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The Effect of Social Capital on Health-related Quality of Life - Using the Data of the 2019 Community Health Survey - (노인의 사회적 자본이 건강 관련 삶의 질에 미치는 영향 - 2019년 지역사회건강조사를 중심으로 -)

  • Kim, Ji-Hee;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.280-294
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    • 2021
  • Objectives: The purpose of this study is to investigate the effects of social capital characteristics, socio-demographic characteristics, physical condition, and health behavior characteristics on health-related quality of life of the elderly in Korea. Methods: T-test, one-way ANOVA, and regression analysis were performed by applying a complex sample design to 57.787 people aged 65 and over using the 2019 Community Health Survey. Results: First, as a result of complex-sample T-test and ANOVA analysis, it was found that there were differences in health-related quality of life according to social capital characteristics, physical condition & health behavior characteristics, and socio-demographic characteristics. Complex Sample Regression Analysis Results, the explanatory power of the model was 28%. When living in the metropolitan area, living in an apartment building, having a spouse, having a higher household income, economic activity, higher educational attainment, increase sleeping time, walking time, frequent binge drinking, health checkup, networking, trust, and social participation showed higher health-related quality of life. When people were older, their gender was female, higher BMI, number of chronic diseases, and severe stress that showed lower health-related quality of life. Conclusions: It was proved that the factors affecting the health-related quality of life of the elderly are not only physical condition and health behavior factors, but also social capital and socio-demographic characteristics. It was found that the role as a member was important.

TRelationship between Oral Health Behavior, Chronic Disease and Periodontal Disease in Middle and Older Adults According to Gender (성별에 따른 중·장년층의 구강건강행태, 만성질환과 치주질환의 연관성)

  • Hong, Min-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.403-410
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    • 2018
  • This study is to look at the risk of chronic diseases in adults and oral health behaviors affecting periodontitis by gender. This study selected 3,071 males aged 35 to 65, 4,273 females, and 7,344 people as the final subjects of the study using the sixth original data from the National Health and Nutrition Survey. In this study, subjective oral health classified under 'bad' presented 1.69 times(p<0.001) the risk of Periodontitis for males and 1.50 times(p<0.001) for females. There was a 2.01 times(p<0.001) of a risk of periodontitis for male and 1.40 times(p=0.001) of a risk for females. Smokers have a 1.68 times(p<0.001) of a risk for males and 2.07 times(p<0.001) of a risk for females, thus a higher risk for periodontitis for females. The risk of periodontitis was 1.44 times(p<0.001) of a risk for males and 1.30 times(p<0.05) for females when compared in normal hypertension. Obesity was at a rate of 1.199 times(p<0.05) as much for males in the non-military group, 1.202 times(p<0.05) that of females for periodontitis and putting females slightly more at risk. For diabetes, males were at risk of 1.28(p<0.05) whereas it being 1.53 times(p<0.05) for females, compared the average health female. In total, Males were found to be at the greatest risk of periodontitis, while women were at the highest risk for smoking. All parameters except smoking and diabetes show a higher risk of periodontitis for females. As males are more likely to have a higher risk of periodontitis than females, they are considered to be more interested in oral health care and need systematic oral health education and policies to prevent oral diseases.

Spawning Season and Growth of Korean Dark Sleeper, Odontobutis platycephala in Jaho Stream, Korea (자호천에 서식하는 한국고유종 동사리(Odontobutis platycephala)의 산란시기와 성장)

