To analyze of determinants influencing the utilization of the rural health sub-centers (HSCs), 116 of 144 HSCs in Kyong Gi Do, were selected for this study. The self-administered questionnaire covering the environment and the characteristics of doctors working in the HSCs was sent to HSCs by mail. 105 questionnaires were returned of which 88 were completed and use in the study. The dependant variable was the total number of medical care visits to the HSCs from January 1, 1990 to March 31, 1990. Data was analyzed by multiple regression analysis. The results were as follows : First, the more time required to set from the HSCs to nearest hospital or clinic, the higher the utilization of the HSCs. Second, the more geographically accessible the HSCs was, the more utilization the HSCs. Third, the older of the HSCs doctors were, the more utilization of the HSCs. Fourth, the higher frequency of bus service from the HSCs to town, the more utilization of the HSCs. Fifth, the more time required from the HSCs to town, the more utilization of the HSCs. Therefore, the determinants influencing the utilization of the rural HSCs in Kyong-Gi Do, are mostly geographical accessibility of medical care.
Objectives : To investigate the prevalence and utilization pattern of complementary and alternative medicine (CAM) in individuals with type 2 diabetes. Methods : We conducted a nationwide survey and a total of 535 individuals with type 2 diabetes were asked about their demographic, diabetes-related characteristics and CAM use. We used multiple logistic regression modeling to determine independent predictors of CAM use. Results : Of the 535 subjects, 417 (77.9%) used CAM in last 12 months. The most commonly used modality was red ginseng (17.9%). CAM use was independently associated with being married, northern area residence, higher education and diabetes duration of 3-5 years. More than half(58.3%) of the CAM users used it expecting a better outcome in addition to conventional therapy. Information sources about CAM were mostly friends (36.0%) and family (31.9%), only 28.1% of diabetic patients seek counsel from medical doctors or oriental medical doctors about CAM. Many people perceived CAM as effective (62.7%) and reported side effects only rarely (1.2%). Conclusions : Many diabetic patients used CAM and found it effective, which urges clinicians to pay attention to CAM use of their diabetic patients. Also, further studies are required regarding efficacy and safety about CAM.
The purpose of this study was to find the factors affecting the bum out syndrome and its degree in terms of personal, organizational and clients characteristics, and then to find the ways to reduce or eliminate those factors. The 228 doctors and the nurses who worked at the emergency departments in 6 general hospitals with more than 700 beds in Seoul were surveyed from April 15, 2002 for 15 days. A structured self-recording questionnaire was used; the t-test and ANOVA was used to analyse the median difference between the occupation, and multiple regression was employed to find the factors affecting the bum-out syndrome. The summary of this research analysis is as follows : First, of several variables, the highest frequency of the burn-out was the emotional burn-out followed by lack in personal touch toward the patients, decrease in sense of personal achievement. These results indicate that the doctors and nurses in emergency departments experience higher degree of burn-out than the social workers and the nurses who work at other departments in heath care environment as other studies revealed. Second, the analysis of the total burn-out factors showed the lower self respect, younger age, heavier work load, higher dissatisfaction rate toward remuneration and not-so-smooth relationship with the patients and their relatives the higher burn out rate. These variables explained 54% of the total variables. Third, the nurses experienced more burn-out syndrome than the doctors. The degree of self-respect, work pattern, relationship with the clients, age and remuneration were the causes of the burn-out. The doctors recorded lack in personal touch toward the patients more, while the nurses more to emotional exhaustion. The limitations of this research are the subjective answers of the respondents to certain questions and differences in sample numbers of each hospital in which some reservation can be exercised in explaining statistical significance of the data, and generalizing the conclusion. Despite of its limitation, this research has its own merit as an unpreceded research in this field, and provision of the basic materials to prevent and find causes of the burn-out syndrome among the doctors and nurses in the emergency departments.
The concept of Myeongmun(命門) could be found in early medical texts such as "Naegyeong (內經)" and "Nan-gyeong(難經)", but the real idea about Myeongmun(命門) had mainly originated from "Nan-gyeong", in successive medical research. The concept of Myeongmun in "Nan-gyeong" could be read as an organ without form, and under the influence of Taoism theory, the concept of Myeongmun could also be understood as Danjeon(丹田). The theory about Danjeon in Taoism theory affected the concept of Myeongmun in medical theory to be closely related with the concept of Hwa(火), especially Sanghwa(相火). Through the theoretical development of Myeongmun and Sanghwa, the concept of Sanghwa could have been understood as a kind of Hwa(火) in human body, and the theoretical development like this had appeared from the time of Geumwon(金元) dynasty, when many medical doctors had experienced the Naedan(內丹) theory of Taoism. Under the influence of Taoism theory, from the time of the Geumwon dynasty to Myeong(明) dynasty, efforts to explain the concept of Myeongmun and Sanghwa in the human body made various meaningful theoretical products, which was not well-known within medical theories of ancient times. We need to recognize the differences in the understanding of the concept of Myeongmun and Sanghwa among each medical doctors, especially among those that showed opposite views. This study is based on the opinion that the difference in the understanding of the concept of Myeongmun and Sang-hwa among each medical doctors had been mainly due to the difference of understanding and analyzing the Taoism theory as the origin of the Myeongmun and Sanghwa theory in medicine. Regarding this, this study will take an overview of the successive development of Myeongmun and Sang-hwa theory in medicine, and will also look into the concept of Danjeon and Sanghwa in Taoism theory, which will allow better understanding of the progress of development of the Myeongmun and Sanghwa theory.
