• 제목/요약/키워드: Public Health Doctor

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만성질환이 노인들의 스트레스인지, 우울증상 경험 및 자살생각에 미치는 영향 (The Influence of Chronic Disease on the Stress Cognition, Depression Experience and Suicide Thoughts of the Elderly)

  • 최령;문현주;황병덕
    • 보건의료산업학회지
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    • 제4권2호
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    • pp.73-84
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    • 2010
  • This study conducted a secondary analysis by using original data of performed by Korea Institute for Health and Social Affairs to determine factors affecting doctor's diagnosed disease-related mental health for the elderly aged over 65 years living in Korea. The survey was conducted in 2007 and it evaluated finally 720 cases by excluding cases with no answer or a wrong answer. The results were as follows. The proportion of the elderly who stress cognition was influenced when subjects were female and older, lower subjective health condition and osteoporosis, showed statistically significant difference. The proportion of the elderly who experience depression was influenced when subjects were older, had not health insurance or medical care, and lower subjective health condition, showed statistically significant difference. The proportion of the elderly who have suicide thoughts was influenced when subjects were female and higher educational background, lower subjective health condition, COPD(Chronic obstructive pulmonary disease), and diabetes mellitus, showed statistically significant difference. We knew that the relationship between diseases and depression in the elderly influenced on the depression about most of the diseases. Particularly, Depression and suicide had a high correlation. The results suggest that it should be necessary to systematic management of diseases in the depression treatment of the Elderly in Korea.

주치의에 대한 인식도 전화 조사 (A Telephone Survey on the Opinions about Family Doctor)

