• Title/Summary/Keyword: low income patients

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Therapeutic Compliance and Its Related Factors of Lung Cancer Patients (폐암환자의 치료순응도와 관련요인)

  • Kam, Sin;Park, Jae-Yong;Chae, Sang-Chul;Bae, Moon-Seob;Shin, Moo-Chul;Yeh, Min-Hae;Nam, Si-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.1
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    • pp.13-23
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    • 2002
  • Objectives : To investigate the therapeutic compliance and its related factors in lung cancer patients. Methods : The subjects of this study comprised 277 patients first diagnosed with lung cancer at Kyungpook National University Hospital between Jan 1999 and Sept 1999. Of these, 141(50.9%) participated in the study by properly replying to structured questionnaires. The data was analyzed using a simplified Health Decision Model. This model includes categories of variables covering therapeutic compliance, health beliefs, patient preferences, knowledge and experience, social interaction, sociodemographic and clinical characteristics. Results : The therapeutic compliance rate of the 141 study subjects was 78.0%. An analysis of health beliefs and patient preferences revealed health concern (p<0.05), dependency on medicine (p<0.05), perceived susceptibility and severity (p<0.05) as well as preferred treatment (p<0.01) as factors related to therapeutic compliance. Factors from the sociodemographic characteristics and clinical factors that were related to therapeutic compliance were age (p<0.01), monthly income (p<0.05), histological type (p<0.05) and clinical stage (p<0.05) of cancer. Conclusions : In order to improve therapeutic compliance in lung cancer patients it is necessary to educate the aged, low-income patients, or patients who have small cell lung cancer or lune cancer of an advanced stage for which surgery is not indicated. Additionally, it is essential for medical personnel to have a deep concern about patients who have poor lifestyles, a low dependency on medicine, or a high perceived susceptibility and severity. Practically, early diagnosis of lung cancer and thoughtful considerations of low-income patients are important. By means of population-based education in a community, we may promote attention to health and enhance the early diagnosis of lung cancer.

Factor Associated with the Unmet Healthcare Needs Types among Family Living with Dementia Patients (치매환자 동거 가족의 미충족 의료 유형별 관련 요인)

  • Kim, Bomgyeol;Noh, Young-Min;Lee, Yejin;Kim, Tae Hyun;Noh, Jin-Won
    • Korea Journal of Hospital Management
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    • v.25 no.1
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    • pp.21-31
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    • 2020
  • Purposes: Family living with dementia patients have the burden for caring and suffer from health problems. Therefore, proper supports for their health disorders are required. The purpose of this study with regard to this is to subdivide unmet healthcare needs of family living with dementia patients into affordability, accommodation, and accessibility and figure out the relevant factors. Methodology: The 2017 Community Health Survey was used, and 2,331 families living with dementia patients was included. To figure out the factors with regard to the types of unmet healthcare needs, multinominal logistic regression analysis was conducted. Findings: According to the analysis result, sex, age, monthly household income, economic activity, self-rated health, self-rated stress and perception of depressive symptoms turned out to be the factors related to unmet healthcare needs. Regarding affordability, unmet healthcare needs were low when the object was female, over 65, highly educated, and monthly household income were high. On the other hand, unmet healthcare needs was high when self-rated health was bad, self-rated stress was high, and had depression. With regard to accommodation, unmet healthcare needs were low when the object was over 65. Unmet healthcare needs were high when the object was female, economically active and had depression, and self-rated health was high. Regarding accessibility, unmet healthcare needs were low when the object was high school graduate, but it was high when self-rated health was bad. Practical Implication: This study confirmed that the family with dementia patients had a high proportion of unmet healthcare needs due to affordability and accommodation. The existing main discussion was that the experience of unmet healthcare needs normally occurred due to economic reasons, but a consideration on various cases and factors is required to ultimately achieve the policy goal to reduce the unmet healthcare needs of the family living with dementia.

The Relationship between Perceived Family Functioning and Depression in Patients with Chronic Low-Back Pain (만성요통환자가 지각하는 가족기능과 우울의 관계)

  • Son Jung-Tae;Park Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.316-331
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    • 2000
  • This study was conducted using a descriptive correlational survey design to identify how patients with chronic low-back pain perceived family function and to examine the relationship between family function and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-up treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were FACE II-Korean version and Beck's Depression Inventory(1983). The data collected were analysed using mean, standard deviation(SD), t-test, F-test, Duncan test and Pearson correlation coefficient, done with SAS. The results are as follows; 1. The mean of the respondents' perceived family function was 3.47, with emotional bonding at 3.61, acceptability and sharing at 3.61, participation at 3.23, negotiation and satisfaction at 3.24 and responsibility and expectation at 3.76. 2. The mean of the respondents' perceived depression was $17.53{\pm}8.76$. 3. There was significantly negative correlation between family function and depression(r=-0.4817, p=.0001). 4. Research variables included demographic characteristics and showed that subjects who were aged 65 years or older showed significantly lower scores in patient's perceived family function than those who were aged 45 years or below(p=.0502). Perceived family function of females respondents were significantly lower than males(p=.0026). The illiterate showed significantly lower scores than other groups(p=.0001). Respondents with spouse and extended family tended to show significantly higher scores than those who were living with spouse only or by themselves alone(p=.0091). Those who had higher income showed significantly higher scores than in the lower income group(p=.0001). 5. For family function regarding pain characteristics, those who reported severe pain-related daily activity impediments showed significantly lower scores in family function than others with less pain(p=.0357).

