• Title/Summary/Keyword: 환자건강문제

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Depressive Disorders among Hansen Disease Patients Living in a Collective Farm (한 집단 농원 한센병 환자들의 우울장애)

  • Kim, Yun-Gu;Park, Min-Ho;Park, Jae-Won;Song, Joon-Ho;Sim, Seong-Gyun;Lee, Joo-Hyoung;Lee, Hee-Young;Yun, Dong-Il;Jung, Sung-Hwan;Min, Young-Sun;Bae, Geun-Ryang;Jung, Cheoll;Lim, Hyun-Sul;Cheong, Hae-Kwan
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.133-145
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    • 2004
  • Objectives: Depression is a major health concern that can be life threatening if not recognized and treated early. However, there is few report on the depressive disorder of Hansen disease patients in Korea. Therefore, the authors executed this study in order to check factors related to a depressive disorder of a Hansen disease patients and compare with factors to reach to a depressive symptoms of ordinary people with studying their life state and the trouble that Hansen disease patients were currently experiencing Method: The authors surveyed depressive symptoms using self-reported questionnaires in 74 Hansen disease patients and 84 controls. The severity of depressive symptoms was measured using Korean Form of Geriatric Depression Scale (KGDS) score. Result: Positive rate of depressive disorders among Hansen disease patients was 70.3% and that the referents was 31.0%. There is significant difference positive rate of depressive disorders between Hansen disease group and the referents in the factors such as gender, age, frequency of going out, familial type, and familial income. Depressive disorder of Hansen disease group was associated with sex, familial income. According to the multiple logistic regression, the odds ratios of the Hansen disease group versus referents, gender, familial income, frequency of going out were significant (p<0.05). Conclusion: Hansen disease patients had statistically significant higher depressive symptom score than the referents. Also, Hansen disease patients who have lower familial income were more likely to have depressive disorders. Therefore, Economical supports and policy are required for the Hansen disease patients.

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OSTEORADIONECROSIS ON MANDIBLE : A CASE REPORT AND LITERATURE REVIEW (하악골에 발생한 방사선골괴사증 증례보고 및 문헌고찰)

  • Park, Jin-Hyuk;Shin, Sun-Ho;Lee, Su-Woon;Kim, Woo-Hyung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.5
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    • pp.458-463
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    • 2006
  • The osteoradionecrosis of the mandible can be a serious complication of radiotherapy for malignancies of the head and neck. The cause and pathogenesis of osteoradionecrosis are unclear and anecdotal. There are various treatment-, patient- and tumor-related risk factors on development of osteoradionecrosis. The treatment of osteoradionecrosis relies on conservative measures (antibiotics, debridement, irrigation and HBO) and surgical measures (sequestrectomy, marginal resection and segmental resection with or without reconstruction). But the indications are not defined. We present the two cases of patients who were not controlled by conservative treatment but good-resulted by surgical treatment.

The Problem of Individuality and Intrinsic Norms in Canguilhem's Philosophy of Life (캉길렘의 생명철학에서 개체성과 내재적 규범의 문제)

  • Hwang, Su-young
    • Philosophy of Medicine
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    • v.15
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    • pp.3-37
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    • 2013
  • George Canguilhem(1904-1995) is one of the rare French philosophers of the 20th century to develop an approach that was shaped by a medical education. For him, medicine is considered as "a technique or an art at the junction of many different sciences, rather than a proper science." The thesis that medicine is a technique is presented not at a practical level, but on an axiological horizon which reflects the totality of humanity. This character of medicine became a motive that concretized Canguilhem's philosophical thinking. Medical knowledge is not an application of physiology, but is derived from clinical observations which are based on the personal experiences of each patient. If medicine were based on scientific knowledge and its practice the very application of this pure knowledge, the patient might be a passive object. However, the patient doesn't remain passive, but reacts to the menace of disease according to attitude that the patient developed over the course of his or her life. Canguilhem characterizes this point as 'normativity', the core of individual life, which eludes positivist medicine. Here appear the essential contents of his vitalism. Although they emphasized the activity of individual living being, other modern French vitalists didn't consider this dimension of norms. Since the normativity in Canguilhem concerns the subjectivity of the first person, it avoids a mechanical form of explanation. Thus Canguilhem's originality is found in his derivation of the essence of medicine from individuality, values and norms.

