• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.65-77
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• 1999

In order to estimate the utilization pattern of a rural health subcenter, and to identify the recognition for it among the farmhouse members in a suburban area, a questionnaire survey was carried out for objects of 696 population. The results observed were as follows: The annual utilization rate of rural health subcenter for a basic health service unit was 25.0 per 100 persons, and annual mean visiting times was 0.22 times. And the most frequent disease by annual health subcenter utilization illness was musculoskeletal disease(30.6%), and the next was respiratory disease(14.1%), gastrointestinal disease(13.9%) by order. Favorite reason for community health subcenter utilization were near distance from living place(49.6%), lower disease severity(18.9%) and lower medical cost(18.1%) by order. But disfavoring reasons for it were absence of specialist(20.2%), non effective treatment(19.2%) and insufficient equipment(14.7%) by order. And insufficient items about community health subcenter utilization were restriction of treatment limit(40.7%), lower reliance(22.5%) and difficulty in traffic(13.4%) by order. The results of logistic regression analysis suggested that statistically significant factors in health subcenter utilization was educational level. The desirable works for the health subcenter in a suburban area were disease control of elderly and disease preventing service. These results suggested that to increase the utilization of rural health subcenter in a suburban area and to promote the accessibility of rural residents to primary health care, there must be considered public relation about health subcenter, improvement of medical quality and change of priority about health subcenter's works.

• Journal of the Korean association of regional geographers
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• v.3 no.2
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• pp.163-193
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• 1997

Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1332-1339
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• 2002

Purpose : Through a survey undertaken among doctors practicing pediatric patients in primary medical facilities on nutrition during infancy, the present study was done to determine whether these doctors were giving appropriate advice on infant nutrition. Methods : We visited pediatric specialists(group one) and non-pediatric specialists or general practitioners(group two) who were practicing in Daegu to ask them to fill out a questionaire on infant nutrition. Results : When 10 points were given to each question for a total of 100 points, the results of the evaluation showed that the score in group one was $73.0{\pm}15.8$ points and $45.1{\pm}18.4$ points in group two, showing a significant difference. No statistical difference was seen in the scores between non-pediatric specialists and general practitioners. Each answer to each question on the feeding period of breast milk, on loose stools during breast milk feeding, methods to deal with jaundice during breast milk feeding, choice of commercial baby food, criteria on directing soy milk, and criteria of guiding infant cereal was different between group one and two. Conclusion : The results of the present investigation showed that specialists in other fields or general practitioners were giving inappropriate advice on nutrition during the infant stage compared with pediatric specialists; thus, we need to confirm methods to prevent inappropriate consultations by specialists of other fields, together with continued education of pediatric specialists.

• The Journal of Korean Academic Society of Nursing Education
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• v.1 no.1
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• pp.17-23
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• 1995

One of the biggest problems of Nursing Education in Korea is the division among nursing education programs of the last 3 and 4 years. To solve this problem, Nursing community must do variable trials to achieve the unity of a 4-year educational program. With this, we need to observe the phenomena and reality of the present 4-year nursing educational program that we have. The object of this study is to analyse and discuss that we have. The object of this study is to analyse and discuss the problems and future strategies of 4-year Nursing Baccalaureate program. 1. Problems as nursing department in Medical School. 1) Many 4-year nursing baccalaureate programs are operating under the medical school as nursing department. So the academic development in nursing department is unprogressive and is not approved as unique discipline. 2) The operating system between nursing and medical department are different even though they are in the same school. 3) Inequality between nursing and medical department : In many case, the nursing professor can not attend administraion committees to discuss the medical school's operation because of many differences between nursing and medical organization. 4) Weakness of the leadership and the student activities in nursing student : The nursing student involvement is usually passive because of the difference of curriculum, less number than medical students and the difference between 4-year and 6-year education program. 5) There is the obscurity of the relationship between department of nursing and other departments in whole university. 2. Problems in nursing itself 1) We need to reconstruct nursing discipline. We must change from the disease centered model to health centered model and life cycle centered model so that we can be distinguished from medicine. We also must change from hospital centered nursing to all population centered nursing, 2) The improvement of curriculum ; When the independent framework of nursing discipline become established, we need to improve the curriculum. 3) The education of clinical practice ; Most nursing school programs are divided into professors who are lecturing the theory and clinical teachers who are teaching the nursing technique in the clinic. So, what is needed in nursing discipline is that the professors have a dual position. In America, The professor is required to be a clinical specialist and to have his or her clinic so that the professor become a good role model, teach the clinical practice effectively, and give the student the practice field. 4) To extend fields of nursing : At first, the school nurse must become the school health educator, a real teacher. The nurse must establish and operate a childern's wellbeing center or nursery school, a disabled people's house or senile's wellbeing center, a mental health center, and a health promotion clinic for healthy people. 5) The name 'nursing department' need to be considered. When the focus is to be changed from the disease model to health improvement model, we take into consideration change 'nursing college', 'nursing department' and 'nursing profession' to 'health science college' or 'health wellbeing college'. 6) We must have highly qualified academic students. Each Nursing educational faculties must have the high qualified students through the development of nursing educational program and the increment of scholarship. The Korean Nurses Association and The Korean Clinical Nurses Association need to make an endeavor for the improvement of work condition and payment of clinical nurses of hospitals who consist of 70% of all nursing manpower. 3. Improvement Strategy 1) All nursing educational program must be changed 4-year program gradually. 2) Nursing department need to try to become nursing college. 3) We need to study many researches for improvement of the problem in nursing discipline and nursing education. We need more interdisciplinary researches, and we need to be granted for that research. 4) We need to have many seminars and workshops thoughout the whole country to expand a sense of nursing education. 5) Drawing up a policies plan for the nursing educational improvement : The Korean Nurses Association, The Korean Academic Nursing Association, Korea Nursing College and department President's Committee, and Korea Academic Society of Nursing Education must try for the development of nursing educational improvement and ask for government frame the policy to develop nursing education.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1142-1151
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• 2018

Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.1
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• pp.27-44
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• 2002

The main purpose of this study was to identify the effect of hand massage on pain and anxiety related to chest tube removal in patients with a lobectomy. The research design of this study was a nonequivalent control group non-synchronized design. Of the twenty nine adult subjects, fourteen were assigned to the experimental group and fifteen to the control group. The data were obtained over 3 months from a medical center in Seoul. The instruments used to assess trait state anxiety was the Spielberger Trait-State anxiety Inventory. For pain and psychological anxiety. The Visual Analogue Scale was used. Hiko analogue sphygmo-manometer(2001) was used to check blood pressure and pulse rate as indicators of physiological anxiety Subjects in the experimental group received hand massage for 5 minutes just before chest tube was removed, and subjects assigned to the control group did not receive hand massage. Data were analysed with $x^2$-test and Mann-Whitney U test using the SPSSWIN 10.0 program. The results of the study are as follows : 1. Hypothesis 1: 'there will be a significant difference between two groups in the level of pain after chest tube removal' was supported (u = 23.00, p < 0.001). 2. Hypothesis 2: 'there will be a significant difference between the two groups in the level of psychological anxiety after chest tube removal' was supported (u = 3.00, p < 0.001). 3. Hypothesis 3: 'there will be a significant difference between the two groups in physiological anxiety(systolic, diastolic blood pressure and pulse rate) after chest tube removal' was supported(u =55.50, p = 0.01 ; u = 41.50, p = 0.01 ; u = 20.50, p < 0.001, relatively). The findings of this study indicate that hand massage is effective for pain and anxiety related to chest tube removal in patients with lobectomy. Therefore, hand massage is recommended as an effective nursing intervention for relieving pain and anxiety in patients undergoing chest tube removal. Further research is needed to identify the proper duration and timing to achieve the optimal effect of hand massage. A larger subject population is required to apply the current findings to the general population. Further research is also needed to assess the effects of hand massage in other patient subsets. Finally, it would be interesting to see if the effects of hand massaging would be attenuated when performed by a non-medical specialist.

• Journal of dental hygiene science
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• v.10 no.1
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• pp.45-54
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• 2010

The purpose of this study was to offer the importance on factors of selecting dental institution according to general characteristics targeting general dental patients, and the information of having important influence upon choosing dental clinic and dental hospital. The survey was carried out from August 2009 to September. As a result of analyzing SAS(ver 9.1), the following conclusions were obtained. In the importance on factors of selecting dental institution according to general characteristics, it was thought to be important in convenience of movement or mobility such as distance, transportation, and parking convenience according to age level. According to final academic background, the importance in a factor of rumor in dental clinic was high(p < 0.05). According to job, the significant difference was shown in rumor of dentistry and parking convenience(p < 0.05). According to income, the factor in the appearance of training a medical specialist was indicated to be statistically higher in the group with over 5 million won than the group with under 2 million won(p < 0.05). Given seeing the distribution of opinion about dental hospitals (comparison with dental clinics), the excellence in the medical staff's ability was indicated to be the highest in all of the factor of influencing the use satisfaction(${\beta}=0.18$), the factor of influencing the recommendation level(${\beta}=0.21$), and the factor of influencing the re-use intention(OR=2.09).

• Journal of Preventive Medicine and Public Health
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• v.37 no.1
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• pp.88-98
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• 2004

Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.441-452
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• 2018

Background : The prevalence of the chronic metabolic disease is increasing due to the aging society. Therefore, Korean Society of Health-system Pharmacists (KSHP) has a specialty pharmacist system to improve the professionalism of pharmacists. The purpose of this study is to suggest the difference between specialty pharmacist and non-specialty pharmacist with regards to their knowledge, delivery of information on medication, service provision, and job satisfaction. Methods : An online survey research was conducted for hospital pharmacists. The reliability of the questionnaire items was presented using Cronbach's ${\alpha}$ test. The t-test or ANOVA analysis was used for evaluating differences in continuous variables. Results : A total of 171 pharmacists responded to the questionnaire, and 87.7% of the respondents were aged less than 30 years (76.6%) and four-year graduates (86.0%). Typically, 108 (63.2%) were candidates for the pharmacist's specialty certificate, and the remaining 63 (36.8%) were not enrolled. Considering the field of specialty with overlapping, the total number of certificated patients was 140 (26.3% of the total of 532 in 2016). The results of the reliability analysis of the specific questionnaire showed that the Cronbach's ${\alpha}$ value was over 0.78. There was no significant difference in customer directionality between the two groups. However, there was a significant difference (p<0.05) with respect to overall knowledge about the treatment process, drug efficacy, and side effects, information about medicines and adverse drug reactions, and in providing appropriate information to medical staff including patients and physicians. Conclusions : The pharmacist with specialization showed a positive result of self-evaluation of items such as knowledge about drugs, communication of information on medications, and service provision, compared to other pharmacists, and the result was in correlation with the numbers of specialization. There was no difference in job satisfaction related to working environment. Henceforth, it is hypothesized that there is a necessity for continuous improvement in the working environment to suit the purpose of the pharmacy specialist system.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.