This experimental study was undertaken to gauge the possibility of application and extension of a program for hypertension care to be operated by Community Health Practitioners. Four community health posts were selected. Two places were experimental groups and the other two control groups. The study was carried out from April 1987 to March 1988. In this study the hypertensives were screened form a group of adults who were over 20 years old. The rate of prevalence was 10.7% in the experimental group, and 11.1% in the control group. The hypertension care program was composed of three parts : regular care by CHPs, reinforcement of education and family support for the changing of health beliefs. The data for this analysis is based on 109 the hypertensives, with 78 from the experimental group and 31 from the control group. After the program was completed, the results obtained were as follows ; 1) Sick role behavior compliance in the experimental group were significantly higher than the control group. 2) Blood pressures were decreased in both systolic and diastolic in the experimental group. Diastolic pressure was strikingly decreased from those of the control group and showed statistical significance (p<0.05). 3) In the experimental group, benefits, perceived family support and family support behavior were high, out benefits was significantly higher than those of the control group(p=0.000). Sensitivity, seriousness and barriers were high in the control group, but not statistically significant. 4) In conclusion, it is revealed that hypertension care program developed in this study has an effect of decreasing blood pressure and promoting sick role behavior compliance.
The liver fluke Opisthorchis viverrini is a serious health problem in Thailand. Infection is associated with cholangiocarcinoma (CCA), endemic among human populations in northeast and north Thailand where raw fish containing fluke metacercariae are frequently consumed. Recently, Thailand public health authorities have been organized to reduce morbidity and mortality particularly in the northeast through O. viverrini and CCA screening projects. Health modification is one of activities included in this campaign, but systemic guidelines of modifying and developing health behavior among liver fluke and CCA prevention in communities towards health belief and social support theory are still various and unclear. Here we review the guidelines for modifying and developing health behavior among populations in rural communities to strengthen understanding regarding perceived susceptibility, severity, benefits, and barriers to liver fluke and CCA prevention. This model may be useful for public health officers and related organizations to further health behavior change in endemic areas.
Purpose: The study purposes were to explore school nurses' experience, perceived barriers, and education needs in diabetes management at school. Methods: This study was a cross sectional study and the study participants were recruited conveniently at continuing education seminars for school nurses at Incheon Metropolitan City. Results: Data for 101 school nurses were analyzed. The nurses were all women and their mean age was $46.9{\pm}9.3$ years. About 66% of them had experience with children with diabetes at school. The school nurses reported that 74.6% of the students tested their blood glucose by themselves, the school clinic was the most common place for blood glucose tests (47.8%) and insulin injections (50.8%) and the nurses knew students' diagnosis through the student health survey (58.2%). About half of the nurses (53.7%) reported that glucagon should be available at school and 49.2% were willing to inject glucagon when necessary. The most frequently reported barrier in diabetes management was role confusion ($6.0{\pm}1.3$) and the most common educational need was emergency responses ($5.9{\pm}1.4$). Conclusions: School health policy for diabetes management and diabetes resources are necessary to minimize role confusion of school nurses, improve emergency response, and facilitate health promotion activities in diabetes management.
Context: Tobacco is the single largest cause of preventable death among adults globally, as it is in India. Despite this alarming situation, there is very minimal inclusion of tobacco in formal education systems, including the medical discipline, in India. Aims: The present study analyzed the extent of integration of tobacco control related content in Masters of Public Health (MPH) curricula of various institutes in India. Materials and Methods: This cross-sectional study was conducted during January 2011 to May 2011 in all colleges of the country offering a MPH course. The colleges were enlisted using various internet search engines (Google Scholar, Pubmed, Medline), other published literature and snowball technique. A 50 items semi-structured questionnaire was designed, posted and e-mailed (followed by hard copy) to the Person-In-Charge of the MPH program. Statistical Analysis: Descriptive statistics were used to profile the tobacco control content in respective institutions. All data entry and analysis was conducted using SPSS (version 16) for windows. Results: The duration of the MPH course was two years in all institutes and had accreditation with some affiliated body. Tobacco related diseases were covered under 'non communicable diseases' section by every institute. However, a mere 41.4% of institute's had faculty who had received specialized training in tobacco control. More coverage was given to health risks and effects of smoking as compared to cessation interventions (5 A's), symptoms of withdrawal and pharmacological treatments. Only 25% of institutes were in process of introducing tobacco courses into their curricula. Lack of expertise and administrative barriers were cited as perceived major problems in inclusion of tobacco control in MPH curricula. Conclusions: It can be concluded that tobacco control is not receiving adequate attention in public health curricula in India. There is a need for coordinated efforts in the area of tobacco control so as to reduce morbidity and mortality from tobacco induced diseases.
Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.
Objectives: The purpose of this study is to investigate the factors of oral health beliefs on scaling performance by national health insurance coverage in consumers. Methods: The subjects were 353 people living in Seoul, Incheon, and Gyeonggi-do from September 25 to October 20, 2013. They filled out the self-reported questionnaire after receiving informed consents. The questionnaire included 6 questions of general characteristics, 6 questions of oral health behavior, 6 questions of health insurance coverage, and 1 question of subjective oral health recognition. The oral health belief consisted of 6 questions of seriousness, 6 questions of susceptibility, 8 questions of barriers, 5 questions of benefit, and 3 questions of self-efficacy measure by Likert 5 scale. Cronbach's alpha in the study was 0.759. Data were analyzed using SPSS version 20.0 for frequency analysis, t-test, ANOVA, post-hoc Scheffe test, Pearson's correlation coefficient, and binary logistic regression. Results: The influencing factors of oral health belief model were Seriousness(${\beta}=0.091$), Self efficacy(${\beta}=-0.471$) and age(${\beta}=0.855$)(p<0.05). Those who had highly perceived seriousness and younger age tended to have probability of scaling performance. Higher self-efficacy tended to take more chance to have scaling performance probability. Conclusions: In order to cover the scaling by national health insurance, it is very important to notice the benefit of health insurance coverage of scaling to the consumers. National health insurance coverage enables the scaling practice to be easily accessible to the people. Easy access to scaling by low cost strategy can improve the oral health behavior.