Objective : This study aims to investigate legal and regulatory status of traditional and complementary medicine (T&CM) focusing on regulation on health practitioners and health practice in 33 countries. Method : 33 countries were selected based on several factors such as interest of Korean medical doctors, strategic importance, and distribution over the world. The questionnaire was distributed to Korean embassies in 33 countries in March 2014 through Ministry of Foreign Affairs, and the answers from those countries were collected from April to September. 24 countries that provided sufficient information were included in the analysis. Results : 18 countries have law or regulation on T&CM. Only five countries regulate T&CM practitioners as medical personnel or health practitioner by law, and 12 countries have regulation on license or certificate. Half of 24 countries recognize license of T&CM practitioners issued abroad. There are nine countries that recognize T&CM practice as medical practice, and four of them regulate acupuncture as medical practice by western medical doctors or a few health practitioners recognized by the government. There are six countries that do not recognize T&CM practice as medical practice by law, but regulate it as practice that affect public health, and these countries have law or regulation on T&CM. Conclusion : As T&CM have great impact on public health, many countries have recently legislated law or regulation on T&CM. Rapid change in regulatory status of T&CM affects globalization of Korean medicine. Thus, development of timely strategies will be essential for it.
Objectives The purpose of this study is to provide data for development of the korean medicine (KM) clinical practice guidelines (CPG) for growth disorder (GD) by identifying the awareness and knowledge needs of KM doctors (KMD) through online survey. Methods Survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed 18 questions regarding the current status of clinical care for GD, clinician's knowledge level about GD, and other details that clinicians use during practice. The survey was conducted from January 2021 to March 2021. An online survey was conducted on 101 KMDs from the association of pediatrics of KM. Results According to the survey, 96 respondents (40.3%) said the causation of GD without growth hormone deficiency needs to be included in CPG. 96 (23.5%) of the respondents wishes to utilize percentile in diagnosis and evaluation of the growth assessment. 24.7% of the clinicians were using the herbal medicine treatment. Currently, when treating with KM for GD, herbal medicine (100%) is the most widely used, followed by acupuncture (77.6%), and moxibustion (36.7%). In terms of a complex treatment, growth therapy efficacy (26.8%) is shown to be the most important factor to consider and needed to be included in CPG for the complex treatment, and diet (22.3%) is also considered to be important in GD. Conclusions In this study, we were able to understand the clinical KMDs' perception of GD, knowledge level, and the requirements in the CPG. The results of this study will provide the basic data for development of CPG for GD.
The Purposes of this study were to understand the types of appellations used by nurses and doctors for patients in a hospital and to analyze satisfaction and reason about appellation for patient. This would enable us to provide basic data on culturally suitable appellations for admitted patients. 454 patients at K University hospital in Seoul were subjects for this study. Subjects were interviewed individually using a questionnair and frequency $X^2-test$. Results are as follows. 1. The most frequently used type of appellations in hospitals was '-ssi ; -sir' used by 88.1% of the nurses and 83.9% of the doctors. About 3 quaters of the medical staff used '-ssi' while none used job position. 2. 93.2% of the patients were satisfied with the appellations used by nurses and 93.0% of the patients were satisfied with the appellations used by the doctors 43.7% didn't think appellations were important and 44.3% thought it natural to use the appellation. The most satisfactory form of appellation used by nurses was '-ssi' to 93.3% of patients. All were satisfied with '-nim ; -sir', '-teacher' and there was no statistically significance. On the other hand, the level of satisfaction and the appellation used by doctors showed a relationship($X^2=19.72$, p=.000). Every patient was satisfied with '-nim' and '-teacher' but 19.9% were dissatisfied with the others of appellations. 3. Most patients preferred to be called '-ssi' by nurses(77.3%) and doctors(78.7%) respectively. The dominant reason being accuracy(45.8%), naturalness(33.9%) for nurses and 43.8% and 45.4% respectively for doctors. 4. The relationship between the type of appellations requested of nurses and general characteristics showed that age($X^2=83.91%$ p=.000), level of education($X^2=33.35$ p=.000), and occupation($X^2=38.22$ p=.033) were related to the type of appellation. The type of appellation requested of doctors was related to the age($X^2=72.56$ p=.000), level of education($X^2=30.01$ p=.000), and occupation($X^2$=42.90 p=.010). Generally, '-ssi' was requested of doctors and nurses, but lower age group or higher age group(over 61), those in elementary schools or elementary school graduates snd students preferred being called by their first names or grandfather, grandmother. From the results above, we can see that the most general type of appellation used for patients by the medical staff is '-ssi' and most patients were satisfied with the appellation but, the reason being that such appellations were accepted without concern. This shows that most are not adequately satisfied with the appellation. Only a small number of people use '-nim' and '-teacher' but is the preferred and frequently used types of appellation. Therfore, a continuous research of appellations used for patients with patients using '-nim' and an investigation with nurses' opinions of appellations for patients as the subject are required.
