Kim, So-Young;Cho, In-Sook;Lee, Jae-Ho;Kim, Ji-Hyun;Lee, Eun-Jung;Park, Jong-Hyock;Lee, Jin-Seok;Kim, Yoon
Journal of Preventive Medicine and Public Health
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v.40
no.6
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pp.487-494
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2007
Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.
Breast cancer is one of the most feared health problems in women ; Recent studies revealed that it had come up to be the second most in this country and high prevalent disease in the western countries among breast disease in women. However, early detection of the cancer mass is known to be easier than in many other malignancies. This study was performed to investigate the various characteristics of patients of breast cancer ; by the structural variables, menstrual, marital, and child bearing, and also their understandings and attitude towards the disease. A hundred any in- and out- patients of 51. Mary's Hospital and National Atomic Institute, Seoul were sampled. Data were gathered through direct interview by the researcher from February 1976 to January 1977 and the clinical records were used as references. Results are as follows ; 1. Breast cancer revealed to be most prevalent in the forties ; average age of 45.2 years. 2. The average age of menarche revealed to be 15.4 years ; the largest group were the 16-20 years (N=75, 68.2%). In 55 cases (50%) menstruation were normal, 38 (34.5%) postmenopausal and only in 17 (15.5%), menstruation revealed irregularity. 3. The average marital age revealed to be 22.3 years ; the largest group were 21-25 group (N=43, 39.1%). The average duration of marital life revealed to be 24.7 years ; 11-20 years group were the largest (M=34, 30.9%). 4. Most of the patients revealed to have pregnancy experiences(N=100, 90.9%) ; the average rate of experience were 5, 3 times the largest group were 3.4 times group(N= 32, 29.1%). 54 patients (49.1%) revealed to have had abortion experience ; the average were 3.4 times. 5. The largest group(N=77, 70%) had been breast feeding : followed by mixed feeding (N=12, 10.9%) and artificial feeding(N=10, 9.1%). 6. Personal health history revealed that in 20 patients (18.2%) revealed to have the past history of Purulent mastitis, 5 patients(4.5%) of breast cancer and 3 patients(2.7%) of uttering cancer family history. 7. In the one half (N=56, 50.9%, they had some information about breast cancer :27 (24.5%) by mass media, 12 (10.9%) through personal contacts and 17 (15.5%) were not able to classify the source of information. 8. In 55 cases (50%) the canoe, mass were discovered incidentally, in 39 cases (35.5%) by manual detection by self, in 10 cases (9%) by others and in 6 cases(5.5%) by observing subjective symptoms. 9. The average duration lapsed between the discovery of cancer mass and the visit to the hospital revealed to be 9.4 month. Chief reason for the delay revealed to be the non-chaplaincy due to the absence of pain(N=50, 45.5 %) followed by the administration of herb and commercial medication (N=19, 17.3%). 10. The left side breast was more affected than the right side breast, represent by 60 cases in the left and 39 cases in the right. The most frequent site of the breast cancer was the upper- outer quadrant in 53 cases (47.7%), and followed by the center in 20 cases(18 %), and the upper inner quadrant, in 19 cases (17.1%). There was / cases of bilateral carcinoma. The most prominent symptom was painless mass.
