• 제목/요약/키워드: low income patients

검색결과 171건 처리시간 0.026초

Association Assessment among Risk Factors and Breast Cancer in a Low Income Country: Bangladesh

  • Ahmed, Kawsar;Asaduzzaman, Sayed;Bashar, Mamun Ibn;Hossain, Goljar;Bhuiyan, Touhid
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7507-7512
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    • 2015
  • Background: In the low incoming country Bangladesh, breast cancer is second most common neoplasm and is increasing at an alarming rate among females. Lack of awareness and illiteracy are contributory factors for late presentation and therefore mortality. Purpose: To examine associations of different factors with breast cancer mortality and to raise awareness among the women of society in Bangladesh. Materials and Methods: This descriptive case-control study was conducted on 160 participants from April 2011 till July 2014. Through a valid questionnaire covering personal and family history, data were collected by face to face interview. For analyzing correlations among factors with breast cancer data, binary logistic regression, Pearson's ${\chi}^2$-value, odd ratios and p-value tests were conducted with SPSS version 20. Results: The mean age of the patients was 43.0 ($SD={\pm}11.12$). In ascending order the leading significant factors were hormone therapy (p<0.0000, OR=4.897), abortion (p<0.0001, OR=3.452), early start menarche (p<0.0002, OR=3.500), family history (p<0.0022, OR=3.235), and late menopause (p<0.0093, OR=3.674) with both ${\chi}^2$ test and logistic regression analyses. Non-significant factors were cancer experience, fatty food habits, marital status and taking alcohol. Conclusions: Regarding the investigation of this study, significant and insignificant factor's correlation visualization with breast cancer will be helpful to increase awareness among Bangladeshi women as well as all over the world.

Challenges in the Management of Breast Cancer in a Low Resource Setting in South East Asia

  • Ley, P;Yip, CH;Hong, C;Varughese, J;Camp, L;Bouy, Sok;Maling, E
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3459-3463
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    • 2016
  • Background: Breast cancer is the second most common cancer in women in Cambodia, a low income country in South-East Asia. The Sihanouk Hospital Centre of Hope (SHCH) is a charity hospital set up by an international non-governmental organisation, HOPE Worldwide. In 2008, SHCH partnered with AmeriCares, a global health organisation to set up and deliver a breast cancer programme to provide education, diagnosis and treatment for women with breast cancer. The objective of this study is to characterise the presentation, diagnosis, treatment and outcomes of women treated under this program. Materials and Methods: A total of 215 women newly diagnosed with breast cancer from 1 March 2008 until 31 March 2011 were studied. Age at diagnosis, tumour size, histological type, tumour grade, ER, lymph node involvement, treatment modalities (surgery, radiotherapy, chemotherapy, hormone therapy) were recorded. Data on mortality at 3 years were obtained whenever possible. Results: The median age was 47 years old. Some 77.8% were diagnosed with stage 3 and 4 lesions, and 78.5% underwent mastectomy, of which 28.4% the intent was palliative. Of those whose ER status were known, only 48.3% were ER positive. Only 6 patients could afford chemotherapy while only 1 patient had radiotherapy. Hormone therapy was provided free for those who were ER positive. The overall survival rate at 3 years was 39.1%. Conclusions: Breast cancer presents at a late stage, and because treatment is suboptimal, survival is poor in Cambodia. A more aggressive approach to early detection and treatment needs to be developed to improve outcome from this potentially curable disease.

미국 치과위생사의 전문직화 경향 (The trend toward professionalization of American dental hygienists)

  • 김형미;박정란;김창희;원영순;심선주;이선미
    • 한국치위생학회지
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    • 제21권6호
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    • pp.773-784
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    • 2021
  • Objectives: This study presents the basic data necessary to explore the methods used of Korean dental hygienists to resolve oral health inequalities in Korea via reviewing the professionalization trend of American dental hygienists. Methods: The supervision levels of American dental hygienists, and system of dental therapists were analyzed using the data published by the relevant associations. Results: In America, dental hygienists help address oral health inequalities. However, due to limitations in the supervision levels and scope of practice of dental hygienists, the autonomy of dental hygienists was expanded, and mid-level practitioner were employed. The autonomy for dental hygiene practice was higher in public than in private in America. Some states have introduced dental therapists as mid-level practitioners. Their practice settings have limitations such as serving low-income, uninsured, and underserved patients or serving in a dental health professional shortage area. Conclusions: It is necessary to expand the autonomy of dental hygienists based on their profession. In particular, it is suggested that they start with the low-risk level practices. Further, it is necessary to introduce a dental hygiene specialist system specialized for fields with high social demands.

