• Journal of Preventive Medicine and Public Health
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• 제10권1호
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• pp.3-15
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• 1977

In order to find out health problems among inhabitants in slum areas in Kwanak-Ku, Seoul, a series of health survey was conducted upon 510 households by interview from March to December, 1976. The results obtained were as follows: 1. Employments of householders were unstable; Out of 508 householders, 164(32.3%) were unemployed and 184 (36.2%) were daily or temporary employees. 2. Average number of households per house was 2.0 and average area of residential room per person was $4.0m^2$. 3. 476(93.3%) out of 510 households were supplied with tap water and rest of them made use of ground water as a source of drinking water. 4. Only 279(18.3%) out of 1527 live births were delivered at medical facilities, 496(32.7%) were at home attended by doctors or midwives and 358(25.1%) took prenatal care. The above findings were worse in urban slum area than in other urban area of relatively high economic level, but were better than in rural area of less medical facilities. 5. Initiation of treatment were delayed until their illnesses were advanced in most of the households, 472(92.5%) out 510. In the early stage of the illness, 131(25.6%) of the house-holds sought physicians in their clinics or general hospitals and 250 (40.9%) visited chemists, to toy drugs at first hand. Frequency of visits to physician increased to 52.8% as the disease aggravated in later stages. 6. Cost of medical expenditure per household amounted to 815 won, and was paid to, in the order of chemists, physicians, chinese herb stores, chinese herb doctors. 7. Concerning the health knowledge of the inhabitants, 273(53.9%) out of 506 respondents were aware of the infectivity of pulmonary tuberculosis, and 68(13.4%) of them checked regularly their chest findings by X-ray at least once every two years. 8. As for the family planning, although 448(87.3%) out of 510 respondents were in favor of it, 215 (41.8%) of them were actually practicing contraception. 9. About 40.6% (125 respondents) of them obtained information and knowledge concerning contraception through personal contact with family planning workers. 10. Nutritional status of housewives was generally poor: 49(38.3%) out of 128 housewives were found to be anemic and average serum protein level was $7.5{\pm}0.82g/dl$.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.379-388
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• 2001

Background : Cervix cancer is the most common form of cancer among Korea women. in spite of proof that cervical cancer screening could reduce death rates substantially, the screening rates reported by previous Korean studies remain stubbornly very low. Behavioral studies to increase the cervix cancer screening rate are essential in order to develop the cancer screening program. Objective : To evaluate the factors which are related to the intention and behavior for cervix cancer screening using the Theory of Planned Behavior (TPB) and the Theory of Reasoned Action (TRA). Methods : The survey was conducted from July 21 st to 26th in 1998. Of 3,218 women, 303(12.2%) between 30 and 55 years old, voluntarily participated in the survey in the 3 Myeons in Choongju city. Charge-free cervix cancer screening was provided for the subjects 3 months later. Results : The R-square of both TPB and TRA to the intention (30% and 42%, respectively) was greater than the actual behavior (21% and 13%, respectively. TPB and TRA were found to provide an appropriate framework for the study of cervix cancer screening behavior. However, TRA was more powerful in explaining the intention, not only because the perceived behavioral control component exhibited lower reliability and validity than other components(altitude and subjective norm), but also because there may have been a few limitations in this study design. Consequently, the use of TRA is preferred in attempting to explain intention and actual behavior in this study. Conclusions : This study suggests that a successful intervention program should focus on changing attitudes and reducing psychologic barriers, rather than on just providing information. Physician recommendations, and the support of family members and friends are also very important factors in cervix cancer program participation. Physicians, friends, family members, and opinion leaders in rural areas, all of whom could affect the individual subjective norm, may all have the potential to play great roles as facilitators.

• 한국방사선학회논문지
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• 제15권5호
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• pp.761-770
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• 2021

의사의 지도권과 고용권의 남용됨에 따라 직종 간의 독립적인 관계 확립을 위해 각 의사 및 의료기사 단체들의 입장과 일본, 미국, 영국의 교육제도 및 법령을 통해 '지도' 문구 및 의료기사 단독법의 분석을 토대로 국민 보건 향상을 도모하고자 한다. 관련 이해 집단 간의 주요 입장 차이를 분석하였으며, 1963년 이후 발의된 국회 의안 발의 및 판례를 분석하고 선진국의 법과 비교 분석하였다. OECD 회원국 중 우리나라를 제외한 26개국이 의료기사 단독법이 제정된 상황이며, 지도와 감독의 의미는 나라마다 상이하다. 의료기사법 등은 8개 의료기사등의 법을 전부 대변해 주기에는 20세기의 법으로는 시대적 흐름과 상황을 적용하기 부적합하며, 보건의료체계는 전문성, 다양성, 국제화 추세와 발맞춰 나아가야 하며, 더불어 의사의 지배권 아래에 있는 지도 및 감독의 문구를 미래지향적 수평적 관점에서 변화가 불가피할 것으로 사료된다.

