• Title/Summary/Keyword: affect response

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A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment (외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구)

  • Jang, Seung-Ho;Park, In-Hwan;Lee, Sang-Yeol;Roh, Suhee;Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.46-55
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    • 2017
  • Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

Meat Production Characteristics of Black Bengal Goat

  • Chowdhury, S.A.;Faruque, S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.6
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    • pp.848-856
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    • 2004
  • Black Bengal goat is primarily reared for meat, skin comes here as a by-product. The present trial describes the effect of age on different carcass characteristics of Black Bengal goats of either sex. A total of 61 Black Bengal goats of different age and sex groups were slaughtered. They were reared under semi-intensive management on milk alone or with concentrates (of 10.14 MJ ME and 10.48 g M/kg DM) and freshly cut Napier grass (2 MJ ME and 25 g CP/kg of fresh matter) that provides the estimated NRC (1981) requirement. The four age groups were: pre-weaned kids (0-90 day), post-weaned kids (91-180 days), growing (181-365 days) and adult (>365 days). Goats were slaughtered according to 'Halal' method by severing the major vessels of the throat by a transverse cut. Different slaughter parameters of Black Bengal goat can be best predicted from the equations as follows: live weight (kg)=0.801 (shoulder height (cm))-24.32, ($r^{2}$=0.94); carcass weight (kg)=0.364 (height at hind legs (cm))-11.54, ($r^{2}$=0.91); edible weight (kg)=0.623 (shoulder height (cm))-19.94, ($r^{2}$=0.91) and saleable weight (kg)=0.701 (shoulder height (cm))-21.99, ($r^{2}$=0.92). Live weight, carcass weight, edible weight and saleable weight of castrated goat at one-year onward ranges from 20-22, 9.4-10.5, 14-16 and 16.6-18.8 kg, respectively, which are about 80% higher than most of the reported observations on Black Bengal goat of same age and sex. Slaughter weight, warm carcass weight, edible weight and saleable weight increased curvilinearly with age of slaughter but not affected (p>0.05) by sex. However, linearity of the response curve of affect of age on mentioned parameters ends at around 9 months. Visceral fat as per cent of live weight increased curvilinearly with age and attain its maximum (about 6%) at about 500 days. However, linear part of the quadratic model ends at about 300 days when visceral fat content is about 4.8% of body weight. Blood and skin yield for one-year old male goat was 797 g and 1.61 kg, respectively. Absolute yield of blood and skin increased curvilinealry and attained maximum level at about 400 days (13.3 months). Average proportion of different carcass cut were - round 27%, rump 7%, loin 10%, ribs (6-12th) 14%, shoulder 21%, Neck 7%, chest 14%. Thigh and shoulder constituted about 48.3% of the cold carcass weight. Overall crude protein content of meat samples of different carcass cuts progressively decreased with age starting from 57 at 0-90 days to 58, 47 and 33 per cent, respectively at 91-180, 181-365 and >365 days, respectively. Overall meat fat content increased almost linearly from 11.1% during 91-180 days to 22.9 and 39.5% during 181-365 and >365days, respectively. Results from this trial suggest that both carcass yield and carcass composition changes with age; and sex have little or no effect on carcass yield and carcass composition. However, caution should be made in using second conclusion as there were few female animals slaughtered relative to the male. Optimum slaughter age for Black Bengal goat reared under semi-intensive management with adequate feeding and management would be about 9 months when their live weight, warm carcass weight, edible and saleable weight of carcass can be about 16.74, 7.28, 12.05 and 13.81 kg, respectively.