중년기 암환자의 삶의 질에 관한 연구 (Quality of life of Middle -Aged Persons Who have cancer)

  • 한윤복;노유자;김남초;김희승
    • 대한간호학회지
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    • 제20권3호
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    • pp.399-413
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    • 1990
  • This descriptive study was under taken to explore relationships among the quality of life, health locus of control and perceived state of health persons with cancer to contribute theoretical understanding about these phenomenon of interest to the quality of nursing care. The subjects of this were 200 persons with cancer (100- in patients and 100- out patients), both male and female, between 30 and 59 years of age. Data were obtained using a convenience sample technique from two university hospitals in seoul from August, 1989, to June, 1990. The instruments used for this study were the Quality of life scale developed by Ro, You - Ja and the Health Locus of Control scale developed by Wallston & Wallston. Data were analyzed using a SAS program for ANOVA, t-test, Schefffe test, Pearson Correlation Coefficients and Stepwise multiple regression. The results were as follows : 1. The scores on the quality of life scale ranged from 95 to 191 with as mean of 147.85(range 47 to 235). The Mean scores(range 1-5) on the different dimensions were family relationships 3.50, relationships with neighbours 3.48, self - esteem 3.17, physical state and function 2.99, economic life 2.93 and emotional life 2.91. 2. Significantly higher scores on the quality of life and demographic characteristics were as follows : the quality of life for women(t=2.80, p= .006), for those without complications(t=2.54, p= .013), and for those who perceived their illness as mild(F=4.85, p= .009). Higher scores on quality of life were correlated with the following : 1) emotional state and the age group 50-59(F=3.43, p= .34). 2) economic life and higher income(F=6.72, p= .002), those without complications(t=2.68, p= .00), and those who perceived their illness as mild(F=3.11, p= .05). 3) self-esteem and marriage(F=3.64, p=.028), those without complications(t=2.18, p=.03), and those who perceived their illness as mild(F=7.72, p=.000). 4) physical state and funciton and the age group 30-39(F=4.65, p=.010), those without complications (t=2.00, p=.05), and those who perceived their illness as mild(F=3.38, p=.04). 5) family relationship and those who live with their spouse(t=2.82, p=.005). 3. There was a significant positive correlation between the subjects perceptions of their current state of health and the quality of life score(r=.4364, p=.0001). 4. There was no relationship between Locus of control and quality of life in this sample. 5. Stepwise multiple regression analysis showed that: 1) the perception of current health status was the main predictor and accounted for 20.11% of the total variance. 2) sex and educational level accounted for an additional 21.71% of the total variance. 6. The quality of life and the perception of their current health status of these patients with cancer were generally lower than those of healthy adults as noted in previous studies. In conclusion, the quality of life for these cancer patients was generally low especially in regard to their emotional state. The current perceived state of health, sex, complications and perceived degree of illness were important variables relatiog to quality of life.

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한국 당뇨병 노인의 혈액생화학적 특성, 식이 섭취, 당화혈색소 관련 위험 요인 및 위험도: 국민건강영양조사 제4기(2007-2009)와 제7기(2016-2018) 비교 (Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4th(2007-2009) and the 7th(2016-2018) Korea National Health and Nutrition Examination Surveys)

  • 오성원;김숙배
    • 대한지역사회영양학회지
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    • 제27권5호
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    • pp.406-421
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    • 2022
  • Objectives: The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age. Methods: Data from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared. Results: Compared to the 4th survey, the 7th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7th survey was lower than in the 4th. Compared to the 4th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7th. A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7th in addition to the risk factors highlighted in the 4th survey. Conclusions: For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

뇌졸중환자의 자가간호 수준과 가족구성원의 간호요구 (A Study on the Care Needs of Family-Caregivers and the Level of Self Care for Patients of Cerebral Vascular Accident(CVA))

