• Title/Summary/Keyword: Preventive Intervention

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Up-to-date or Complete Immunization Coverage and Their Related Factors (영유아의 예방접종 및 그 관련요인)

  • Lee, Moo-Sik;Kim, Eun-Young;Kim, Keon-Yeop;Lee, Jin-Yong;Jang, Min-Young;Hong, Jee-Young
    • Journal of agricultural medicine and community health
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    • v.37 no.4
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    • pp.233-245
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    • 2012
  • Objectives: Understanding the predictor of immunization status in childhood is critical issue to improve National Immunization Program (NIP). The aims of this study were to verify the status of up-to-date or complete immunization coverage and to investigate its related factors. Methods: As of 2005, according to local residence registry data, there were 2,188 children who aged 12 to 35 months in Nonsan city, Korea. We conducted household survey for aged 12 to 35 months children, using questionnaires to obtain data on the status of immunization such as BCG, DTaP (diphtheria, tetanus, and pertussis), Polio, and MMR (mump, measles, rubella). Finally 1,472 participated in the survey. The operating definitions used in this study were following; "Complete immunization rate" refers to the rate of children who received all immunization within recommended age intervals fully "on-time"; "The 4:3:1 series" means status of receiving the fourth diphtheria-tetanus-pertussis (4 DTP), the third Polio (3 Polio), and the first measles-mumps-rubella (1 MMR) doses. Multivariate logistic regression analyses were used to determine factors affecting complete vaccination coverage of children. Results: Immunization rates of vaccine based on the vaccination card were from 92.7% to 96.4% except 4th DTaP (79.3%). Complete immunization rate of Korea NIP was 74.0% and that of the 4:3:1 series was 77.1%. A parent as primary caregiver (OR 0.59, 95% CI 0.39-0.87 at 19-35 months of children's age) and first-born children (OR 1.79, 95% CI 1.05-3.03 at 24-35 months of children's age) were significantly related to complete immunization coverage of Korea NIP. And a parent as primary care giver (OR 0.58, 95% CI 0.38-0.88 at 19-35 months of children's age) and first-born children (OR 1.94, 95% CI 1.21-3.14 at 19-35 months, OR 2.23, 95% CI 1.27-3.91 at 24-35 months of children's age) were significantly related to complete immunization rate of 4:3:1 series. Conclusions: Government should take actions to increase complete immunization rate. In particular, intervention on the secondary caregiver and non-first-born children should be needed.

Development of tailored nutrition information messages based on the transtheoretical model for smartphone application of an obesity prevention and management program for elementary-school students

  • Lee, Ji Eun;Lee, Da Eun;Kim, Kirang;Shim, Jae Eun;Sung, Eunju;Kang, Jae-Heon;Hwang, Ji-Yun
    • Nutrition Research and Practice
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    • v.11 no.3
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    • pp.247-256
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    • 2017
  • BACKGROUND/OBJECTIVES: Easy access to intervention and support for certain behaviors is important for obesity prevention and management. The available technology such as smartphone applications can be used for intervention regarding healthy food choices for obesity prevention and management in elementary-school students. The transtheoretical model (TTM) is comprised of stages and processes of change and can be adopted to tailored education for behavioral change. This study aims to develop TTM-based nutrition contents for mobile applications intended to change eating behaviors related to weight gain in young children. SUBJECTS/METHODS: A synthesized algorithm for tailored nutrition messages was developed according to the intake status of six food groups (vegetables, fruits, sugar-sweetened beverages, fast food and instant food, snacks, and late-night snacks), decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. The messages in this study were developed from December 2014 to April 2015. After the validity evaluation of the contents through expert consultation, tailored nutrition information messages and educational contents were developed based on the TTM. RESULTS: Based on the TTM, stages of subjects are determined by their current intake status, decision to make dietary behavioral changes, and self-confidence in dietary behavioral changes. Three versions of tailored nutrition messages at each TTM stage were developed so as to not send the same messages for three weeks at most, and visual materials such as figures and tables were developed to provide additional nutritional information. Finally, 3,276 tailored nutrition messages and 60 nutrition contents for applications were developed. CONCLUSIONS: Smartphone applications may be an innovative medium to deliver interventions for eating behavior changes directly to individuals with favorable cost-effectiveness. In addition, using the TTM for tailored nutrition education for healthy eating is an effective approach.

