• Korean Journal of Schizophrenia Research
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• v.22 no.2
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• pp.56-65
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• 2019

Objectives: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. Methods: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. Results: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. Conclusion: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.53-62
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• 2020

Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.1
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• pp.29-41
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• 2017

Objectives: We analyzed chief complaints of patients visiting Korean Gynecology clinic to figure out their characteristics and expand medical fields of Korean Gynecology. Methods: We analyzed chief complaints of 1,690 female patients who visited Korean Gynecology clinic of ${\bigcirc}{\bigcirc}$ University Hospital from 2013 to 2015. Results: 1. Average age of outpatients were $38.68{\pm}12.4$ and the age group distribution showed 30s were most (41.4%), followed by 40s, 20s, and 50s. 2. The season distribution showed patients were most in winter (28.0%), and least in summer (22.7%). 3. The disease distribution showed patients of puerperal disease were most (18.9%). 4. Patients of menstruation-associated disease were most in 20s and less, puerperal disease in 30s, supplemental and postoperative care in 40s, reproductive and endocrine disease in 50s, abnormal sense disease in 60s, and supplemental and postoperative in 70s and more. 5. The age group distribution of chief complaints showed cold hypersensitivity in hands and feet in 20s, and the season distribution showed puerperal winds in summer and cold hypersensitivity in hands and feet in winter. 6. The distribution of all chief complaints showed puerperal care were most (10.1%), and the percentage of all-kind care were high (29.9%). Conclusions: The clinical fields of Korean Gynecology can be expanded in general health care of women as well as treatment of diseases.

• Journal of Society of Preventive Korean Medicine
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• v.18 no.2
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• pp.31-45
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• 2014

Objective : This study was intended to provide information pertaining to reasonable consumption of medical services based on comparative analysis of the characteristics of musculoskeletal diseases(MSDs) among outpatients of Korean medical institutes, and furthermore help lay groundwork for mapping out effective Korean medical policies. Method : Based on the data of 3,889 outpatients of Korean medical institutions which were obtained from the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine, the analysis was carried out by using the SAS 9.2. Results : 68.2% of subjects were found to use Korean medicine(KM) for the treatment of MSDs. Patients with MSDs were older than those with nonmusculoskeletal diseases(NMSDs). And married state, education, employed state and incomes are effected on MSDs and NMSDs. Subjective health status, number of outpatient treatments, medical cost, medical treatment satisfaction, and habitue status are depend on MSDs or NMSDs. Acupuncture and physical therapy is Major treatments of subjects investigated to have the highest treatment effect. It was found that they had high degree of satisfaction with Korean medicinal outpatient treatments, and those with MSDs were found to have significantly greater satisfaction than those with NMSDs. Conclusion : Although aforesaid results suggest significant satisfaction with KM and high treatment effects for MSDs. Accordingly it is considered necessary to develop various services related to KM for treatment of MSDs and to plan for cost down of KM. Moreover, in-depth research into NMSDs is required for utilization growth of KM.

• Journal of Preventive Medicine and Public Health
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• v.36 no.3
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• pp.248-254
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• 2003

Objective : This study was conducted in order to investigate predictors of smoking cessation in outpatients. Method : Subjects were 40f adult smoking patients who saw their doctors in the outpatient setting at a university hospital, regardless of their willingness of otherwise in smoking cessation. Physicians delivered a brief, stop smoking prompt to all patients who smoked one or more cigarettes a day. Then they referred to on-site counselors who provided a brief, nurse assisted intervention with a survey to a randomly assigned intervention group (200 smoking patients), whom the counselors telephoned later to prevent relapse or promote the motivation to quit, or gave only a survey to a control group (201 smoking patients). After at least 5 months, self-reported current smoking cessation was confirmed later using cut-off values of 7 ppm or less in expired alveolar air after breath holding portable CO analyzer. Results : After 5 months, subjects in the intervention group were 1.56 times (95% C.I. 0.89-2.73) more likely to quit smoking than those in the non-intervention group (14.0% vs. 9.0%). Willingness to quit smoking in a month, scheduled admission in a month, self efficacy score and FTND (Fagerstrom Test for Nicotine Dependence) score were all significantly related with smoking cessation. In stepwise multiple logistic regression, previous attempts to quit smoking were significant instead of self efficacy score. In the intervention group who had willingness to quit smoking in a month (132 smoking patients), FTND score, whether quit date was today, and whether quit promise paper was submitting were all significantly related with smoking cessation. In stepwise multiple logistic regression, scheduled admission in a month and whether quit date was today were significant predictor variables, Smoking cessation treatment should be tailored to individual smoking patients considering these predictors.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.10 no.1
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• pp.153-165
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• 2006