Objectives : To gather information about the factors which influence the interest and intention of admission into charging nursing hones for the elderly(CNH), as these homes represent an important method for resolving the problems related to the rapid population aging occurring in Korea. Methods : A face-to-face interview survey was carried out with 320(men 159, women 165) patients over 60 years old who were admitted at 2 university hospitals and 5 general hospitals in the Busan area between December 1998 and March 1999. Data were analyzed through t-test, ANOVA, correlation and multiple regression analysis. Results : The mean age and years of education of the study population was 67.0 and 7.7 years, and the types of chronic degenerative disease included musculoskeletal disorders(20.1%), cerebrovascular disease(17.1%), and diabetes(14.3%). The major forms of household living arrangement prior to admission were elderly alone(22.6%), and elderly couple(33.5%), while about half of them(55.5%) didn't want to live with their children id the future. Almost half were paying medication fees by themselves(46.6%). The level of actual intention of admission$(3.07{\pm}1.39)$ into a CNH was lower than that of interest$(3.22{\pm}1.33)$(p<0.01). Multiple analysis revealed that the intention of admission increased with decreasing number of future supportive persons$(\beta=-0.107)$, lower level of activity in daily life$(\beta=-0.447)$, and longer years of education$(\beta=-0.447)$ with 32.7% of $R^2$. As for the factors which determined the admission into a CNH, the fee and facilities were considered to be most important, and professional nursing and physician's care were the most desired services. In nomenclature, they preferred 'elderly hospital' or 'elderly health center' to CNH. Conclusions : Interest in CNH is increasing recently, but existing studies about patient experiences in CHN are still limited. This study may form a basis for future examinations of the needs and uses for CNH. Active financial support and public information are considered by the authors to be important factors for the induction of welfare services for the elderly, though CNH.
Journal of the Korea Institute of Information and Communication Engineering
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v.13
no.7
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pp.1399-1410
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2009
It is a method to treat pain using medication, neurotomy, and surgery. And acupuncture, ultrasound, electric treatment, and magnetic treatment are applied as a alternative physiotherapy. Electronic therapy is useful but it can be affected by impedance of skin or subcutaneous tissue. So, percutaneous stimulation is leading therapy, that is very randomly. We developed the system which can stimulate parts of acupuncture point noninvasively using the focused magnetic field. And we designed the magnetic stimulation electrode which is considered efficiency of the magnetic stimulation. It can make similar stimulation with manual acupuncture. To confirm the availability and reliability we compared Meridian Electronic Potential(MEP) change between manual acupuncture and magnetic stimulation. From this result, we found out the MEP changes of manual acupuncture and magnetic stimulation were similar. And there were various response properties as changes of stimulation method, intensity, and frequency. Also, the MEP change can be induced by electromagnetic stimulation. We confirmed that it is possible to use electromagnetic stimulation as a acupoint stimulation or pain treatment instrument.
This study is an attempt to provide fundamental information on how to manage menstruation discomforts by surveying the subjective viewpoint s on menstruation from female college students. Utilizing 40 Q-samples in Seoul between May 1 and June 30, 2001, data has been collected from 30 randomized P-samples. Data analysis involves the PC QUANL Program, Q-factor analysis, and Principal Component Analysis. The result of the data analysis gives four types of categorizat ion as follows : The first is the "inconvenience-recognizing" type that includes 10 subjects out of 30. During menstruation, this type of subject usually complained of physical discomfort such as pain in the lower back and abdomen. Even though they considered menstruation to be troublesome, they did nothing about the in convenience. The second is the "positively-accepting" type that includes 7 subjects out of 30. This type of subject takes menstruation as natural and even a privilege for a woman. They think they are blessed to conceive a new life through their biological cycle. Therefore unlike other types, they rarely complained of any physical and psychological discomfort caused by menstruation. The third is the "destined course" type that includes 6 subjects out of 30. This type of subject endures the discomfort caused by menstruation with out any medication or medical treatment. They appeared to take menstruation a s fate without having any specially negative or positive attitude. The fourth is the "negatively-accepting" type that includes 7 out 30. This type of subject takes menstruation as negative, even if it is unavoidable for a woman. Menstruation, very negatively taken, felt uncomfortable and caused them to have pain in the lower back and abdomen and an oversensitive nervous system. The four types of attitude towards menstruation show their own characteristic features in dealing with menstruation. Understanding these features in detail will enhance nursing implementation which is related to menstruation. This study is intended to provide fundamental information with which nurses can deal with menstruation problems by investigating subjective viewpoints about menstruation. This study is a stepping stone on which further study on this subject can build to develop an effective and efficient way to deal with menstruation discomforts.
