• Journal of Korean Biological Nursing Science
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• 제9권2호
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• pp.125-134
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• 2007

Purpose: To examine knowledge and attitudes of nurses on post-operative pain, and to find the factors that hinder pain management by the nurses. Method: Data was collected using a questionnaire from all the nurses working in the surgical units and intensive care units in a hospital in Seoul between March 12 and 22, 2007. Data was analyzed with descriptive statistics, t-test, $x^2$ test, and Pearson Coefficient Correlation. Result: The average knowledge score on pain was $9.33{\pm}1.55$, and that for analgesics was $6.89{\pm}2.00$. There was a significant difference in knowledge of analgesics in terms of career(p=0.012), present work place(p=0.024) and education(p=0.042). The knowledge on pain etiology was significantly different in career. Around 61.1% of respondents answered that they would administer analgesics immediately if patients complaint pain, and 94.1% re-administer analgesics if the VAS score is over 5.69.3% thought that their knowledge was adequate for pain management. The attitudes of pain management were significantly different in career. Conclusion: We found that a further improvement on nurses' knowledge on pain management and analgesics is necessary. This study also suggests a need for professional education for nurses on post-operative pain management.

• 한국지역사회생활과학회지
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• 제23권4호
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• pp.419-439
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• 2012

Family dissolution and economic difficulties of the grandchild's parents are the most prevailing reason for an increase of grandparent-headed families in rural Korea. However, there is a lack of empirical research looking at the experiences of custodial grandmothers, social support, and their psychological well-being. In this regard, this study examined the effect of social support (formal & informal) on the psychological well-being of custodial grandmothers in rural Korea. For this purpose, quantitative and qualitative research methods were conducted. Quantitative data were gathered, using structured questionnaire, from 311 grandmothers who were raising their grandchildren in rural Korea as primary care-givers. Statistical methods used for data analysis were descriptive statistics and hierarchical regression analysis with SPSS WIN 19.0 programs. Qualitative data were collected by in-depth interviews to 10 custodial grandmothers in rural area. The results of this study are as follows. First, almost half of the parents of the grandchild didn't visit and didn't call anymore. Some relatives -aunt, uncle, etc.- support the grandparent-headed family economically and emotionally. 3/4 of the grandparent-headed families were supported by the government and community. This was not small numbers, but the amount of economic support was low. Second, grandmothers in the study showed quite a high level of depression while their happiness level was relatively low. There were differences in the factors influencing the level of happiness/depression of these rural grandmothers. Overall, the study's results showed the importance of formal & informal support for psychological well-being of the custodial grandmothers in rural Korea. Policy and theoretical implications are discussed.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.265-278
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• 1996

This paper concerns professional socialization of medical students. Professional socialization, in the context of this paper, means the process through which a layperson becomes a doctor equipped with professional identity and values. While medical education does not include such process in the curriculum, medical students obtain certain values and identity informally. The dependent variables were professional values and professionalism. The former means the desirable attributes required to conducting professional works such as humane attitudes, science-oriented mind, capability for organizational management. The latter means socio-political reasoning with which doctors can rationalize their privileges such as autonomy. A specially designed questionnaire was developed. The data were collected from five medical schools for 1,318 students in 1994. A total of 1,070 cases were finally included in the statistical analysis. The students emphasized the human factor in the professional values. Their attitude did not change with the grade. Other independent variables such as motives for entering a medical school, socioeconomic status, satisfaction with medical education, etc. also did not influence professinal values. It implies that professional values were not consolidated among the students. However, the factors of professionalism change significantly with the grade. It implies that the students paid more attention to socio-political issues related to doctor's interests as the grade went up. And the factor scores for professionalism were higher for those students who had more positive attitude towards doing medical practice for profit, expected higher income, and were more conservative about social reform. Other independent variables did not influence professionalism. It seems that the students also give emphasis on professionalism, like current medical doctors, mainly because of their concern with recent unfavorable changes in economic conditions of medical care providers.