School gardens are known to be effective for increasing vegetable consumption in children. This study was carried out to examine the perception of garden program leaders for actual conditions and barriers to promote school gardens according to their sense of dedication. The 49 garden program leaders at schools and child care centers in Pocheon city were surveyed and grouped into two groups: dedicated (57.1%) and less dedicated (42.9%) as program leaders. Compared to dedicated leaders, leaders in the less dedicated group less advocated promotion of school gardens (P<0.001) and were less willing to attend training for school garden (P<0.01), despite less experience as program leaders (P<0.01) and past training (P<0.05). Moreover, leaders in the less dedicated group less acknowledged the educational results of school garden in every aspect (P<0.001, respectively), less perceived support from parents and colleagues (P<0.05, respectively), and less used garden produce in more active activities such as donation and literature (P<0.05, respectively), compared to the dedicated group. The most answered barrier against the promotion of school gardens was work burden, followed by manpower shortage, shortage of technique, knowledge, and information, and time shortage. The results of this study provide evidence that developing strategies is needed to make more teachers and child care providers more dedicated as garden program leaders.
Objective : This study aimed to investigate the level of friendship perceived by hospital staffs in korean medicine hospitals in Gwangju and relationship between friendship and organizational effectiveness. Method : The subject were 134 hospital staffs in 5 different hospitals in Gwangju. The questionnaire used in this study contained 44 questions about workplace friendship (15 questions), organizational effectiveness (16 questions), social demographic characteristics (8 questions) and others (5 questions). Results : Young woman in their 20s and 30s were major participants (69person, 52.7%), nursing and administrative department(72person, 55%) were dominant division, the person those who have less than 1 year current workplace career(69person, 52.7%) were major group in this study. Participants responded about barriers of friendship at workplace were lack of opportunities for formal or informal meeting and lack of hospital's interest and supporting about human relations among employees at workplace. Both friendship level with superior and friendship level with subordinate were lower than friendship level with colleague. (p=.000) Participants who have higher workplace friendship level, were also higher level at job satisfaction, organizational commitment and lower level at turnover intention, job stress. Especially friendship level with superior had biggest relationship with variables of organizational effectiveness. Conclusion : Participants showed close relationship with friendship degree and organizational effectiveness. We suggest that the CEOs of korean medicine hospital would make their effort to improve friendship level of workers for the rise of organizational effectiveness.
Under the assumption that people go through stages in making dietary behavior change, this study was attempted to apply the stages of a change model for fat intake by examining the associations of social psychological variables with stages of change in dietary fat reduction. Derived from social psychological theories, 10 social psychological variables on motivational beliefs(6), social influence(3) and self-efficacy(1) related specifically to selecting every day diets low in fat were constructed. Fat and energy intakes were assessed by a short form semi-quantitative food frequency questionnaire. The associations of stages of change with motivational beliefs, social influence, and self-efficacy variables and energy and fat intakes were assessed in 333 female adults from large cities in Korea. Dietary stage groups differed significantly on most of the social psychological variables in ways predicted by theory. Motivational factors that lead to a psychological state of readiness to take action were important in the early stages of the dietary change process. Social influences were more important in the stages as people decide to take action. Self efficacy and motivational beliefs, particularly, reduction of perceived barriers were important in maintaining fat reduction behavior. The results of our study indicate differences in stages of change in fat reduction behavior in terms of nutrient intakes and social psychological correlates and suggests that adding a time dimension to social psychological models increases our understanding of dietary change, which assist us in designing nutrition education interventions that are more appropriately targeted by stage of change. (Korean J Community Nutrition 5(4) 615∼623, 2000)
Purpose: This study was performed to examine motivational factors affecting sweetness preference in Korean and Japanese children. We identified meaningful variables that could be targeted to nutrition education interventions designed to overcome innate barriers and reduce sweetness preference and sweet food intake in Korean and Japanese children. Methods: Questionnaire surveys and sweetness preference test were conducted to examine variables affecting behavioral intention (BI) regarding sweetness preference. Questionnaire variables were based on the theory of planned behavior. Participants were recruited from one urban school from each country. In total, 166 children (mean age: 8.4 years) and their guardians (n = 166) participated in the study. A trained research assistant provided all children with personal guidance regarding completion of the sweetness preference test and survey questionnaire at school. The data were analyzed using Pearson's correlation coefficients, t tests, repeated measure ANOVA, and stepwise multiple regression analysis (significance level: p < 0.05). Results: Perceived behavioral control (PBC) and parenting practice were significantly associated with BI in both groups. Motivation to comply affected BI only in Japanese children, whereas affective attitude was associated with BI only in Korean children. In predicting sweetness preference, BI was associated only in Japanese children, whereas sweets consumption frequency had a significant effect in Korean children. Conclusion: The study shows similarities and differences in motivational factors, which could be considered when developing nutrition education programs in Korea and Japan. PBC and parenting practice were common factors in predicting BI. In predicting sweetness preference, BI had a significant effect on Japanese children, whereas sweets consumption frequency was the greatest contributor in Korean children.
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