  • 서홍관;강재헌;김철환;김성원
    • Journal of Preventive Medicine and Public Health
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    • 제31권2호
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    • pp.310-322
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    • 1998
  • 국민들의 주치의에 대한 인식도 및 수요 등을 알아보고 주치의제도와 관련된 기초자료를 제공하기 위하여 1997년 1월 현재 서울시, 청주시, 안성군 3곳에 사는 주민들을 대상으로 3개 지역에서 각각 600 개씩 총 1,800개의 전화번호를 다단계 층화 무작위 표본추출(multi-stage stratified random sampling)하였다. 이와 같이 선정된 전화번호를 대상으로 각 지역마다 200명씩 조사가 완료될 때까지 20세 이상의 전 가구원을 대상으로 전화설문조사를 실시하였다. 이 조사 결과를 요약하면 다음과 같다. 1. 주치의가 있는지 여부를 물었을 때 남성은 9.9%, 여성은 13.2%가 가지고 있다고 응답하여 남녀간에 의미 있는 차이가 없었다. 이를 전체로 보면 11.9%가 주치의를 가지고 있는 반면 85.4%는 가지고 있지 않았고 2.7%는 모른다고 응답했으며 이는 지역별로 유의한 차이를 보이지 않았다. 또한 학력 수준에 따른 차이는 없었으며, 연령이 증가할수록 주치의를 가진 사람들이 많았다. 2. 현재 주치의가 어떤 과 의사인지를 살펴보면 내과의사 62.1%, 일반외과 의사 12.1%, 소아과 의사 6.1%, 한의사 4.5% 순이었다. 이를 남녀별로 비교해본 결과 한의사를 주치의로 둔 남자는 20명중 3명(15%) 이었으나 여자들은 한 명도 한의사를 주치의로 두고 있지 않았다. 이외의 모든 과 에서 남녀간에 통계학적인 차이가 없었다. 지역별로는 서울 지역보다는 안성, 청주 등 지방에 거주하는 사람들이 내과의사를 주치의로 두고 있는 경향을 보였다. 3. 주치의로 삼고 싶은 진료과목은 내과가 61.8%로 가장 많았고, 가정의가 15.9%로 두 번째였으며, 그밖에 소아과 5.8%, 산부인과와 한의사가 각각 5.6%였다. 여자들이 남자들에 비해 가정의학과, 산부인과를 선호하고 있고, 여자들에 비해 남자들이 내과를 더욱 선호하고 있었다. 이들 과를 제외한 다른 과 에서는 남녀간 차이가 없었다. 지역별로는 청주 지역에서 가정의학과 의사를 선호하고 있었고, 내과 의사인 경우 지역별로 선호도의 차이는 없었다. 또한 학력이 높을수록 가정의학과를 선호하고 있었고, 내과 의사에 대한 선호도는 학력 수준과 관련성이 없었다. 4. 주치의 등록제에 대해서 들어본 적이 있느냐는 질문에 16.0%만이 알고 있다고 응답했고, 84.0%는 모른다고 응답했다. 이와 같은 인지율은 남녀간에 차이가 없었다(p>0.05). 서울 지역에 거주하는 사람들이 여타 지역보다 인지율이 높은 것을 알 수 있었다. 5. 주치의 등록제가 시행될 경우 등록할 생각이 있느냐는 질문에 48.0%는 그렇다고 대답했으며, 17.4%는 할 생각이 없다고 응답했고, 34.6%는 잘 모르겠다고 응답했다. 남자들이 여자들보다 유의하게 등록 의사를 가진 사람들이 많았고, 대도시 지역으로 갈수록 등록 의사를 가진 사람들이 많았다. 또한 학력이 높을수록 등록 의사가 많았다. 6. 주치의 등록을 하겠다는 경우에 등록하는 이유에 대해서 질문한 결과 건강을 지키는데 도움이 될 것 같아서가 68.2%, 병원 이용이 편해질 것 같아서가 28.7%, 보험료 혜택이 있으니까가 2.3% 등이었다. 7. 주치의 등록제를 이용하지 않는다면 어떤 이유에서인지를 물은 결과 귀찮기만 하고 도움이 될 것 같지 않아서가 68.8%, 주치의 등록료가 너무 비싸서와 보험료 혜택이 적어서가 각각 10.9%, 7.81% 등이었다. 8. 1인당 1년에 2만원인 주치의 등록료에 대한 의견을 물은 결과 적당하다는 의견이 63.1%, 비싸다는 의견이 32.7%, 싸다는 의견이 4.2%였다. 이를 남녀별로 비교한 결과 여자들이 등록료에 대하여 유의하게 비싸다고 생각하고 있었으며, 지역별로는 차이가 없었다. 또한 학력이 낮을수록 1년에 1인당 2만원인 현행의 주치의 등록료에 대하여 너무 많다고 생각하는 사람들이 많았다.

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Effectiveness of Home Visiting Treatment using Traditional Korean Medicine

  • Kim, Na-Young;Lee, Jae-Hoon;Go, Ho-Yeon;Youn, Sang-Jun;Lee, Jae-Hyok;Lee, Dong-Nyoung;Shin, Mi-Ran
    • 대한한의학회지
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    • 제32권6호
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    • pp.103-111
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    • 2011
  • Objectives: The study was investigated to assess efficacy for home visiting treatment using Traditional Korean Medicine (TKM). Methods: The traditional medical doctor of Um-Sung health center has treated the 109 patients and they also answered the questionnaires of home visiting treatment using TKM before and after. The questionnaires were composed of flexibility, pain, health behavior, perception of health, satisfaction, cognition of TKM, etc. The questionnaires were analyzed by use of paired t-test and chi-square test. Results: They have significantly improved the flexibility (p<.001), pain (p<.001), health behavior (p<.001), and the perception (p<.001) of health after home visiting treatment. It was also brought to improve about the perception of TKM, and showed a good satisfaction and the improvement of health. Conclusion: Home visiting treatment using TKM is helpful to improve the health based on these results. We need to systemize the research for the activation of home visiting treatment using TKM.

