To date, there was no controlled-study regarding awareness and knowledge of colorectal cancer in the Turkish population. We therefore designed a questionnaire consisting of items related to socio-demographic parameters, medical and family history and questions of awareness and knowledge about colorectal cancer for use in a descriptive cross-sectional study. An interviewer-administered technique was applied and 450 subjects were interviewed in the outpatient clinics at Near East University Hospital. Among all subjects, 337 were found to be eligible for the study group. Exclusion criteria were age below 18 years, any cancer history, family history of colorectal cancer, current colorectal problems, history of any diagnostic or therapeutic interventions for colorectal diseases. All participants stated that they heard about colorectal cancer. When asked about the lifetime risk of colorectal carcinoma, only 25.4% of women and 37.9% of men estimated correctly. Univariate analysis revealed that the total awareness score was significantly correlated with age, marital status, parenthood and fecal occult blood testing history. On multivariate analysis of independent predictors for awareness of colorectal cancer were found to be history of fecal occult blood testing, age and marital status were found to be the most important determinants. As a conclusion, opportunistic screening with fecal occult blood test by physicians from non-gastrointestinal specialties not only helps to reduce the mortality but also increases the awareness of colorectal cancer.
Kharameh, Zahra Taheri;Foroozanfar, Sahar;Zamanian, Hadi
Asian Pacific Journal of Cancer Prevention
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제15권11호
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pp.4595-4599
/
2014
Background: Colorectal cancer is a serious health problem. Early detection of colorectal cancer is crucial for treatment and reducing mortality. Beliefs related to colorectal cancer have been found to be a factor in a person's decision about colorectal cancer screening programs. To determine such beliefs, a valid and reliable instrument is necessary. Objective:The aim of this study was to adapt and determine the psychometric properties of the Persian version of Champion's Health Belief Model Scale of breast cancer screening in the measurement of beliefs toward colorectal cancer (CRC) screening. Materials and Methods: The 'forward-backward' procedure was applied to translate the instrument from English into Persian. This study was conducted in Iran from June 2012 to May 2013. A convenience sample of 200 individuals aged 50 years and older was recruited from the population at the outpatient clinics in the three teaching hospitals. Validity was assessed using content, face and construct validity. To test reliability, the internal consistency was assessed by using Cronbach's alpha coefficient and test-retest (intraclass correlation coefficient) analyses. Exploratory factor analysis was used to assess the construct validity and determine the factors of adapted Champion's Health Belief Model Scale. Results: The mean age of the participants were 62.5 years (SD=10.8 years) and the majority of them (75.5 percent) were female. The results of exploratory factor analysis indicated a six-factor solution for the questionnaire (benefits, motivation and confidence, seriousness, susceptibility, emotional barriers and background barriers) that jointly accounted for 55.52% of variance observed. Cronbach's alpha of the subscales ranged from 0.57 to 0.89 and test-retest reliability ranged from 0.81 to 0.93 indicating a good range of reliability. Conclusions: The findings of this study suggest that the Persian version of Champion's Health Belief Model Scale of CRC screening has good psychometric properties and could be an appropriate measure for health beliefs related to CRC screening in national and international studies.
The purpose of this study was to assess adequately equipped with convenience facilities for the disabled in 160 healthcare institutions in Jongno district, Seoul. Healthcare institutions were equipped an average of 3.7 facilities out of 10. General hospitals had an average of 5.0 facilities, which was higher than an average of 3.6 facilities for private clinics (p<0.05). Of 160 healthcare institutions, only 13 (8.1%) offered easy access to the outpatient setting from the entrance for wheelchair users, highlighting difficult wheelchair access within hospitals. To provide easy access to medical service for the disabled, more accessible designs need to be adopted as part of the effort to improve public facilities for the disabled. Also, universal designs could be applied for newly constructed roads, structures and transportation vehicles to maximize accessibility for the disabled. Increased accessibility for the disabled in the community will eventually increase the use of healthcare institutions.
Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.
The purpose of this study is to provide a basis for nursing intervention strategies to promote quality of life in cancer patients. Therefore the study is designed to evaluate the effectiveness of perceived health status, self-esteem, health locus of control, self-efficacy, perceived susceptibility /severity, health promoting behaviors, and hope for quality of life. The sample was composed of 164 stomach cancer patients who visited outpatient clinics at a university hospital in Seoul. The following instruments were used in the study after some adaptation : Lawstone and others' Health Self-rating Scale, Rosenberg's Self-esteem Scale, Wallston and others 'Multidimensional Health Locus of Control Scale, Sherer & Maddux's Self-efficacy Scale, Moon's Health Beliefs Scale, Walker and others' Health Promoting Lifestyle Profile, Nowotney's Hope scale and Noh's Quality of Life Scale. Data were analyzed using a SAS program for Pearson correlation coefficients, descriptive correlational statistics and stepwise multiple regression. The results are as follows : 1. The scores on the quality of life scale ranged from 115 to 243 with a mean of 177.84(SD : 25.35). The mean scores(range 1-5) on the different dimensions were : emotional state 3.37 : economic life 3.47 : physical state & function 3.52 : self-esteem 3.66 : relationship with neighbors 3.37 ; family relationships 3.80. 2. There was a significant correlation between all the predictive variables and the quality of life (r=.20-.65, p<.01). 3. Stepwise multiple regression analysis showed that : 1) Self-esteem was the main predictor of quality of life and accounted for 46.9% of the variance in quality of life. 2) Perceived health status, hope and perceived susceptibility/severity accounted for 11.8%, 8.3%, 1.5% of the variance in quality of life, respectively. 3) Self-esteem, perceived health status, hope & perceived susceptibility /severity combined accounted for 68.5% of the variance in quality of life. In conclusion, self-esteem, perceived health status, hope and perceived susceptibility / severity were identified as important variables in the quality of life of cancer patients.