• Journal of Preventive Medicine and Public Health
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• 제36권2호
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• pp.101-107
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• 2003

Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.

• 대한간호학회지
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• 제35권8호
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• pp.1493-1499
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• 2005

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

• Journal of Preventive Medicine and Public Health
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• 제28권3호
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• pp.563-575
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• 1995

In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBI(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and Chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBI data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality, duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.84-96
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• 1987

For the purpose of preparing the basic data for further cancer epidemiologic study and cancer patients control, we conducted the analysis on the degree and structure of deaths from cancer in metropolitan areas of Korea with 7,934 certified cancer deaths records of Seoul, Pusan, Taegu and Incheon in 1982. The analyzed results were as follows: 1) The total number of cancer deaths in metropolitan areas were 7,934 (male: 4,749, female: 3,185) as 14.1% of deaths from all causes in the same area. 2) The rate of physician's certification on cancer deaths was 77.4% and most of cancer deaths (84.4%) occured at their home. 3) Cancer specific death rate was 51.7 per 100.000 population (male: 62.9, female: 41.9) and age-adjusted cancer death rate was 82.4 in male and 51.6 in female per 100,000 population. And the difference was statistically significant (p< 0.01). 4) Age-specific cancer death rate was generally increased with age and most of cancer deaths (male: 75% , female: 65%) occurred from 45 to 74 years old. 5) The first three orders of cancer site were stomach (32.7%), liver (28.8%), lung (11.7%) in male and stomach (30.6%), uterus (18.4%), liver (13.8%) in female. And the relative frequency of these three cancer sites among total cancer deaths was corresponded to 73.2% in male and 62.8% in female. 6) The ratio of male to female cancer death rate was 1.5:1. And the ratio was aboye 3.0 in esophagus, liver, larynx, bladder cancer and the ratio was similar to 1.0 in stomach, pancreas, leukemia, brain, colon cancer, but the ratio was reversed in gall bladder and bile duct, and thyroid cancer.

• Journal of Preventive Medicine and Public Health
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• 제33권1호
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• pp.99-108
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• 2000

Objectives : The purpose of this study was to examine the present status of cancer screening recommendations(beginning age, interval, recommended screening methods, etc.) by physicians and analyze the association between physician's characteristics and the content of their recommendations. Methods : Data were collected from March 1 to April 30 of 1997, and 373 physicians who were from different hospital settings all over Korea were interviewed by telephone about their screening recommendations for stomach, cervical and breast cancer for these who provided cancer screening services. Results : For stomach cancer screening, respondents recommended that cancer screening begin at 40 years of age(57.8%), with a 1 year interval(77.2%), and by gastrofibroscopy (86.2%). For cervical cancer screening, respondents recommended that cancer screening begin at 25 years of age(42.0%), with a 1 year interval(67.8%), and by using a Pap smear(100.0%). For breast cancer screening, respondents recommended that cancer screening begin at 35 years of age(38.7%), with a 1 year interval(57.3%), and by mammography (97.3%). Conclusions : To establish appropriate cancer screening recommendations for Korea, if may be useful to consider the above results concerning medical care providers.

• 한국화재소방학회논문지
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• 제30권3호
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• pp.124-132
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• 2016

직접의료지도란, 현장에서 환자에게 응급처치를 수행하거나 이송하는 구급대원이 의사에게 전문적인 지도와 자문을 제공받는 행위를 말한다. 본 연구는 직접의료지도의 이용 실태를 파악하고 관련요인을 조사하고자 실시되었다. 광주광역시에 근무하고 있는 119 구급대원 153명을 연구대상으로 하였고, 자기기입식 설문조사를 이용하여 자료를 수집하였다. 통계분석은 SAS version 9.3을 이용하였다. 연구대상자 중 약 82%가 최근 한 달 이내 직접의료지도 경험이 있었고, 다중로지스틱 회귀분석 결과 기혼자인 경우(OR = 3.87, 95% CI = 1.22~12.27), 1급 응급구조사인 경우(OR = 2.87, 95% CI = 1.02~8.09), 심혈관계 응급환자를 처치한 경우(OR = 9.19, 95% CI = 1.87~45.08)에 직접의료지도 이용에 대한 교차비가 유의하게 높았다. 따라서 향후 직접의료지도 내용과 제도 개선 시 119 구급대원의 특성과 처치하는 환자의 질병상태를 고려한다면 직접의료지도 활성화에 도움이 될 것이다.

• Journal of Preventive Medicine and Public Health
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• 제40권4호
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• pp.321-328
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• 2007

Objectives : The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. Methods : The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physician-diagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. Results : Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to non-cases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (p-interaction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). Conclusions : Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.