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A Study on Health Seeking Behavior - Focused on Shopping-Around Phenomenon in Banwol-Eup Residents (일부(一部) 지역사회(地域社會) 주민(住民)의 의료(醫療) 행태(行態)에 관(關)한 연구(硏究) - 반월읍(半月邑) 주민(住民)의 Shopping-around 현상(現象)을 중심(中心)으로 -)

  • Choi, Young-Teak;Lee, Eun-Il;Kim, Hyo-Joong
    • Journal of agricultural medicine and community health
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    • v.11 no.1
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    • pp.44-54
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    • 1986
  • This study was aimed at investigating the health seeking behaviors of patients; For the purpose of analyzing the research theme we classified the study into two phase. First, the types of patients' health seeking behavior were categorized into a scheme according to what medical care resources were utilized in patients' coping process. Second, from patients' first visits to third visits to medical resources, we analyzed variations of factors which noted as crucial elements in constituting the patients' sickness career. To grasp the generalized characteristics from complicated empirical data, we limited the scope of our analysis to third stage of health seeking. A total of 121 persons who had beer suffering from chronic diseases more than 3 months was sampled among the residents of Banwol-Eup, the target Area of Korea University Health Project. The findings are as follows ; 1) In the course of visiting medical care resources, 34 different types of health seeking Behavior were found. From this result we inferred the idea that patients in Banwol-Eup had not any stable norms to cope with their pains. Clinics, hospital, pharmacy, Herb-doctors', folkways (self-treatment) were accessed by patients in orders. But more than half of patients who had utilized clinics or hospitals from their first to third visits, changed medical care resources to others, for example herb doctors or folkways, which had fundamentally different treatment models. Upon these two facts, the diversified types and capricious patterns in the health seeking behavior of Banwol patients, we observed a typical Shopping-Around phenomenon. 2) Factors which influenced patients' to their sickness career were changed along the courses of health seeking, from first to third visits as follows ; $\cdot$ Perceived seriousness of diseases were tended to decrease. $\cdot$ Professional medical personnel tended to be influencial in the patients' sickness career, (5.0%, 25.0% and 65.7%). The influence of the primary interaction groups such as parents, friends, neighbours, tended to decrease ; (90.9%, 71.2% and 30.0%). $\cdot$ The subjective reasons why to choose such a medical care resource were related to economic affordability and disease-itself as main motives. Credibility of health resources tended to increase 14.9%, 24.0% and 31.4 sequently. $\cdot$ Geographic accessibility factors did not change significantly. Most of patients had utilized health resources in Banwol and Anyang area. 3) Cultural inclination in the shopping-around phenomenon has shown difference among age groups. The age group' over 50 years' preferred traditional health resources to modern health resources. 4) Consistency of health seeking behavior on the shopping around phenomenon has shown difference according to the degrees of patients' economic affordability and those of psychological satisfaction toward modern health services. However, there were some restrictions in this thesis ; a) the study was limited to the 3rd health seeking career so it did not allow us to collect more informations after that, b) the study was not able to carry out causal analysis on patients health behavior determinated by explanatory model of health resources, and c) the study was not able to take into consideration of factors connected with social structural circumstances. Despite of restrictions described above, we are sure that this thesis would promote health providers' understanding toward patients' inclinations, through which they could provide efficient and accurate medical service.

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Review of Primary Chest wall Tumors (원발성 흉벽종양의 임상적 고찰)

  • Sohn, Sang-Tae;Chon, Soon-Ho;Shin, Sung-Ho;Kim, Hyuck;Chung, Won-Sang;Kim, Young-Hak;Kang, Chung-Ho;Park, Moon-Hang;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.988-994
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    • 1998
  • Background: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. Materials and methods: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. Results: Among a total of 68 patients 33(48.5%) were males and 35(51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients(17.6%) were from the 6th decade, and 10 patients(14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases(32.1%) were in the 4th decade and among the malignant tumors, 6 cases(40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases(26.4%). Osteochondroma and lipoma each had 8 cases(15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications(and their postoperative courses were uneventful). Conclusions: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

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CLINICAL CHARACTERISTICS AND TREATMENT COURSES OF THE CHILDREN WITH SELECTIVE MUTISM (선택적 함구증 아동의 임상특성 및 치료경과)