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Angiogenesis Markers in Breast Cancer - Potentially Useful Tools for Priority Setting of Anti-Angiogenic Agents

  • Keyhani, Elahe;Muhammadnejad, Ahad;Behjati, Farkhondeh;Sirati, Fereidoon;Khodadadi, Faranak;Karimlou, Masoud;Moghaddam, Fatemeh A.;Pazhoomand, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7651-7656
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    • 2013
  • Background: Breast cancer is the most common malignancy among women in both developed and developing countries. The burden is increasing in low-income and middle-income countries (LMCs) and threatens the public health of such societies. Introduction of expensive monoclonal antibodies to cancer treatment regimens poses a real challenge in the health systems of LMCs. Despite controversy of cost-effectiveness of bevacizumab in breast cancer, some studies indicate gain of patients from this drug. The present study aimed to propose a priority setting model for administration of anti-angiogenic agents in breast cancer via assessment of tumor angiogenesis by the microvessel density (MVD) method and associations with clinicopathological characteristics (including simultaneous mutations of TP53 and HER-2 genes). Materials and Methods: Age, axillary lymph nodes status, tumor size, stage and grade, estrogen and progesterone receptors status, HER-2/neu status (by immunohistochemistry and FISH test), TP53 mutation, Ki-67 (for proliferation assay) and CD34 (for angiogenesis assay) were assessed in 111 breast cancer patients. The molecular subtype of each tumor was also determined and correlations of simultaneous mutations of HER-2 and p53 genes with angiogenesis and other clinicopathological characteristics were evaluated. Results: There were significant associations between simultaneous mutations of HER-2 and p53 genes and all other parameters except tumor size. The degree of angiogenesis in the ERBB2 subtype was greater than the others. Younger patients showed a higher angiogenesis rate rather those older than 50 years. Conclusions: Our results demonstrated that patients with simultaneous mutations of HER-2 and p53 genes, those with ERBB2 molecular subtype and also younger women (often triple negative) seem more eligible for obtaining anti-angiogenic agents. These results suggest a model for priority setting of patients with breast cancer for treatment with anti-angiogenic drugs in LMCs.

Health-related Quality of Life among Breast Cancer Patients and its Influencing Factor in a Chinese Population

  • Shen, Fang-Rong;Liu, Ming;Zhang, Xia;Feng, Ya-Hong;Zhou, Long-Shu;Chen, You-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3747-3750
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    • 2012
  • Aim: The aim of this study was to investigate the quality of life (QOL) of breast cancer patients by using the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaires. Methods: A total of 522 adult patients who were admitted to our hospital with breast cancer were collected during the period of Jun. 2007 to Dec. 2009. Results: Our FACT-B questionnaire study suggested that women below 50 years old, employed, higher education and annual income, lower TNM stage and receiving modified radical mastectomy manifested significantly better QOL using the assessment tool of the FACT-B subscale. Moreover, regression analysis indicated patients with young age, low stage cancer, high education and income were more likely to have high score of QOL, with ORs (95% CI) of 2.8 (1.52-4.56), 2.1 (1.15-3.95), 3.1 (1.45-5.12) and 3.54 (1.54-5.43), respectively. Conclusions: Our study showed younger age, lower stage of cancer, higher education and income could influence the QOL of breast cancer patients in our Chinese population. Further large sample studies are still needed for confirmation.

Factors Influencing Health related Quality of Life among Patients with Chronic Hepatitis B (만성 B형 간염 환자의 건강 관련 삶의 질과 영향요인)

  • Kim, Ja-Ok;Kim, Man Woo;Kim, Ja-Sook;Han, Su-Jeong;Kim, Sehyun
    • Korean Journal of Adult Nursing
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    • v.26 no.3
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    • pp.287-299
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    • 2014
  • Purpose: The aim of this study was to investigate the factors contributing to health-related quality of life (HRQOL) among patients with chronic hepatitis B (CHB). Methods: A cross-sectional, descriptive design was used. The sample included 114 patients in a gastroenterology outpatient department at one hospital located in G city. Data were collected using a structured questionnaire from June to December 2009. The collected data were analyzed using SPSS/WIN 15.0. Results: Health-related quality of life was most strongly related to age, sex, income, occupation, and the care provider. Old age, female gender, lower income, not having an occupation and having a non-medical person were associated with lower HRQOL ($R^2$=.03~.22, p=.041~<.001). Conclusion: CHB infection had a negative impact on HRQOL among the older, female gender, low socioeconomic status and not having medically knowledgeable care givers. Interventions beyond nursing care may be needed to improve the quality of health for patients with Chronic Hepatitis B.