The influence of ginseng, reserpine, and chlorpromazine on epinephrine-induced and morphine induced hyperglycemiae (인삼(人蔘), reserpine, 및 chlorpromazine이 epinephrine 및 morphine 과혈당(過血糖)에 미치는 영향(影響))

  • Cheong, Dong-Kyun
    • The Korean Journal of Pharmacology
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    • v.1 no.1 s.1
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    • pp.17-36
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    • 1965
  • Besides it's all important analgesic action, morphine has, among others, hyperglycemic effect, though not important clinically, which is believed to be resulted from augmented glycogenolysis in the liver and muscles due to the increased liberation of epinephrine from the adrenal medulla upon the stimulation of the posterior part of hypothalamus. It is known that adrenergic blocking agents are acting inhibitory to this sort of hyperglycemia. Much, however, should as yet be studied for the drugs which affect central nervous system and release of endogenous catecholamine as far as their effects on hyperglycemia are concerned. Much is still not known about the effect of ginseng, which has been highly regarded in the Herb Medicine, as far as it's influence on the blood sugar is concerned. Author investigated the effects of chlorpromazine, reserpine and ginseng on epinephrine induced, and morphine-induced hyperglycemiae. Animals used in this experiment were healthy albino rabbits weighing approximately 2.0 kg of body weight and were all fasted for 24 hours, before the experiment undertaken. Blood sugar determination was carried out by Nelson-Somogy method. Results obtained are summarized as follows; 1. The groups of rabbits administered intravenously with epinephrine 0.02 mg/kg, and 0.05 mg/kg, showed marked and transient hyperglycemia within 15 minutes after injection. The maximal rate of elevation in blood sugar to the control level, were 28% and 57% respectively. The blood sugar returned to the control level within 3 hours. Thus, the hyperglycemic responses were paralleled with epinephrine doses. 2. The hyperglycemic responses by morphine were different according to the doses. The groups of rabbits in which 4 mg/kg of morphine was administered, did not show any hyperglycemic effect, but, in which 10 mg/kg of morphine administered, showed severe hyperglycemic effect, resulting in the maximal level within 2 hours after injection. The maximal rate of increasing in blood sugar ,level was 88%. Compared .with epinephrine-injected groups, morphjne-injected groups showed more persistent hyperglycemic effect, but returned to control blood sugar .level in 6 hours after injection. 3. The intravenous injection of chlorpromazine 2 mg/kg and 8 mg/kg evoked a slight, and persistent hyperglycemia. The maximal rate of increasing in blood sugar level were 15% and 23% respectively. These hyperglycemia gradually returned to the normal level in 5 or 6 hours after injection. Thus, the intensity of response was paralleled with the dose of chlorpromazine. 4. The intravenous injection of reserpine 0.2 mg/kg and 0.5mg/kg, showed the most persistent but steady elevation of blood sugar level in this experiments, resulting in the maximal level in 5 hours after injection. The maximal rate of increasing of blood sugar level were 18% and 39% respectively. 5. The blood sugar level from 24 hours to 30 hours after intraperitoneal administration of reserpine 1.0mg/kg, did not show statistically significant difference, compared with control groups. 6. The oral administration of ginseng extract 15 ml/kg did not. show any :change in blood sugar level. 7. The intravenous administration of epinephrine 0.05 mg/kg or morphine 4 mg/kg to the group pretreated with ginseng extract 15 ml/kg $20{\sim}30$ minutes before the experiment, evoked more marked hyperglycemic effect than the non-pretreated group. 8. The intravenous administration of epinephrine 0.02 mg/kg, morphine 4 mg/kg, or morphine 10 mg/kg to the groups pretreated with reserpine 0.2 mg/kg or 0.5 mg/kg $20{\sim}30$ minutes before experiment, produced more marked and persistent hyperglycemic effects than the groups injected with single epinephrine or morphine injection. 9. When epinephrine 0.05 mg/kg or morphine 10 mg/kg administered intravenously to the groups pretreated with the intraperitoneal administration of reserpine 1 mg/kg 24 hours before experiment morphine-induced hyperglycemia was inbibited, but epinephrine-induced hyperglycemia was augmented. 10. When epinephrine 0.05mg/kg or morphine 10 mg/kg administered intravenously to the groups pretreated with chlorpromazine, 2 mg/kg, 4 mg/kg, and 8 mg/kg $20{\sim}30$ minutes before the experiment, morphine-induced hyperglycemia was inbibited, but epinephrine-induced hyperglycemia was more persistent.