농촌 지역 보건소 일차의료의 질 평가 (Evaluating the Primary Care Quality of a Public Health Center in a Rural Area)

  • 변영관;최용준
    • 농촌의학ㆍ지역보건
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    • 제42권1호
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    • pp.24-35
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    • 2017
  • 이 연구의 목적은 한국형 일차의료 평가 도구(KPCAT)를 이용하여 한 농촌 지역 보건소의 일차의료의 질을 평가하는 것이다. 또 이 연구에서는 KPCAT 적용 및 결과 해석과 관계된 몇 가지 방법론적 이슈를 검토하였다. 농촌 보건소 진료 의사에게 4회 이상 진료받은 환자 79명이 KPCAT 설문에 응답하였다. 응답자의 특성을 빈도와 백분율, 중앙값과 사분위 범위, 평균과 표준 편차로 제시하였다. 일차의료의 질은 KPCAT 총점과 영역별 점수의 중앙값과 사분위 범위로 제시하였고 최댓값과 최솟값, 기대 점수와 함께 방사형 도표로 제시하였다. KPCAT 문항별 점수와 중앙값과 사분위 범위, 기대 점수 이상 응답자 비율, 잘 모름 응답자 비율을 제시하였다. 연구 대상 농촌 지역 보건소 일차의료 질의 중앙값과 사분위 범위는 각각 45점, 16점이었다. KPCAT 영역별 점수 중앙값이 기대 점수에 이른 영역은 최초 접촉 하나였다. KPCAT 문항별 점수가 기대 점수 이상인 응답자 비율이 50% 미만인 문항은 포괄성 4문항 중 2개, 조정 기능 3문항 전부, 전인적 의료 5문항 중 2개, 가족 및 지역 사회 지향성 4문항 전부였다. 잘 모름 응답의 처리 방침 개선, 잘 모름 응답률이 높은 문항의 타당성 검토, 응답 척도의 내용과 점수의 일치 등이 방법론적 개선 과제였다. 농촌 지역 보건소 일차의료의 질은 개선할 여지가 많았다. 특히 조정 기능과 가족 및 지역 사회 지향성 영역의 개선 필요성이 두드러졌다. KPCAT의 방법론적 개선을 통하여 타당하고 신뢰성 있는 일차의료 평가가 이루어지기를 기대한다.

지역사회 여성 주민의 건강보험제도를 활용한 건강검진 및 암검사 수검 특성 (The Factors Associated with Health and Cancer Screening Using Preventive Programs from Health Insurance among Women of a Community)

  • 김영복;이원철;노운녕;조선진;백희정;손혜현;이순영;맹광호
    • 보건교육건강증진학회지
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    • 제20권1호
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    • pp.41-60
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    • 2003
  • This study, performed to analyze the factors associated with health and cancer screening using preventive programs form health insurance among the women of a community, through a survey of about 923 women in Euijungbu-city. The subjects of the study were selected by a proportional cluster sampling method. The self-reported questionnaire was intended to fine factors associated with health screening and cancer screening. The results of this study were as follows: 1. In the case of health screening using health insurance, 14.1% of the subjects turned out to have been screened once or more in their respective life-time. Reasons given for non-participation in the screening were : 'lacking screening information', a belief that' it's not useful' and a belief that they' weren't sick'. 2. The factors associated with health screening behavior were age, educational level, number of doctor visits, BMI and health promotion behavior(p<0.01, p<0.05). Also, the factors associated with health screening behavior were cue to action and health status, and the predictors on health screening behavior were age and health promotion behavior(p<0.01, p<0.05). 3. In the case of cancer screening through the health insurance, 7.4% of the subjects turned out to have been screened once or more respectively in their life-times. Reasons given for non-participation in the screening were : 'lacking screening information', a belief they 'weren't sick' and that it's not useful'. 4. The factors associated with cancer screening behavior were age, educational level, income, alcholol intake, exercise, number of doctor visits and BMI(p<0.01, p<0.05). Aditional factors associated with cancer screening behavior were cue to action, health belief score and health status. Predictors for cancer screening behavior were: age, health belief score, screening attitude and health status(p<0.01, p<0.05). As indicated by the above results, a lack of information was an important factor for a lack of participation in screening. Age and cue to action were also important factors in promoting the cancer screening rate. Therefore, a dissemination of information about cancer screening contributes to the promotion of a screening rate, and cooperation between health insurance and local health cancer facilitates to be public the community-based cancer screening program.

