in the limitation of LW fluvial export from the systems. However, in Korea, such depositional sites were developed in the extremely limited streams with a large dimension and no flood history for decades, and thus it does not be expected that the reduction of LW export amount, which can be caused by the long-term storage. Our review presents a generalized view of LW processing and is relevant to ecosystem management and disaster prevention for Korean mountain streams.

Experimental Study for the Development of the Mixing Ratio as a Compaction Pile (다짐말뚝 재료로서 쇄석과 저회의 적정 혼합비 도출을 위한 실험적 연구)

  • Leem, Hansoo;Kim, Sunkon;Lee, Jooho;Chun, Byungsik
    • Journal of the Korean GEO-environmental Society
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    • v.13 no.9
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    • pp.5-16
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    • 2012
  • In the case of using the soil materials created by cutting in-situ ground directly without adjusting particle size, it is recommendable to seek the compaction property or material constant required for filling design or density control through indoor test, and many studies on this subject have been carried out during that time. The researches conducted during that time, however, were focused on the mixed materials with different diameters that exist in a natural condition. There has been no study conducted using coal fly ash that is by-product of the thermal power plant that is actively considered as the building materials. Therefore, this study was aimed at implementing compaction test and examining the basic engineering property in order to explore the influence of crushing the particles through compacting the admixture of crushed stone and coal fly ash produced from thermal power plant on its engineering property, and then the impact of the admixture volume of each material on compaction property and material property by conducting the One-Dimensional Compression Test. As result of compaction test, the optimum moisture ratio of coal fly ash was shown to be approx. 23%. As result of compaction test in accordance with the mixed ratio of coal fly ash and crushed stone under the same compaction energy and moisture ratio, dry unit weight tended to drop when the mixed ratio of coal fly ash exceeded 30%, while it reached approx. $1.81gf/cm^3$ when the mixed ratio was 30%. As result of One-Dimensional Compression Test in accordance with the mixed ratio of crushed stone and coal fly ash, the change in void ratio by particle crushing was at the highest level in the case of coal fly ash 100%, while the lowest level in the case of crushed stone 100%. In the case of mixed materials of crushed stone and coal fly ash, compression index was at the lowest level in case of coal fly ash 30%, and therefore this ratio of mixed material was judged to be the most stable from an engineering aspect.

A study on the process of spatial reduction of cotton culture in Korea since 1945 (해방 이후 우리나라 면작농업 소멸의 지역적 전개과정)

  • ;Kim, Kihyuk
    • Journal of the Korean Geographical Society
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    • v.29 no.3
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    • pp.318-339
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    • 1994
  • U.S. had given large amount of cotton to Korea as food aid program since 1945. This cotton aid had negative impact on cotton culture in Korean agriculture. Korean government used counterparts funds (sale proceeds of food aid) not for investment to agriculture sector, but for military budgets. And food aid on program type had influenced general economic policies, which neglected agricultural sector too. Anti-agricultural policy which was helped by U.S. food aid, had caused cotton cultivator an economic loss. So this economic loss had made many farmers abandon cotton culture. But in our times, cotton is cultivated for the purpose of domestic consumption in a few rural villages. The purposes of this study are 1) to analyze the process of spatial reduction of cotton culture since 1945 in regional contexts in Korea, and 2) to identify the function and meaning of cotton culture which does not pay off in agricultural region. Materials for acreage of cotton culture are acquired through the agricultural statistical year book(1952-1989) and census. To clarify the meanings of cotton culture, field survey are conducted in a rural village which is identified as only one where cotton was cultivated in 1993. In these contexts, this study has come to the following conclusions. In the period of under the rule of Japanese Imperialism (1910-1945), G. arboreum, species of cotton which was traditionally cultivated since 1364, had been driven out. And G. hirustun species, which is suitable for the production of highly qualified textile, has been hierarchically diffused by policy. In these period, regional structure of Korean agriculture was reorganized for the provision with food to Japan. Crops leading this dependent spatial structure were rice and cotton. So agricultural region, specialized with cotton, were distributed in the hinterland of the area which is specialized with rice. U.S. cotton aid to Korea began in 1947. U.S. took an interest in agricultural export because of her domestic surplus of cotton. Cotton aid is one mechanism by which U.S government developed agricultural market in recipient countries, Specially in the exchange rates, up-valuation of won to the U.S. dollars made domestic cotton more expensive than cotton imported, Production cost of domestic cotton is higher than Government's purchasing price of cotton which was also more expensive than price of cotton imported. Korean farmer could not help abandoning the cultivation of cotton, and this gave rise to spatial reduction of cotton culture. Spatially, cotton culture was abandoned in early stage of reduction in regions where stand at a disadvantage climatically, and in next stage in regions where other up-land crops which paid off in urban market, eg, fruits, could be cultivated. In the stage of extinction, cotton was cultivated only in area where G. hirustun species was originated in Korean peninsula. This region is not only suitable climatically for cotton culture, but is far away from urban market. Use of cotton produced is not for spinning, but for fillings of comforter. The main purpose of cotton culture in rural village is not for cotton yields, but for increase of production of seasame, which is grown together with cotton as mixed crops. Cotton product are used for domestic consumption and sold out to gin house. Though cotton culture is not paid off, farmer wanted to cultivate continuously for the cultural purpose, and they wanted the cotton culture promotion policy with the goverment subsidy.