Objectives: The purpose of this study is to obtain basic data about medical consumer's behavior by the examination of the demographic characteristics, experience of medical service and attitude toward traditional medicine based on the outpatients of oriental medicine clinic. Methods: The participants of this study are outpatients in 5 oriental medicine clinics located in the metropolitan area. The resources were collected from the self-administration questionnaire survey. 202 samples were collected. The SPSS 13.0 for windows was used for statistical analysis: One-way ANOVA, $x^2-test$, correlation analysis were used to verify the results. Results & Conclusions: The results from this study are as follow. 1, The group which are in low-ade educational background and income selected traditional medicine for the promotion of health. In this group, traditional medicine was consumed with higher purchasing frequency and more satisfaction and considered more safe and effective, on the other hand western medicine was consumed with lower frequency. People In this group highly evaluated the kindness of oriental medicine doctor and more interested in health. 2. The group which selected traditional medicine for the treatment of disease more frequently consumed traditional medicine. People In this group highly evaluated the efficacy and economical efficiency of traditional me야cine and the kindness of oriental medicine doctor. 3. The group which selected traditional medicine for the management of disease iess : frequently consumed western medicine. People In this group highly evaluated the efficacy of traditional medicine. 4. Purchasing frequency on traditional medicine was higher in the 50year above group than $30{\sim}39year$, 29year and below group.(P<0.1) 5. Purchasing frequencyy on traditional medicine slightly correlated with the satisfaction of traditional medicine and the kindness of oriental medicine doctor. The satisfaction of traditional medicine strongly correlated with the kindness of oriental medicine doctor. 6. The efficacy of traditional medicine and the kindness of oriental medicine doctor were highly evaluated in the $10{\sim}19times$ experience group and 20times above experience group than $1{\sim}4times$ experience group.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4077-4082
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• 2013

The purpose of this descriptive and comparative study was to examine gender differences relevant to pain intensity, opioid prescription patterns and opioid consumption in Taiwanese oncology outpatients. The 92 participants had been prescribed opioid analgesics for cancer-related pain at least once in the past week and were asked to complete the Brief Pain Inventory - Chinese questionnaire and to recall the dosage of each opioid analgesic that they had ingested within the previous 24 hours. For opioid prescriptions and consumption, all analgesics were converted to morphine equivalents. The results revealed a significant difference between males and female minimum pain thresholds (t = 2.38, p = 0.02) and current pain thresholds (t = 2.12, p = 0.04), with males reporting a higher intensity of pain than females. In addition, this study found that males tended to use prescribed opioid analgesics more frequently than females on the bases of both around the clock (ATC) (t = 1.90, p = 0.06) and ATC plus as needed (ATC + PRN) (t = 2.33, p = 0.02). However, there was no difference between males and females in opioid prescriptions on an ATC basis (t = 0.52, p = 0.60) or at an ATC + PRN basis (t = 0.40, p = 0.69). The results suggest that there may be a gender bias in the treatment of cancer pain, supporting the proposal of routine examination of the effect of gender on cancer pain management. These findings suggest that clinicians should be particularly aware of potential gender differences during pain monitoring and the consumption of prescribed opioid analgesics.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• The Journal of Korean Medicine
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• v.30 no.5
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• pp.88-101
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• 2009

Objectives: Since Korean traditional medicine has an integrative perspective by its nature, the patients' psychological and physical problems in a Korean traditional clinic may be resolved through a more integrative approach. The purpose of this study was to describe the latent characteristics of psychological health of child outpatients and their parents visiting Korean traditional clinic with physical complaints and was to propose an alternative curriculum to meet their needs based on their psychological and physical aspects. Methods: Subjects studied consisted of 100 outpatients (59 boys, 41 girls, mean age 55 months, age range 18 to 83 months) and their parents. Behavior characteristics for children were measured by Korean version of Child Behavior Checklist for Ages 1.5-5 (CBCL1.5-5) while parenting stress, depression, and anxiety for parent were measured by Korean-Parenting Stress Index-Short Form (K-PSI-SF), Center for Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI), respectively. The data of subjects were compared to those of standardized groups and then were compared according to child's gender within sample. Results: Child participants were reported to have significantly higher scores of all CBCL 1.5-5 subscales than the standardized group. When compared, no differences of K-PSI-SF, CES-D, and STAI was found between parents of participants and the standardized groups. However, parents of child participants with at-risk psychological problems showed significantly higher scores of all parenting stress subscales than those of all child participants. In addition, the mothers of boy participants demonstrated significantly higher anxiety, depression and parenting stress than those of girl participants irrespective of psychological severity. Conclusions: We discussed the implication of these results in clinical situation and make recommendations for curriculum of psychiatry and pediatrics with the aim of improving proper diagnosis, consulting and treatment.

• Herbal Formula Science
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• v.18 no.2
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• pp.135-158
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• 2010

The purpose of this survey was to find out the actual condition and the problems of combined medications of patients who have general diseases, respiratory diseases. The objects of this survey were 1,769 outpatients who visited 8 Oriental hospitals and Seoul national university hospital respiratory clinics. SPSS program was used to analyze the survey data. The mean age of patients was lower in oriental hospital than in western hospital. The monthly family incomes were higher in oriental hospital patients than in western hospital patients. The condition of patients was better in oriental hospital than western hospital and self-assessed health status was more positive in oriental hospital patients than in western hospital patients. The percentage of having experienced of treated in oriental and western hospital at the same time was 21% in western hospital patients and 45% in oriental hospital patients. In patients with respiratory diseases, the percentage of having taken combined medications was 40.2% in oriental hospital and 13.7% in western hospital. In patients with non-respiratory diseases, the percentage of having taken combined medications was 27.4% in oriental hospital and 8.3% in western hospital. And in the patients with two different diseases, the percentage of having taken combined medications was 27.9% in oriental hospital and 6.3% in western hospital. The percentage of having experienced synergistic effects was 33.0% in western hospital and 56.3% in oriental hospital. The percentage of side effects was 12.6% in western hospital and 12.2% in oriental hospital. This survey was meaningful in that it reported the actual condition of combined medications of patients who have general diseases, respiratory diseases. For the deep study on synergistic and side effects of combined medications, it is necessary to collect many cases of synergistic and side effects by doctors in western and oriental hospitals.