• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.165-172
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• 2013

A noncommunicable disease (NCD) is a medical condition or disease that is by definition non-infectious and non-transmissible among people. Currently, NCDs are the leading causes of death and disease burden worldwide. The four main types of NCDs, including cardiovascular disease, cancer, chronic lung disease, and diabetes, result in more than 30 million deaths annually. To reduce the burden of NCDs on global health, current public health actions stress the importance of preventing, detecting, and correcting modifiable risk factors; controlling major modifiable risk factors has been shown to effectively reduce NCD mortality. The World Health Organization's World Health Report 2002 identified tobacco use, alcohol consumption, overweight, physical inactivity, high blood pressure, and high cholesterol as the most important risk factors for NCDs. Accordingly, the present report set out to review the prevalence and trends of these modifiable risk factors in the Korean population. Over the past few decades, we observed significant risk factor modifications of improved blood pressure control and decreased smoking rate. However, hypertension and cigarette smoking remained the most contributable factors of NCDs in the Korean population. Moreover, other major modifiable risk factors show no improvement or even worsened. The current status and trends in major modifiable risk factors reinforce the importance of prevention, detection, and treatment of risk factors in reducing the burden of NCDs on individuals and society.

• 의료법학
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• 제17권2호
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• pp.57-81
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• 2016

환자가 의사를 상대로 의료사고에 대한 민사책임을 추궁하기 위하여 소송을 제기하게 될 때, 의사의 의료과실과 환자에게 발생한 손해 사이에 인과관계가 존재하는지 여부는 소송의 승패를 좌우한다. 의료과실소송에서는 의료가 지니는 특수성으로 인하여 다른 민사사건과 달리 인과관계의 존부의 판단이 쉽지 않다. 또한 의료과실소송에서는 진료기록을 비롯한 정보가 의사에게 집중되어 있고, 환자의 의료지식은 의사에 비하여 상대적으로 부족하다. 따라서 원고인 환자가 부담하는 인과관계에 관한 증명책임의 완화가 판례를 통하여 인정되고 있다. 이에 본고에서는 우리나라에서 의료민사책임에서 인과관계를 어떻게 인정하는지에 관한 법리를 살펴보고자 한다. 그리고 우리나라 판례의 태도를 인과관계가 문제되는 유형별 - 일반적 의료행위의 경우, 설명의무의 경우, 의료과실과의 인과관계가 없는 경우 - 로 나누어 고찰하기로 한다.

• Korean Journal of Radiology
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• 제25권9호
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• pp.788-797
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• 2024

Objective: To investigate the potential association among preoperative breast MRI features, axillary nodal burden (ANB), and disease-free survival (DFS) in patients with early-stage breast cancer. Materials and Methods: We retrospectively reviewed 297 patients with early-stage breast cancer (cT1-2N0M0) who underwent preoperative MRI between December 2016 and December 2018. Based on the number of positive axillary lymph nodes (LNs) determined by postoperative pathology, the patients were divided into high nodal burden (HNB; ≥3 positive LNs) and non-HNB (<3 positive LNs) groups. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors associated with ANB. Predictive efficacy was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Univariable and multivariable Cox proportional hazards regression analyses were performed to determine preoperative features associated with DFS. Results: We included 47 and 250 patients in the HNB and non-HNB groups, respectively. Multivariable logistic regression analysis revealed that multifocality/multicentricity (adjusted odds ratio [OR] = 3.905, 95% confidence interval [CI]: 1.685-9.051, P = 0.001) and peritumoral edema (adjusted OR = 3.734, 95% CI: 1.644-8.479, P = 0.002) were independent risk factors for HNB. Combined peritumoral edema and ultifocality/multicentricity achieved an AUC of 0.760 (95% CI: 0.707-0.807) for predicting HNB, with a sensitivity and specificity of 83.0% and 63.2%, respectively. During the median follow-up period of 45 months (range, 5-61 months), 26 cases (8.75%) of breast cancer recurrence were observed. Multivariable Cox proportional hazards regression analysis indicated that younger age (adjusted hazard ratio [HR] = 3.166, 95% CI: 1.200-8.352, P = 0.021), larger tumor size (adjusted HR = 4.370, 95% CI: 1.671-11.428, P = 0.002), and multifocality/multicentricity (adjusted HR = 5.059, 95% CI: 2.166-11.818, P < 0.001) were independently associated with DFS. Conclusion: Preoperative breast MRI features may be associated with ANB and DFS in patients with early-stage breast cancer.

