• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.687-696
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• 2016

Purpose: The purpose of this study was to define and clarify the concept of volition for health behavior. Methods: For this study the process of Walker & Avant's concept analysis was used. Seventeen studies from electronic data basses met criteria for selection. Results: Volition can be defined by the following attributes: 1) planning, 2) maintenance of self-efficacy, and 3) self regulation. The antecedents of volition consisted of: 1) risk awareness, 2) outcome expectation, 3) perceived self-efficacy, and 4) social support. The consequences occurring as a result of volition were: 1) prevention of disability and complications, 2) improvement of functional ability, and 3) enhencement of quailty of life. Conclusion: Definition and attributes of volition identified by this results can be applied to develop measurements and intervention programs for chronic patients health behavior.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.43-52
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• 2019

Purpose: This study aimed to analyze the affecting factors related to cancer screening for persons with disabilities. Methods: We examined the factors affecting cancer screening in individual aged older than 20 years who participated in the 2017 National Survey of the Disabled. The subjects were 6031 individuals with disabilities who were aged older than 20 years. Data were analyzed using descriptive statistics, the chi-square test, and multiple logistic regression with the SPSS Win 21.0 software. Results: Cancer screening among persons with disabilities is differentiated based on age, education level, marital status, type of disability, grade of disability, subjective house economic status, health insurance, chronic disease, unmet healthcare needs, suicidal thinking, and health screening. The significant predictors of health screening were age, marital status, chronic disease, and health screening. Conclusion: Based on the results of this study, it is necessary to develop a program for young, medical care recipients to improve the participations of disabled in cancer screening.

• Journal of Korean Neurosurgical Society
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• v.45 no.5
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• pp.293-296
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• 2009

Objective : Pain has long been regarded as a subjective symptom. Recently, however, some regard a type of intractable chronic pain as a disease. Furthermore, chronic persistent pain becomes a cause of permanent impairment (PI) In 6th edition, the American Medical Association (AMA) Guides has rated the pain as a PI. In Korea, pain has been already been rated as a PI. Here, we examined the present status and the prospect of disability evaluation for the pain in Korea. Methods : Pain can be rated as a PI by the Workmen's Compensation Insurance Act (WCIA) and Patriots and Veterans Welfare Corporation Act (PVWCA) in Korea. We examined the definition, diagnostic criteria and grades of the pain related disability (PRD) in these two acts. We also examined legal judgments, which were made in 2005 for patients with severe pain. We also compared the acts and the judgments to the criteria of the 6th AMA Guides. Results : The PRD can berated as one of the 4 grades according to the WCIA. The provisions of the law do not limit the pain only for the complex regional pain syndrome (CRPS). The PRD can berated as one of the 3 grades by the PVWCA. If there were objective signs such as osteoporosis, joint contracture and muscle atrophy corresponding to the CRPS, the grade is rated as 6. When the pain always interferes with one's job except easy work,the grade is rated as high as 5. In Korea, judicial precedents dealt the pain a sa permanent disability in 2005. Conclusion : Although there were no objective criteria for evaluation of the PRD, pain has been already rated as a PI by the laws or judicial precedents, in Korea. Thus, we should regulate the Korean criteria of PRD like the AMA 6th edition. We also should develop the objective tools for evaluation of the PRD near in future.

• Women's Health Nursing
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• v.30 no.1
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• pp.56-66
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• 2024

Purpose: This study explored the factors influencing the health-related life satisfaction of people with disabilities who engaged in physical activity, by age and gender. Methods: A secondary analysis was conducted of the 2020 Third Disability and Life Dynamics Panel (2021). The participants were 2,796 people who performed regular physical activity at least once a week. The variables selected were disability-related factors (degree of disability, multiple disabilities, and type of disability), sociodemographic factors (age, gender, living alone, and mean monthly family income), and health-related factors (amount of physical activity, self-esteem, depression, chronic disease, subjective health, and health-related life satisfaction). Descriptive statistics, the chi-square test, the t-test, two-way analysis of variance, and multiple regression analysis were conducted. Results: In total, 58.0% of participants were male, and 42.0% were female. For age groups, 14.4% were children/adolescents (0-19 years), 42.6% were adults (20-59 years), and 43.0% were seniors (≥60 years). The mean score for health-related life satisfaction was 5.0±2.15 out of 10. Adults and seniors whose level of physical activity met or exceeded recommendations had higher subjective health. Moreover, men had better subjective health than women in seniors. Health-related life satisfaction was higher among those who had higher self-esteem, were not depressed, did not have chronic diseases, and had better subjective health. Conclusion: Gender significantly influenced health-related life satisfaction in children/ adolescents and seniors. Disability-related factors were significant in adults, and health-related factors were significant in all age groups. Therefore, these factors should be considered when designing interventions to promote subjective health and health-related life satisfaction of people with disabilities.