  • Chung, Sun-Ju;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.74-89
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    • 1995
  • Selective mutism is a childhood condition defined by persisten failure to speak in specific social situation when speaking is expected, dispite preserved ability to comprehend spoken language and speak. Present study is to investigate clinical characteristics, treatment method and outcome of 23 children who were diagnosed as selective mutism by DSM-IV criteria at the child psychiatry ouptatient department of SNUH. The results were as follows : 1) The Sex ratio was 1: 4.8, female dominant Mear age of onset was 33 years old and mean age of first referral was 7.7 years old. 2) 22% of subjects had perinatal problem such as low birth weight, preterm birth, 26% of the subjects have history of delayed language development. There are subjects who had been separated with mam caretaker before 3 years old(26%) and who experienced physical or psychological trauma before 3 years old(26%). A few subjects had enurests(30%) and encoprests(4%). 3) Many subjects(65%) had symbiotic relationship with their mother. These families consist of dominant, verbally aggressive mother and passive father. Parents of 39% of all subjects were judged to have definite psychopathology(social phobic, depression, hysterical trait or alcohol problem) 26% of all subject, were reported physically abused. 4) The personality trait of the subjects were frequently described as follows(in order of frequency) ; Shy(100%), anxious(83%), stubborn(83%)m rigid and tense posture(78%), immature(65%) overdependent(65%), irritable(52%), manipulative(39%), depressive(39%). 5) The mean performance IQ of 16 subjects by KEDI-WISC was 88.3 Among them, the subjects with IQ below 69 were seven and those with IQ above 70 were nine. When comparing these two group(Mental retardation group vs Normal IQ group), we could find some difference in language development, personality trait, family dynamics and treatment outcome. 6) Among several treatment methods for selective mutism, play therapy was the most frequently used method(65%). Other commonly used treatment methods were pharmacotherapy(21%), behavioral therapy(8%), combined therapy(play therapy+pharmacotherapy+family therapy+behavioral therapy)(12%), 7) Regarding the outcome of treatment 8.6% was evaluated as Excellent, 30.4% as Good, 52% as Fair, 8.7% as Poor at the tinic of treatment. At follow up interview 21.7% was evaluated Excellent, 13% as Good, 21.7% as Fair, 34.8% as Poor. 8) We classified all subjects by Havden's 4 subtype. Symbiotic mutism was most common(65%) and other subtypes are Speech phobic mutism(8.6), Reactive mutism(13%) and Passive-aggressive mutism(30%).

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Science Teachers' Diagnoses of Cooperative Learning in the Field (과학교사들이 진단한 과학과 협동학습의 실태)

  • Kwak, Young-Sun
    • Journal of the Korean earth science society
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    • v.22 no.5
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    • pp.360-376
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    • 2001
  • This qualitative research investigated in-service science teachers' perceptions about cooperative learning and their perceived barriers in implementing cooperative learning in their classrooms. The underlying premise for cooperative learning is founded in constructivist epistemology. Cooperative learning (CL) is presented as an alternative frame to the current educational system which emphasizes content memorization and individual student performance through competition. An in-depth interview was conducted with 18 in-service science teachers who enrolled in the first-class teacher certification program during 2001 summer vacation. These secondary school teachers's interview data were analyzed and categorized into three areas: teachers' definition of cooperative learning, issues with implementing cooperative learning in classrooms, and teachers' and students' responses towards cooperative learning. Each of these areas are further subdivided into 10 themes: teachers' perceived meaning of cooperative learning, the importance of talk in learning, when to use cooperative learning, how to end a cooperative class, how to group students for cooperative learning, obstacles to implementing cooperative learning, students' reactions to cooperative learning, teachers' reasons for choosing (not choosing) student-centered approaches to learning/teaching, characteristics of teachers who use cooperative learning methods, and teachers' reasons for resisting cooperative learning. Detailed descriptions of the teachers' responses and discussion on each category are provided. For the development and implementation of CL in more classrooms, there should be changes and supports in the following five areas: (1) teachers have to examine their pedagogical beliefs toward constructivist perspectives, (2) teacher (re)education programs have to provide teachers with cooperative learning opportunities in methods courses, (3) students' understanding of their changed roles (4) supports in light of curriculum materials and instructional resources, (5) supports in terms of facilities and administrators. It's important to remember that cooperative learning is not a panacea for all instructional problems. It's only one way of teaching and learning, useful for specific kinds of teaching goals and especially relevant for classrooms with a wide mix of student academic skills. Suggestions for further research are also provided.

