• Title/Summary/Keyword: family factors

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The Long-term Clinical Outcomes after Coronary Artery Bypass Graft Surgery (관상동맥 우회술의 장기 임상성적)

  • Park, Chan Beom;Jo, Min-Seop;Kim, Young-Du;Jin, Ung;Moon, Seok-Whan;Kim, Chi-Kyung;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.22-27
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    • 2009
  • Background: Coronary artery bypass grafting (CABG) is the standard surgical treatment for coronary artery disease. Although there are many clinical reviews of the long term results after CABG in the Western countries, not many such studies have been done for Korea. Therefore, we reviewed the long term clinical results for the patients who underwent CABG at our hospital. Material and Method: We retrospectively reviewed the medical records of 342 patients who underwent CABG at our hospital from February 1984 to December 2006, which is when CABG was first performed in our institution. A total of 286 patients (83.6%) were able to be followed-up, and the mean follow-up period was $75.7{\pm}46.1$ months. Result: The early mortality rate was 5.6%, and late mortality rate was 23.1%. The one-year survival rate, the five-year survival rate, the ten-year survival rate and the fifteen-year survival rate were 91.5%, 82.1%, 60.7% and 50.0%, respectively. The survival rate was significantly lower for the patients over the age of 60 (p=0.002) and for those with diabetes mellitus (p=0.000), hypertension (p=0.002), multivessel disease (p=0.006) and left ventricular dysfunction (p=0.015). No significant difference was observed between the genders. Multivariate analysis showed that the statistically significant risk factors were diabetes mellitus (p=0.001), age (p=0.005) and those cases for which the left internal thoracic artery was not used (p=0.037). Conclusion: CABG is the effective method of treatment for coronary artery disease. Therefore, active usage of the internal thoracic artery and appropriate medical treatment after surgery, and especially for diabetes mellitus patients, are mandatory for achieving good long-term survival.

Impact of fetal diagnosis of congenital heart disease on parents (선천성 심질환의 산전 진단이 보호자의 임신 유지 결정에 미치는 영향)

  • Choi, Eun Young;Lee, Chang Hoon;Yoon, Myung Ja;Han, Eun Sook;Hong, Joon Suk;Jung, Yun Sook;Choi, Jung Yun
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1073-1078
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    • 2006
  • Purpose : This study was performed to assess how a fetal diagnosis of congenital heart disease affects parents, as regards pregnancy management and care of infants after birth. Methods : Database search to find out abnormal fetal echocardiography performed at Seoul National University Children's Hospital from July 1988 to June 2003 revealed 370 examinations. After excluding both arrhythmias without structural cardiac disease and multiple pregnancies, 299 pregnancies remained and this data formed the basis of this analysis. We retrospectively reviewed the medical records with special attention to pregnancy outcomes and also tried to find out factors influencing parental decisions on whether to continue or terminate pregnancy. Results : In this study, the mean gestation age at diagnosis was $28{\pm}6.0weeks$. The mean age of mothers was $30{\pm}3.9$ years old. Younger gestational ages at diagnosis(P=0.000), more severe grades of fetal heart disease(P=0.002) and younger mothers(P=0.014) correlated with terminations of pregnanies. But the grades of fetal status, the grades of associated anomaly, whether in-vitro-fertilization was carried out or not and numbers of previous children were not significant. Conclusion : This study found that the earlier gestational ages at diagnosis, younger maternal age and higher grades of fetal heart disease tended to lead parent to select abortions. Fetal echocardiographies were performed too late. Moreover Koreans have a biased view that malformation is a something incurable and a tragedy not only to oneself, but also to a family. So parents select terminations of pregnancy, even in curable cases. This is very unethical.