Journal of the Korea Society of Computer and Information
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v.26
no.8
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pp.197-207
/
2021
Relationship between bone mineral density (BMD) and type 2 diabetes is still inconsistent. Recently, many epidemiologic data show that fracture risk is increased in type 2 diabetic patients regardless of BMD status. In this study, we used nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) to analyze the BMD status in patients with type 2 diabetes compared to non-diabetics. We included subjects aged 50 years or older in men (N=2,959, 2,430 without diabetes, 529 with type 2 diabetes) and postmenopausal women (N=2,902, 2,479 without diabetes, 423 with type 2 diabetes). Subjects with history of medication for osteoporosis or with illness or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Serum was separated from peripheral venous blood samples obtained after 8 hours of fasting. BMD was measured at lumbar spine and femur using dual-energy X-ray absorptiometry (DXA). There was a significant positive association between lumbar spine BMD and type 2 diabetes after adjusting age, gender, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration by multiple regression analysis in all subjects. In the subgroup analysis by gender, this association was maintained both in male and female after adjusting those confounding factors. However, femur BMD was not different between type 2 diabetic and non-diabetic subjects. In conclusion, lumbar spine BMD was significantly higher in type 2 diabetic patients aged 50 years or more in men and postmenopausal women compared to non-diabetic subjects.
Journal of the Korea Society of Computer and Information
/
v.26
no.8
/
pp.209-220
/
2021
The effect of body composition such as lean mass and fat mass on bone mineral density (BMD) is complex and still controversial. In this study, we investigated the relationship between body composition and bone mineral density using nation-wide data from 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES) in 2,139 men and 2,193 postmenopausal women aged 50 years or older. Subjects with history of medication for osteoporosis or with diseases or malignancy affecting bone metabolism were excluded. Data of anthropometric measurements and demographic characteristics were collected by trained examiner. Fasting blood sample was obtained for blood chemistry analysis. BMD of the lumbar spine, total femur, and femoral neck, and body composition such as total lean mass (TLM), total fat mass (TFM), truncal fat mass (TrFM) were measured using dual-energy X-ray absorptiometry (DXA). There were significant positive correlations between body composition indices such as lean mass and fat mass with BMD. In multiple regression analysis, TLM was positively associated with BMD after adjusting age, body mass index, monthly house income, education level, physical activity, daily calcium intake and vitamin D concentration in both men and postmenopausal women. BMD at lumbar spine and femur in lowest quartile of TLM was significantly lower than other quartiles after adjusting those confounding factors in both gender. TrFM was negatively associated with total femur BMD in male and femur neck BMD in postmenopausal women after adjusting confounding factors. In conclusion, TLM is very important factor in maintaining BMD in subjects aged 50 years or older in men and postmenopausal women.
Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.