Anxiety and Depression among Breast Cancer Patients in an Urban Setting in Malaysia

  • Hassan, Mohd Rohaizat;Shah, Shamsul Azhar;Ghazi, Hasanain Faisal;Mujar, Noor Mastura Mohd;Samsuri, Mohd Fadhli;Baharom, Nizam
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4031-4035
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    • 2015
  • Background: Breast cancer is one of the most feared diseases among women and it could induce the development of psychological disorders like anxiety and depression. An assessment was here performed of the status and to determine contributory factors. Materials and Methods: A cross-sectional study was conducted among breast cancer patients at University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur. A total of 205 patients who were diagnosed between 2007 until 2010 were interviewed using the questionnaires of Hospital Anxiety and Depression (HADS). The associated factors investigated concerned socio-demographics, socio economic background and the cancer status. Descriptive analysis, chi-squared tests and logistic regression were used for the statistical test analysis. Results: The prevalence of anxiety was 31.7% (n=65) and of depression was 22.0% (n=45) among the breast cancer patients. Age group (p= 0.032), monthly income (p=0.015) and number of visits per month (p=0.007) were significantly associated with anxiety. For depression, marital status (p=0.012), accompanying person (p=0.041), financial support (p-0.007) and felt burden (p=0.038) were significantly associated. In binary logistic regression, those in the younger age group were low monthly income were 2 times more likely to be associated with anxiety. Having less financial support and being single were 3 and 4 times more likely to be associated with depression. Conclusions: In management of breast cancer patients, more care or support should be given to the young and low socio economic status as they are at high risk of anxiety and depression.

Low Income and Rural County of Residence Increase Mortality from Bone and Joint Sarcomas

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5043-5047
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    • 2013
  • Background: This is a part of a larger effort to characterize the effects on socio-economic factors (SEFs) on cancer outcome. Surveillance, Epidemiology and End Result (SEER) bone and joint sarcoma (BJS) data were used to identify potential disparities in cause specific survival (CSS). Materials and Methods: This study analyzed SEFs in conjunction with biologic and treatment factors. Absolute BJS specific risks were calculated and the areas under the receiver operating characteristic (ROC) curve were computed for predictors. Actuarial survival analysis was performed with Kaplan-Meier method. Kolmogorov-Smirnov's 2-sample test was used to for comparing two survival curves. Cox proportional hazard model was used for multivariate analysis. Results: There were 13501 patients diagnosed BJS from 1973 to 2009. The mean follow up time (SD) was 75.6 (90.1) months. Staging was the highest predictive factor of outcome (ROC area of 0.68). SEER stage, histology, primary site and sex were highly significant pre-treatment predictors of CSS. Under multivariate analysis, patients living in low income neighborhoods and rural areas had a 2% and 5% disadvantage in cause specific survival respectively. Conclusions: This study has found 2-5% decrement of CSS of BJS due to SEFs. These data may be used to generate testable hypothesis for future clinical trials to eliminate BJS outcome disparities.

A Study of Low Back Pain Patient's Satisfaction with Physical Therapist in Seoul and Uijongbu City (요통환자의 물리치료사 만족도에 대한 조사 -서울 및 의정부 시 일부 병, 의원에 내원하는 외래, 재진 환자를 중심으로-)

  • Oh Seung-Kil
    • The Journal of Korean Physical Therapy
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    • v.9 no.1
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    • pp.37-50
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    • 1997
  • Low back Pain(LBP) is a common problem, and the resulting disability frequently contains nonorganic, psycho-logical and social elements that are difficult for the physical therapists to manage. The physical therapist-patient relationship is the most important factors in the management of low back pain as chronic disease. The purpose of this study was to evaluate and to identify factors that had influenced low, back pain patients satisfaction with physical therapist The subjects of this study were 223 out-patients(116 males and 107 females) who had been visited to physical therapy room of medical institutions in Seoul and Uijgngbu city. They were examined by the questionaire of Dimatteo and Hays which was amended to serve the purpose of this study by author. The collected data was analyzed by ANOVA according to the purpose of this study. There was no difference with statistic value in LBP patient's satisfaction according to occupation, sex, schooling, religion, marital status, medical security, duration of disease, the tine required, recurrence, but was a difference according to age, income, period of treatment, cost, diagnosis, waiting time, the number of physical therpy's sort, sex ane age of physical therapists (p<.05). LBP patients was satisfied with physical therapist's communicative behavior, but was dissatisfied with physical therapist's competence.

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Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: the Korea National Health and Nutrition Examination Surveys 1998~2014 (성인 당뇨병 환자의 소득수준에 따른 혈당, 당화혈색소, 혈압, 및 혈중지질 지표의 변화 추이 : 국민건강영양조사 1998~2014 분석 결과)

  • Cho, Sukyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.52 no.2
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    • pp.206-216
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    • 2019
  • Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.