A rise and fall in AST and ALT level in nonspecific reactive hepatitis (비특이 반응성 간염에서 AST와 ALT 수치 상승과 회복)

  • Kim, Tai Sung;Hur, Tae Hyung;Lim, Sun Jeong;Bin, Joong Hyun;Hahn, Seung Hoon;Kim, So Young;Kim, Hyun Hee;Lee, Wonbae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.396-400
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    • 2008
  • Purpose : The study was performed to assess the distribution of the diseases associated with nonspecific reactive hepatitis (NRH) for the past 10 years and to evaluate the change in the level of AST and ALT, and the difference by several variable factors. Methods : From January 1997 to December 2006, 646 patients had elevated liver enzymes among 22,763 patients admitted to the Holy Family Hospital. We analyzed the difference in the age distribution, the period of elevated levels of AST and ALT, the resolution period, the peak value, the daily resolution value of AST and ALT, the sexual differences and the difference in several disease entities. One hundred and ninety-seven patients not confirmed as NRH or lost during follow-up were excluded. Results : The prevalence rate of NRH was 2.84%. When compared to AST, ALT showed longer period of morbidity and resolution and the peak value was also higher in ALT. The male and female ratio showed significant value of 1.63:1. The morbid and resolution periods of AST and ALT between males and females were longer periods in males. The most prevalent disease entities were respiratory and gastrointestinal infections. Between the respiratory and the gastrointestinal diseases, the highest level of AST and ALT was observed in the respiratory disease. Conclusion : NRH is a common disease that occurs in 2.84% of the admitted pediatric patients. However, the pathogenesis and the progress of the disease have not been well known due to the lack of generalized information. Further research is necessary in the future.

Analysis of the consumption pattern of delivery food according to food-related lifestyle (식생활라이프스타일에 따른 배달음식의 소비성향 분석)

  • Heo, So-Jeong;Bae, Hyun-Joo
    • Journal of Nutrition and Health
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    • v.53 no.5
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    • pp.547-561
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    • 2020
  • Purpose: This study was conducted to segment the delivery food market and to develop customized products and services. Methods: This study analyzed 636 responses collected from customers who ordered delivery food. Statistical analyses were conducted using the SPSS program (ver. 25.0) for frequency analysis, χ2-test, one-way analysis of variance, factor analysis, and cluster analysis. Results: Four factors were extracted by exploratory factor analysis (safety-orientation, convenience-orientation, taste-orientation, and economy-orientation) to explain the consumers' food-related lifestyles. The results of cluster analysis indicated that the 'low-interest group', 'convenience and economy-oriented group', and 'gourmet and economy-oriented group' should be regarded as the target segments. Characteristic analysis of each cluster showed that lowinterest group had higher rates of married (67.1%) and living with family (85.4%) than other clusters. The convenience and the economy-oriented group had higher rates of living alone (28.9%) than others. The gourmet and the economy-oriented group had a higher percentage of unmarried (62.0%) than the others. In addition, the average age of convenience and economy-oriented group (32.3 years) and gourmet and economy-oriented group (32.5 years) were significantly lower than the safety seeker (40.0 years) (p < 0.001). Difference analysis of the consumption practice according to the cluster, revealed significant differences in the order frequency (p < 0.001), main day to order (p < 0.05), source of information about delivery food (p < 0.001), order method (p < 0.001), and co-consumer (p < 0.01). In addition, the convenience and the economy-oriented group had significantly higher overall satisfaction than the others (p < 0.001). Conclusion: These findings suggest that customer segmentation based on a food-related lifestyle can be used to build a successful marketing strategy. Therefore, restaurant managers and delivery platform operators should consider developing products and services according to the segmentation to maximize customer satisfaction.

TEACHERS' PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN STUDENTS AND PSYCHIATRIC CONSULTATIONS (학생들의 정신건강문제와 정신과 의뢰에 대한 교사의 인식도 조사)

  • Kwak, Young-Sook;Chun, Ja-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.82-90
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    • 1998
  • This study is attempted to examine Korean teachers’ perceptions of mental health problems in students and their attitudes towards psychiatric consultations through a questionnaire survey. The results of this study are as follows. 1) Teachers thought that 5.3% of their students had mental health problems, 1.9% of students required psychiatric evaluation, and 1.2% of students were referred or recommended psychiatric evaluation by their teachers. 2) The most frequent mental health problems in students discovered by teachers were distractibility and inattention, lack of academic skills, and language difficulties in elementary schools;distractibility and inattention, conduct problems, and lack of academic skills in middle schools;and conduct problems, distractibility and inattention, physical symptoms, and substance abuse in high schools. 3) Teachers thought the mental health problems in students were caused by the family environment, psychological factors, the educational system, and a lack of mental health services. 4) Teachers desired smaller classes, improvement of the school environment, more time, regular mental health education, a special program for students with mental health problems, and the counseling staffs or consultants for the school mental health. 5) Teachers consulted with other teachers, the parents of the students, the counseling teachers, the health care teachers, the counseling institutes, the psychiatric clinics, and the principals in descending order to handle the hard case problems. The frequent reasons for failing in psychiatric consultations were the prejudice of parents against psychiatric services, the teachers’ sense of superiority in dealing with the problems of students, the prejudice of teachers themselves against psychiatric practice, and inaccessible professional consultation. 6) About 20.4% of teachers reported they had proposed psychiatric consultations or had recommended their students to receive psychiatric evaluations.

