• Title/Summary/Keyword: low income patients

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Uncertainty, Anxiety and Coping with Mastectomy for Breast Cancer (유방절제술 환자의 불확실성, 불안 및 대처방식)

  • Cho, Ok-Hee
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1006-1017
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    • 2000
  • The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows : 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7∼12 months(1 yr.) post operation period had higher than the one below 6months, 25∼36 months(3 yrs.), 37∼60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7∼12 months(1 yr.) post operation period, but there was no significant difference by general characteristics 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25∼36 months of post operation period showed significantly lower level of coping than those below 6 months or 37∼60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.

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A Study on the Degree of Burden and Quality of Life in Family Caregivers of Patients with Stroke (뇌졸중 환자가족이 인지한 부담감 및 삶의 질에 관한 연구)

  • Kim Hyun-Mi;Jang Gun-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.1
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    • pp.81-94
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    • 1998
  • This study was designed and undertaken to identify the degree of burden and quality of life in family caregivers of patients with stroke and to determine whether burden was directly related to quality of life. The data were collected from October 3rd, 1997 to March 20th, 1998. The subjects in this study were 126 caregivers as a family member and 126 patients with stroke who were hospitalized in two oriental medicine hospitals, three general hospitals located in Taegue City and Pusan City. The questionnaires consisted of questions regarding burden(25 items) and quality of life (18 items) of caregivers. Data were analyzed using percentages, mean, 1-test, ANOVA and Pearson-correlation coefficients done with the SPSS program. The results of thi study are as follows : 1. The score for family caregiver's burden was higher than the middle score. 2. The score for family caregiver's quality of life was relatively low. 3. The relationship between burden and quality of life was showed a significant inverse correlation. 4. The family caregivers' age had statistically significant differences in the degree of burden. 5. The education and monthly income of caregivers had statistically significant differences in the quality of life. That is, the higher the level of education and the higher the monthly income, the higher the degree of quality of life. 6. The age and sex of patients had affected the qualiry of life of caregivers sigmificantly. That is, caregivers felt more burden when caring for the patient group in sexties than any other age group and female patients than for male patients. 7. In the relationships between quality of life and general characteristics of the stroke patients, only the patients' sex was showed a statistically significant difference. That is, caregivers felt more quality of life when taring for male patients than female patients.

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Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study (정신병적 장애로 첫 내원한 환자들의 임상 특징과 투약 순응도 및 의료 이용 추이: 예비 연구)

  • Heo, Jung Un;Kim, Dong Wook;Oh, Seung-Taek;Choi, Won-Jung;Park, Jaesub
    • Korean Journal of Schizophrenia Research
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    • v.22 no.2
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    • pp.42-50
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    • 2019
  • Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

Socio-economic Status Plays Important Roles in Childhood Cancer Treatment Outcome in Indonesia

  • Mostert, Saskia;Gunawan, Stefanus;Wolters, Emma;van de Ven, Peter;Sitaresmi, Mei;van Dongen, Josephine;Veerman, Anjo;Mantik, Max;Kaspers, Gertjan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6491-6496
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    • 2012
  • Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

Comparative study of geographic differences of severe trauma mortality in Korea (한국의 중증외상 사망률의 지역적 차이에 대한 비교 연구)

  • Jeong, Tae-Wook;Jo, Ji-Yeon;Kim, Seong-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.37-48
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    • 2021
  • Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.

The Relationships Between Low Vision and Socioeconomic Status in Korean Adults (저시력과 사회경제적 상태와의 관계)

  • Park, Jee-Hyun
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.3
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    • pp.319-325
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    • 2011
  • Purpose: The relativity of factors between low vision and socioeconomic status were investigated. This study represented the preliminary data for establishment of public eye health policy. Further, this report would encourage people to change the social attitudes about the eye health equity of the nation. Methods: The number of people (2,514 people) who have been tested the forced visual activity were examined as it was referred the Korea National Health and Nutrition Examination Survey (KNHNE) of 2009-year data. The prevalence rate of low vision of subjects which are related with house income, education level and occupations were conducted with ttest and chi square test. Besides, the Binominal Logistic Regression was conducted to measure the odds ratio of the subjects. Results: In outline, the prevalence rate of low vision was high with low house income, low education level and low function. The odds ratio represented that 2.77(95% CI, 1.72-4.47) at low house income group and 4.02(95% CI, 1.75-9.23) at the case of below primary school education level. Moreover, the results of unemployed group showed 3.65(1.14-11.68) from the odds ratio measurement. Conclusions: The eye health policy need be instituted which is broad and meticulous support to ease the eye health equity of low eye sight patients. For instance, the education about eye health, examination business of eye disease, and education of assistant units which are useful for low eye sight would suggest practical solution.

