• Journal of Korean Medical Science
• /
• 제33권52호
• /
• pp.339.1-339.11
• /
• 2018

Background: Hip pain is a common musculoskeletal complaint in general practice. Although comprehensive diagnostic approach on hip pain is mandatory for adequate treatment, un- or mis-diagnosis is not rare in primary care. The aim of this study was to analyze descriptively un- or mis-diagnosed hip pain cases referred from primary care to a tertiary hospital, especially in young adults ${\leq}50years\;old$. Methods: We retrospectively analyzed a consecutive cohort of 150 patients (${\leq}50years\;old$) with chronic hip pain (${\geq}6weeks$), which was not diagnosed or misdiagnosed based on the information provided on the referral form. Results: Overall an average 32 cases/month were referred due to hip pain without a diagnosis or with an incorrect diagnosis. Among them, 150 patients were enrolled in this study and 146 (97.3%) could be allocated to a specific disease by using data from routine clinical practice. Four common final diagnoses were femoroacetabular impingement (FAI) syndrome (55.3%), hip dysplasia (HD, 13.3%), referred pain from the lumbar spine (9.3%), and spondyloarthritis (SpA, 7.3%). In patients with FAI syndrome, 37 (44.0%) had pincer-type FAI and 33 (39.8%) had combined-type. Although the pain site or gender was not tightly clustered, the distribution of final diagnosis was significantly different according to hip pain location or gender. Especially, SpA or HD was not observed in younger women subgroup or elder men subgroup, respectively, when stratified by the mean age of participants. Conclusion: Most (> 80%) young patients with hip pain, a difficult issue to diagnosis for many primary physicians, had FAI syndrome, HD, spine lesions, and SpA. This study could give a chance to feedback information about cases with un- or mis-diagnosed hip pain, and it suggests that primary physicians need to be familiar with the diagnostic approach for these 4 diseases.

• 아동학회지
• /
• 제33권4호
• /
• pp.107-127
• /
• 2012

This study investigates the factors influencing service outcomes of group homes and residential care centers, as well as the factors causing any differences between the two service outcomes. 119 and 137 5-6th graders were selected from group homes and residential care centers respectively, using the cluster sampling method. Multiple regression and Blinder-Oaxaca decomposition were used in this study. The results revealed that 'stigma', 'school adjustment', and 'social support' were significant factors influencing service outcomes among children in group homes, while 'stigma', 'primary caregivers' attitude', and 'peer relations' were identified as significant factors among children in residential care centers. The study also found that the mean service outcome score for group homes was higher than that of residential care centers. The 74 percent of this difference in the mean scores was due to the difference in children' characteristics of the two out-of-home care service types. The remaining 26 percent of this difference was due to unobserved characteristics. Finally, the implications of this study in child welfare practices were also discussed.

• 한국치위생학회지
• /
• 제19권3호
• /
• pp.343-350
• /
• 2019

This study focused on the status of dental care development for children and adolescents. In contrast to the chronic disease management project, this research intended to provide basic data for the expansion of the system. We summarized the status of the system's expansion since 2012. It analyzed research reports, papers, related literature and books on the system of children and adolescent dental care service. The literature analysis classifies year, publication, title and published location. The current state of the system is listed as location, target, support funds, etc. Implementation of the project was first discussed in 2007. Initial planning focused on the Oral Health Policy Research Society of the Gunchi. Effective measures were formulated in 2008 under the center of the Gunchi. It is time to discuss the dental care system's direction and development, as well as future aims based on a beneficial program of preventive care. A system of dentistry should be introduced to benefit the entire population.

• 농촌의학ㆍ지역보건
• /
• 제12권1호
• /
• pp.124-132
• /
• 1987

• Parasites, Hosts and Diseases
• /
• 제53권2호
• /
• pp.247-247
• /
• 2015

• 보건행정학회지
• /
• 제1권1호
• /
• pp.54-71
• /
• 1991

Health of a nation is quite often represented by the statistics such as infant death rate and maternal mortality rate. It is indisputable that maternal child health(MCH) is the basis of health of a nation. MCH is also one of the cardinal component of primary health care. The importance of MCH is conspicuous especially in the developing countries. In Korea, People in the rural communities still have high access barrier to basic health care needs, including MCH services. Access to quality care during pregnancy and delivery seems to be the crucial factor in preventing deaths in women and children. The beneficial effects of prenatal and postnatal care on the outcome of pregnancy for mother and child, and those of health professional-attended institutional delivery on the health of mother and child have been well documented in many studies. Recognizing these effects, the government of Korea received IBRD loan of $30 million in 1979 for th purpose of constructing 89 rural MCH centers. The construction is complete now and all 89 MCH centers are under operation ti imporve primary health care for mothers and children in Korea. However, it has been observed over time that overall performance of public MCH centers is declining. The decline has been attributed partly to low quality services by public MCH centers, poor management by health center mangers, competition with for-profit private clinics, and to the development of national health insurance. This study investigates the utilization by rural communities in Korea of MCH services provided by public sector health centers deemed to be physically and financially accessible to the community but suboptimally used. It seeks also to determine the factors that influence people's utilizations. This study sets out to discover a desirable form of MCH center from among alternative forms of centers, thereby to construct a MCH model.

