• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.248-254
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• 2022

Purpose: To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys. Methods: We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1, 2019 to June 30, 2021. Results: In trauma patients with an Injury Severity Score ≥16 accounted for 27.5% in the non-missed injury group (non-MIG), but this rate was considerably higher at 71.2% in MIG. The mean hospitalization longer in MIG (50.90±39.56) than in non-MIG (24.74±26.11). The proportion of patients with missed injuries detected through tertiary trauma survey (TTS) was 28 patients (23.5%) within 24 hours, 90 patients (75.6%) after 24 hours to before discharge. The majority of missed injuries were fractures (82.4%) and ligament tears (8.4%), which required consultation with the orthopedic department. The final diagnoses of missed injuries were confirmed by computed tomography (44.5%), magnetic resonance imaging (19.3%), X-ray (19.3%), bone scan (11.8%), and physical examination (5.0%). Conclusions: TTS is considered a useful process for detecting missed injuries that were not identified at the time of initial resuscitation in the primary and secondary surveys. In the future, to detect missed injuries quickly, it is necessary to develop a suitable TTS program for each trauma center. In addition, further research is needed to verify the effectiveness of the protocolized TTS and survey chart to improve the effectiveness of TTS.

• 보건행정학회지
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• 제20권1호
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• pp.125-136
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• 2010

Objectives: The purpose of this study is to analyze the proportion of fundus examination of DM patients for preventing microvascular complication and to examine the factors related to fundus examination in DM patients. Methods: This study used 2005 Korean national health and nutrition survey data. We selected all 1,129 diabetes mellitus patients from the data. And we choose 8 factors related to diabetes mellitus patients. These are sex, age group, type of residential area(rural or urban), education level, income level, comorbidity with hypertension, current insulin use, and duration of suffering from DM. We have analysed these factors by whether he had been examined fundus or no through Chi-square and logistic regression analysis. Results: Female DM patients have tendency to get more fundus examination than Male DM patients. And Young patients, patients who live in urban area, well educated patients, high income patients, comorbidity with hypertension, patients have got the insulin injection, patients have long duration of suffering from DM are to get more fundus examination. According to multivariate logistic regression analysis, sex and education level, income level, and duration of suffering from DM, comorbidity with hypertension, patients have got the insulin injection are significant factors on fundus examination for prevent microvascular diabetes mellitus complications. Conclusions and Discussion: We have concluded that physicians and policy makers should consider to fundus examination especially of man and DM patients who have more shorter disease period and low educated patients and low incomed patients and patients who have taken insulin therapy.

• 대한간호학회지
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• 제32권2호
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• pp.165-175
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• 2002

The purpose of this descriptive study was to identify the nursing needs of patients with chronic illness. Method: The subjects of this study were 636 patients with chronic illness, 323 general nurses, and 106 public health nurses. The instruments used for this study were questionnaires including perceived functions of nursing from the center for chronic illness, preference to placement, intention to use, needs to receive services from the center for chronic illness, strategies management for nursing, and nursing needs of chronically ill patients. Results: The mean of perceived functions for nursing from the center were 3.1(0.5) in public health nurses, 2.9 (0.59) in general nurses, and 2.4(1.33) in chronically ill patients. Regards of needs to receive on services of the nursing centers were, the regularly physical examination, for health educational services which was perceived highest request amongst chronically ill patients. We found the means of each specific need as 2.2(0.6), for physical health, 2.1(0.7), for psychosocial health, and 1.8(0.6) for spiritual health. Conclusion: From the results of this study, it is suggested that establishing a nursing center for chronically ill patients consider physical, psychosocial, for spiritual health needs of chronically ill patients. It is also a consideration that direct care for symptom management and health education in the nursing center be implemented.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7685-7692
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• 2013