  • Hwa-Keun Byeon
    • Korean Journal of Environment and Ecology
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    • v.38 no.2
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    • pp.148-155
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    • 2024
  • This study investigated the ecological characteristics of Odontobutis platycephala at Jaho stream from January to December 2022. The riverbed structure of the species' habitat was rich in cobble and pebble. The water was deep, ranging from 22 to 153 cm, with an average of 64 cm, and the stream velocity was rapid at 0.89 (0.42-1.46) m/sec. The ratio of females to males was 1:1.02, and the total length of collected individuals ranged from 38 to 156 mm. The age according to the total length frequency distribution as of May indicated that the group with a total length of 38-69 mm was one year old, the group with 60-99 mm was two years old, the group with 100-139 mm was three years old, and the group 140-156 mm was four years or older. As a secondary gender characteristic, the genital papilla was cylindrical in females and cone-shaped with a pointed tip in males. Some females with a length ranging from 60 to 69 mm and all females 70 mm or longer were sexually mature. Some males with a length ranging from 70 to 79 mm and all males 80 mm or longer were sexually mature. The spawning season was from May to July, and the water temperature was between 17 ℃ and 28 ℃ during that period. The prosperous spawning season was June (24 ℃). The average number of eggs in the ovaries was 988 (284-2,722) per mature female, and the mature eggs were yellowish and spherical with a mean diameter of 1.46 (1.19-1.71) mm. The correlation between total length and body weight is BW=0.00000006TL3.12 with the constant a as 0.00000006 and the parameter b as 3.12. The mean condition factor (K) was 1.44 (0.96-2.26), and the slope was negative at -0.0007

Prevalence and Associated Factors of Depressive Symptoms Among Elderly Individuals in Rural Areas of Jeju Island (제주 농촌 지역 노인들의 우울증상 유병률 및 관련 요인)

  • Hyun Ju Yang;Min Su Oh;Woo Young Im;Sung Wook Song
    • Korean Journal of Psychosomatic Medicine
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    • v.32 no.1
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    • pp.43-51
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    • 2024
  • Objectives : This study aims to explore the prevalence of depressive symptoms among elderly residents in the relatively stable rural areas of Jeju and to examine the relationships between levels of depression, sociodemographic factors, and health habits. Methods : The study site was within rural Jeju, where elderly individuals aged 65 and older were randomly selected from the 'Agricultural Cohort' registered at the Centers for Farmers' Safety and Health Center. Trained interviewers conducted surveys using the Short Form Geriatric Depression Scale (sGDS-K), defining those with scores of 6 or above as experiencing depressive symptoms for the analysis. Other variables such as sex, age, educational level, marital status, annual income, subjective health status, underlying disease, perceived stress levels, smoking, and drinking status were also recorded Results : Out of 533 subjects, the prevalence of depressive symptoms was 35.3%, with 28.5% in male and 45.6% in female (p<0.001). Factors significantly associated with the prevalence of depressive symptoms included marital status (p=0.014), educational level (p<0.001), annual income (p=0.034), subjective health status (p<0.001), perceived stress level (p<0.001), feeling of despair (p<0.001) and suicidal ideas (p<0.001). Multivariate logistic regression analysis revealed that subjective health status, perceived stress level, and feelings of despair were associated with the prevalence of depressive symptoms. Conclusions : The high prevalence of depressive symptoms among the rural elderly in Jeju highlights the need for targeted mental health interventions. Addressing sociocultural factors and improving early detection and intervention strategies can help reduce the socioeconomic impact of depression in this population.

A Study on the Location of Retail Trade in Kwangju-si and Its Inhabitants와 Effcient Utilization (광주시 소매업의 입지와 주민의 효율적 이용에 관한 연구)