• Journal of Preventive Medicine and Public Health
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• 제50권2호
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.257-262
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• 2018

Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

• Journal of Preventive Medicine and Public Health
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• 제51권5호
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• pp.242-247
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• 2018

Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3767-3772
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• 2012

Objective: We estimated the total medical costs incurred during the 5 years following a cancer diagnosis and annual medical use status for the six most prevalent cancers in Korea. Methods: From January 1 to December 31, 2006, new patients registered with the six most prevalent cancers (stomach, liver, lung, breast, colon, and thyroid) were randomly selected from the Korea Central Cancer Registry, with 30% of patients being drawn from each cancer group. For the selected patients, cost data were generated using National Health Insurance claims data from the time of cancer diagnosis in 2006 to December 31, 2010. The total number of patients selected was 28,509. Five-year total medical costs by tumor site and Surveillance, Epidemiology, and End Results (SEER) stage at the time of diagnosis, and annual total medical costs from diagnosis, were estimated. All costs were calculated as per-patient net costs. Results: Mean 5-year net costs per patient varied widely, from $5,647 for thyroid cancer to $20,217 for lung cancer. Advanced stage at diagnosis was associated with a 1.8-2.5-fold higher total cost, and the total medical cost was highest during the first year following diagnosis and decreased by the third or fourth year. Conclusions: The costs of cancer care were substantial and varied by tumor site, annual phase, and stage at diagnosis. This indicates the need for increased prevention, earlier diagnosis, and new therapies that may assist in reducing medical costs.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7753-7756
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• 2014

Incidence trends of head and neck cancer (HNC) have implications for screening strategies, disease management, guiding health policy making, and are needed to further oral cancer research. This paper aims to describe trends in age-adjusted HNC incidence rates focusing on changes across calendar period between 2007 and 2010 in Australian Northern Territory. Age-adjusted incidence rates of HNC were calculated for 2007-2010 using Northern Territory population based data assembled by Department of Health, Northern Territory Government of Australia. Changes in the HNC rate ratio (RR) and Estimated Annual Percentage Change (EAPC) between 2007-2008, 2008-2009 and 2009-2010 were calculated. A total of 171 HNC patients were recorded by the Northern Territory Department of Health during the time period between 2007 and 2010, out of which, 135 were males (78.9% of male HNC patients) and 36 were females (21.1% of female HNC patients). In conclusion, HNC incidence rate has decreased in the Northern Territory Australian males but remains unchanged in Australian females. High incidences of HNC may be associated with the high smoking rate and high alcohol consumption in the Northern Territory. Continued monitoring of trends in HNC incidence rates is crucial to inform Northern Territory based cancer prevention strategies.

• 경영과정보연구
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• 제31권2호
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• pp.173-197
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• 2012

본 연구는 점차 확대되고 있는 중국 서비스 시장의 개방과 외국계 의료기관들의 중국시장 진출시도가 본격화 되고 있는 현시점에서 중국 소비자들의 외국계 의료서비스 이용 의사결정과정에 대한 분석과 설명을 위한 이론적 분석 모형을 개발하기 위하여 수행되었다. 본 연구의 결과를 요약하면 의료서비스를 제공하는 국가의 국가이미지는 해당 국가에 대한 태도와 해당국가의 의료서비스에 대한 태도에 영향을 미쳤다. 게다가 국가이미지는 국가에 대한 태도를 통해 이용의도에 간접 영향을 미치기도 하지만 해당 국가의 의료서비스 이용의도에 직접적인 영향관계를 가지고도 있었다. 그러나 국가이미지와 해당국가에 대한 태도 등에 영향을 받아 형성된 의료서비스에 대한 태도는 의료서비스 이용의도에 직접적인 영향관계를 가지지 못하였다. 따라서 중국 의료시장에서의 성공을 위해서는 한류로 형성되어져 있는 국가이미지와 우호적인 태도 등을 활용하는 적극적 전략이 필요할 것으로 보인다.

• 디지털융복합연구
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• 제13권12호
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• pp.303-311
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• 2015

본 연구의 목적은 환경문제 인식, 친환경 태도, 친환경 간호수행의 상관관계를 알고자 하는데 있다. 191명의 병원 간호사가 2012년 10월부터 11월까지 자기기입식 설문을 작성하였으며, 자료 분석은 t-test, one way ANOVA, Pearson 상관관계, multiple regression analysis를 사용하였다. 설문은 환경문제인식, 친환경태도, 친환경보건 관리로 구성되었고, 환경문제인식 (r=.46, p<.001), 친환경태도 (r=.36, p<.001), 친환경 보건관리 사이에 양의 상관관계가 있었다. 변수들에 대한 설명력은 35.0%였다. 본 연구를 통해 국내 병원 간호사의 환경문제와 친환경태도에 대한 인식도를 향상시킬 필요가 있음을 증명하였다. 본 연구 결과를 통해 병원 간호사의 친환경 간호수행을 향상시키기 위한 병원 내 친환경 프로그램 개발 연구를 제언한다.