Background: Management of hypertension and diabetes in cancer survivors is an important issue; however, not much is known about the level of management of such chronic disease in Korea. This study therefore assessed the prevalence, awareness, control, and treatment of hypertension and diabetes in Korean cancer survivors compared to non-cancer survivors. Materials and Methods: A cross-sectional design was employed, wherein data were obtained from standardized questionnaires completed by 943 cancer survivors and 41,233 non-cancer survivors who participated in the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (2007-2011). We calculated adjusted proportions for prevalence and management of hypertension and diabetes in non-cancer survivors and cancer survivors. We also assessed the associated factors with prevalence and management of cancer survivors. Results: Cancer survivors are more likely than the general population to have higher prevalence, awareness, treatment, and control of hypertension. However, diabetic management was not significantly higher in cancer survivors than in non-cancer survivors, despite their having a higher prevalence. Several factors, such as, age, drinking, years since cancer diagnosis, self-perceived health status, and specific cancer types were found to affect to management of hypertension and diabetes. Conclusions: These data suggest that cancer survivors appear to be better than non-cancer survivors at management of hypertension, but not diabetes. There is a need for healthcare providers to recognize the importance of long-term chronic disease management for cancer survivors and for the care model to be shared between primary care physicians and oncologists.

• 한국지역사회생활과학회지
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• 제18권1호
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• pp.71-85
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• 2007

This study investigates differences by type of caregiving using data on three groups of caregivers, 177 from home stay situations, 189 from day care centers, and 138 from nursing homes. First, the result shows that characteristics of both caregivers and elders differ by type of caregiving. Second, caregivers in the home stay situation have the highest caregiving burden of the three groups. Third, from examination of the related variables, the caregiving burden of home stay caregivers is affected by family income, caregivers' health, type of job, and whether or not the elder has symptoms of dementia. Also, the study reveals that emotional services for elders reduce the aggravation of family relations and economic burden, but that instrumental services highly increase economic burden. It reveals that caregivers of elders in day care centers, especially those who are in bad health, are more likely to experience feelings of constriction, aggravation of family relations and economic burden. On the other hand, caregivers who receive more emotional services have better experiences in family relations, including relations with the elder. In case of the elders of nursing homes, if the main caregiver is a daughter-in-law, aggravation of family relations is higher than if the main caregiver is a spouse. Finally, the caregiver's burden is affected by their own health and income, and by whether the elder has symptoms of dementia or stroke.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6389-6392
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• 2013

Background: Cervical cancer is one of the ten most frequent cancers in Turkey. We here examined knowledge about cervical cancer in relation to Papanicolaou (Pap) testing among female primary health care workers in Hatay, a city is located in the south of Turkey. Materials and Methods: The study was completed on 261 women healthcare workers who were or had been sexually active and who accepted to participate to the study. The participants gave verbal informed consent and thereafter questionnaires prepared by the investigators were administered by personal interview. Results: Only 30.3% (n=79) of the participants regularly had a gynecologic examination. While 87.4% (n=228) of the participants reported that they had already heard about the Pap smear test, only 45.2% (n=118) had undergone this test. It was determined that had undergone an average of $1.66{\pm}0.89$ times (1-4) within the last five years. Some 56.0% (n=117) of the participants were well informed about the Pap smear test (p<0,001) and 81.1% (n=63) of the participants who regularly had gynecological examinations (p<0,001) had this test. Conclusions: For the early diagnosis of the cervical cancer, regularly having a Pap smear test is crucial. Healthcare workers should also demonstrate sensitivity about this issue. We think that the importance of the issue should be re-highlighted by organizing in-service training for female primary healthcare workers. Studies are warranted to determine the psychosociological factors that cause individuals to not have the test.