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A Study of Oral Health Impact Profile 14 among the Elderly in Rural Area (일부 농촌노인들의 구강건강영향지수(Oral Health Impact Profile)14 평가)

  • Lee, Ga-Ryoung
    • Journal of dental hygiene science
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    • v.10 no.2
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    • pp.109-116
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    • 2010
  • Objective: The purpose of this study was oral health related quality of life among elderly population in some rural area, Korea. Methods: 546 participants (male 196, female 350) aged more than 65 years (mean $71.4{\pm}4.6\;years$) were surveyed cross-sectionally. All the subjects were examined short-form of Oral Health Impact Profile (OHIP-14) by face to face interview. Categorical responses of strata-adjusted Wilcoxon correlation and Kruskal-Willis test and multiple regression analysis after adjusting for socio-demographic variables were adapted for statistical analysis. Results: 1. As for sub-factors of the quality of living related to oral health, the drop in social ability was 4.61, the drop in mental ability 4.53, the drop in physical ability 3.99, mental inconvenience 3.98, social disadvantages 3.82, physical pains 3.77, and functional division 3.44, on the average. 2. As for the quality of living related to oral health, there were statistically significant differences in functional restrictions by gender, the educational level, and the presence of occupation, in physical pains by gender, the educational level, family members living together. mental inconvenience by gender, the educational level, the presence of occupation. and in the drop in physical ability by gender, the educational level, monthly incomes. There were statistically significant differences in the drop in physical ability by gender, the educational level. in the drop in social ability by the educational level, the presence of occupation, monthly income. and in social inconvenience by age, the presence of occupation, monthly income. 3. There were statistically significant differences in the general quality of living related to oral health by gender, the educational level, the presence of occupation.

An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Study of the Construction of Nursing Theory in Korean Culture - View of Medicine- (한국문화에 따른 간호정립을 위한 기초조사연구 III -의료관을 중심으로-)

  • Park, Jeong-Sook;Ok, Yun-Jung
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.143-162
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    • 1998
  • This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

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Private Income Transfers and Old-Age Income Security (사적소득이전과 노후소득보장)

  • Kim, Hisam
    • KDI Journal of Economic Policy
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    • v.30 no.1
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    • pp.71-130
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    • 2008
  • Using data from the Korean Labor & Income Panel Study (KLIPS), this study investigates private income transfers in Korea, where adult children have undertaken the most responsibility of supporting their elderly parents without well-established social safety net for the elderly. According to the KLIPS data, three out of five households provided some type of support for their aged parents and two out of five households of the elderly received financial support from their adult children on a regular base. However, the private income transfers in Korea are not enough to alleviate the impact of the fall in the earned income of those who retired and are approaching an age of needing financial assistance from external source. The monthly income of those at least the age of 75, even with the earning of their spouses, is below the staggering amount of 450,000 won, which indicates that the elderly in Korea are at high risk of poverty. In order to analyze microeconomic factors affecting the private income transfers to the elderly parents, the following three samples extracted from the KLIPS data are used: a sample of respondents of age 50 or older with detailed information on their financial status; a five-year household panel sample in which their unobserved family-specific and time-invariant characteristics can be controlled by the fixed-effects model; and a sample of the younger split-off household in which characteristics of both the elderly household and their adult children household can be controlled simultaneously. The results of estimating private income transfer models using these samples can be summarized as follows. First, the dominant motive lies on the children-to-parent altruistic relationship. Additionally, another is based on exchange motive, which is paid to the elderly parents who take care of their grandchildren. Second, the amount of private income transfers has negative correlation with the income of the elderly parents, while being positively correlated with the income of the adult children. However, its income elasticity is not that high. Third, the amount of private income transfers shows a pattern of reaching the highest level when the elderly parents are in the age of 75 years old, following a decreasing pattern thereafter. Fourth, public assistance, such as the National Basic Livelihood Security benefit, appears to crowd out private transfers. Private transfers have fared better than public transfers in alleviating elderly poverty, but the role of public transfers has been increasing rapidly since the welfare expansion after the financial crisis in the late 1990s, so that one of four elderly people depends on public transfers as their main income source in 2003. As of the same year, however, there existed and occupied 12% of the elderly households those who seemed eligible for the National Basic Livelihood benefit but did not receive any public assistance. To remove elderly poverty, government may need to improve welfare delivery system as well as to increase welfare budget for the poor. In the face of persistent elderly poverty and increasing demand for public support for the elderly, which will lead to increasing government debt, welfare policy needs targeting toward the neediest rather than expanding universal benefits that have less effect of income redistribution and heavier cost. Identifying every disadvantaged elderly in dire need for economic support and providing them with the basic livelihood security would be the most important and imminent responsibility that we all should assume to prepare for the growing aged population, and this also should accompany measures to utilize the elderly workforce with enough capability and strong will to work.