  • 조영희
    • 기본간호학회지
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    • 제7권2호
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    • pp.239-255
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    • 2000
  • The purpose of this study was to explore the care needs of family-caregivers caring for patients with a CVA and the level of self care of the patients. The subjects for the study were 112 patients with a CVA and their caregivers. These patients were seen in a hospital or out-patient-department(OPD) at two oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL checklist for self care of patients and Kim's Likert-style checklist for care needs of family-caregivers to patient with CVA. The survey was conducted from July 4 to August 30, 1999. Internal validity by calculation of Cronbach's alpha was 0.95, which was regarded as high. The survey results were analyzed using the SPSS program, with percentages, means, t-test, ANOVA and Pearson's correlation coefficients. The results of this study are as follows : 1. The level of self care for patients with a CVA was : 1) complete dependence(M=14.9, 13.1%), 2) complete independence(M=23.6, 20.9%), 3) incomplete independence(M=23.9, 21.0%), 4) incomplete dependence(M=26.6, 25.0%), 5) dependence and independence(M=23.0, 20.0%). The items for which there was a high level of self care were : 1) drinking(M=3.62), 2) eating (M=3.25), 3) position returning(M=3.18) : and the items for which there was a low level of self care were : 1) ascending and descending stairs(M=2.08), 2) walking(M=2.47). 3) putting on and taking off trousers(M=2.55). 2. The mean score of the sum of the care needs of the family-caregivers was : 1) need for immediate care and help: 2) need of the way to communicate with patient: 3) need for education and assistance related to physical functional level: 4) need to be informed about the disease, treatment and care: 5) need for social support and consultation: 6) need for appreciation: 7) need for management of nursing problems related to immobility. The highest meed factor was the need for immediate care and help(M=3.47): and lowest need factor was the need for management of nursing problems related to immobility(M=2.80). 3. There were significant differences between the level of care need and general characteristic of the caregivers, there were family-caregivers age(P=0.001), marital status (P=0.276), occupation (P=0.006), monthly income(P=0.000), Patient's relationship to caregivers(P=0.004) and health(P=0.000). 4. There were significant differences between the level of self care and general characteristic of the patients, there were patient paralytic condition(P=0.01), blood pressure(P=0.01), and length of suffering(P=0.03). 5 There were significant differences between the level of care need and the general characteristic factors, which were CVA patient's blood pressure (P=0.05), problem of medical fee (P=0.05). 6. There was significantly correlation with the family-caregivers care need and the level of self care in the CVA patient(r=0.300, P=0.000). As a result, need to promote the level of self care in patients and to meet the care need of family-caregivers for more efficient nursing of CVA patients, is emphasized. Therefore more study is needed on an efficient way to provide rehabilitation and quality nursing interventions for family-caregivers and patients with CVA.

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뇌졸중환자의 희망 (The Hope of the Stroke Patients)

  • 김이순
    • 대한간호학회지
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    • 제27권1호
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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제주지역 암환자의 의료서비스 요구도 및 만족도 분석 (Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province)

  • 김우정;김민영;장원영;최재혁
    • Journal of Hospice and Palliative Care
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    • 제13권3호
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    • pp.153-160
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    • 2010
  • 목적: 본 연구는 제주지역에 거주하는 암환자의 요구도와 만족도를 파악하기 위한 조사연구이다. 방법: 2009년 7월 13일부터 7월 30일까지 제주대학교 병원에 내원한 암환자 174명의 의료서비스에 대한 요구도와 만족도를 분석하였다. 보건복지부에서 재가암환자 관리사업 시행 시 제시한 서비스 요구도 및 충족도 조사 항목을 이용하여 조사하였으며, 수집된 자료는 SPSS 12.0 for Windows program을 이용하여 분석하였다. 결과: 대상자는 위암과 대장직장암 등 위장관계 암환자가 33.3%로 가장 많았으며, 52.3%가 진단 후 경과 기간이 1년 이하였으며, 진단 후 5년 이상 경과한 대상자는 5.2%로, 최장기간은 12년이었다. 전체의 60.9%가 암으로 인한 수술 경험이 있었으며, 28.2%가 항암화학요법 경험이 있었다. 요구도가 가장 높았던 항목은 경제적지원(3.38점)이었으며, 치료 계획에 대한 상담(3.22점), 질병에 대한 정보(3.07점), 암 이외의 다른 질병 관리(2.97점) 순이었다. 만족도가 가장 높았던 항목은 종교상담(3.41점)이었으며, 간병보조(3.39점), 직업상담(3.26점), 가족 및 대인관계 상담(3.26점), 물리치료 및 재활치료(3.20점), 보험 상담(3.18점) 순이었으며, 만족도가 가장 낮은 항목은 경제적 지원(1.98점)이었다. 남성의 서비스 만족도는 3.1점으로 여성(2.8점)보다 높았으며, 자녀와 사는 경우 서비스 요구도가 가장 높았으며, 홀로 살거나 자녀와 사는 경우 서비스 만족도가 가장 낮았다. 의료보호 환자 및 암보험에 가입하지 않은 경우 서비스 요구도가 더 높은 것으로 나타났다. 대상자의 연령, 직업, 학력수준, 결혼여부, 종교, 수입에 따른 차이는 없었으나, 60대 및 수입이 높은 그룹에서 서비스 만족도는 가장 높고, 요구도는 가장 낮은 것으로 나타났다. 의학적 진단 및 치료 방법에 따른 서비스 요구도 및 만족도의 차이는 없었으나, 갑상샘암 환자에서 서비스 만족도가 다소 낮았으며, 방사선 치료 및 색전술을 받은 경우 만족도가 다소 낮은 것으로 나타났다. 결론: 암환자들은 경제적 지원 및 치료계획이나 질병에 대한 정보를 얻고자 하는 요구도가 높으며, 실제 경험하는 증상에 대한 관리는 잘 이루어지지 않는 것으로 보인다. 또한, 환자의 지지체계 및 경제적 지원 체계의 확보 여부에 따라 의료서비스에 대한 요구도도 다양하고, 주요 5대암 이외의 암환자에 대한 지원이 다소 부족한 것으로 보인다. 따라서, 의료기관에 내원 중인 암환자 및 재가암환자 모두를 대상으로, 대상자 특성 및 요구도를 고려한 지속적인 정책적 노력이 필요할 것이다.