This study examined the knowledge and understanding of integrative medicine in Korea, specifically conflicts between western and oriental medicine within Parallel (Dual) health care systems. Qualitative methodology using grounded theory guided semi-structured, in-depth interviews with Western Medical Doctors (W.M.D., n = 6), Oriental Medical Doctors (O.M.D., n = 5) and Traditional Chinese Medicine Practitioners (T.C.M.P., n = 4). Thematic analysis was used to determine broad themes from the interviews. 15 professionals (W.M.D. (40%), O.M.D. (33%), T.C.M.P. (27%), 10 males (67%) and 5 females (33%), mean age 45) were interviewed, recorded, and transcribed. Thematic analysis revealed three key themes: systematic conflicts, integration and future directions. Subthemes of systematic conflicts included: credibility of Oriental Medicine, commercial imperatives, maintaining social standing of O.M.D., professional qualifications and lack structures supporting collaborative practice. Integration subthemes included lack of academic linkage and clarity for appropriate triage, opposing medical paradigms and limited social imperative. Future directions should include: social justification, guarantee of oriental medicine legitimacy, role of government and understanding of scientific evidence. To successfully integrate dual medical systems there is a need to address differences in social-environmental factors and perceptions of scientific understanding, as well as developing strong academic links in clinical practice.
Objectives : To compare the herbal ingredients of the prescriptions in 「Newly Selected Twenty-four Key Formulas applied to Tae-eumin(新定太陰人病應用要藥二十四方)」 chapter of the Shinchuk edition of the 『Donuisusebowon』 and those from the texts of the Four Great Doctors of the Jin Yuan period. Methods : The herbal ingredients of the 『Donuisusebowon』 and those from 『Huangdisuwen Xuanminglunfang(黃帝素問宣明論方)』, 『Lanshimicang(蘭室秘藏)』, 『Suwenbingji Qiyibaomingji(素問病機氣宜保命集)』, 『Shanghan Biaoben Xinfaleicui(傷寒標本心法類萃)』, 『Piweilun(脾胃論)』, 『Neiwai Shangbianhuolun(內外傷辨惑論)』, 『Shanghanzhige(傷寒直格)』, 『Shanghanxinyao(傷寒心要)』, 『Sanxiaolun(三消論)』 were entered into the database. Next, formulas which included the herbal combination pattern of Tae-eumin formula were determined. Results : Among the 27 Tae-eumin formulas including edited versions, those that showed similar pattern among those in the JinYuan texts were the following 12: Gegenjiejitang(葛根解肌湯), Reduohanshaotang(熱多寒少湯), Gegenchengqitang(葛根承氣湯), Gegentaichengqitang(葛根大承氣湯), Gegenshaochengqitang(葛根小承氣湯), Mahuangpobiaotang(麻黃發表湯), Bufeiyuantang(補肺元湯), Zaojiaodahuangtang(皂角大黃湯), Guadisan(瓜蒂散), Shexiangsan(麝香散), Shichangpuyuanzhisan(石菖蒲遠志散), Maimundongyuanzhisan(麥門冬遠志散). Conclusions : Based on the finding that 44.4% of the Shinchuk edition's Tae-eumin formula patterns could be found in the texts of the Four Masters, Dongmu's assertion that about half of the Tae-eumin formulas has been clarified by the doctors of the Song, Yuan, Ming eras could be understood as true.
Songjeol-tea is a prescription that mixes alcohol with some ingredients and Songjeol[松節], and appears only in the King-Yeongjo era throughout 『Seungjeongwon Ilgi』. King Yeongjo recognized that the Songjeol-tea was an excellent prescription for the treatment of leg diseases, and took it in various ways thanks to the title of "tea" by his officials and doctors. There were many internal conflicts as King Yeongjo taking a prescription in the form of alcohol in a situation where an official who violated it was punished after issuing prohibition of drinking alcohol, and recognized the Songjeol-tea as alcohol. The officials and doctors of King Yeongjo's reign rationalized the King's actions by creating a justification for taking the Songjeol-tea to treat the disease because the king's body was related to the safety of the state.
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