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Changes of Glutamate and Polyamine Levels of Hippocampal Microdialysates in Response to Occlusion of Both Carotid Arteries in Mongolian Gerbils (뇌허혈 손상에 있어서 해마-세포외액내 Glutamate와 Polyamine 농도의 변동에 관한 연구)

  • Shin, Kyung-Ho;Kim, Hyung-Gun;Choi, Sang-Hyun;Cho, So-Hyun;Chun, Yeon-Sook;Chun, Boe-Gwun
    • The Korean Journal of Pharmacology
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    • v.30 no.3
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    • pp.273-289
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    • 1994
  • Reversible brain ischemia was produced by occluding both common carotid arteries for 5 min, and the effects of aminoguanidine (AG), $DL-{\alpha}-difluoromethylornithine$ (DFMO), MK-801, and nimodipine (NM) on the ischemia induced changes of the polyamine, glutamate and acetylcholine levels in the hippocampus CA1 subfield and the specific $[^3H]\;MK-801$ binding to the hippocampus synaptosomal membranes were studied with a histological reference of the cresyl violet stained hippocampus. The basal putrescine level $(PT:\;74.4{\pm}8.8\;nM)$ showed a rapid increase (up to 1.7 fold) for 5 min of ischemia, remained significantly increased for 6 h, and then resumed the further increase to amount gradually up to about 3 fold 96 h after recirculation. However, the level of spermidine was little changed, and the spermine level showed a transient increase during ischemia followed by a sustained decrease to about 40% of the preischemic level after recirculation. The increase of PT level induced by brain ischemia was enhanced with AG or MK-801, but it was reduced by DFMO or NM. The basal glutamate level $(GT:\;0.90{\pm}0.l4\;{\mu}M)$ rapidly increased to a peak level of $8.19{\pm}1.14\;{\mu}M$ within 5 min after onset of the ischemia and then decreased to the preischemic level in about 25 min after recirculation. And NM reduced the ischemia induced increase of GT level by about 25%, but AG, DFMO and MK-801 did not affect the GT increase. The basal acetylcholine level $(ACh:\;118.0{\pm}10.5\;{\mu}M)$ did little change during/after brain ischemia and was little affected by AG or NM. But DFMO and MK-801, respectively, produced the moderate decrease of ACh level. The specific $[^3H]\;MK-801$ binding to the hippocampus synaptosomal membrane was little affected by brain ischemia for 5 min. The control value (78.9 fmole/mg protein) was moderately decreased by AG and MK-801, respectively but was little changed by DFMO or NM. The microscopic findings of the brains extirpated on day 7 after ischemia showed severe neuronal damage of the hippocampus, particularly CA1 subfield. NM and AG moderately attenuated the delayed neuronal damage, and DFMO, on the contrary, aggravated the ischemia induced damage. However, MK-801 did not protect the hippocampus from ischemic damage. These results suggest that unlike to the mode of anti-ischemic action of NM, AG might protect the hippocampus from ischemic injury as being negatively regulatory on the N-methyl-D-aspartate (NMDA) receptor function in the hippocampus.

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Study of Rainfall-Runoff Variation by Grid Size and Critical Area (격자크기와 임계면적에 따른 홍수유출특성 변화)