• 한국사회복지학
• /
• 제65권3호
• /
• pp.155-182
• /
• 2013

본 연구는 장기요양보호대상노인의 시설생활 적응과정은 어떠한지, 어떻게 경험하고, 어떠한 행태적 특징을 보이는지를 살펴보는데 그 목적이 있다. 노인요양시설에서 생활하는 노인 15명을 대상으로 심층면담을 한 내용을 Strauss 와 Corbin(1998)이 제시한 근거이론을 활용하여 분석하였다. 분석결과, 15개의 범주와 42개의 하위범주 그리고 170개의 개념이 추출되었다. 장기요양보호대상노인의 시설적응 과정에서 경험하는 중심현상은 '내버려짐'으로 나타났다. 이에 대한 인과적조건, 맥락적조건, 중재적조건, 작용/상호작용 전략과 결과를 통합한 핵심범주는 '받아들임'으로 구체화되었으며, 그 유형에 따라 운명-체념형, 현실-수용형, 자발적-선택형으로 구분되는 것으로 확인 하였다. 연구 결과를 바탕으로 노인을 둘러싸고 있는 상호작용요인으로써 시설환경과 종사자, 시설 내 다른 노인과의 대인관계, 가족의 지지가 강화되도록 실천적 대안을 제시하였다.

• 대한치과의료관리학회지
• /
• 제10권1호
• /
• pp.53-65
• /
• 2022

The Primary Care Patient Measure of Safety (PC-PMOS) is a measure of safety that allows patients to evaluate contributing factors related to patient safety in primary care. This study aimed to examine which questionnaire items of the PC-PMOS could be used in Korean dental institutions. A survey of the Korean translation of the PC-PMOS, a self-reported questionnaire, was conducted in August 2022 by 400 adults who had used dental-care services within the last three years. Of the 77 items, 34 were selected using principal component analysis and two experts' evaluations based on face validity. Five domains were identified from factor analysis: patient centeredness, patient information update, complaint processing, communication, and information about the complaint process. The Cronbach's alpha of the data was 0.913, indicating high reliability. As a result of the generalized multiple regression analysis, regression coefficients were not statistically significant, except for household income. This indicated that there was no bias in the patient safety scores of dental institutions evaluated by patients within the range of independent variables used in this study. The five domains with 34 items identified in this study suggested the factors that contribute to the safety of patients who used dental care services in Korea. However, validation of this study result is still important to refine questionnaires suitable for dental institutions in Korea so as to further improve the quality of dental care.

• Journal of Hospice and Palliative Care
• /
• 제26권2호
• /
• pp.42-50
• /
• 2023

Purpose: The purpose of this study was to identify barriers to effective conversations about advance care planning (ACP) and palliative care reported by health care and community-based service providers in Massachusetts, USA. Methods: This qualitative research analyzed open-ended responses to two survey questions, inquiring about perceived barriers to having conversations about ACP and palliative care with patients and consumers. Data were collected between November 2017 and June 2019 from nine organizations in Massachusetts, including health care provider organizations, health insurers, community-based organizations, and a nursing education institution. Two researchers reviewed and coded the responses and identified common themes inductively. Results: Across 142 responses, primary barriers to ACP included hesitation and lack of understanding and knowledge, discomfort and resistance among service providers, lack of staff knowledge, difficulties with followup, and differences in ACP policies across regions. Common barriers to palliative care were misconceptions about palliative care and lack of knowledge, service providers' lack of preparedness, and limited policy support and availability. Challenges relevant to both ACP and palliative care were fear and discomfort around serious illness discussions, lack of knowledge and awareness, discussions that occur too late, and cultural and language barriers. Conclusion: Health care practitioners and community-based professionals reported consumer-, service provider-, and system-level barriers to facilitating conversations about ACP and palliative care with patients experiencing serious illness. There is a need for more tools and support to strengthen service providers' ACP and palliative care competencies and to promote a structured approach to health care planning conversations.

• 농촌의학ㆍ지역보건
• /
• 제12권1호
• /
• pp.5-27
• /
• 1987

It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.