• 지역사회간호학회지
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• 제15권2호
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• pp.308-322
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• 2004

Purpose: 'The purpose of the present study was to understand students' experiences from their standpoint, to identify relevant variables and to examine into their relations by analyzing and describing what phenomenon 'nursing students' visiting ambulatory bathing service' is, what are the reasons for the phenomenon, and what interactions are in the phenomenon. Method: The subjects were thirteen students. Data were collected through in-depth interviews and analyzed by Strauss and Corbin's analysis method. Result: With regard to ambulatory bathing service, participants responded 'lack of education', 'inexperienced personal relations' and 'disappointment with recipients families'. They recognized 'burden' and 'compassion'. The intensity of generated 'burden' and 'compassion' was determined by volunteering persons, the degree of health care service, recipients' response and interaction of climate. When 'burden' and 'compassion' were generated, participants selected their own coping strategies. Strategies in the situation of 'burden' and 'compassion' were significantly influenced by 'burden' and 'compassion' and structural situation - 'mutual relation structure,' 'volunteers' capability,' 'the degree of volunteering guidance,' 'community participation,' 'recipients' environment,' 'information sharing,' 'special vehicle equipment' and 'economical burden.' Strategies include' service training,' 'receiving volunteering training,' 'preliminary service preparation,' 'volunteering.' 'connection to local medical center,' 'intention,' 'information sharing,' 'passive response to recipients' appreciation' and 'the understanding of publicity'. The results of selected 'burden' and 'compassion' are described with 'worthiness' and 'cohesion' as follows. Conclusion: This study is significantly meaningful in that it examined bathing service welfare in its initial stage. There are not much outcome from previous studies. However. it is meaningful that this study intended to develop theories on the nature of experiences and the relations among concepts derived from the visiting ambulatory bathing service process of nursing students. Professors who taught social volunteering in universities understood the experience of nursing students who did the visiting ambulatory bathing service. Consequently, professors will provide an effective instruction to enable these students to carry out visiting ambulatory bathing services efficiently in order to meet demands when they conduct the services. For the volunteering service activity in major-related fields among college students' social volunteering activities, they recognized the necessity of systematic education and preparation.

• 여성건강간호학회지
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• 제3권2호
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• pp.180-191
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• 1997

When women are removed with their matrix which is a emotionally significant organ of symbol in psychologically adapting themselves to mother and woman, that is threatened and injured with woman role decisively. The nursing for women with hysterectomy is limited to medical treatment and the nursing related to troubles in psychology, emotion they experience in general situation due to operations is hardly realized. New basis for nursing can be realized when we both have relation with lived human experience related th health and become to be a part of it. We need to catch their experience due to the loss of matrix to understand women with hysterectomy. The subjects of the study were nine patients who were admitted to a gynecological ward of a hospital in Seoul, suffering from vaginal bleeding, back pain, abdominal pain and so on and diagnosing as non-cancer. The data were collected from April to May 1997 by listening to the subjects' expression of their experience and by participant observation of the subjects' reactions. A tape-recorder was used under the permission of the subjects, to prevent the loss of spoken information. The result of the study was as follows : The data on burden content from the interview were categorized as psych-emotional, physical, personal interaction, financial burden and maternal role burden. The factors which have influence on the burden of the subjects are an offer of information, support system, age, occupation, economic situation, family history, character, season, the existence of ovary and religion. In conclusion, since we ascertained that the nursing in the process of recovery decide the quality of life, though women with hysterectomy undergo various burden experience and adapt to it in the end, it is necessary to give them enough information and educate husband, having on important effect on the burden experience, to be a good supporter. And technically skilled nurses of consultant are thought to be able to contrive better qualitative life of women with hysterectomy as an important bridge between the subjects and their required information, since the nurses have their well-formed position of relationship of confidence through continuous contact with patients and their family.

• 성인간호학회지
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• 제24권6호
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• pp.615-626
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• 2012

Purpose: The purpose of this study was to investigate caregiver burden and health related quality of life (HRQoL) among male spouses who cared for partners with a stroke. Methods: The subjects were spouses of 121 female patients who visited the neurology outpatients department in one tertiary hospital located in Seoul between February and April in 2011. Results: The mean age of the male caregivers was $71.25{\pm}5.51$ years. The mean score of caregiver's burden was moderate ($63.28{\pm}9.85$). The average reported caregiving time was $58.48{\pm}5.51$ min/day with the male spouses spending more time in house-working than with caregiving activities. The reported depression and care giving time, plus the cognitive status and functional dependencies of the spouse were significantly related to male caregiver's burden. The mean scores of 'physical health' and 'mental health' for quality of life for the male caregivers was moderate (47.49 and 47.33 respectively). Overall, caregiver's burden has a negative effect on the HRQoL of male spouses. Conclusion: Caregiver's burden and HRQoL are important problems which are in need of nurses' attention. It is suggested that intervention programs for male spouses be developed with a focus on emotional and social support as well as education about the caregiving role.