Veterans Hospital Medical Expenses Increase & Decrease Characteristics and Convergence Phenomenon-Focusing on the implications of the medical support system for national veterans-

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • v.9 no.1
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    • pp.16-21
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    • 2021
  • As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

Determination of Sexual Problems of Turkish Patients Receiving Gynecologic Cancer Treatment: a Cross-sectional Study

  • Demirtas, Basak;Pinar, Gul
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6657-6663
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    • 2014
  • Background: The present study aimed to determine the prevalence and types of sexual problems of Turkish patients receiving gynecologic cancer treatment. Materials and Methods: A cross-sectional convenience sample of 168 women completed the Index of Female Sexual Function (IFSF) and a Patient Identification Form in a hospital in Ankara, Turkey. Mean IFSF scores of the patients were low ($15.7{\pm}5.72$, out of a possible 45), indicating high rates of sexual problems. Results: Women frequently reported problems with dyspareunia (97.1%), vaginal dryness (97.6%), decreased sexual desire (91.1%), and difficulties of sexual arousal (92.9%) related with the cancer treatment process. They reported increased sexual problems following the period of treatment as compared to before treatment (p<0.05). Sexual dysfunction was associated with low educational and income levels, advanced age, TAH-BSO-LND surgery (total abdominal hysterectomy-bilateral salphingoopherectomylymph node dissection), experiencing side effects of chemotherapy, receiving chemotherapy in addition to surgery and radiotherapy (CT+RT+Surgery), and having a large number of chemotherapy cycles (p<0.05). Conclusions: Patients hoped for and expected counseling from healthcare professionals about their sexual functioning in relation to cancer treatments. Nurses and physicians can help to improve the overall quality of life for gynecologic cancer patients through sexual counseling.

A Study on Physical Indices, Food Habits and Nutrient Intakes in Patients with Hypertension (고혈압 환자의 체격지수, 식습관 및 영양소 섭취상태에 관한 연구)

  • Jeon Sang-Mi;Kim Sung-Mee
    • Journal of the East Asian Society of Dietary Life
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    • v.15 no.3
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    • pp.271-282
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    • 2005
  • This study analyzed the physical indices, food habits and nutrient intakes of patients with hypertension, to provide better research data for the prevention and the cure for disease as well as basic data for nutrition education. The subjects were 44 patients who visited the general hospital, located in Daegu, to receive hypertension treatment The lifestyle, food habit, nutrient intakes, anthropometric measurements, body fat and blood pressure were measured as main indices. By the BMI, $72.8\%$ of the patients were over weight or obesity $(>23\;kg/m^2)$. In the male group, the WHR tended to increase according to the BMI (p<0.05). In the female group, the body fat tended to increase according to the BMI (p<0.05). The group with more monthly income showed lower systolic blood pressure than the group with smaller monthly income (p<0.05). The scores about food habits concerning balanced diet and preference for salt were low, which implied that food habits of subjects were not desirable. The intakes of riboflavin and calcium didn't meet the RDA requirements. Especially, the lack of calcium was more ap~nt in the female patients than the male ones. Despite this, they had more than enough protein, vitamin C, and iron. The physical indices according to blood pressure revealed that the group of higher blood pressure showed greater WHR (p<0.001). The male group with higher systolic blood pressure showed greater BMI than one with lower systolic blood pressure (p<0.05). As for nutrient intakes according to blood pressure, the group with higher blood pressure had more sodium and iron than one with lower blood pressure (p<0.05). The patients with hypertension tended to be more overweight or obese, preferred salty foods, and were in an unbalanced state of nutrient intakes. Thus more systematic and ongoing measures should be pursued to take care of patients with hypertension.

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The Factors Influencing Depression in Patients with Breast Cancer (유방암 환자의 우울에 영향을 미치는 요인)

  • Kim, Soo-Hyun;Jun, Eun-Young;Lee, Won-Hee
    • Asian Oncology Nursing
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    • v.6 no.2
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    • pp.133-142
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    • 2006
  • Purpose: The purpose of this study was to identify factors influencing depression in breast cancer patients. Method: A descriptive correlational study design was used. A convenience sample of 155 subjects was recruited from the outpatient for breast cancer patients at one hospital in Gyeonggi, South Korea. Body image was measured with the category of "Body image" from the EORTC QLQ-BR23(European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast cancer version) and sexual function was measured with category of "sexual function" from it. Depression was measured with Korean version of Beck Depression Inventory(BDI). Results: The mean score of body image was relatively low(M = 54.44, SD = 30.92), of sexual function was low (M = 24.82, SD = 22.50), and of depression was relatively low(M =14.90, SD = 8.00). Depression had a significant relationship with body image(r = -.363, p = <.001), however, there was no significant relationship between depression and sexual function(r = -.137, p = .103). In the regression analysis, depression was found to be influenced significantly by monthly income and body image, these variables explained 28.8% of the variance in depression(F = 4.662. p = <.001). Conclusion: It suggests that nurses need to take into consideration body image and economic status in management depression in breast cancer survivors.

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