산림치유 프로그램의 현황과 학제간 융합가능성에 대한 전망 (A States about Forest Therapy Program in Korean and the Prospect for the Fusion of Korean Medicine with Forestry)

  • 홍민아;이한결;한은경;권영규
    • 한국한의학연구원논문집
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    • 제16권3호
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    • pp.95-105
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    • 2010
  • Background and Purpose : Forest-Therapy has received attention as a treatment of regulating living habits with the increase of chronic disease. Forest-Therapy and Korean Medicine are in same as their philosophy to adapt to nature and they can suggest new alternative treating of chronic diseases. Now we want to look the possibility of development of Forest-Therapy program adopting Korean Medicine with the analysis of research status and cases of Forest-Therapy. Methods : We searched articles in Korea by using keyword 'Forest-Therapy', 'Forest & Therapy' 'Forest' and 'Therapy' Korean. Results : Even though the domestic research about Forest-Therapy is still insufficient, there is a need of try referring the cases of Germany and Japan. Forest-Therapy program was used to get psychological stability, release stress and treat alcohol diseases. There was some cases that adopt the nature to clinical field actively. The clinical articles were mainly published about stress and health. Conclusions : It seems that running the constitutional program that considers different among individuals adopting Sasang constitutional medicine, utilizing Forest-Therapy Doctor through the participation of Public Oriental Medicine Doctor, and operating experience program applying Herb have sufficient possibility.

국가 암 비용 감소를 위한 환자중심 진료의 적정성 확보 전략 (Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea)

  • 배종면
    • Journal of Preventive Medicine and Public Health
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    • 제50권4호
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    • pp.217-227
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    • 2017
  • In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

Urine therapy briefing for scientists

  • Kang, Kook-Hee
    • 셀메드
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    • 제2권4호
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    • pp.32.1-32.3
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    • 2012
  • Urine is a gift of God for the health of human being in proverbs of the Old Testament in Hindu. Urine therapy (UT) is not a mysterious folk remedy, it is doctor's examined prescription based on modern science and UT is recommended strongly with absolute confidence. It is effective and amazing to a number of incurables such as chronic fatigue, lingering, a cold, nose allergy, diabetes, high blood pressure, and gout. Also, UT is applied not only for human beings but also for animals, the latter including amazing effects for pigs and cows. The purpose of this manuscript is to help change the misunderstandings of urine and UT and to help reader realize it is one of the helpful alternative remedies.

Nurse-perceived Patient Adverse Events and Nursing Practice Environment

  • Kang, Jeong-Hee;Kim, Chul-Woung;Lee, Sang-Yi
    • Journal of Preventive Medicine and Public Health
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    • 제47권5호
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    • pp.273-280
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    • 2014
  • Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea

  • Kim, Hyesun;Seo, Kawoun
    • 지역사회간호학회지
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    • 제33권4호
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    • pp.446-455
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    • 2022
  • Purpose: This study investigated the mediating effects of acceptance action on the relationship between diabetes distress and self-stigma in older adults with diabetes. Methods: A descriptive research approach was adopted using 187 patients diagnosed with diabetes mellitus by an endocrinology doctor. The data were collected from 26 to 31 March, 2020 and were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient analysis, and hierarchical multiple regression. Results: The mean scores for diabetes distress, self-stigma, and acceptance action were 2.98±0.64, 2.54±0.74, and 4.16±0.35, respectively. Acceptance action partially mediated the relationship between diabetes distress and self-stigma (z=1.98, p=.024), with an explanatory power of 51.0%. Conclusion: To reduce diabetes self-stigma among old adults in diabetes distress situations, it is necessary to improve their acceptance action and develop step-by-step differentiated acceptance action enhancement programs through multidisciplinary collaborations.