• 대한간호학회지
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• 제37권2호
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• pp.242-248
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• 2007

Purpose. Parkinson's disease (PD) is a common neurodegenerative disorder characterized by motor disabilities and increasing dependence on others for daily life activities with consequent impact on patients' and caregivers' quality of life. The aim of this study was to elucidate the burden on primary caregivers of patients with PD, and identify related factors. Methods. A cross-sectional descriptive study. Seventy-six primary caregivers of PD patients in a neurology out-patient clinic, Seoul, Korea completed structured questionnaires, of which 68 were analyzed. The structured self-report questionnaire included (1) demographic information on the caregivers, (2) information regarding the disease characteristics of the patients, and (3) the subjective and objective caregiver burdens as assessed on Montgomery, Gonyea, & Hooyman's scale. Results. The mean age of the caregivers was 54.56 years, and spouses represented the largest proportion (47.0%). Caregivers of PD patients experienced high levels of burden (mean scores on the subjective and objective burdens were 45.22 and 34.90, respectively), which were comparable to the caregiver burdens in stroke, and higher than the caregiver burdens in general chronic disease. Older caregivers and spousal caregivers experienced significantly higher burdens (p=.004 and p=.019, respectively). A greater motor disability and higher modified Hoehn and Yahr grade were related to higher caregiver burden (p=.001 and p=.018, respectively). Conclusion. Caring for PD patients is associated with a high level of caregiver burden. Therefore, healthcare professionals should identify the burden of caregivers who look after PD patients and develop comprehensive management strategies both for patients and their caregivers.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.3954-3962
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• 2015

연구목적: 본 연구에서는 말기암환자 가족원의 부담감과 삶의 질 정도와 그들 사이의 관계를 조사하였다. 연구방법: 말기암환자 가족원 80명에게 부담감 및 삶의 질을 조사하였고 SPSS 19.0 program을 이용하여 분석하였다. 연구결과: 말기암환자 가족원의 부담감은 연령, 결혼, 환자와의 관계, 환자와의 동거 유무 및 의료비 부담에 따라, 삶의 질은 연령, 결혼, 교육 수준, 환자와의 관계 및 환자와의 동거 유무에 따라 각각 통계적으로 유의한 차이가 있었다(p<.05). 말기암환자 가족원의 부담감과 삶의 질(r=-.538, p<.001)은 음의 상관관계가 확인되었다. 결론: 이러한 결과는 말기암환자 가족원들에게 많은 관심을 기울여야 함을 시사하고, 말기암환자 가족원의 삶의 질을 증진시키기 위해서는 부담감을 줄일 수 있는 지지 프로그램과 같은 중재 방안들을 모색할 필요가 있겠다.

• 동의신경정신과학회지
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• 제26권3호
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• pp.211-224
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• 2015

Objectives: This study aimed to investigate gender differences in the Korean Medical Community. Methods: Participants in the research study included 90 students regularly attending the fourth grade in Korean Medicine College, of which 48 were male and 42 were female. Results: 1. Patient's preferences for female KMD (Korean Medicine Doctor) had the lowest response rate in Korean Medical Society. Preferences for male KMD were due to factors including comfort level, rationality, good training, and patient's preference. 2. Patient's preferences for female KMD had the highest response rate in Gynecology, and Pediatrics. On the other hand, patient's preferences for female KMD had the lowest response rate in the other 7 specialty subjects. 3. The reasons for gender discrimination against male KMD were lack of subtlety, lack of empathy, authoritative attitude, and lack of patient management skills. The reasons for gender discrimination, against female KMD were childcare burden, social prejudices, lack of physical strength, and housekeeping burdens. Conclusions: The study results indicated that there was a lower preference for female KMD than male KMD among the Korean Medical Society and in patients' consciousness. Male-centered culture of Korean Medical Society had no role in this finding, but masculine image for KMD jobs and work-family double burden for female KMD were important contributing factors.

• Journal of Nutrition and Health
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• 제51권2호
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• pp.140-152
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• 2018

식품알레르기는 알레르기 행진의 시작 단계로 원인 식품의 섭취 제한으로 인하여 성장기 아동의 영양 불균형과 아동을 비롯한 가족구성원의 삶의 질을 저하시키는 원인이 될 수 있다. 이에 본 연구는 2세 이상의 영유아 및 학령기 식품알레르기 아동의 주양육자인 어머니를 대상으로 자녀의 식품알레르기로 인한 양육부담을 정량화하여 자녀의 식품알레르기가 부모의 삶의 질에 미치는 영향을 분석하고자 하였다. 식품알레르기 아동 부모의 양육부담은 정서적 고충, 일상생활 제약에 대한 2개의 하부 요인으로 세분화되며, 자녀의 연령 증가, 섭취 제한 식품의 수, 일부 알레르기질환 진단 여부가 양육부담의 감소 및 증가에 유의한 영향을 미치는 것으로 분석되었다. 이처럼 식품알레르기 아동은 식품알레르기가 다른 알레르기질환으로 이행되지 않도록 전문 의료진에 의한 진단과 증상관리가 필수적이며, 환아를 비롯한 가족 구성원에 대한 주변의 지지와 간호 중재가 동반되어야 한다. 또한 성장기의 식품알레르기 아동은 식품 항원에 대한 식품경구유발시험 등의 정확한 임상 진단을 통해 필수 영양소를 포함한 식품의 과도한 섭취 제한을 방지해야 한다. 지역사회와 의료기관은 식품알레르기의 예방 및 증상완화를 위한 맞춤형 영양교육, 대체 식품에 대한 정보 제공 등의 현실적 지원과 정서적 지지를 병행해야 한다. 이처럼 다양한 형태의 사회적 노력과 제도적 방안을 통해 식품알레르기 아동의 삶의 질을 향상시키고 부모의 양육부담 대처능력을 강화해야 할 것이다.