• Title/Summary/Keyword: low income patients

Search Result 171, Processing Time 0.023 seconds

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

  • 김자옥;김만우;김자숙;한수정;김세현
    • 성인간호학회지
    • /
    • 제26권3호
    • /
    • pp.287-299
    • /
    • 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
    • /
    • 제16권9호
    • /
    • pp.4031-4035
    • /
    • 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
    • /
    • 제14권9호
    • /
    • pp.5043-5047
    • /
    • 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.

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

  • 오승길
    • The Journal of Korean Physical Therapy
    • /
    • 제9권1호
    • /
    • pp.37-50
    • /
    • 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.

  • PDF

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

  • 조수경;박경
    • Journal of Nutrition and Health
    • /
    • 제52권2호
    • /
    • pp.206-216
    • /
    • 2019
  • 본 연구는 당뇨병 환자들의 소득수준에 따라 대사위험지표 관리수준을 비교하고, 최근 관리 추이를 관찰하여 궁극적으로 당뇨병 환자들의 합병증 예방 관련 전략을 마련할 수 있는 기초자료를 마련하기 위하여 1998 ~ 2014년 국민건강영양조사 자료를 분석하였다. 국민건강영양조사에 참여한 조사대상자 중 당뇨병 환자이면서 본인의 질환을 인지하고 있는 대상자들을 추출하였고, 가구소득정보를 이용하여 세 그룹으로 분류하여 분석하였다. 당뇨병 환자들의 기본정보, 생활습관정보, 영양소 섭취 정보, 혈액지표 등은 건강설문조사, 영양조사, 검진조사를 통해 수집되었다. 자료 분석은 변수 특성에 따라 카이검정, 일원분산분석 등을 실시하였고, 다중선형회귀분석을 이용하여 혈압 및 혈액지표의 보정평균을 산출하였다. 당뇨환자들의 공복혈당, HbA1c 및 혈중지질 농도의 평균은 소득수준에 따라 유의적인 차이를 보이지 않았다. 조사기간인 1998년부터 2014년간의 16년 동안 대사위험지표 변화 추이를 살펴본 결과, 모든 그룹에서 혈압의 유의미한 감소 추세를 보였다 (p < 0.001). 소득이 가장 높은 그룹에서는 공복혈당 (p = 0.004), 총 콜레스테롤 (p < 0.001), LDL-콜레스테롤 농도 (p = 0.01)가 유의하게 감소하는 추이를 보였고, HDL-콜레스테롤 농도 (p < 0.001)는 유의하게 증가하는 추이를 보였다. 저소득층에서는 공복혈당 (p = 0.02), 총 콜레스테롤 (p < 0.001), 중성지방 농도 (p = 0.003)가 시간 경과에 따라 유의적으로 감소하는 경향을 보였다. 그러나 중간소득층에서는 혈압을 제외한 모든 대사 위험 인자에 유의적인 변화 추이가 발견되지 않았다. 결론적으로 당뇨병 환자의 소득수준에 따른 대사 위험 인자의 관리수준에는 차이가 없었다. 최근 16년의 관찰 기간 동안 소득이 가장 높은 그룹과 가장 낮은 그룹은 대사 위험 인자의 유의미한 개선 추이를 보였으나, 중간소득 그룹은 변화가 관찰되지 않았다. 본 연구는 당뇨병 환자들의 지표 관리에 대한 전략 마련과 효과적인 보건대책을 위한 기초자료로서 중요한 의미가 있다고 사료된다.

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

  • 조옥희
    • 대한간호학회지
    • /
    • 제30권4호
    • /
    • pp.1006-1017
    • /
    • 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.

  • PDF

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

  • 김현미;장군자
    • 한국간호교육학회지
    • /
    • 제4권1호
    • /
    • pp.81-94
    • /
    • 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.

  • PDF

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

  • 허정운;김동욱;오승택;최원정;박재섭
    • 대한조현병학회지
    • /
    • 제22권2호
    • /
    • pp.42-50
    • /
    • 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
    • /
    • 제13권12호
    • /
    • pp.6491-6496
    • /
    • 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.

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

  • 정태욱;조지연;김성호
    • 한국응급구조학회지
    • /
    • 제25권3호
    • /
    • pp.37-48
    • /
    • 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.