The Relevance of Caregiver Burden, Depressive symptoms and Mental Related Quality of Life in a Stroke Patient's Caregiver (뇌졸중 환자 보호자의 부양부담감 및 우울감과 정신건강관련 삶의 질과의 관련성)

  • Kim, Min-jeong;Kim, Young-Ran;Jung, Jae-Hun;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.208-218
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    • 2017
  • Objective: This study examined the caregiver burden, depressive symptoms, and mental-related quality of life of 226 caregivers of stroke patients, who had been hospitalized in 7 general hospitals located in Cheongju and Daejeon Metropolitan city. Methods: Data were collected from August 5, 2014 to October 5, 2014 and a structured self-administered questionnaire was used. The results were analyzed using a t-test, ANOVA for different comparisons of the mental related quality of life in the sociodemographic characteristics, care-related characteristics, health-related behavioral characteristics, caregiver burden, and depressive symptoms. Hierarchical multiple regression was conducted to determine the explanatory power of the independent variables on the dependent variables, with the variables showing significant differences in univariate analysis as independent variables. Results: According to the results of hierarchical multiple regression analysis, the relevant factors that influenced the mental-related quality of life were the relationship with a patient, burden by 'care', burden by sacrifice of 'personal life', and depressive symptoms. Conclusion: To enhance health-related quality of life, not only is a systematic complement on such factors needed, but the development and implementation of an intervention program to the caregiver burden and depressive symptoms is also urgently required.

An Analysis of Master's and Doctoral Thesis in Nursing - Centered on a Nursing, an Education, and a Public Health Graduate College - (간호학 석.박사 학위논문의 분석)

  • Chon, S.J.;Hong, K.P.;Yang, W.Y.;Lee, J.J.;Lee, B.S.;Hur, H.K.;Kim, J.I.;Yim, J.Y.;In, J.Y.
    • The Korean Nurse
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    • v.33 no.2
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    • pp.45-58
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    • 1994
  • This study was conducted for the purpose of identifying the trends of nursing research and to suggest the direction of future research in the graduate levels of the study. The data was collected from 469 abstracts of master's and doctoral rapers from three graduate schools, one in Nursing, another in Education, and the other in Public Health Graduate College. The results of the study are as follows: The number of research was increased from 102 to 286 between the 1970 s and 1980's. The most frequently employed research design was descriptive studies in the master's level, but there was some balance between descriptive and experimental studies along with some qualitative approaches in the doctoral thesis. Patients were the most often studied sample group reaching 42% of the cases, though it Was noted that there was steady shift: toward the non-ratient population. With this shifting of the study sample, the places of the study also have showed some changes moving toward community. The most widely studied area was in clinical practice. Chronic illness, preventive, and health promoting areas of studies also increased in numbers. However, most of them were at the descriptive level of phenomena and only a few were concerned with cost/effective measures of nursing intervention. The number of variables studied repeatedly more than five times was 43. They were not only physical but also psychosocial aspects which imply the efforts to incorporate the whole person in nursing discipline. However, most researches with repeated studies showed little relation to previous studies, and thus little accumulation in knowledge. There was also little evidence of linkage to nursing theory in most studies of master's level. For the doctoral rapers, 17 out of 51 rapers showed specific theories related to the researches. Based on the above findings, the following suggestions were made. Various research design should be employed including case studies, historical studies, as well as qualitative approaches. There should be more effort to establish linkage between theory and research. The areas needing more attention are Korean Nursing History, Ethics in our Culture, Cost/Effective Measures of Nursing Intervention, Concept and Thory Development, and the Strategies for the Implication of the Research Results in clinical practice.

