Journal of Physiology & Pathology in Korean Medicine
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v.34
no.1
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pp.53-59
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2020
Dietary habits are known to be closely related not only to chronic diseases such as cardiovascular disease and diabetes, but also to self-rated health (SRH). Consequently, there is a highly important lifestyle component in maintaining a healthy life. The aim of the present study was to determine the correlation between diverse dietary habits based on the Sasang constitutions (SC) and SRH. The data were collected from 2,984 participants who met the constitution pharmacology criteria and whose SC were clinically confirmed by SC professionals. Dietary habits were observed by assessing the regularity of diet, meal volume, and meal speed; single-answer questions were used for SRH. Fisher's exact/chi-square test and logistic regression were used to analyze the correlation between dietary habits depending on constitutional type and SRH. In association with constitutional SRH, the Taeum type is related to the amount of meal, the Soeum and Soyang types are related to the regularity of meal and meal volume. In the Taeum type, there was a significantly higher risk of lower SRH when meal volumes were irregular less than previous amounts. Irregular diet, as well as increased or decreased meal volume, negatively correlated with SRH in the Soeum type; in the Soyang type, irregular diet and decreased or irregular meal volume negatively affected SRH. This showed the presence of the different effects of dietary habits on health depending on constitution and also confirmed the association of the regularity of diet and meal volume based on constitution and the frequency of bad dietary habits with SRH. We suggest that personalized healthcare with adequate dietary improvement considering constitution is needed for health management or improvement.
Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.
The purpose of this study was to describe and understand how diabetics dealt with the result of the various changes of lifestyle. The grounded theory approach of qualitative research methods was used for building a substantive theory about that. The subjects of this study were 10 clients who experienced diabetes from 4 to 30 years. The data was collected from August 1999 to November 1999 through in-depth interviews utilizing home visitation and telephone interview technique then it was and analyzed simultaneously by a constant comparative method in which the new data was continuously coded into categories and properties according to Strauss & Corbin,s methodology. One hundred six concepts were found and they were grouped into 35 categories and then into 14 categories. The results were as follows difficulty, unable to overcome the changes, disposition, disease process, tiredness, supportive environment, perception, handling, concent- ration, mastering, endurance, avoidance, giving up and tailoring. The core phenomenon was 'tiredness' and these categories were synthesized into one core concept, the process of tailoring. The process of tailoring in diabetics consisted of : 1) going through difficulty of disease management 2) experiencing tiredness from the difficulty of disease management 3) perception of disease from tiredness 4) undergoing various self-management 5) controlling the process of tailoring by one's own method. Six hypotheses were derived from the relation of these concepts and four types were from intensity of tiredness, direction of disposition, type of disease process and the level of supportive environment and perception. This study offers better understanding on diabetic experiences and may facilitate more appropriate interventive strategies to provide support, information and knowledge. The nurses should utilize the results to help diabetics enjoy their lives without any trouble and must continuously develop nursing knowledges and skills.
BACKGROUND/OBJECTIVES: This study aims to develop a mobile nutritional management program for integration into the already developed web-based program, Diabetes Mellitus Dietary Management Guide (DMDMG) for diabetic patients. Further, we aim to evaluate the amended DMDMG program. SUBJECTS/METHODS: The mobile application based on an Android operating system includes three parts: 1) record of diet intake, which allows users to take pictures of the meal and save to later add diet records into DMDMG; 2) an alarm system that rings at each meal time, which reminds users to input the data; 3) displays the diet record and the results of nutrient intake, which can be also viewed through the web program. All three parts are linked to the web-based program. A survey was conducted to evaluate the program in terms of nutrition knowledge, dietary attitude, eating behavior and diet intake by non-equivalent control group design among diabetic patients with 14 DMDMG users and 12 non-user controls after a one-month trial of DMDMG. RESULTS: Non-users did not use the program, but participated in the weekly off-line nutrition classes for one month. The program users showed increased healthful dietary behavior (P < 0.01) and dietary attitude scores (P < 0.05). More DMDMG users had higher nutrition knowledge scores after one-month trial than non-users. However, dietary intake significantly increased in non-user group for calcium and sodium (P < 0.05) while the user group did not show significant changes. CONCLUSIONS: The program has created positive changes in patients' dietary life. All the users were satisfied with the program, although some expressed minor difficulties with an unfamiliar mobile app.
Purpose: This study aimed to systematically review the contents and effectiveness of education programs for preventing diabetic foot ulcer among patients with type 2 diabetes mellitus in Korea. Methods: Six electronic databases were searched using search terms, and 748 articles were identified. Ten articles were eligible based on inclusion and exclusion criteria. Article quality was evaluated using a critical evaluation checklist for manuscripts before performing the systematic review. Results: Although education programs for preventing diabetic foot ulcers have been continuously studied for 20 years, the number of studies is small, and to our knowledge, there have been no studies reporting on the subsequent prevalence of foot ulcers or amputations. While the effect of these education programs on knowledge (ES=1.23) and self-management behavior (ES=.96) was shown to be statistically significant, it was not shown to be significant in preventing diabetic foot ulcers (ES=.03). Conclusion: The actual preventive effect on the prevalence of foot ulcers, through education programs for preventing diabetic foot ulcer could not be determined. Our findings highlight a potential need for studies aimed at developing effective programs to improve education on preventing diabetic foot ulcers.