• Journal of Society of Preventive Korean Medicine
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• v.25 no.3
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• pp.25-37
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• 2021

Objectives : To investigate the effectiveness of Korean Medicine services use on the all-cause mortality and incidence of Parkinson's disease(PD) in elderly patients with chronic disease based on the National Health Insurance Service Corhort Database (elderly), called as the NHIS-senior. Methods : This study was a retrospective cohort analysis conducted using the NHIS-senior. Patients with chronic diseases over 65 years old who were not diagnosed PD during 2007-2009 were identified. The case group was defined as patients who used both Korean Medicine and Western Medicine services and the control group consisted of patients who used Western Medicine service only. The all-cause mortality and incidence of PD was analyzed using the Cox proportional hazard model after a propensity score matching(PSM) with a 1:1 ratio. Results : After PSM, the cohort included 47,546 subjects (23,773 in the case group, 23,773 in the control group). Sex, age, comorbidity, severity of disability, and neurology medical service utilization were adjusted in both groups. The mortality was 0.668 times (95% C.I.: 0.646-0.690) lower in the case group than the control group, which was statistically significant (p<0.001). The incidence of PD was 1.051 times (95% C.I.: 0.962-1.148) higher in the case group than the control group, which was not statistically significant(p=0.272). Conclusion : It was not obvious that the use of both Korean Medicine service and Western Medicine services for prevention of PD is benefitial than using only Western Medicine. But it would be possible that using both Korean Medicine and Western Medicine services decreases the mortality than using Western Medicine alone.

• Health Policy and Management
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• v.24 no.2
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• pp.172-180
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• 2014

Background: People with disabilities have higher prevalence rates and earlier onset of chronic disease than the non-disabled; therefore, their participation in health screening is important. This study evaluates the participation rate and trends in health screening of people with disabilities, and examines the association between their participation rate and disability characteristics, and socioeconomic status. Methods: Data on disability-related characteristics were collected from the National Disability Registry, and participants' corresponding health examination data were taken from the Korean National Health Insurance Corporation between 2002 and 2011. A total of 873,819 participants aged ${\geq}20$ years were analyzed in this study. Results: The rate of participation of people with disabilities in health screening has increased each year, but their participation rate is lower than that of the total population. The participation rate was lower in females than in males; the elderly group than in the younger group; those who live in city areas than rural areas; self-employed for health insurance than employees; those with an internal organ disability than those with an external physical disability; those with a severe disability than those with a mild disability; and those with a short-term disability than for those with a long-term disability. Conclusion: The factors associated with participation rate are age, sex, socioeconomic status, and disability characteristics. These findings indicate that health check-ups of people with disabilities should be promoted using an approach that takes into account the large individual differences in socioeconomic status and disability characteristics in this population.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.738-745
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• 2021

Objective: This study investigated the efficacy of using Nokyonggunbi-tang and other Korean medical treatments for a patient with consumptive disease and chronic fatigue. Methods: A 59-year-old female patient with fatigue, headache, dizziness, and neck pain due to consumptive disease and chronic fatigue was treated with herbal medicine (Nokyonggunbi-tang), together with acupuncture, pharmacopuncture, cupping, and chuna manual therapy, for 22 days. The treatment effects on the pain were evaluated using the scores for the Fatigue Severity Scale (FSS), European Quality of Life Five Dimensions (EQ-5d) Scale, Neck Disability Index (NDI), and Numerical Rating Scale (NRS). Results: Following treatment, the patient showed a decrease in the FSS, NDI, and NRS scores and an improvement in the EQ-5d score. Conclusions: Nokyonggunbi-tang and Korean medical treatment significantly improved fatigue symptoms in a patient with no substrate disease.

• Journal of Preventive Medicine and Public Health
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• v.54 no.5
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• pp.293-300
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• 2021

The study aims to examine the current status and differences in the burden of disease in Korea during 2008-2018. We calculated the burden of disease for Koreans from 2008 to 2018 using an incidence-based approach. Disability adjusted life years (DALYs) were expressed in units per 100 000 population by adding years of life lost (YLLs) and years lived with disability (YLDs). DALY calculation results were presented by gender, age group, disease, region, and income level. To explore differences in DALYs by region and income level, we used administrative district and insurance premium information from the National Health Insurance Service claims data. The burden of disease among Koreans showed an increasing trend from 2008 to 2018. By 2017, the burden of disease among men was higher than that among women. Diabetes mellitus, low back pain, and chronic lower respiratory disease were ranked high in the burden of disease; the sum of DALY rates for these diseases accounted for 18.4% of the total burden of disease among Koreans in 2018. The top leading causes associated with a high burden of disease differed slightly according to gender, age group, and income level. In this study, we measured the health status of Koreans and differences in the population health level according to gender, age group, region, and income level. This data can be used as an indicator of health equity, and the results derived from this study can be used to guide community-centered (or customized) health promotion policies and projects, and for setting national health policy goals.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Clinical and Experimental Pediatrics
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• v.53 no.11
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• pp.936-941
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• 2010

The systematic approach to pharmacologic treatment is typically to begin with the safest, simplest, and most conservative measures. It has been realized that the more rapidly inflammation is under control, the less likely it is that there will be permanent sequelae. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of initial treatment for inflammation. In addition, the slow-acting antirheumatic drugs (SAARDs) and disease-modifying antirheumatic drugs (DMARDs) have efficacy of anti-inflammatory action in children with chronic arthritis. New therapeutic modalities for inflammation, such as etanercept and infliximab, promise even further improvements in the risk/benefit ratio of treatment. It is not typically possible at the onset of the disease to predict which children will recover and which will go on to have unremitting disease with lingering disability or enter adulthood with serious functional impairment. Therefore, the initial therapeutic approach must be vigorous in all children.