• Korean Journal of Clinical Pharmacy
• /
• v.18 no.2
• /
• pp.124-131
• /
• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• Health Policy and Management
• /
• v.14 no.4
• /
• pp.88-113
• /
• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

• Journal of Yeungnam Medical Science
• /
• v.16 no.1
• /
• pp.10-14
• /
• 1999

The World Association for Sexology (WAS) will adopt a Declaration of Sexual Rights as basic and fundamental human rights August this year in Hong Kong. Two years ago WAS has been developing a Declaration of Sexual Rights in order to further promote sexual health and protect the sexual rights of everyone. Undoubtedly sexuality is one of the most intriguing subjects in the area of human behavior and psychology, and has been so since antiquity. The influence of sexual factors of human on all aspects of the society has been immense. The varieties of marriage, from traditional to the open marriage model are presented in front of our sight. The influences of women's movement in Korea, which has produced sexual, psychological, economic, political, familial and social changes look so small and the changes are not that much in America. But the profound effects of the women's movement affect on Korean society being realized as man's view of woman and woman's view of herself undergo constant change and reevaluation. With increased sexual awareness on the part of the public owing to mass media, for example AH-U-SEONG aired in TV and with increased emphasis on sexual matters in daily life, more and more physicians are being asked to deal with and manage sex-related problems in their daily practice. Yet, despite the obvious need for informed sexual counseling, doctors are often uncomfortable about sexual matters and many physicians have no special expertise in this area. So physicians concerned in sexology especially such as gynecologists, urologists, psychiatrists and endocrinologists must realize well about sex-related knowledge which is needed for counseling the patient as medical consumer and gap between reality and ideality in sexual diagnosis and treatment. Establishment of management system for the people who have sexual problems is strongly needed to promote sexual health and protect the sexual rights of everyone and for the Sexual Rights as basic and fundamental human rights.

• Journal of mucopolysaccharidosis and rare diseases
• /
• v.5 no.1
• /
• pp.29-33
• /
• 2021

Prader-Willi Syndrome (PWS) is a neurodevelopmental genomic imprinting disorder involving a lack of gene expression from the paternal chromosome 15q11-q13 region. This is typically due to paternal 15q11-q13 deletions (in approximately 60% of cases), maternal uniparental disomy 15, or when both 15s are from the mother (about 35% of cases). An imprinting center controls the expression of imprinted genes in the chromosome 15q11-q13 region. PWS is a neurodevelopmental disorder characterized by mental retardation and distinct physical, behavioral, and psychiatric features. Characteristic behavioral disturbances in PWS include excessive interest in food, skin picking, difficulty with a change in routine, temper tantrums, obsessive and compulsive behaviors, and mood fluctuations. Individuals with PWS typically have intellectual disabilities (borderline to mild/moderate mental retardation) and exhibit a higher overall level of behavior disturbances compared to individuals with similar intellectual disabilities. This condition severely limits social adaptations and quality of life. Different factors have been linked to the intensity and form of these behavioral disturbances, but there is no consensus regarding the cause. Consequently, there is still controversy surrounding management strategies and there is a need for new data. PWS is a multisystem disorder. Family members, caregivers, physicians, dieticians, and speech-language pathologists all play an important role in the management and treatment of symptoms in an individual with PWS. Here we analyze behavioral problems in children and adults with PWS by age and review appropriate management and treatment strategies for these symptoms.

• Korean Journal of Community Nutrition
• /
• v.14 no.2
• /
• pp.236-244
• /
• 2009

Dietary therapy is a basic and emphasized treatment for diabetes. Several clinical studies have shown that diet can play a major role in preventing and managing diabetes. The purposes of this study were to evaluate the dietary behavior and to find solutions to barriers of diabetes mellitus patients. From February to July in 2007, questionnaires were distributed to one hundred and ten patients who were diagnosed DM by physicians and excluded first coming out-patients. One hundred and three data were used for statistical analysis using SPSS/Win 12.0. The main results of this study included the following: To measure dietary behaviors and barriers, a five point scale was used with the following labels: 'strongly yes', 'yes', 'fair', 'no', 'strongly no'. Thirteen dietary behaviors related to diabetes were grouped into the following 4 factors using factor analysis; 'taste control factor', 'blood glucose influence factor', 'practice volition factor', and 'exercise factor'. The mean scores of 4 factors were 3.88, 3.48, 3.55, 3.21, respectively. The 'taste control behaviors' score of subjects who had practiced diet therapy(4.00) was higher than those who had not practiced diet therapy(P<0.05). The 'blood glucose influence behaviors' score of subjects who had nutrition education(3.59) was higher than those who had no nutrition education(P<0.05) and subjects who had practiced diet therapy showed higher score(3.59) than those who had not practiced diet therapy(P<0.05). 'Exercise behaviors score' of subjects who were over 60(3.59) was the lowest(P<0.05). Subjects who had nutrition education showed higher 'exercise behaviors' scores(3.38) than those who had no nutrition education(P<0.05). Subjects who had practiced diet therapy showed higher 'practice volition behaviors' scores(3.72) than those who had not practiced diet therapy(P<0.001). Subjects who were over weight showed the highest 'practice volition behaviors' scores(3.78) concerning BMI(P<0.05). In conclusion, this study expected that Nutrition educators(Dietitian) applied to patient effective nutrition education and counseling through evaluation of Dietary behaviors and barriers considered management types and ecological factors of diabetes patients. Also diabetic patients were easy to change dietary habits because they formed behaviors through education and counsel and there were positive effects in their blood glucose control through removing barriers related to dietary therapy.