Objectives: The purpose of this study was to review predictive factors associated with weight loss in moderate to severe obesity treatment. The direction of the treatment for moderate to severe obesity will be suggested in consideration of various factors. Methods: Authors searched the articles published from 2018 to 2023 in three international databases (PubMed, Embase and the Cochrane Central Register of Controlled Trials) and two domestic databases (Research Information Sharing Service, Korean studies Information Service System). Studies including treatment with moderate to severe obese patients were selected. Results: A total of 43 studies were included. The main factors of weight loss were unchangeable predictors such as low initial degree of obesity, younger age, non-diabetes and high resting energy expenditure with changeable predictors such as increase in protein, physical activity, self-efficacy, initial weight loss and attendance of the treatment. Conclusions: Our review results suggest that based on the characteristics of moderate to severe obese patients, predictors of weight loss can be used to determine treatment and prognosis in various aspects.
The purpose of this study was to analyze task performance and importance level of the dietitian who is working in the public health nutrition area. Work oriented job analysis methodology was employed for the study purpose. Subjects of 38 dietitians currently working at health centers in 2002 were recruited. Based on the focus group interview with 7 public health nutritionists and 7 professors, information about task elements was collected. Questionnaires measuring work performance and self-perception of importance of the selected task elements were administered. The results of this study can be summarized as follows; 1) The tasks with high performance and importance level among 20 tasks are developing nutrition education material (B1), nutrition services for adults and the elderly (C3), writing the proposal for nutrition services (A2), evaluating service effect (A4), improving professionalism (E1), and self management (E2). 2) The task elements with high performance and importance level among weekly task elements are nutrition education for diabetes (C56), nutrition counseling for adults (C47), nutrition for hypertension (C53), managing and keeping records (C80), nutrition education for kindergarten and nursery school children (C42), searching for nutrition education materials (B26), and searching for media (B27). 3) The number of task elements with high performance and importance level among monthly task elements are 13 in the planning and evaluation of public health nutrition service, and 5 in developing nutrition education materials. The tasks of a dietitian in the public health center show a very wide spectrum. However dietitians recognize most of the tasks are important even though they cannot perform those tasks adequately.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.6
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pp.324-333
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2018
The aim of this study was to investigate the latent classes and predictors of chronic diseases such as hypertension, dyslipidemia, arthritis, thyroid disease, depression, atopy, allergy, and diabetes. The subjects of this study were Korean citizens who participated in the Korea National Health and Nutrition Examination Survey in 2014. Stratified cluster sampling method was used with a sample size of 7,550. Latent hierarchy analysis was applied to this data. Four classes were identified. Class 1 consisted of participants with hypertension and diabetes. Class 2 consisted of participants with atopy and allergies. Class 3 consisted of participants with dyslipidemia, arthritis, thyroid disease, and depression. Class 4 consisted of participants without any chronic diseases. In comparing Class 1 to Class 4, age, physical activity, self-management, obesity, and presence of high cholesterol were found to be significant. In comparing Class 2 to Class 4, gender, age, and education level were significant. When Class 3 was compared to Class 4, gender, age, pain and discomfort, as well as high cholesterol were found to be significant. Diabetes and hypertension should be treated as comorbid conditions, applying integrated treatments involving effective drug treatment, diet, and physical activity programs. Atopy was found to be strongly correlated with allergies. Thyroid disease was found to coexist with dyslipidemia and arthritis, along with having a strong correlation to depression. Age-appropriate preventive measures can help reduce the risk of chronic diseases.
Journal of the Korea Academia-Industrial cooperation Society
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v.12
no.2
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pp.765-774
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2011
The purpose of this study is to provide informative statistics which can be used for effective Diabetes Management Programs. We collected and analyzed the data of 666 diabetic people who had participated in Korean National Health and Nutrition Examination Survey in 2007 and 2008. Group classification on management behavior of Diabetic Mellitus is based on the K-means clustering method. The Decision Tree method and Multiple Regression Analysis were used to study factors of the management behavior of Diabetic Mellitus. Diabetic people were largely classified into three categories: Health Behavior Program Group, Focused Management Program Group, and Complication Test Program Group. First, Health Behavior Program Group means that even though drug therapy and complication test are being well performed, people should still need to improve their health behavior such as exercising regularly and avoid drinking and smoking. Second, Focused Management Program Group means that they show an uncooperative attitude about treatment and complication test and also take a passive action to improve their health behavior. Third, Complication Test Program Group means that they take a positive attitude about treatment and improving their health behavior but they pay no attention to complication test to detect acute and chronic disease early. The main factor for group classification was to prove whether they have hyperlipidemia or not. This varied widely with an individual's gender, income, age, occupation, and self rated health. To improve the rate of diabetic management, specialized diabetic management programs should be applied depending on each group's character.
Purpose: The management of urethral defect represents one of the most challenging clinical problems in uroplastic surgery. Especially for defect after Fournier's Gangrene, optimal management is still a hard problem. During extensive urethral reconstruction, to overcome the poor vascularity due to periurethral scarred tissue and limitation of the choice of local flap, we report our experience with one-stage reconstruction of urethral defect using a longitudinal tubed flap of scrotal skin. Methods: A 72-year-old man with several years of diabetes mellitus history visited for swelling and pain of scrotal area. After diagnosis of Fournier's Gangrene, radical debridement was performed and 6 cm of urethral defect on border of penile-scrotal ventral area was made. Rectangular scrotal skin flap ($6{\times}2.5\;cm$) based on external spermatic fascia was elevated and tubed longitudinally. After transfer the flap to the defect area, end-to-end anastomosis was performed bilaterally. Results: 4 weeks after the operation, the patient started voiding him-self and urethrography showed good fluence of contrast agent. Long term evaluation reveals stable performance characteristics without any complications. Conclusion: We suggest a one-stage reconstruction of extensive urethral defect using a longitudinal tubed flap of scrotal skin. Advantages of this procedures are simple, one-stage reconstruction with the reliable scrotal skin flap based on external spermatic fascial vasculature, and no donor morbidity.
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