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Review of Production, Husbandry and Sustainability of Free-range Pig Production Systems

  • Miao, Z.H.;Glatz, P.C.;Ru, Y.J.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.11
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    • pp.1615-1634
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    • 2004
  • A review was undertaken to obtain information on the sustainability of pig free-range production systems including the management, performance and health of pigs in the system. Modern outdoor rearing systems requires simple portable and flexible housing with low cost fencing. Local pig breeds and outdoor-adapted breeds for certain environment are generally more suitable for free-range systems. Free-range farms should be located in a low rainfall area and paddocks should be relatively flat, with light topsoil overlying free-draining subsoil with the absence of sharp stones that can cause foot damage. Huts or shelters are crucial for protecting pigs from direct sun burn and heat stress, especially when shade from trees and other facilities is not available. Pigs commonly graze on strip pastures and are rotated between paddocks. The zones of thermal comfort for the sow and piglet differ markedly; between 12-22$^{\circ}C$ for the sow and 30-37$^{\circ}C$ for piglets. Offering wallows for free-range pigs meets their behavioural requirements, and also overcomes the effects of high ambient temperatures on feed intake. Pigs can increase their evaporative heat loss via an increase in the proportion of wet skin by using a wallow, or through water drips and spray. Mud from wallows can also coat the skin of pigs, preventing sunburn. Under grazing conditions, it is difficult to control the fibre intake of pigs although a high energy, low fibre diet can be used. In some countries outdoor sows are fitted with nose rings to prevent them from uprooting the grass. This reduces nutrient leaching of the land due to less rooting. In general, free-range pigs have a higher mortality compared to intensively housed pigs. Many factors can contribute to the death of the piglet including crushing, disease, heat stress and poor nutrition. With successful management, free-range pigs can have similar production to door pigs, although the growth rate of the litters is affected by season. Piglets grow quicker indoors during the cold season compared to outdoor systems. Pigs reared outdoors show calmer behaviour. Aggressive interactions during feeding are lower compared to indoor pigs while outdoor sows are more active than indoor sows. Outdoor pigs have a higher parasite burden, which increases the nutrient requirement for maintenance and reduces their feed utilization efficiency. Parasite infections in free-range pigs also risks the image of free-range pork as a clean and safe product. Diseases can be controlled to a certain degree by grazing management. Frequent rotation is required although most farmers are keeping their pigs for a longer period before rotating. The concept of using pasture species to minimise nematode infections in grazing pigs looks promising. Plants that can be grown locally and used as part of the normal feeding regime are most likely to be acceptable to farmers, particularly organic farmers. However, one of the key concerns from the public for free-range pig production system is the impact on the environment. In the past, the pigs were held in the same paddock at a high stocking rate, which resulted in damage to the vegetation, nutrient loading in the soil, nitrate leaching and gas emission. To avoid this, outdoor pigs should be integrated in the cropping pasture system, the stock should be mobile and stocking rate related to the amount of feed given to the animals.

Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.