• Journal of agricultural medicine and community health
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• v.32 no.3
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• pp.139-153
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• 2007

Injury in agriculture is a serious public health issue with a major impact on the lives of Korean farmers. It is one of the leading causes of death and is also a major cause of longand short-term disability. In 2001, the social cost of one accident in agricultural machinery was estimated as 97.7-97.8 million won that is 4 fold of farm household income in Korea. Effective prevention and control of injuries requires a system of surveillance that monitors the incidence of injuries, their causes, treatment and outcomes. This requires an integrated system of data collection, analysis and interpretation and communication. Creating effective injury surveillance system in Korea requires to establish a framework for a national agenda. Discussions regarding the development of the framework should address, but not be limited to issues related to Data Holdings and Linkages; Capacity and Skills; Communication; Interconnection; and Surveillance Products. Ideally, an injury surveillance system would meet the information requirements across all sectors, while allowing each to have the ongoing information it needs for its policy and programming needs. This study was carried out to develop a surveillance system of agricultural injuries in Korea. Study subjects were residents who lived in a typical agricultural area (Yangpyung area in Kyung-gi province). The main data sources were reports of village headmen, compared with data of 'National Emergency Management Agency', 'National Health Insurance Corporation', 'Insurance of National Agricultural Cooperative', and 'Emergency Medical Centers'. Each data were reviewed to validate the strengths and weaknesses.

• Journal of agricultural medicine and community health
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• v.27 no.2
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• pp.107-126
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• 2002

Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.869-879
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• 2000

The purpose of this study was to assess the perceived exercise self-efficacy and exercise benefits/barriers of Korean adults with chronic diseases, and the relationship between the two variables. For the study, 249 Korean adults with chronic diseases with ages ranging from 18 to 79 years were recruited from hospitals or health centers in five Korean cities and surrounding rural areas. The research instruments were the scales that researchers psychometrically verified the Exercise Self-Efficacy Scale, developed by Bandura (1997), and the Exercise Benefits/ Barriers Scale, developed by Sechrist, Walker, and Pender(1987). Results of descriptive analysis showed that Korean adults with chronic diseases perceived relatively low exercise self-efficacy and relatively high exercise benefits/ barriers. Exercise self-efficacy was significantly correlated with gender, education, regular exercise, and exercise benefits/barriers was significantly correlated with gender, regular exercise. Pearson correlation coefficient showed the significant relationship between the two variables. Further researches, which are a study to evaluate a causal structure for Pender's Health Promotion Model and an intervention study to increase physical activity of chronic patients, are recommended.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.351-360
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• 2012

Background: Identification of reliable predictors of leisure time physical activity (LTPA) will enable healthcare providers to intervene and change the patterns of LTPA in the population to improve community health. Objectives: The objectives of this study were to determine prevalence and pattern of LTPA among adult Saudis aged 18-65 years, and to define the socio-demographic determinants that correlate with LTPA in Al-Hassa, Saudi Arabia. Subjects and Methods: A cross-sectional study of 2176 adult Saudis attending urban and rural primary health care centers were selected using a multistage proportionate sampling method. Participants were personally interviewed to gather information regarding socio-demographics, physical activity pattern using the Global Physical Activity Questionnaire (GPAQ). Physical activity (PA) in each domain was expressed in metabolic equivalents (METs). Results: The median total METs minutes/week for LTPA for both genders was 256, higher for men (636 METs minutes/week) compared to women (249METs minutes/week). Overall, only 19.8% of the total PA was derived from LTPA. Of the sampled population 50.0% reported doing no leisure activity. Using the cut off of 600 METs-minutes/day or 150 minutes of moderate intensity over 5 or more days/week, only 21.0% of the included sample were considered as being sufficiently active and 10.4% were in the high active category with beneficial health effects. Multivariate regression analysis showed that male, younger age (<35 years), absence of chronic disease conditions and moderate level of total PA were significant predictors for being active in the LTPA domain. Conclusion: The prevalence and intensity of LTPA among the included sample demonstrated low levels. Nearly 80% of the included sample population did not achieve the recommended LTPA level with beneficial health effects. Female gender, urban residence and associated chronic diseases correlated with a low LTPA.

• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2785-2791
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• 2014

Aims: To analyze time-dependent changes in female breast cancer (BC) mortality in China, forecast the trend in the ensuing 5 years, and provide recommendations for prevention and management. Materials and Methods: Mortality data of breast cancer in China from 1991 to 2011 was used to describe characteristics and distribution, such as the changes of the standardized mortality rate, urban-rural differences and age differences. Trend-surface analysis was used to study the geographical distribution of mortality. In addition, curve estimation, time series modeling, Gray modeling (GM) and joinpoint regression were performed to estimate and predict future trends. Results: In China, the mortality rate of breast cancer has increased yearly since 1991. In addition, our data predicted that the trend will continue to increase in the ensuing 5 years. Rates in urban areas are higher than those in rural areas. Over the past decade, all peak ages for death by breast cancer have been delayed, with the first death peak occurring at 55 to 65 years of age in urban and rural areas. Geographical analysis indicated that mortality rates increased from Southwest to Northeast and from West to East. Conclusions: The standardized mortality rate of breast cancer in China is rising and the upward trend is predicted to continue for the next 5 years. Since this can cause an enormous health impact in China, much better prevention and management of breast cancer is needed. Consequently, disease control centers in China should place more focus on the northeastern, eastern and southeastern parts of China for breast cancer prevention and management, and the key population should be among women between ages 55 to 65, especially those in urban communities.

• Journal of agricultural medicine and community health
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• v.40 no.1
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• pp.9-20
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• 2015

Objectives: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. Methods: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. Results: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). Conclusions: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.

• Journal of agricultural medicine and community health
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• v.45 no.3
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• pp.141-153
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• 2020

목적: 한국은 지역사회 기반 통합 돌봄(커뮤니티케어)을 통해 노인들을 위한 보건 및 사회복지 서비스의 확대를 추진하고 있다. 본 연구는 노인의 경로당 이용에 대한 인구사회인적 요인, 삶의 만족도, 건강상태 등이 미치는 영향을 파악하고자 한다. 연구방법: 2017년 노인실태조사 자료를 이용하여, 횡단 분석 연구가 실시하였다. 이용패턴을 파악하기 위해 기술통계를 하였고, 경로당 이용과 관련된 요소들을 결정하기 위해서는 다변량 로지스틱 회귀분석을 실시하였다. 연구결과: 지난 12개월간 노인 1만299명 중 22.7%가 경로당을 이용하였다. 경로당을 이용하는 이유 중 가장 많은 응답은 경로당 동료들과 여가를 보내기 위함이었으며, 대상자의 95% 이상이 제공되는 서비스에 만족하고 있었다. 사회인구학적 특성에 대해서는 여성(AOR=1.20; 95% 신뢰 구간(CI), 1.05-1.38), 80세 이상 노인(AOR= 3.94, 95% CI, 3.30-4.71), 문맹자(AOR=5.27; 95% CI 3.80-7.30), 교육 수준이 낮거나 읍면 지역 출신(AOR=6.42; 95 % CI, 5.72-7.20)이 경로당을 이용할 가능성이 가장 높았다. 생활 만족도 부분에서는 재정적 만족도(AOR=1.21; 95% CI, 1.06-1.37), 문화에 대한 만족도(AOR=1.49; 95% CI, 1.24-1.79) 및 친구들과 사회에 대한 만족도(AOR=4.24; 95% CI, 3.17-5.66)가 높은 사람이 경로당을 더 많이 이용하는 것으로 나타났다. 질병이 없다는 응답자에 비해 만성 질환을 2개 이상 보유한자(AOR= 2.01; 95 % CI, 1.60-2.53)의 경로당 이용률이 2 배 더 높았다. 결론: 정부의 지역사회 기반 통합돌봄 정책 수립을 위하여 경로당 이용에 영향을 미치는 인구사회학적요인, 삶의 만족도, 건강상태와 관련된 요인들을 고려하여, 이용률을 높이고, 건강관리를 위한 통합 돌봄 시설이 될 수 있도록 하여야 할 것이다.

• Journal of the Korea Convergence Society
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• v.10 no.6
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• pp.49-58
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• 2019

This study aims to analyze the relevance between oral health practices and oral discomforts of the elderly in an urban-rural area by surveying the elderly in welfare centers for the Elderly-continued oral health care program. The result shows that the elderly brush their teeth under regular oral care, and practice oral health life by scaling for the prevention of periodontal disease. Most of the elderly who drink alcohol have experienced implant care and tend to quit drinking after the treatment, and seemed to get their oral discomfort relieved. However, no relevance is found between implant experiences and social discomfort. Furthermore, the elderly who had bad breath expressed pronunciation, taste, pain and chewing discomfort, and social discomfort (P>.05). The educational level of the elderly did not have an impact on oral discomfort, but smoking, chewing and bad breath discomfort seemed to be related to social discomfort(P>.05). Therefore, since oral discomfort of the elderly causes social discomfort which decreases their quality of living, we recommend oral health departments of local governments to help the elderly maintain happy lives by continuing to study the practical use of reducing oral discomfort.

• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.43-51
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• 2024

Objectives : This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods : The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the 'Agricultural Cohort' registered at the Centers for Farmers' Safety and Health Center. Trained interviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those with scores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results : Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6% in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included marital status (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions : The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.