  • Ahn, Seung-Seop;Lee, Jeung-Seok;Jung, Do-Joon;Han, Ho-Chul
    • Journal of Environmental Science International
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    • v.16 no.4
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    • pp.523-532
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    • 2007
  • This study utilized the 1/25,000 topographic map of the upper area from the Geum-ho watermark located at the middle of Geum-ho river from the National Geographic Information Institute. For the analysis, first, the influence of the size of critical area to the hydro topographic factors was examined changing grid size to $10m{\times}10m,\;30m{\times}30m\;and\;50m{\times}50m$, and the critical area for the formation of a river to $0.01km^2{\sim}0.50km^2$. It is known from the examination result of watershed morphology according to the grid size that the smaller grid size, the better resolution and accuracy. And it is found, from the analysis result of the degree of the river according to the minimum critical area for each grid size, that the grid size does not affect on the degree of the river, and the number of rivers with 2nd and higher degree does not show remarkable difference while there is big difference in the number of 1st degree rivers. From the results above, it is thought that the critical area of $0.15km^2{\sim}0.20km^2$ is appropriate for formation of a river being irrelevant to the grid size in extraction of hydro topographic parameters that are used in the runoff analysis model using topographic maps. Therefore, the GIUH model applied analysis results by use of the river level difference law proposed in this study for the explanation on the outflow response-changing characters according to the decision of a critical value of a minimum level difference river, showed that, since an ogival occurrence time and an ogival flow volume are very significant in a flood occurrence in case of not undertow facilities, the researcher could obtain a good result for the forecast of river outflow when considering a convenient application of the model and an easy acquisition of data, so it's judged that this model is proper as an algorism for the decision of a critical value of a river basin.

The Effect of 6 Weeks of Treatment with Inhaled Budesonide on Bronchial Hyperresponsiveness and Adrenal Function in Asthmatic Patients (흡입용 스테로이드인 Budesonide 6주 치료가 기관지 천식환자의 기관지 과민반응과 부신피질기능에 미치는 영향)

  • Kim, Kwan-Hyoung;Oh, Yong-Seok;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.219-227
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    • 1992
  • Background: Acute and chronic airway inflammation are important in the pathogenesis of bronchial asthma. Corticosteroids have proved to be very effective in the management of asthma. Although the mechanism by which they produce this effect is still debated, suppression of the inflammatory response is thought to be the most likely. Although inhaled steroids are known to be safe and have less side effects than oral steroids, the extent which inhaled steroids have beneficial and the detrimental effects in the treatment of asthma has remained open to question. Budesonide is a recently developed corticosteroid for inhalation treatment with a strong local effect combined with rapid inactivation in the systemic circulation. We set out to look in more detail at the time course of change in bronchial reactivity, clinical symptoms and the effects on the adrenal function during 6 weeks of treatment with budesonide (800 ug per day). Methods: Clinical symptoms, pulmonary function test, histamine $PC_{20}$, serum ACTH and cortisol (8 AM and 4 PM) were measured in 23 allergic asthmatic patients before and after 6 weeks of treatment with budesonide. Results: 1) Pulmonary function test; PEFR, FEV1 and FVC after 6 weeks of treatment with budesonide were higher than those before treatment. 2) Clinical symptoms; Clinical symptoms were significantly improved after 3 weeks and 6 weeks of treatment with budesonide. 3) Histamine provocation; Histamine $PC_{20}$ after 6 weeks of treatment with budesonide was significantly higher than that before treatment. 4) Adrenal function; 6 weeks of budesonide therapy did not significantly affect the level of serum ACTH and cortisol. Conclusion: From these results, it is concluded that budesonide therapy improved the clinical symptoms, pulmonary function and bronchial hyperreactivity after 3 weeks of treatment and the improvement after 6 weeks of treatment was higher than that after 3 weeks of treatment. During 6 weeks of treatment with budesonide, the inhibitory effect on the adrenal function was not obvious.