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Research of university students' awareness of career development and their preparation for employment (대학생의 진로개발과 취업준비에 대한 인식 연구)

  • Park, Ki-Moon;Lee, Kyu-Nyo
    • 대한공업교육학회지
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    • v.34 no.2
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    • pp.103-127
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    • 2009
  • The purpose of this study is to offer the basic data regarding the problems of the employment training activities and their solutions by way of the research and analysis of the awareness of career development of university students and their preparation for employment opportunities. The results of the study are as follows. First, it is necessary that the students themselves make plans for future jobs and their preparation for them, from the start of their university work. This includes taking employment preparation courses as liberal arts requirements. It also needs to have a systematic association with some organizations such as employment preparation centers. Second, it is necessary that the career portfolios of university students be accepted as materials for objective evaluation so that the companies use them at the time of hiring new employees. If those materials are stored and managed in a database even after their graduation, they will be the strong foundation for the competitive power of the university.Third, it is necessary that university students establish the orientation of employment training in advance, according to their personal and disciplinary possibilities by diagnosing the level of basic employment ability they possess and that they find out the appropriate programs, both personal and disciplinary, to enforce the abilities they need to develop further. Accordingly, it is necessary to have an evaluation system in order to assess student's basic employment abilities, so as to increase the degree of their employment preparation and its support strategy based on the evaluation. Fourth, in the higher education level, university students' lower awareness (M=2.86) of their discipline satisfaction, their major selection, and the university's employment opportunity service shows that it is necessary that there be close connection between learning and work. For short-term purpose, the quantitative and qualitative evaluation must be preceded about the various employment training programs and self-development programs offered by the university. From the long-term perspective, it is urgently necessary that the university ensure the human resources development experts for the purpose of diagnosing employment services within the university.

Outcome of Continuous Renal Replacement Therapy in Children (소아에서 지속적 신대체요법의 치료 결과)

  • LIm, Yeon Jung;Jin, Hyun-seung;Hahn, Hyewon;Oh, Sei Ho;Park, Seong Jong;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.68-74
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    • 2005
  • Purpose : There is growing use of continuous renal replacement therapy(CRRT) for pediatric patients, but reports about the use and outcome of CRRT in children is rare in Korea. We report our experiences of CRRT in critically ill pediatric patients. Methods : We reviewed the medical records of 23 pediatric patients who underwent CRRT at Asan Medical Center between May 2001 and May 2004. We evaluated underlying diseases, clinical features, treatment courses, CRRT modalities and outcomes. Results : Ages ranged from three days to 16 years with a median of five years. Patients weighed 2.4 to 63.9 kg(median 23.0 kg; 10 patients ${\leq}20kg$). The underlying diseases were malignancy(nine cases), multiple organ dysfunction syndrome(five cases), hyperammonemia(four cases), acute renal failure associated with liver failure(three cases), dilated cardiomyopathy(one case) and congenital nephrotic syndrome(one case). Pediatric Risk of Mortality(PRISM) III score was $17.6{\pm}7.6$ and the mean number of failing organs was $3.0{\pm}1.7$. Duration of CRRT was one to 27 days(median : nine days). Eleven patients(47.8%) survived. Chronic renal failure developed in two cases, intracranial hemorrhage in one case, and chylothorax in one case among the survivors. PRISM III score and the number of vasopressor before the start of CRRT was significantly lower in the survivors($12.7{\pm}4.2$ and $0.9{\pm}1.1$) compared with nonsurvivors($22.1{\pm}7.8$ and $2.4{\pm}1.4$)(P<0.05). Conclusion : CRRT driven in venovenous mode is an effective and safe method of renal support for critically-ill infants and children to control fluid balance and metabolic derangement. Survival is affected by PRISM III score and the number of vasopressors at the initiation of CRRT.

Different Clinical Courses of Henoch-Schönlein Purpura in Children, Adolescents and Adults (Henoch-Schönlein Purpura에서 연령에 따른 임상 양상 및 예후에 관한 고찰)