  • ;Jeon, Kyung-sook
    • Journal of the Korean Geographical Society
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    • v.30 no.1
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    • pp.68-92
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    • 1995
  • Recentry the structure of the retail trade have been chanaed with its environmantal changes. Some studies may be necessary on the changing process of environment and fundamental structure analyses of the retail trade. This study analyzes the location of retail trades, inhabitants' behavior in retail tredes and their desirable utilization scheme of them in Kwangju-si. Some study methods, contents and coming-out results are as follows: 1. Retail trades can be classified into independent stores, chain-stores (supermarket, voluntary chain and frenchiise system and convenience store), department stores, cooperative associations, traditional, markets mail-order marketing, automatic vending and others by service levels, selling-items, prices, managements, methods of retailing and store or nonstore type. 2. In Kwangju, the environment of retail trades is related to the consumers of population structure: chanes in consumers pattern, trends toward agings and nuclear family, increase of leisur: time and female advances to society. Rapid structural shift in retail trade has also been occurred due to these social changes. Traditionl and premodern markets until 1970s altere to supermarkets or department stores in 1980s, and various types, large enterprises and foreign capitals came into being in 1990s. 3. The locational characteristics of retail trades are resulted from the spatial analysis of the total population distribution, and from the calculation of segregation index in the light of potential demand. The densely-populated areas occurs in newly-built apartment housing complex which is distributed with a ring-shaped pattern around the old urban core. The numbers and rates of the aged over sixty in Kwangsan-gu and the circumference area of Mt.Moodeung, are larger and higher where rural elements are remarkable. A relation between population distribution and retail trade are analysed by the index of population per shop. The index of the population number per shop is lower in urban center, as a whole, being more convenient for consumers. In newly-formed apartment complex areas, on the other, the index more than 1,000 per shop, meeting not the demands for consumers. Because both the younger and the aged are numerous in these areas, the retail trade pattern pertinent to both are needed. Urban fringes including Kwangsan-gu and the vicinity of Mt.Moodeung have some problems owing to the most of population number per shop (more than 1, 500) and the most extensive as well. 4. The regional characteristic of retail trade is analyzed through the location quotient of shops by locational patterns and centerality index. Chungkum-dong is the highest-order central place in CBD. It is the core of retail trades, which has higher-ordered specialty store including three big department stores, supermarkets and large stores. Taegum-dong, Chungsu-dong, Taeui-dong, and Numun-dong that are neiahbored to Chungkum-dong fall on the second group. They have a central commercial section where large chain stores, specialty shopping streets, narrow-line retailing shops (furniture, amusement service, and gallary), supermarkets and daily markets are located. The third group is formed on the axis of state roads linking to Naju-kun, Changseong-kun, Tamyang-kun, Hwasun-kun and forme-Songjeong-eup. It is related to newly, rising apartment housing complex along a trunk road, and characterized by markets and specialty stores. The fourth group has neibourhood-shopping centers including older residential area and Songjeong-eup area with independent stores and supermarkets as main retailing functions. The last group contains inner residential area and outer part of a city including Songjeong-eup. Outer part of miscellaneous shops being occasionally found is rural rather than urban (Fig. 7). 5. The residents' behaviors using retail trade are analyzed by factors of goods and facilities. Department stores are very high level in preference for higher-order shopping-goods such as clothes for full dress in view of both diversity and quality of goods(28.9%). But they have severe traffic congestions, and high competitions for market ranges caused by their sma . 64.0% of respondents make combined purpose trips together with banking and shopping. 6. For more efficiency of retail-trading, it is necessary to induce spatial distribution policy with regard to opportunity frequency of goods selection by central place, frontier regions and age groups. Also we must consider to analyze competition among different types of retail trade and analyze the consumption behaviors of working females and younger-aged groups, in aspects of time and space. Service improvement and the rationalization of management should be accomplished in such as cooperative location (situation) must be under consideration in relations to other functions such as finance, leisure & sports, and culture centers. Various service systems such as installment, credit card and peremium ticket, new used by enterprises, must also be carried service improvement. The rationalization and professionalization in for the commercial goods are bsically requested.

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A Study on Red Cell Protoporphyrin Concentration and Iron Metabolism (적혈구(赤血球) Protoporphyrin과 철분대사(鐵分代謝)에 관(關)한 연구(硏究))