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Effects of Stress and Personality Characteristics on Sleep (스트레스와 성격요인이 수면에 미치는 영향)

  • Yoon, Ho-Kyoung;Kang, Seung-Gul;Ham, Byung-Joo;Lee, Heon-Jeong;Kwon, Ho-In;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.10 no.1
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    • pp.32-38
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    • 2003
  • Objectives: The purpose of this study is to investigate the effects of stress and personality on sleep patterns, and further, to identify potential correlations between stress and personality characteristics. Methods: A total of 174 healthy college students were subjects for this study. Participants filled out the Daily Stress Inventory before sleep and the Modified Pittsburgh Sleep Quality Index after sleep on three consecutive days. They also filled out the 16 Personality Factor Questionnaire (16-PF), BDI (Beck Depression Inventory) and STAI (State-Trait Anxiety Inventory). Results: Minor stresses highly correlated with subjective sleep quality and symptoms of non-restorative sleep. However, total sleep time, sleep latency, awakening frequency, and frequency of dreams were not explained by stress scores. The O (guilty feeling), C (low ego strength) and Q4 (high anxiety) factors of the 16-PF also highly correlated with symptoms of non-restorative sleep and significantly affected sleep patterns. BDI and STAI scores also correlated with the above personality factors and minor stresses. Conclusion: This study showed that minor stresses impaired the restorative effects of sleep. Personality characteristics such as low ego strength, high levels of anxiety, and feelings of guilt were vulnerable to minor stresses. Minor stress, various personality characteristics, different coping patterns, and emotional response are highly correlated with each other and affect sleep patterns.

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Depression and Coronary Artery Disease(I) : Pathophysiologic Mechanisms (우울증과 관상동맥 질환(I) : 병태생리적 기전)

  • Bae, Kyung-Yeol;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.15 no.4
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    • pp.275-287
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    • 2008
  • Depression and coronary artery disease are both highly prevalent diseases. Many previous studies suggest that depression is a common comorbid condition in patients with coronary artery disease and has a significant negative impact on the onset, course, and prognosis of coronary artery disease. However, the exact mechanisms that underlie the association between these two diseases remain unclear. Pathophysiologic mechanisms that may explain the effect of depression on coronary artery disease include hypercoagulability, hypothalamus-pituitary-adrenal axis and autonomic nervous system dysregulation, altered inflammatory response. On the contrary, pathophysiologic mechanisms in coronary artery disease that affect depression are less well known. It is also suggested that both diseases may share a common genetic vulnerability. The authors reviewed the literature on the pathophysiologic relationships of depression and coronary heart disease.

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Influence of Motivational, Social, and Environmental Factors on the Learning of Hackers (동기적, 사회적, 그리고 환경적 요인이 해커의 기술 습득에 미치는 영향)

  • Jang, Jaeyoung;Kim, Beomsoo
    • Information Systems Review
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    • v.18 no.1
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    • pp.57-78
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    • 2016
  • Hacking has raised many critical issues in the modern world, particularly because the size and cost of the damages caused by this disruptive activity have steadily increased. Accordingly, many significant studies have been conducted by behavioral scientists to understand hackers and their practices. Nonetheless, only qualitative methods, such as interviews, meta-studies, and media studies, have been employed in such studies because of hacker sampling limitations. Existing studies have determined that intrinsic motivation was the dominant factor influencing hackers, and that their techniques were mainly acquired from online hacking communities. However, such results have yet to be causally proven. This study attempted to identify the causal factors influencing the motivational and environmental factors encouraging hackers to learn hacking skills. To this end, hacker community members using the theory of planned behavior were observed to identify the causal factors of their learning of hacking skills. We selected a group of students who were developing their hacking skills. The survey was conducted over a two-week period in May 2015 with a total of 227 students as respondents. After list-wise deletion, 215 of the responses were deemed usable (94.7 percent). In summary, the hackers were aware that hacking skills are considered socially unethical, and their attitudes toward the learning of hacking skills were affected by both intrinsic and extrinsic motivations. In addition, the characteristics of the online hacking community affected their perceived behavioral control. This study introduced new concepts in the process of conducting a causal relationship analysis on a hacker sample. Moreover, this research expanded the discussion on the causal direction of subjective norms in unethical research, and empirically confirmed that both intrinsic and extrinsic motivations affect the learning of hacking skills. This study also made a practical contribution by raising the educational and policy response issues for ethical hackers and demonstrating the necessity to intensify the punishment for hacking.

Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.