Kim, Mi-Ki;Jung, Ji-Ho;Ahn, Jae-Sun;Yim, Jung-Hoon;An, Min-Seop;Park, Jin-Su;Lee, Hai-Ja;Park, Eun-Jung
The Journal of Pediatrics of Korean Medicine
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v.23
no.3
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pp.143-153
/
2009
Objectives The purpose of this study is to get the basic information from patients how much they understood about their medication and also to know whether patients are making reasonable drug choice between Health Functional Foods and Herbal medicine. Methods 500 questionnaires were handed out to the parents of students in two elementary schools located in OO, Junlabukdo province. 421 questionnaires were completed to be evaluated. Results Among 421 subjects, 53.0% were female, and 47.0% were male. The percentages of the subjects consuming Health Functional Foods and herbal medicine were67.7% and 67.8%, respectively. Among those people who consumed Health Functional Food, 44.1% were using nutritional supplements, red ginseng or ginseng products (26.9%), chlorella products (11.5%), and plum extract products (7.7%). As for the reason to consume Health Functional Foods were varied, but 'in order to be healthy, although currently displaying no illness.'(43.0%) were the most responses among the given choices. On the other hand, the reason for consuming herbal medicine was 'In order to grow taller'(26.1%), 'In order to cure weak physical state frequently displaying common illnesses',(25.9%), and 'In order to cure diseases.'(23.3%). For the questions about effectiveness after consumption,the 69.9% subjects said that it seemed to be effected, and that % was slightly higher than that of subjects with consuming Health Functional Foods(64.4%). For question concerning preferences between Health Functional Foods and herbal medicine, 57.5% chose herbal medicine, and this percentage was higher than that of Health Functional Foods(42.5%).As for the reasons of additional consumption of the Health Functional Foods, subject answered as 'Easy to consume.'(41,6%), which was the most common among the subjects consuming Health Functional Foods. On other hand, the subjects of herbal medicine answered as that herbal medicine is 'more effective'(45.7%), and 'more trustworthy in preventing side-effects.'(40.3%). After consumption of the herbal medication, only 3.9% of the subjects consuming either Health Functional Foods or herbal medicine had side-effects. The most common side-effects were 'dermal reaction' which is normally caused by Health Functional Foods and 'indigestion' problems caused by herbal consumption. Conclusions According to the 421 subjects those involved in study, the percentages of consuming Health Functional Foods(67.7%) and herbal medicine(67.8%) were similar. The most commonly consumed products were a type of Health Functional Foods which were the nutrition-supplying products. Ginseng or red ginseng products were the next commonly used products. Health Functional Foods were commonly consumed for preventing illness and maintaining health rather than any other purpose. In contrary, herbal medicines were more commonly consumed for purposes such as for growth or treating certain type of disease. As a result of consumption, more than half of both subject replied as 'satisfied'. As for the side effects, dermal reaction was the most common problem for those with consuming Health Functional Foods, while indigestion was the most common side effect from the subjects with consuming herbal medicine.
This study is designed to examine the effects of information source effects of the word mouth have on the formed expectations for the private institution and to explore the formed expectations' effects on the actual sales of the educational service. Moreover, its purpose is in analyzing what medication effects the pre-conceived expectation has on selecting the educational service. After testing hypothesis, the results showed that the source effects of the information from word of mouth had a significant effect on the expectation factors, in terms of expertise, similarity, likability and familiarity expectation factors. However, it was found that effect was not significant for the truthfulness. The significant result was found on the expectation factors before visiting the private institution on selecting educational service, indicating a positive effect. As for the influence of source of the word of mouth information on selecting educational service, the results from the mediation effects of the expectation factors on selecting the educational service showed that for expectation factors, expertise had the partial mediation effect, truthfulness, perfect mediating effect, similarity, partial mediation effect, likability, perfect mediating effect, and familiarity, perfect mediating effect. A test of the mediating role of attribute expectations in the influence of WOM message source attributes on educational services choices showed the following: 1) It was proven that attribute expectations played a partial mediating role in the influence of expertise and similarity, respectively, on educational services choices. 2) On the influence of trustworthiness, likability, and familiarity on educational services choices, respectively, attribute expectations had a full mediation effect. This research differs from the previous ones, which focused only on consumer satisfaction with educational services offered by private educational institutions in that it covers not only the influences of both WOM source attributes and key component factors of educational services on both educational services choices and satisfaction with such services but also the influence of WOM source attributes on attribute expectations prior to the first visit to a particular private educational institutions, and in turn the influence of such attribute expectations on educational services choices. Most particularly, the significance of this study lies in the fact that in an effort to more clearly explain the causal relationship between WOM source effects and educational services choices a test of the mediating role of attribute expectations was conducted. Although the research seems simple, some theoretical implications can be drawn as follows: WOM message source effects on educational services choices were positive and moreover these positive impacts are likely to be reinforced by means of the mediating variable of attribute expectations.
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