• Journal of the Korea Convergence Society
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• v.10 no.8
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• pp.75-82
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• 2019

Many people suffers from multiple chronic diseases, leading cause of death and disability in the world. The purpose of this study was to investigate factors affecting multiple chronic diseases, hypertension, and diabetes. We analyzed the data of one metropolitan city of community health survey, 2015. 4,590 citizens were enrolled in this study. Prevalence of multiple chronic diseases, hypertension, and diabetes were 5.14%, 16.8%, and 3.89%, respectively. Educational attainment, income, salt intake, and BMI were identified as independent risk factors associated with multiple chronic diseases. Educational attainment, income, salt intake were significantly associated with hypertension and age, educational attainment, frequency of alcohol drinking, salt intake were associated with diabetes. Multiple chronic diseases, hypertension, and diabetes were associated with sociodemographic, economic, and health behavioral factors. We should consider these variables in the prevention and management programs and policies for patients with multiple chronic diseases.

• Research in Community and Public Health Nursing
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• v.18 no.1
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• pp.32-41
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• 2007

Purpose: The purpose of this study was to describe how the rural elderly cope with experiences in multiple chronic diseases. Method: Data were collected through participant observation and in-depth interview using ethnography. The participants were 9 women and 2 men who aged over 65, were living in rural community, and had experienced two or more chronic diseases. Results: According to the results of this study, those who had experienced multiple chronic diseases went through the stages of 'recognizing of revealed symptoms', 'discovering of disease', 'overcoming', 'neglecting', 'discovering another disease', 'being frustrated' and 'living with suffering'. Conclusion: The results of this study are expected to be utilized as basic materials to develop a nursing intervention program for effective management of chronic diseases.

• Korean Journal of Health Education and Promotion
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• v.31 no.3
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• pp.27-37
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• 2014

Objectives: This study aims to identify the factors associated with regular medical services utilization of chronic disease patients. Methods: The research selected 4,489 adults aged over 30, diagnosed with hypertension, diabetes, hyperlipidemia, hypercholesterolemia, from the Korea health panel. We analyzed states of regular medical service utilization using descriptive statistics. Multiple regression analysis was used to examine the main factors associated with regular medical services utilization in chronic disease patients. Results: In terms of socio-demographic factors, gender, age, marital status, education level, employment, household income and disability were significantly different between hypertension, diabetes, hyperlipidemia and hypercholesterolemia. Among health status and behavioral factors, number of chronic diseases, subjective health status, smoking, high risk drinking, regular meals, physical activity, obesity were significantly different. From the multiple logistic regression analysis, age, number of chronic diseases, obesity, type of chronic diseases were associated with regular medical services utilization. Conclusions: It is necessary to develop effective health education programs and individualized approach to improve continuous management in chronic diseases patients.

• Nutrition Research and Practice
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• v.8 no.3
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• pp.233-240
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• 2014

Epidemiology studies indicate that diet or specific dietary components can reduce the risk for cancer, cardiovascular disease and diabetes. An underlying cause of these diseases is chronic inflammation. Dietary components that are beneficial against disease seem to have multiple mechanisms of action and many also have a common mechanism of reducing inflammation, often via the $NF{\kappa}B$ pathway. Thus, a plant based diet can contain many components that reduce inflammation and can reduce the risk for developing all three of these chronic diseases. We summarize dietary components that have been shown to reduce cancer risk and two studies that show that dietary walnut can reduce cancer growth and development. Part of the mechanism for the anticancer benefit of walnut was by suppressing the activation of $NF{\kappa}B$. In this brief review, we focus on reduction of cancer risk by dietary components and the relationship to suppression of inflammation. However, it should be remembered that most dietary components have multiple beneficial mechanisms of action that can be additive and that suppression of chronic inflammation should reduce the risk for all three chronic diseases.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.1
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• pp.95-107
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• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

• Journal of Korean society of Dental Hygiene
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• v.20 no.2
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• pp.129-137
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• 2020

Objectives: Using the annual data from the 2016 Korean Health Panel, this study aims to identify the factors that affect the dental utilization and expenditure of patients with chronic diseases, and to provide basic data to explain the inequality gap in dental utilization. Methods: The dental utilization and expenditure of 3,557 patients with chronic diseases were analyzedfor frequency using the SPSS Windows version 23.0 (SPSS Inc. IL, USA). Analysis of the factors that affect dental utilization and expenditure were performed using a multiple regression analysis. The level of statistical significance was 0.05. Results: The frequency of dental utilization in patients with chronic diseases was high for subjects who were younger than 65 years and those whose education level was below high school. The frequency of dental utilization was relatively lower for subjects who did not have disabilities and those with healthier subjective health status. The dental expenditure of patients with chronic diseases was higher in subjects who were younger than 65 years and those with greater household income. Conclusions: The above findings suggest that a plan is needed to control dental utilization by efficiently managing chronic diseases, and that a policy-based plan is needed to devise ways to supplement the uninsured medical expenses of dental care.