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Characteristics and Effects of Lifestyle Interventions for Community Dwelling Older Adults: A Systematic Review (지역사회 노인을 대상으로 적용한 라이프스타일 중재의 형태와 효과에 관한 체계적 고찰)

  • Won, Kyung-A;Shin, Yun Chan;Park, Sangmi;Han, Areum;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.8 no.2
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    • pp.7-30
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    • 2019
  • Objective : The purpose of this study was to analyze the format and effects of lifestyle intervention provided to community dwelling older adults. This systematic review was written following the PRISMA guideline. Methods : The National Digital Science Library(NDSL), RISS, PubMed, and CINAHL were used to search for articles published from January 2008 to December 2017. In total, 20 articles were selected for the analysis and the risk of bias was screened through the Physiotherapy Evidence Database Scale. Lifestyle interventions in the articles were classified according to the disease of the participants. Results : Major contents of the lifestyle interventions were increased physical activity like moderately intensive exercise and education or training to help participants have a healthy diet. Of the 20 articles, 17 included more than 2 types of contents. Examining biochemical factors was the most common measurement among the multifaceted measurements used to assess the effects of lifestyle interventions. The results of the lifestyle interventions described in each article did not indicate congruent effects. 14 of the 20 articles reported the lifestyle interventions had significant effects. Conclusions : The results of this study could help practitioners select the contents of and provide lifestyle interventions to older adults. Further study on the various applications of lifestyle interventions in a community setting is necessary.

Prevalence of Metabolic Syndrome and Its Associated Factors among Health Checkup Examinees in a University Hospital (종합건강검진 수검자들의 대사증후군 유병률 및 관련요인)

  • Cho, Young-Chae;Kwon, In-Sun;Park, Jae-Young;Shin, Min-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5317-5325
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    • 2012
  • The purpose of this study was to estimate the prevalence of metabolic syndrome and determine the distribution of the clustering of the metabolic risk factors, and we wanted to evaluated the related factors in urban areas. 1,388 adults of 30 years and over, not recognized as taking medicines for or having cardiovascular diseases, who underwent health package check-up at the health promotion center of a university hospital. All subjects were measured by height, weight, waist circumference, blood pressure and blood chemistry(lipid profile). As a results, the prevalence rates of metabolic syndrome of study subjects were 21.7%, and the rates of metabolic risk factors were HDL-C, blood pressure, TG, abdominal obesity and FBS in that order. And the factors such influencing on metabolic syndrome as age, BMI, smoking habits, vegetable consumption and family history of the diabetes. Consequently, it is suggested that the evaluation and intervention for lifestyle factors may be needed in order to the risk management of metabolic syndrome.

The Effectiveness of a Hospital-Based Obesity Management Program using Korean Medicine in Uzbekistan (우즈베키스탄 한방병원에서 진행한 한의약 비만관리 프로그램의 효과)

  • Lee, Eun-Kyoung;Chong, Myongsoo;Ryu, Young Jin;Kwon, Donghyun;Lee, Joonseok;Jang, Bo-Hyoung;Yun, Jin Won;Park, Yu Lee;Park, Haemo;Lee, Sundong;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.2
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    • pp.23-35
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    • 2015
  • Objective : As part of the Korean Medicine Official Development Assistance(ODA) and Public Health Project, we implemented a obesity management program(OMP) using Korean medicine in Uzbekistan and its follow-up study was conducted to evaluate the effectiveness of the program. Method : We recruited the participants of whose Body Mass Index(BMI) were over $25kg/m^2$ and who agreed to participate in the program at the South Korea-Uzbekistan Friendship Korean Medical Hospital in Uzbekistan. The program consisted of auricular acupuncture, functional food, and education program on diet and exercise. It was provided once a week during 7-week period. Anthropometric measurements and blood test measuring total cholesterol, triglyceride, and glucose were performed at the baseline, the end of the program, and 10-month follow-up. At the end of the program and the follow-up, survey on satisfaction and self-evaluation of the effectiveness of the program was additionally conducted. Results : 43 out of 78 participants completed the program and were included in the analysis. The analysis of the main outcomes showed that there were significant decreases in anthropometric measurements such as body weight, waist circumference, body mass index (BMI) and body fat content as well as blood test including triglycerides, total cholesterol and blood glucose levels. In the follow-up study, 24 subjects participated and 19 subjects (79.1%) reported that they succeeded in weight control. Furthermore, many participants reported that they maintained healthy lifestyles like healthy diet and regular exercise. The satisfaction with the program was also relatively high, and the education program was selected as the most motivating intervention for weight control. The outcomes such as body weight, BMI, body fat content, and blood glucose level were maintained to be at the decreased level; however, waist circumference, total cholesterol and triglycerides levels either returned back to the baseline level or were elevated to the level higher than the baseline. Conclusion : This study suggests that the OMP using Korean medicine may contribute to weight control of obese population in Uzbekistan. It is meaningful in that the study shows the possibility of implementing health promotion programs using Korean medicine in other countries with different cultures. In the future, more efforts to evaluate the effectiveness of the programs using rigorous methodologies and utilize the effective programs in ODA project will be needed.