  • Cho, Kyung-Hwan;Tchai, Bum-Suk
    • Journal of Nutrition and Health
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    • v.7 no.3
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    • pp.1-13
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    • 1974
  • The relative state of human iron storage may be ascertained more reliably through determination of the serum iron, iron binding capacity, transferrin saturation and absorption of radioactive iron in conjunction with studies of red cell morphology than from the study of red cell morphology alone. Recent investigations have shown that there is an increase in red cell protoporphyrin concentration in iron deficiency anemia. The significance of the red cell protoporphyrin has been discussed greatly during the years since its discovery. Two of the main factors which appear to influence the amaunt of protoporphyrin are increased erythropoiesis and factors interfering with the utilization of iron in the synthesis of hemoglobin, and iron deficiency. Recently Heller et al. have described a simplified method for blood protoporphyrin assay and this technique could be used assess nutritional iron status, wherein even minor insufficiencies are detectable as increased protoporphyrin concentrations. Based on the evaluation of the relationship between nutritional iron status and red cell protoporphyrin as an index suitable for the detection of the iron deficiency is described in this paper. RESULTS 1. Hemoglobin Concentrations and Anthropometric Measurements. The mean and standard deviations of the various anthropometric measurements of different age and sex groups are shown in table 1. There measurements have been compared with the Korean Standard. In the absence of local standards for arm circumference and skin-fold thickness over triceps, they have been compared with the standard from Jelliffe. Table 2,3, and 4 give anthropometric measurements and frequency (%) of anemia in children surveyed. The mean height of the children studid was 10 to 20 percent; below the Korean Standard. The distribution of height below 80 percent of the Standard was 21.2 percent, however, among anemic group this percentage was 27.7 percent. In general, the mean weight of the children was 10 to 15 percent below the Korean Standard. The percentage of children with weight less than 80 percent of the Standard was about 35 percent. But in the anemic group of the children, this percentage was 44 percent. The mean arm circumference was about 15 percent lower than the Jelliffe's standard. 61.2 percent of the children had values of arm circumference below 80 percent of the standard. Children with low hemoglobin levels, this percentage was 80 percent. The mean skinfold thickness over the triceps of the children studied was about 25 Percent lower than the Jelliffe's standard and 61.2 percent of the children had the value less than 80 percent of the standard. Among anemic children, this percentage was 70.8%. As may be seen from table 5, the mean hemoglobin concentration of the total group was 11.3g/100ml. Hemoglobin concentration was less than 11.0g/100ml. in 65(36.5%) of the 178 children. The degree of anemia in most of these children was mild with a hemoglobin level of less than 8.0g/100ml. found in only one child. In general, the prevalence of anemia was high in female children than male and decreased its frequency with increasing age. Relatively close relationship was observed between hemoglobin level and anthrophometric measurements especially high between arm circumference and skinfold thickness and hemoglobin but very low in height and low in weight and hemoglobin level, estimated by chi-square value. II. Serum iron, Transferrin saturation (1) Serum iron, and transferrin saturation Serum iron, transferrin saturation and red cell protoporphyrin concentrations were estimated in sub-sample of 84 children from 1 to 6 years and 24 older children between 7 and 13 years of age. The findings are presented in table 6. The mean serum iron concentration of the total group was 59ug/100ml. However, the level incrased with age from 36.6ug/100ml. (1-3years) to 80.8ug/100ml. (7-13 years). 60 percent of these children had a serum iron level less than 50ug/10ml. in the 1-3 years age group and 31.4 percent for 4-6 years group. These contrast with the finding of 12.5 percent anemic children in the 7-13 years age group. The mean transferrin saturation for the total group was 18.1 percent and frequency of anemia by transferrin saturation was observed same pattern as serum iron concentration. (2) Red cell protoporphyrin concentrations. (a) Red cell protoporphrin levels of children: Red cell protoporphyrin and other biochemical data are shown in table 4. The mean concentration in red cell of all children was fround 46.3ug/100ml. RBC. and differences with age groups were observed; in the age group 1-3 years, the mean concentration was $59.5{\pm}32.14$ ug/100ml. RBC; 4-6 years $44.1{\pm}22.57$ ug/100ml. RBC. and 7-13 years, $39.0{\pm}13.56$ ug/100ml. RBC. (b) Normal protoporphyrin values in adults: It was observed that in 10 normal adult males studied here the level of protoporphyrin in red cell ranged from 18 to 54 ug/100ml. RBC. and the mean concentration was $47.5{\sim}14.47$ ug/100ml. RBC. Other biochemical determination made on the same subjects are presented in table 8. (c) Red tell protoporphyrin concentration of occupational blood donors: The results of analyses for red cell protoporphyrin as well as serum iron, transferrin saturation and hemoglobin in the 76 blood donors are presented in table 7 and 8. In this experiment, donors were selected at random, however, most of them bled repeatedly because of poor economic situation, I doubt. Table 9 shows the distribution of red cell protoporphyrin concentration and hemoglobin concentration of occupational donors. The mean hemoglobin value for the total was 11.9 g/100 ml. When iron deficiency anemia is defined as a transferrin saturation below 15%, prevalence of anemia was 47.4 percent and the mean serum iron was 27.1ug/100ml. and red cell protoporphyrin, 168.3ug/100ml. RBC. However, mean serum iron and protoporphyrin concentration of above 15% transferrin saturation were 11.6 ug/100 ml. and 58.8 ug/100 ml. RBC. respectively. The mean Protoporphyrin concentration of non-anemic (above 15% transferrin saturation) donors was slightly higher than the results of normal adult males.