  • Hong, Joo Hee;Na, Hyung Joon;Namgoong, Mee Kyung;Choi, Seung Ok;Han, Byng Geun;Jung, Soon Hee;Kim, Hwang Min
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1244-1251
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    • 2005
  • Purpose : $Henoch-Sch{\ddot{o}}nlein$ purpura(HSP) is the most common and benign systemic vasculitis in children. Few reports have focused on worse outcomes of HSP in adults. The age of onset is suggested as a main risk factor. We assessed the characteristics of adolescent-onset HSP. Methods : We retrospectively analyzed 205 cases presented from Aug. 1993 to Oct. 2003. Patients were classified as children(<10 years of age), adolescents(10-20 years of age), and adults(>20 years of age). Results : The mean age was $5.7{\pm}1.8years$ in 149 children, $13.5{\pm}2.4years$ in 38 adolescents, and $44.9{\pm}14.5years$ in 18 adults. The male to female ratio was 1.2 : 1 in children and adolescents, and 2 : 1 in adults. Previous upper respiratory infections were found in 53.4 percent of children, 32.4 percent of adolescents, and 33.3 percent of adults. Positivity of stool occult blood was more frequent in adults(50.5 percent) than in children(23.0 percent)(P<0.05). Renal involvement was found in 46 cases (30.9 percent) of children, 23 cases(60.5 percent) of adolescents, and 15 cases(83.3 percent) of adults. Recurrences occurred in 23 cases(15.4 percent) of children, nine cases(23.7 percent) of adolescents, and three cases(16.7 percent) of adults. Among the cases with renal involvement, 97.8 percent of children and 87.0 percent of adolescents improved to normal or asymptomatic urinary abnormalities. 60.0 percent of adults persisted with severe nephropathy and 13.3 percent progressed to renal insufficiency. Conclusion : Although the outcome of adolescent HSP was as good as children, the clinical manifestations were similar to those of adults. Adolescents had the highest rate of recurrences. Thus long term observations may be needed in adolescent onset HSP.

Factors Affecting Participation Intention of the 4th Industrial Technology Education: Applying MGB Model (4차 산업혁명 기술교육의 참여의도에 영향을 미치는 요인 연구: 목표지향행동모델(MGB)을 중심으로)

  • Lee, Jihyun;Dong, Haklim
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.4
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    • pp.231-244
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    • 2020
  • With the rapid progress of the 4th industrial revolution, technical human capitals are considered to be the core competing factors of the enterprise. Technical manpower training of the 4th industrial revolution through technical education has become an essential task of venture start-ups. The opening of technical training courses and the education support system of companies are increasing, but the shortage of technical manpower is getting worse. This study was conducted to analyze the factors affecting participation intention of the 4th industrial revolution technology education. The research model was established based on the model of goal-directed behavior. For the analysis, 250 valid questionnaire data were used to test with a structural equation model. The results of the study are as follows. First, attitude had a positive effect on the intention to participate in education. Second, subjective norms had a positive effect on the intention to participate in education. Third, the perceived behavioral control has not been tested for a significant influence on educational participation intention. Fourth, positive and negative anticipated emotions had a significant effect on educational intention. The impact of significant variables were found in the order of positive anticipated emotions, attitudes, negative anticipated emotions, subjective norms. On the other hand, as a result of testing the mediating effect of desires, it was found that desires plays a mediating role between attitude, subjective norm, perceived behavioral control, positive anticipated emotions, negative anticipated emotions, and participation intention. In particular, the causal relationship between perceived behavioral control and intention to participate in education was not significant, but perceived behavioral control had a significant effect(full mediation) on participation intention through desires. Based on the results of this study, the following implication were suggested. First, the model of goal-directed behavior(MGB) was applied to the technical education field. Second, the direct relationship between antecedent variables and behavioral intentions was simultaneously tested. Third, unlike the existing education-related research, the factors affecting participation in education were analyzed. Fourth, the importance of desires for education were suggested.

A Study of Improvement of School Health in Korea (학교보건(學校保健)의 개선방안(改善方案) 연구(硏究))

