• Clinical and Experimental Reproductive Medicine
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• v.2 no.2
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• pp.27-36
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• 1975

The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.155-162
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• 2002

Purpose : The purpose of this study is to provide preliminary information on the hospice care needs of hospice volunteers. Methods : The sample of this study was obtained from those who completed the hospice volunteer education program in three different areas in Korea. This study was conducted by a self-administered questionnaire. The sample analyzed for this study contained 88 hospice volunteers. Frequency, percentage, mean, standard deviation, and logistic regression analysis were performed to produce the findings of this study. Results : The characteristics of the study sample were $40{\sim}49$ aged, middle class, christianity, married women with high school diplomas. They attended at the hospice center with less than 1 year experience. Majority of them had no family members who received a hospice care. The hospice care was strongly required in the field of information, particularly regarding their diseases and treatments. The identified hospice care needs were the prevention and treatment of gangrene in the field of physical needs, the maintenance of closer relationship with their doctors in the field of emotional needs, and the support of supporting medical insurance in the field of socioeconomic needs. The significant predictors were 'having hospice care taker among family members' in the field of the total hospice care needs and physical needs. Two predictable variables were found in the field of emotional needs. However, none were found to be a predictable variable in the field of information and socioeconomic needs. Conclusion : The findings or this study have a weekness of generalizability due to the sampling methodology used in this study. Thus, further research should be designed in relation to this topic with a probability sampling method.

• Journal of Korean Medical classics
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• v.9
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• pp.555-652
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• 1996

Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.129-140
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• 1994

The survey has for its object to detect prevalence rate of hypertension in target population, to find out the risk factor to hypertension, to detect the hypertensive patients cared pattern and therefore, to consider a effective counter plan for the long term about hypertension. The study, population of this survey was 894 out of 1013 target population from Feb. 1 1994 to March 31 1994 in Kyougsang-namdo Ulsan-gun Samnam-myoun. For these two month, check of blood pressure and direct measurement of height and weight was carried out by mass screening and home visiting and had an interview about risk factors for hypertension and cared pattern by questionnaire. The results of survey were as follows : 1. The prevalence rate of 894 study, population was 27.5% and 26.0% in man and 28.6% in women. 2. In male, the prevalence rate for age group, family history of hypertension, drinking, salt intake by risk factors were significant statistically. 3. In female, the prevalence rate for salt intake, body mass index by risk factors were significant statistically. 4. Motivation which was diagnosed as hypertension was that be examined for subjective symptoms of hypertension and routine check for health was only 25.0%, 9.1% and visiting to the hospital for other diseases, detect hypertension by chance was 65.9%. 5. The experience of treatment in prevalent cases was significant statistically in middle class of SES. And the place of treatment by risk factors could not be significant statistically in spite of the majority selected hospital generally. 6. The reasons of non-compliance in prevalent cases was restricting daily activities for its 45.5% most high and the interruption of treatment in prevalent cases was far from hospital geographically for its 47.6% most high 7. The preventive behavior about hypertensive by risk factors or general characteristics wasn't significant statistically. 8. Being treated or not in the near future about age group, SES, family history of the hypertension was significant statistically. And with regard to the place of treatment in the near future, in spite of the majority selected hospital generally, it wasn't significant statistically. 9. The reasons of non-compliance in incidence cases was restricting daily activities for its 46.8% most high. 10. The preventive behavior in the near future about age group, education level, SES, family history of hypertension was significant statistically.

• Journal of Korean society of Dental Hygiene
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• v.7 no.1
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• pp.91-103
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• 2007

The purpose of this study was to pave the way for the development of oral health promotion programs for children from the low-income class. The subjects in this study were 322 children from the city of Incheon. Some of them visited local childcare centers, and the others attended six different adjacent elementary schools. Their awareness of oral health, oral health behavior and preventive-treatment experience were investigated in May 2005, and whether there were any characteristics in their visit of dental institutions was checked. Besides, whether their parents advised them to brush their teeth before turning in was examined. The findings of the study were as follows: 1. 22.0 percent of the children investigated were visiting local childcare centers, and 78.0 percent weren't. The guardians of the former group largely received high-school(50.7%) and middle-school or lower education(22.5%), and those of the latter group mostly received high-school(41.0%) and college- or higher education(35.5%)(pE0.001). The common monthly mean house-hold income of the former was one million won or less(54.9%) or ranged from 1.01 to 2.00 million won(19.7%), and the most prevalent monthly mean household income of the latter was between 2.01 and 3.50 million won(28.7%). The second most dominant monthly mean household income of the latter ranged from 1.01 to 2.00 million won(28.3%), and the third most common one was 3.50 million won or more(12.0%)(pE0.001). 2. The most prevalent daily toothbrushing frequency among the local childcare center visitors was twice(39.4%), followed by three times(19.7%). The third largest group of the visitors brushed their teeth after each meal(19.7%). The most dominant daily toothbrushing frequency among the non-users of local child care centers was twice(54.2%), followed by three times(29.1%)(pE0.01). As to the way of toothbrushing, 58.2 percent of the visitors and 74.9 percent of the non-visitors brushed their teeth by turning their toothbrush or up and down(pF0.05). 62.0 percent of the former and 74.9 percent of the latter always brushed their teeth before turning in, and whether they visited local childcare centers made a significant difference to that(pE0.05). 3. 69.7 percent of the non-visitors were always advised by their parents to do toothbrushing before turning in, and the visitors who were given the same advice all the time numbered 29.6 percent(pE0.001). 4. 56.4 percent of the visitors and 72.1 percent of the non-visitors had ever visited dental institutions over the past year. Dental hospitals and clinics were identified as the dental institutions that they visited the most, and they mostly received dental-caries treatment or had a tooth out there. 49.3 percent of the visitors and 35.1 percent of the non-visitors had ever had a toothache. 5. Sealant was experienced by 42.3 percent of the visitors and 46.2 percent of the non-visitors to prevent dental caries(pF0.05). 33.8 percent of the visitors underwent fluoride application, and that rate was higher than that of the non-visitors with the same experience that stood at 22.7 percent(pE0.05). The visitors mainly acquired knowledge on oral health through other channels that weren't specified in the questionnaire(28.2%), and the non-visitors did it mostly at dental clinics(39.0%)(pE0.001).