• Title/Summary/Keyword: Primary Care

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The Determinants of Community Service Utilization Among Family Caregivers of the Impaired Older Persons (만성질환 및 기능손상노인 가족수발자의 재가복지서비스 이용 결정요인에 관한 연구)

  • Lee, In-Jeong
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.183-205
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    • 2004
  • This Study explored three issues in regard to the determinants of community service utilization among family caregivers of the dependent older persons. First, the differences between users and nonusers of community services were compared regarding to predisposing, enabling, need characteristics of the primary caregiver as well as the elder care recipient. Second, the variables which determined the contact of community services were examined. Third, the influence of the variables on duration of the community services among users was also examined. The data collected from 164 family caregivers were used for analyses. Findings suggest that community service users had higher education and higher emotional support, lower family income than nonusers. The level of cognitive impairment of the elder was also higher for users than nonusers. The entry into community services is more likely for elders cared for by caregivers who have higher educational attainment, lower family income and lower level of instrumental support. Once interaction terms for relationship between need factors and social support are entered, caregivers with poorer level of his/her perceived physical health and lower level of instrumental support are more likely to report use of community services. Among those reporting contact with services, more extensive use occurs for caregivers with lower emotional support and lower depression. The entry of interaction terms for relationship between need and support reveals that the combination of lower support(instrumental and emotional) and elder's greater physical impairment are associated with longer period of community service use. However, the effect of caregivers' depression followed the different pattern. For caregivers with greater depression, more supports are related with more service utilization. According to the results, implications for research and practice are discussed.

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Comparative Study on Maternal Health Status With Island and Land Women in A Middle City Area (중도시내(中都市內) 도서(島嶼)와 육지거주부인(陸地居住婦人)의 모성보건실태비교(母性保健實態比較))

  • Kim, Kyu-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.65-75
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    • 1976
  • To compare the maternal health status between women in island and land, the study was conducted to adjacent land (kukdong) and island (kyonghodong) areas in Yosoo city during April 1976. The results obtained from 174 interviewee in island and 192 in land areas were the same as follow, 1. General characteristics of both area. Age: Land, group 20-29 year of age was the largest. Island, 30-39 year of age was the largest. Education; Low educated group, less than primary grade (land 88.6%, island 93.1%), was predominant in both area. Occupation of herself; agriculture and labor was the main occupation (land 50%, island 82.2%) in both area. Occupation of husband: labor and fishery was general (81.2%) in land, and agriculture and fishery was general (81.6%) in island. Duration of residence; Land, 25.0% being resided here more than 10 years. Island, 64.3% being resided here more than 10 years. 2. Marriage, Pregnancy, and Present children. Average age at marriage; Land, 20.7 years. Island, 20.9 years. Average frequency of pregnancy; Land, 4.4 times. Island, 4.3 times. Wastage of pregnancies: Land, 236 per 1000 pregnancies. Island, 151 per 1000 pregnancies. Wastage occupied by induced abortion; land, 73.5%. island, 60.5%. Number and sex of present children; Land, 3.3 per family, sex ratio 52.4 to 47.6. Island, 3.6 per family, sex ratio 53.3 to 46.7. 3. Prenatal and postnatal care. Prenatal consutation: Land, 16.1% received by doctor or midwife. Island 9.2% received by doctor or midwife. Complications during last pregnancy; Land, 46.6% complained. Island, 51.1% complained. Return to work within 1 week after delivery; Land, 40.6%. Island, 50.6%. 4. Delivery environment Home delivery; Land, 97.4% Island, 97.3%. Delivery attdended by non medical professions at home; Land, 80.2% Island, 93.7%. Solo home delivery; Land, 13.0%, Island, 12.9%. Delivery attended by layman without taking any disinfective preparations; Land, 48.1%, Island, 49.1%. Material mainly used to cut umbilical cord at home; Land, scissors (97.4%). Island, scissora (98.8%). Cord cutting material used without giving any disinfective preparations; Land, 79.9%, Island, 84.0%. Delivery sheets used at home; Cement bag paper (land 50.0%, island, 31.3%). Vinyl sheets (land,17.5%, island, 27.6%). News paper (land, 3.2%. island, 11.7%). No sheets (land 19.5%. island, 12.9%). etc. Maternal Meal; Seaweed soup with rice was the most general in both area. (land 95.3%, island, 91.4%).