• Tuberculosis and Respiratory Diseases
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• 제62권5호
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• pp.427-431
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• 2007

기관지 연관 림프조직 림프종은 비특이적인 호흡기 증상만을 나타내며, 전산화단층촬영에서 세기관지 폐포암, 림프구성 간질성 폐렴등과 뚜렷이 구분이 되지 않는 결절 외 림프종의 일종이다. 저자들은 비특이적인 호흡기 증상만을 나타내는 병변에 대해 침습적인 방법인 경피 미세흡입생검을 시행하여, 원발성 기관지 연관 림프조직 림프종으로 진단하였으며, 병리적 진단이 내려진 상태에서 치료를 목적으로 좌상엽 절제술을 시행하였다. 기관지 연관 림프조직 림프종은 서서히 진행되는 질환으로, 대부분 최종 진단이 늦어지는 경향을 보인다. 국소적 병변일 경우 외과적 수술로 완치가 가능한 질환이므로, 질환이 의심되는 경우 적극적 검사와 치료를 시도하는 것이 중요할 것으로 생각된다.

• 대한치과의사협회지
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• 제49권3호
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• pp.136-145
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• 2011

Oral cavity cancer accounts for approximately 3-4% of all malignancies and is a significant worldwide health problem. The Korea Central Cancer Registry estimates that there will be approximately 1500 new cases of oral cancer in Korea. Oral cancer occurs most commonly in middle-aged and elderly individuals. The majority of oral malignancies occur as squamous cell carcinomas and despite remarkable advances in treatment modalities, the 5-year survival rate has not significantly improved over the past several decades, hovering at about 50% to 60%. The unfavorable 5-year survival rate may be attributable to several factors. First, oral cancer is often diagnosed at a late stage, with late stage 5-year survival rates as low as 22%. Additionally, the development of secondary primary tumors in patients with early stage disease has a major impact on survival. The early detection of oral cancer and premalignant lesions offers the promise to cure chance of oral cancer. The major diagnostics moddalities for oral cancer include oral cavity examination, supravital staining, oral cytology, and optical detection systems. But the clinical finding of oral mucosa is the most important key to confirm the oral cancer until now. The traditional clinical examination of oral cavity can be performed quickly, is without additional diagnostic expense to patients, and may be performed by health care professionals. Therefore, clinicians must be well-acquainted with clinical characteristics of oral cancer and practice routine screening for oral cancer in dental clinic to decrease the morbidity and mortality of disease.

• Tuberculosis and Respiratory Diseases
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• 제60권2호
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• pp.221-227
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• 2006

연구배경 : 만성 기침은 정밀 검사를 추가하여도 진단율을 향상시키는데 한계가 있고, 확진은 특이적 치료에 반응할 때에만 가능하다. 스테로이드는 비특이적 항염증 작용을 가지므로 만성 기침에 효과적일 수 있다. 본 연구에서는 원인 진단에 대한 진료 한계를 극복하기 위한 방법으로서, 만성 기침에 대한 흡입 스테로이드의 반응률을 알아보기 위하여 시행되었다. 방 법 : 3주 이상의 만성 기침 환자를 대상으로 처음 내원하였을 때 객담 호산구, 메타콜린 기관지 유발검사, 부비동 방사선촬영 등의 기본적인 객관적 검사를 시행하고, 동시에 budesonide turbuhaler $800{\mu}g/day$를 10일간 투여하고 추적 방문토록 하였다. 추적 방문일에 환자 증상의 개선도에 따라 흡입 스테로이드 반응군과 불응군으로 분류하였고 검사의 진단 성적을 조사하였으며, 각 진단에 따른 스테로이드 반응률을 알아보았다. 결 과 : 총 69명의 만성 기침 환자가 최종 분석되었고, 흡입 스테로이드의 투여로 증상의 호전이 있었던 경우는 79.7%였다. 진단된 질환에 따른 흡입 스테로이드의 반응률은 차이가 없었다. 투여 기간 동안 부작용은 거의 관찰되지 않아서 우수한 내약성을 보였다. 결 론 : 만성 기침 환자를 진료할 때 기본 검사를 시행하는 동시에 흡입 스테로이드를 단기간 투여하는 것은 매우 안전하며, 검사의 진단적 한계를 극복하고 초기에 진료 지침을 세우는 방법이 될 수 있다.