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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Nutritional Risks Analysis Based on the Food Intake Frequency and Health-related Behaviors of the Older Residents (50 Years and Over) in Andong Area (1) (안동주변 농촌지역 50세 이상 주민의 식품섭취빈도 및 건강행위에 따른 영양위험 분석 (1))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.8
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    • pp.998-1008
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    • 2008
  • This study aimed to assess the nutritional status and the nutritional risks based on the food intake frequency and health-related behaviors of middle-aged and elderly people living in Andong area. Interviews were conducted with 1,384 subjects (532 males, 852 females) aged 50 years and over. Nutrient intakes, food intake frequency, and health-related behaviors including smoking, drinking, and exercise were investigated. The average energy intakes were 1410.5 kcal for males and 1279.2 kcal for females, and the percentages of the subjects consuming below the estimated energy requirement (EER) were 92.5% and 88.4%, respectively. The least consumed nutrients compared to the estimated average requirement (EAR) were riboflavin (92.5% for males, 89.6% for females), folic acid (89.7%, 88.5%), and calcium (78.9%, 85.8%), in order. According to the food intake frequency survey, the intakes of meat, fish and vegetable (except kimchi) were very poor, and this low intakes of meat and fish showed as poor status of protein, niacin, vitamin $B_6$, and zinc intakes. Health-related behaviors data showed that the ratio of cigarette smokers, especially male, was higher, while the ratio of the person exercising regularly was lower than that of the nationwide statistics, respectively. Cigarette smoking and drinking were not significantly related to the poor nutrition intake, while regular exercise positively influenced nutrient intakes in female subjects. These results showed that the nutritional status of the subjects was likely to be severely deficient and the low intakes of meat and fish to be highly related to the increase of nutritional risk. Therefore, in order to prevent the occurrence of the secondary disease related to the food intake and health-related behaviors of the subjects, the proper educational program on balanced dietary intake and the correction of health-related behaviors should be developed and applied to this area.

A Grounded theory Approach on the Experience of Sexual Abuse Victims (성폭력 피해여성의 경험에 관한 연구)

  • Kim, Kyung-Hee;Nam, Sun-Young;Chee, Soon-Ju;Kwon, Hye-Jin;Chung, Yeon-Kang
    • Journal of the Korean Society of School Health
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    • v.9 no.1
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    • pp.77-98
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    • 1996
  • This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiosity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", "avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging, "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "information availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporating the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthiness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthiness. 6. The older the victims, The weaker the senses of being taken aback and filthiness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthiness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 13. The more closed the personality of tile subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more lilely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuses, the more likely response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping. 17. The less available information concerning sexual abuses, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 21. The less familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping. 22. The more likely the response to 'being taken aback' and 'filthiness' is 'informing and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypotheses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined with weak sexual curiosity and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness', further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 3) In case the level of violence is strong and 'being taken abuse' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protective and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despite the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong and 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequency is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohesion is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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