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Descending Necrotizing Mediastinitis : The Retrospective Review of Surgical Management (하행 괴사성 종격동염 : 외과적 치료의 후향적 조사)

  • 이재진;신호승;신윤철;지현근;이원진;홍기우
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.769-774
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    • 2001
  • Background: Descending necrotizing mediastinitis(DNM) is a serious complication originating in odontogenic or oropharyngeal infection with previously reported mortality rates of 25% to 40%. We retrospectively reviewed the 4 years of our surgical drainage and debridement in DNM. Material and Method: We studied 7 cases diagnosed as DNM from 1997 through 2000. Primary oropharyngeal infection lead to DNM in four cases(57%) and odontogenic abscess in three cases(43%). All patients were received emergent cervicotomy and thoracotomy or sternotomy for debridement of necrotic tissue and mediastinal or pleural drainage. Result: Five cases were evolved well and were discharged after a mean of 42 days. Two patients(28.6%) died. Three patients required reoperation due to local surgical complication; empyema(two) and impending cardiac tamponade. One of these patients died on 12 post-reoperative day due to great vessel erosion, renal and respiratory insufficiency. The other patient died of broncho- esophageal fistula and asphyxia on 10 postoperative day without reoperation. Conclusion: On the basis of experience accrued in treating these patients, early diagnosis by cervicothoracic computed tomographic scan of neck and thorax aids in rapid indication of a surgical approach of DNM. We emphasize that performing early surgical drainage and debridement of necrotic tissues with intensive postoperative care can significantly reduce the mortality rate.

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The Relationship between Habitual Patient-Reported Symptoms and Signs in the Soft Contact Lens Wearers (소프트 콘택트렌즈 착용자에서 평상시 나타난 증상에 관한 연구)

  • Lee, Koon-Ja;Buyn, Jang-Won;Mun, Mi-Young;Leem, Hyun-Sung
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.19-28
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    • 2008
  • Purpose: To understand symptoms and signs in soft contact lens wearers the authors evaluate the attribution of the tear test to the contact lens related symptoms and signs. Methods: Sixty-two healthy soft contact lens wearers (23.95${\pm}$4.38 years old, 18.60${\pm}$16.92 months of prior lens wear) were participated in this study. 3 kinds of tear test and McMonnies' questionnaire test were performed for the soft contact lens wearers and subjective symptoms and objective signs were graded using CCLRU scales during the study period. Results: In this surveys, we found ocular dryness, redness and tiredness are the most common frequent and severe symptoms in soft contact lens wearers. Frequency of the ocular dryness, redness and tiredness are associated with grittiness, burning sensation and foreign body sensation respectively, and severity of the photophobia, foreign body sensation are associated with unstable vision and grittiness and which are associated with score of McMonnies' Questionnaire. Conjunctival redness and limbal redness are major signs but those are not need to be clinical care and rarely occurred corneal and conjunctival staining which are associated with tear break-up-time statistically. Conclusions: Dryness, redness and tiredness are primary common symptoms in Korean soft contact lens wearers. The frequency of those symptoms are increased with the period of soft contact lens wear and those are associated with other symptoms but have no relationship with signs.

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KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea

  • Song, Dae Jin;Song, Woo-Jung;Kwon, Jae-Woo;Kim, Gun-Woo;Kim, Mi-Ae;Kim, Mi-Yeong;Kim, Min-Hye;Kim, Sang-Ha;Kim, Sang-Heon;Kim, Sang Hyuck;Kim, Sun-Tae;Kim, Sae-Hoon;Kim, Ja Kyoung;Kim, Joo-Hee;Kim, Hyun Jung;Kim, Hyo-Bin;Park, Kyung-Hee;Yoon, Jae Kyun;Lee, Byung-Jae;Lee, Seung-Eun;Lee, Young Mok;Lee, Yong Ju;Lim, Kyung-Hwan;Jeon, You Hoon;Jo, Eun-Jung;Jee, Young-Koo;Jin, Hyun Jung;Choi, Sun Hee;Hur, Gyu Young;Cho, Sang-Heon;Kim, Sang-Hoon;Lim, Dae Hyun
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.591-613
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    • 2018
  • Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