  • Lee, Soo Hee
    • Journal of the Korean Society of School Health
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    • v.1 no.2
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    • pp.118-135
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    • 1988
  • This study is designed to analyze the problems of health education in schools and explore the ways of enhancing health education from a historical perspective. It also shed light on the managerial aspect of health education (including medical-check-up for students disease management. school feeding and the health education law and its organization) as well as its educational aspect (including curriculum, teaching & learning, and wishes of teachers). At the same time it attempted to present the ways of resolving the problems in health education as identified her. Its major findings are as follows; I. Colculsion and Summary 1. Despite the importance of health education, the area remains relatively undeveloped. Students spend a greater part of their time in schools. Hence the government should develop a keener awareness of the importance of health education and invest more in it to ensure a healthy, comfortable life for students. 2. At the moment the outcomes of medical-check-up for students, which constitutes the mainstay of health education, are used only as statistical data to report to the relevant authorities. Needless to say they should be used to help improve the wellbeing of students. Specifically, nurse-teachers and home-room teachers should share the outcomes of medical-check-up to help the students wit shortcomings in growth or development or other physical handicaps more clearly recognize their problems and correct them if possible. 3. In the area of disease management, 62.6, 30.3 and 23.0 percent of primary, middle, and highschool students, respectively, were found to suffer from dental ailments. By contrast 2.2, 7.8, and 11.5 percent of primary, middle and highschool students suffered from visual disorders. The incidence of dental ailments decreases while that of visual impairments increases as students grow up. This signifies that students are under tremendous physical strain in their efforts to be admitted by schools of higher grade. Accordingly the relevant authorities should revise the current admission system as well as improve lighting system in classrooms. 4. Budget restraints have often been cited as a major bottleneck to the expansion of school feeding. Nevertheless it should be extended at least, to all primary schools even at the expense of parents to ensure the sound growth of children by improving their diet. 5. The existing health education law should be revised in such a way as to better meet the needs of schools. Also the manpower for health education should be strengthened. 6. Proper curriculum is essential to the effective implementation of health education. Hence it is necessary to remove those parts in the current health education curriculum that overlaps with other subjects. It is also necessary to make health education a compulsory course in teachers' college at the same time the teachers in charge of health education should be given an in-service training. 7. Currently health education is being taught as part of physical education, science, home economics or other courses. However these subjects tend to be overshadowed by English, mathematics, and other subjects which carry heavier weight in admission test. It is necessary among other things, to develop an educational plan specifying the course hours and teaching materials. 8. Health education is carried out by nurse-teachers or home-room teachers. In connection with health education, they expressed the hope that health education will be normalized with newly-developed teaching material, expanded opportunity for in-service training and increased budget, facilities and supply of manpower. These are the mainpoints that the decision-makers should take into account in the formation of future policy for health education. II. Recommendations for the Improvement of Health Education 1. Regular medical check-up for students, which now is the mainstay of health education, should be used as educational data in an appropriate manner. For instance the records of medical check-up could be transferred between schools. 2. School feeding should be expanded at least in primary schools at the expense of the government or even parents. It will help improve the physical wellbeing of youths and the diet for the people. 3. At the moment the health education law is only nominal. Hence the law should be revised in such a way as to ensure the physical wellbeing of students and faculty. 4. Health education should be made a compulsory course in teachers' college. Also the teachers in service should be offered training in health education. 5. The curriculum of health education should be revised. Also the course hours should be extended or readjusted to better meet the needs of students. 6. In the meantime the course hours should be strictly observed, while educational materials should be revised in no time. 7. The government should expand its investment in facilities, budget and personnel for health education in schools at all levels.

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Chest X-ray Findings and Serum Tumor Necrosis Factor-αLevels in Patients with Kawasaki Disease (가와사끼병 환아에서 흉부 X-선 검사의 변화와 혈중 Tumor Necrosis Factor-α에 대한 연구)

  • Kim, Ji Young;Kwon, Jung Hyun;Kim, Kyung Hyo;Yu, Jung Hyun;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.534-538
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    • 2005
  • Purpose : Kawasaki disease(KD) is a multisystemic inflammatory vasculitis of unknown etiology. Many complications other than cardiovascular involvement have been recognized in KD. However, there have been few reports published concerning involvement of the lungs in this disease. The purpose of this study was to examine the relationship between serum TNF-${\alpha}$, the degree of coronary artery dilatation and chest X-ray(CXR) findings. In addition, we have investigated serum anti-Mycoplasma antibody(AMA) titers in patients with KD who have abnormal CXR findings. Methods : Eighty four patients with KD were included in this study(group I; 41 patients with normal CXR fndings, group II; 43 patients with abnormal CXR findings). Serum levels of TNF-${\alpha}$ and AMA titer were measured. Results : We reviewed the CXR findings and clinical courses of 84 patients with Kawasaki disease and found abnormal CXR findings in 43 patients(51.2 percent). Peribronchial cuffing was the most frequent abnormality(22.4 percent). In the group with abnormal CXR findings(group II), a statistical difference was not noted in age, sex, duration of fever, hemoglobin, WBC, platelet, ESR, and CRP levels and incidence of coronary arterial lesions as compared with the group having normal CXR findings(group I). No difference was noted in serum TNF-${\alpha}$ level between group I and group II. 2 patients(12.5 percent) of 16 KD patients with abnormal CXR findings have positive AMA titer(above 1 : 320). Conclusion : Most of the abnormal CXR findings in KD patients were peribronchial cuffing. The abnormal CXR findings in KD patients did not mean severe inflammations. It is difficult to consider that CXR abnormalities are related to coronary arterial lesions. In addition, further study on the relationship between Mycoplasma infection and Kawasaki disease is needed.