• Child Health Nursing Research
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• v.24 no.1
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• pp.101-108
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• 2018

Purpose: This study aimed to identify the effects of the mother-medical staff partnership on mothers' condition management ability for children with chronic allergic diseases. Methods: A total of 109 Korean mothers caring for a child with a chronic allergic diseases, identified according to the allergic march, such as food allergy, atopic dermatitis, allergic rhinitis, and allergic asthma, were recruited from the pediatric department of a general hospital in Seoul through convenience sampling. Data were collected using structured self-reported questionnaires from August 1, 2017 to October 31, 2017. and analyzed by descriptive statistics and multiple regression using SPSS version 22.0. Results: The Mother-medical staff partnership had a statistically significant effect on mothers' condition management ability for children with chronic allergic diseases (p<.05). Among the general characteristics, satisfaction with nursing services had a statistically significant effect on mothers' condition management ability (p<.05). Conclusion: In conclusion, strategies to support children with chronic allergic diseases, as well as their caregivers, should consider the mother-medical staff partnership as part of a family-centered approach.

• The Korean Journal of Rehabilitation Nursing
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• v.18 no.2
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• pp.98-106
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• 2015

Purpose: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). Methods: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. Results: Mean age was $68.8{\pm}11.63years$, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. Conclusion: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

• Journal of Digital Convergence
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• v.13 no.12
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• pp.245-257
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• 2015

This study was to develop the predictive model for severity-adjusted mortality of inpatients with multiple chronic conditions and analyse the factors on the variation of hospital standardized mortality ratio(HSMR) to propose the plan to reduce the variation. We collect the data "Korean National Hospital Discharge In-depth Injury Survey" from 2008 to 2010 and select the final 110,700 objects of study who have chronic diseases for principal diagnosis and who are over the age of 30 with more than 2 chronic diseases including principal diagnosis. We designed a severity-adjusted mortality predictive model with using data-mining methods (logistic regression analysis, decision tree and neural network method). In this study, we used the predictive model for severity-adjusted mortality ratio by the decision tree using Elixhauser comorbidity index. As the result of the hospital standardized mortality ratio(HSMR) of inpatients with multiple chronic conditions, there were statistically significant differences in HSMR by the insurance type, bed number of hospital, and the location of hospital. We should find the method based on the result of this study to manage mortality ratio of inpatients with multiple chronic conditions efficiently as the national level. So we should make an effort to increase the quality of medical treatment for inpatients with multiple chronic diseases and to reduce growing medical expenses.

• Journal of Preventive Medicine and Public Health
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• v.46 no.5
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• pp.213-225
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• 2013

Objectives: The aim of this study was to evaluate the association between Agent Orange exposure and self-reported diseases in Korean Vietnam veterans. Methods: A postal survey of 114 562 Vietnam veterans was conducted. The perceived exposure to Agent Orange was assessed by a 6-item questionnaire. Two proximity-based Agent Orange exposure indices were constructed using division/brigade-level and battalion/ company-level unit information. Adjusted odds ratios (ORs) for age and other confounders were calculated using a logistic regression model. Results: The prevalence of all self-reported diseases showed monotonically increasing trends as the levels of perceived self-reported exposure increased. The ORs for colon cancer (OR, 1.13), leukemia (OR, 1.56), hypertension (OR, 1.03), peripheral vasculopathy (OR, 1.07), enterocolitis (OR, 1.07), peripheral neuropathy (OR, 1.07), multiple nerve palsy (OR, 1.14), multiple sclerosis (OR, 1.24), skin diseases (OR, 1.05), psychotic diseases (OR, 1.07) and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the division/brigade-level proximity-based exposure analysis, compared to the low exposure group. The ORs for cerebral infarction (OR, 1.08), chronic bronchitis (OR, 1.05), multiple nerve palsy (OR, 1.07), multiple sclerosis (OR, 1.16), skin diseases (OR, 1.05), and lipidemia (OR, 1.05) were significantly elevated for the high exposure group in the battalion/company-level analysis. Conclusions: Korean Vietnam veterans with high exposure to Agent Orange experienced a higher prevalence of several self-reported chronic diseases compared to those with low exposure by proximity-based exposure assessment. The strong positive associations between perceived self-reported exposure and all self-reported diseases should be evaluated with discretion because the likelihood of reporting diseases was directly related to the perceived intensity of Agent Orange exposure.