Effect of Illuminance on Color-based Analysis of Diabetes-Related Urine Fusion Analytes on Dipstick Using a Smartphone Camera (스마트폰 카메라를 활용한 뇨시험지 당뇨병관련 융합 분석인자의 색기반 분석에 미치는 외부 조도 영향)

  • Kim, Na-Kyung;Cho, Young-Sik;Kim, Seon-Chil
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.93-99
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    • 2021
  • Recently, the miniaturization and digitalization for the inspection devices of point-of-care testing (POCT) are rapidly evolving. In the urine test, a lot of researches on index paper technology are being conducted because people can be self-diagnosed through visual color comparison using a urine test paper, Dipsick. The purpose of this study is to analyze the RGB values from the color changes on Dipstick Pad, which isused for urine test, using a smartphone camera. To this end, the primary, analytes in urine wasdiabetes-related parameters such as glucose, ketone body and pH, which is the most frequently tested elements, and we pursuited to quantify the changes in dipstick color caused from artificial urine containing different ranges of sugar, ketone body, and pH. In this experiment, changes in RGB values under bright and dark illuminances were compared, and changes in RGB value were monitored as a function of concentration of analytes under the ambient illumination of laboratory. As a result, color separation at the bright luminance region was good, but it did not appearat the low luminance region, and the changed profiles in RGB value under different illuminances was suggested to correct the problem of the color separation algorithm.

Development of Evaluation Checklist of School Play Environment Based on Convention on the Rights of the Child : Focus Group Interview (아동권리협약에 근거한 학교 놀이 환경 평가 체크리스트 개발: 초점집단 면접연구를 중심으로)

  • Hwang, Ock-Kyeung;Kim, Jeong-Wha;Myung, Jun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.286-294
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    • 2019
  • The purpose of this study is to determine what children's rights to play are. For this purpose, we extracted the core contents of schools' play environments and we developed a checklist that schools can use to evaluate their own play environments. We reviewed the UN Committee on the Rights of Children and the General Comments No. 17. Through this process, we found 16 core contents that the play environment should have. We conducted focus group interviews with children, parents and teachers, who are principle people involved with school play. The focus group interviews discussed the basic elements of the school play environment. The contents' validity was reviewed by a group of professionals. Based on this, we created an evaluation checklist with 10 major areas of the school play environment. The 10 areas of the school play environment evaluation scale are as follows. The ten areas of the play environment assessment scale for the school environment to ensure children's right to play are sufficient play time, sufficient play space, a child's best interests and the child's participation, nondiscrimination, diversity and freedom, challenge and adventure, safety, school policy, the play has an educating component, and community cooperation.

Caregiving Rewards and Costs of Grandmothers Raising Grandchildren (조손가족 조모가 경험하는 손자녀 양육의 보상과 비용)

  • Han, Gyoung-hae;Joo, Ji-hyun;Lee, Jeong-hwa
    • 한국노년학
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    • v.28 no.4
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    • pp.1147-1164
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    • 2008
  • There has been a sharp increase in the number of grandmothers raising grandchildren in contemporary Korean society. However, little is known about the complexity of the experiences of the custodial grandparenting. Most of the studies mainly examined burden/cost and have paid little attention to the positive aspects of custodial grandparenting. In order to overcome this limitation of previous research, this study aims 1) to examine not only the costs but also the rewards of custodial grandparenting and to explore related factors, 2) to develop the typology based on relative rewards-burden perception of grandmothers about custodial grandparenting and explore the group differences. The data were gathered from 449 grandmothers raising their grandchildren as a primary caregiver, using a structured questionnaire. The data were analyzed using descriptive statistics, correlation, hierarchical multiple regression and ANOVA, with SPSS WIN 12.0 program. Main findings are as follows: First, custodial grandmothers report not only care-giving burden such as physical burnout and economic burden but also various rewards such as joy of watching their grandchildren grow and feeling good about themselves to be a help with their adult children, i.e. grandchildren's father or mother. Second, factors related to the level of perceived cost of grandparenting are different from the factors affecting the positive aspects of grandparenting. Third, results of the two by two cross-tab analysis based on the level of rewards and burden show that about 32 percent of the grandparents belong to Type II group(high rewards-low cost). This result is quite contrary to the assumption of previous research focusing mostly on cost and burden of custodial grandparenting. Fourth, four groups were different in terms of grandmother & grandchildren's characteristics. Implications of these results are discussed.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.