Correlation among Ownership of Home Appliances Using Multivariate Probit Model (다변량 프로빗 모형을 이용한 가전제품 구매의 상관관계 분석)

  • Kim, Chang-Seob;Shin, Jung-Woo;Lee, Mi-Suk;Lee, Jong-Su
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.2
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    • pp.17-26
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    • 2009
  • As the lifestyle of consumers changes and the need for various products increases, new products are being developed in the market. Each household owns various home appliances which are purchased through the choice of a decision maker. These appliances include not only large-sized products such as TV, refrigerator, and washing machine, but also small-sized products such as microwave oven and air cleaner. There exists latent correlation among possession of home appliances, even though they are purchased independently. The purpose of this research is to analyze the effect of demographic factors on the purchase and possession of each home appliances, and to derive some relationships among various appliances. To achieve this purpose, the present status on the possession of each home appliances are investigated through consumer survey data on the electric and energy product. And a multivariate probit(MVP) model is applied for the empirical analysis. From the estimation results, some appliances show a substitutive or complementary pattern as expected, while others which look apparently unrelated have correlation by co-incidence. This research has several advantages compared to previous literatures on home appliances. First, this research focuses on the various products which are purchased by each household, while previous researches such as Matsukawa and Ito(1998) and Yoon(2007) focus just on a particular product. Second, the methodology of this research can consider a choice process of each product and correlation among products simultaneously. Lastly, this research can analyze not only a substitutive or complementary relationship in the same category, but also the correlation among products in the different categories. As the data on the possession of home appliances in each household has a characteristic of multiple choice, not a single choice, a MVP model are used for the empirical analysis. A MVP model is derived from a random utility model, and has an advantage compared to a multinomial logit model in that correlation among error terms can be derive(Manchanda et al., 1999; Edwards and Allenby, 2003). It is assumed that the error term has a normal distribution with zero mean and variance-covariance matrix ${\Omega}$. Hence, the sign and value of correlation coefficients means the relationship between two alternatives(Manchanda et al., 1999). This research uses the data of 'TEMEP Household ICT/Energy Survey (THIES) 2008' which is conducted by Technology Management, Economics and Policy Program in Seoul National University. The empirical analysis of this research is accomplished in two steps. First, a MVP model with demographic variables is estimated to analyze the effect of the characteristics of household on the purchase of each home appliances. In this research, some variables such as education level, region, size of family, average income, type of house are considered. Second, a MVP model excluding demographic variables is estimated to analyze the correlation among each home appliances. According to the estimation results of variance-covariance matrix, each households tend to own some appliances such as washing machine-refrigerator-cleaner-microwave oven, and air conditioner-dish washer-washing machine and so on. On the other hand, several products such as analog braun tube TV-digital braun tube TV and desktop PC-portable PC show a substitutive pattern. Lastly, the correlation map of home appliances are derived using multi-dimensional scaling(MDS) method based on the result of variance-covariance matrix. This research can provide significant implications for the firm's marketing strategies such as bundling, pricing, display and so on. In addition, this research can provide significant information for the development of convergence products and related technologies. A convergence product can decrease its market uncertainty, if two products which consumers tend to purchase together are integrated into it. The results of this research are more meaningful because it is based on the possession status of each household through the survey data.

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