Hong, Jin Ho;Ryu, Ho Young;Park, Yong Bok;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
Clinics in Shoulder and Elbow
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제17권3호
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pp.102-106
/
2014
Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.
Background : The introduction of policies expanding the coverage of uninsured Korean Medicine (KM) services have requires an understanding of the following components of the service : current financial expenses, degree of financial burden on the patient, and financial effect of the coverage expansion. Objectives : This study aims to determine the annual trend of outpatients' characteristics and the category of out-of-pocket spending in KM. Methods : This study uses data from the Korea Health Panel to analyze use of KM in the Korean population. Using the user characteristics and behavior drawn from the Korea Health Panel data, out-of-pocket spending trends of KM were analyzed by year. The diagnosis and prescription of out-of-pocket spending were also analyzed. Results : The proportion of patients receiving uninsured medical treatment and the number of uninsured medical treatment in outpatient clinics have increased. However, the average out-of-pocket spending per person and out-of-pocket spending per visit are consistent or have decreased. Meaningful trends are the increase of R00-R99 (unclassified symptoms) and the decrease of K00-K93 (digestive system disease) and J00-J99 (respiratory system disease). Conclusions : Expansion of KM medical service and insurance is influenced by uninsured medical treatment of KM. Hence, research to increase medical treatment categories for out-of-pocket spending or explore diseases where KM diagnosis has been proven effective should be further developed.
Background Increasingly, prophylactic mastectomy has been evaluated as a treatment of breast cancer. Hereditary breast cancer now accounts for approximately 5%-10% of all cases of breast cancer, meaning that the widespread implementation of prophylactic mastectomy may significantly reduce the occurrence of breast cancer. However, prophylactic mastectomy is rarely performed in Korea. Therefore, in this study, we assessed Koreans' attitudes toward and awareness of preventive mastectomy. Methods This was a prospective study of a cohort of patients attending outpatient clinics and their relatives. Data were collected using self-administered questionnaires assessing sex, age, educational level, knowledge of breast cancer, understanding of prophylactic mastectomy, attitudes toward prophylactic mastectomy, and reasons for choosing prophylactic mastectomy. Results Sixty-five patients were included. Most patients (36.9%) were between 40 and 49 years of age and 58.4% were college graduates. Only six respondents (9%) understood prophylactic mastectomy, and 17 respondents (27%) stated that they would agree to undergo prophylactic mastectomy if necessary. Reasons given for refusing prophylactic mastectomy included aesthetic concerns (38%), the perception that it would not cure the disease (26%), possible surgical complications (24%), and financial cost (6%). Conclusions In this study, most of the respondents showed a poor knowledge of prophylactic mastectomy. Ultimately, it will be necessary to establish medical guidelines for patients with a high risk of breast cancer, with the objective of providing accurate information and proper treatment at hospitals.
Background: Psoas compartment block with local anesthetics and corticosteroids is one of the treatments which provides long term analgesia of the lower back and anterior thigh unilaterally, and its technical easiness and safety allows blind application without C-arm guidance in the out-patient clinic. This study aimed to evaluate the mean of the depth from the skin to the psoas compartment, and its correlation to the following attributes: age, weight, height and PI (Ponderal Index). Methods: We investigated 28 patients who underwent psoas compartment block. All blocks were performed using Chayen's method (punctured at the point of 3 cm caudally and 5 cm laterally from the 4th lumbar vertebral spinous process) with a 22 G, 8 cm Tuohy needle under C-arm guidance. We recorded the depth from skin to the psoas compartment, height, weight and PI (weight (kg)/height (cm)$\times100$ (%)). Data were analyzed using the Pearson product-moment correlation coefficients. The correlations between the depth and other attributes identified by p-value of less than 0.05 were considered statistically significant. Results: The mean depths from skin to the psoas compartment were $6.02{\pm}0.28$ cm in men, $5.44{\pm}0.22$ cm in women. There is no significant correlation between the depth and other patient's attributes. Conclusions: The mean depths from skin to the psoas compartment may be one of the guide for psoas compartment block in outpatient clinics without C-arm guidance.
This study was conducted to improve performance flow of PACS registration and output of external medical images by developing or adding File Transfer Protocol(FTP) Module on Order Communication System(OCS) and to upgrade efficiency of performance. The numbers of requests for examination of external medical images from January 2004 to December 2007 were investigated and the numbers of cases of examinations and losses were done respectively from January to June, 2007 as a period before the improvement and from July to December, 2007 as a period after it. Satisfaction of persons inputting external medical images of CD was asked directly before and after the improvement. When the numbers of requests for examination of external medical images from 2004 to 2007 2004 were investigated, they were 12,783, 16,774, 21,613 and 27,487 cases in 2004, 2005, 2005 and 2007 respectively. For the numbers of the requests from January to December, 2007 it was the lowest in February by recording 1846 and it was 2800 in October. While the number of loss of external medical images was averagely 3.6 before using FTP Module on OCS, it reduced to 0 and satisfaction increased to 98% after it. By utilizing FTP Module on OSC for PACS registration of external medical images, the images were delivered simultaneously with occurrence of order, PACS registration of many patients was conducted together and CDs were returned to patients immediately after sending images from outpatient clinics or wards to remove possibility of losing them. In addition, because the module was established on OCS and data were sent associated with order, problems related with order were decreased. By eliminating movement distance it was turned out to be very effective in terms of time and space.
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