Projections of Demand for Cardiovascular Surgery and Supply of Surgeons

  • Lee, Jung Jeung;Park, Nam Hee;Lee, Kun Sei;Chee, Hyun Keun;Sim, Sung Bo;Kim, Myo Jeong;Choi, Ji Suk;Kim, Myunghwa;Park, Choon Seon
    • Journal of Chest Surgery
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    • v.49 no.sup1
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    • pp.37-43
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    • 2016
  • Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis

  • Kim, Hyun Jung;Ahn, Hyeong Sik;Lee, Jae Young;Choi, Seong Soo;Cheong, Yu Seon;Kwon, Koo;Yoon, Syn Hae;Leem, Jeong Gill
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.3-17
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    • 2017
  • Background: Postherpetic neuralgia (PHN) is a common and painful complication of acute herpes zoster. In some cases, it is refractory to medical treatment. Preventing its occurrence is an important issue. We hypothesized that applying nerve blocks during the acute phase of herpes zoster could reduce PHN incidence by attenuating central sensitization and minimizing nerve damage and the anti-inflammatory effects of local anesthetics and steroids. Methods: This systematic review and meta-analysis evaluates the efficacy of using nerve blocks to prevent PHN. We searched the MEDLINE, EMBASE, Cochrane Library, ClinicalTrials.gov and KoreaMed databases without language restrictions on April, 30 2014. We included all randomized controlled trials performed within 3 weeks after the onset of herpes zoster in order to compare nerve blocks vs active placebo and standard therapy. Results: Nine trials were included in this systematic review and meta-analysis. Nerve blocks reduced the duration of herpes zoster-related pain and PHN incidence of at 3, 6, and 12 months after final intervention. Stellate ganglion block and single epidural injection did not achieve positive outcomes, but administering paravertebral blockage and continuous/repeated epidural blocks reduced PHN incidence at 3 months. None of the included trials reported clinically meaningful serious adverse events. Conclusions: Applying nerve blocks during the acute phase of the herpes zoster shortens the duration of zoster-related pain, and somatic blocks (including paravertebral and repeated/continuous epidural blocks) are recommended to prevent PHN. In future studies, consensus-based PHN definitions, clinical cutoff points that define successful treatment outcomes and standardized outcome-assessment tools will be needed.

Analysis of Development and Application of Pattern Identification System -Based on Oriental Obesity Pattern Identification- (변증 진단 체계 개발 및 응용 연구 분석 -한방 비만변증을 중심으로-)

  • Park, Jung-Sik;Song, Yun-Kyung;Hwang, Eui-Hyoung;Chung, Won-Suk;Park, Won-Hyung;Cha, Yun-Yeop;Shin, Seung-Woo;Park, Tae-Yong;Jang, Bo-Hyoung;Kim, Ho-Jun;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.2
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    • pp.107-114
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    • 2014
  • Objectives The purpose of this study is analyzing internal research trends of oriental obesity pattern identification in korean literature based on obesity pattern identification questionnaires, development and application of Pattern Identification System to help solve problems of future researches. Methods 6 Korean databases were searched for articles of oriental obesity pattern identification, irrespective of publication year and 13 studies were reviewed. An analytical method such as descriptive statistics and an actual number and percentage was used. Results We collected 13 studies. 4 studies were published in 2012 and 2008, the highest number of studies. 7 Clinical studies were the major research method. The Studies were classified according to the characteristics and design. 5 studies were about research of analysis and improvement of oriental obesity pattern identification questionnaire, the most number of studies. 4 studies were about research of observational studies in clinical on obesity pattern identification. 3 studies were about research of intervention studies in clinical on obesity pattern identification and 1 study was about clinical practice recommendation. Conclusions Establishment of obesity pattern identification system and its clinical application could lead to standardizing obesity pattern identification and clinical practice guideline. Applied on other diseases, obesity pattern identification system could also lead to improving treatment rate, contributing to the development of clinical practice guidelines and academic field of research.