성인의 건강관련 생활양식과 치아우식증과의 관련성 (Association of Dental Caries with Health Lifestyle in Adults)

  • 김수경
    • 치위생과학회지
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    • 제15권3호
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    • pp.333-339
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    • 2015
  • 본 연구는 성인의 치아우식증에 영향을 미치는 관련요인을 알아보고자 제6기 1차년도(2013년) 국민건강영양조사중 건강설문 검진조사, 영양조사를 완료한 10,113명 중 만 19세 이상의 성인과 영구치우식 유병자 여부 카테코리에 대한 정보가 갖춰진 4,843명을 최종 분석대상자로 복합표본분석을 실시하였으며, 연구결과는 다음과 같다. 사회 경제적 특성에 따른 치아우식증 유병률은 성별에서 남자가 여자보다 높았으며(p<0.001), 연령별로는 30대, 20대, 40대, 60대 이상, 50대 순으로 나타났다(p<0.05). 교육수준에 따라서는 고졸, 중졸, 대졸 이상 순으로 나타났고(p<0.05), 월 소득수준은 '하'인 경우 가장 높게 나타났다(p<0.001). 건강관련 생활양식에 따른 치아우식증 유병률은 흡연자가 비흡연자보다 높게 나타났으며(p<0.001), 비만의 경우 정상보다 다소 높았으며(p<0.05), 구강검진을 받지 않은 경우가 받는 경우보다 높았다(p<0.001). 일일 칫솔질 횟수가 증가할수록(p<0.05), 치실, 치간칫솔을 사용하는 경우 치아우식증 유병률이 감소하는 것으로 유의하게 나타났다. 치아우식증 여부를 종속변수로 로지스틱 회귀분석을 실시한 결과 치아우식증에 영향을 미치는 변수로는 성별, 연령, 소득수준, 흡연, 구강검진, 치실사용 등으로 나타났다. 이상의 결과를 종합해 보면 한국 성인의 사회 경제적 요인 및 생활양식은 치아우식증에 영향을 미치는 것으로 확인되었으며, 성인의 치아우식증 예방 및 구강건강을 향상시키기 위해서는 건강한 생활습관을 실천할 수 있는 구강건강교육 및 실천 프로그램의 개발이 필요하다고 생각되었다.

고혈압(高血壓) 환자(患者)의 혈압관리실태(血壓管理實態)와 한방이용(韓方利用) 현황(現況) (The Condition of Controlling Blood-pressure and the Use of Oriental Medical Services in Hypertensive Patients)

  • 신택수;류성기;정명수;이기남
    • 한국전통의학지
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    • 제15권1호
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    • pp.128-144
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    • 2006
  • This Study aims at looking into the use of oriental medical services in treating hypertension. The first objective to be explored through this study is the morbidity caused by the disease, classifying them by age, gender, and occupation. The second is to determine the regular use of anti-hypertensive medicine and their efficacy in controlling blood-pressure. The third is to investigate the use-rate and satisfaction of oriental medical service. 838 households across the country, were asked to answer questionnaires for the period of time from Apr. to Jun. 2005. The conclusion from the survey can be summarized as following. The age of which the first medical diagnosis of hypertension were made showed lower in males, those with higher education and income. The study showed females were more active in blood-pressure control, with their frequent monitoring of blood-pressure for the past year. With age, people in under 50 age group proved to be less active. The management of high blood pressure was more effective in group with regular dosage compared to group with irregular use of anti-hypertensive medication, but their difference was minimal. Also, group with no medication showed signs of blood-pressure control. The use of oriental medical service for the past year, were more frequent in groups with lower education, either low or high income, old age, females and occupations in agriculture, forestry and fishing industry. Results were similar in both general population and high blood-pressure patient group. Females, people over 51 years old and with lower education showed more intentions in utilizing oriental medical services in the future. Results were similar in both general population and high blood-pressure patient group. It is necessary to offer a more accurate information on oriental medical treatments. Also, a systematic reform to reduce the patient's share of the treatment cost, as well as, heightening public awareness on the infirmity of present blood-pressure management system is crucial.

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