A Basic Study for the Introduction of Green Prescription and Establishment of Policy System in Korea - Through Comparative Analysis of U.K. and U.S. Cases - (국내 녹색처방 도입과 정책체계 수립을 위한 기초연구 - 영국과 미국 사례 비교 분석을 통해 -)

  • Kim, Hyo-Ju;Jung, Hae-Joon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.52 no.4
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    • pp.104-119
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    • 2024
  • The burden of medical expenses and the loss of social capital due to chronic diseases are becoming problems worldwide, and comprehensive and inclusive measures across various fields are required to prevent and manage their impacts. Social prescriptions have been shown to be effective in resolving the fundamental causes of health problems in patients with chronic diseases and in supporting existing treatments. In particular, green prescriptions that utilize the healing effects of nature and green spaces based on social prescriptions are being introduced in many countries overseas. Green prescription is the practice of a healthcare provider recommending activities in green spaces or experiences in the natural environment to patients for the prevention and management of chronic diseases. This study analyzed cases focusing on the policy system, the cases of the United Kingdom and the United States, which have introduced and operated green prescriptions under a national system. For this purpose, this study compared the background of green prescription introduction, related policies, and operation methods. Based on this, four implications were proposed to establish an effective plan for introducing green prescriptions in Korea. First, prior to establishing a policy for green prescriptions, interest in and research on green prescriptions are essential. Second, an implementation plan that fits the national health care system should be established, and policies should support the plan. Third, the introduction of green prescriptions from a long-term and gradual perspective is required. Fourth, comprehensive cooperation is required for the introduction and implementation of the green prescription system. This study can be used as basic data for discussion before introducing green prescriptions in Korea in the future.

Comparison of Emotional and Psychological Characteristics between Suicide Attempters and Non-Attempters in Depressed Patients : Using MMPI-2 Profiles (우울장애 환자의 자살 시도 여부에 따른 심리적 특성의 차이 : MMPI-2 프로파일을 중심으로)

  • Lee, Seul-Ah;Kim, Keun-Hyang;Suh, Shin-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.40-49
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    • 2012
  • Objectives : To examine emotional and psychological characteristics associated with suicide attempts in depressed patients. Methods : A sample of 37 inpatients diagnosed with major depressive disorder or depressive disorder NOS was divided into two groups : lifetime suicide attempters(N=15 ; 40.54%), non-attempters(N=22 ; 59.46%). Beck Depression Scale(BDI), Beck Anxiety Scale(BAI), Hamilton Depression Rating Scale(HDRS), Hamilton Anxiety Rating Scale(HARS), and MMPI-2 were used to evaluate symptoms severity and psychological characteristics. Results : Suicide attempters scored higher on the BDI though there were no group differences on the HDRS and on the both anxiety scales. Also they showed higher scores on the F, Fb, Pa, RC1, DEP, HEA, PK, AAS among MMPI-2 subscales. Our findings suggest that suicide attempters among depressed patients undergo more severe subjective distress and difficulties in adjustment than non-attempters. Also they were more hostile to others and showed lower trust. Lastly, they showed more somatic complaints and substance related problems. Conclusion : The present study showed that suicide attempters among depressed patients have distinct emotional and psychological characteristics. MMPI-2 would be helpful to assess suicidal risk of depressed patients.

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A Study on the Characteristics of Cancer Patients with Radiotherapy and Social Support, Psychosocial Status (방사선치료를 받는 암환자의 특성과 사회적지지 및 심리상태에 관한 연구)

  • Lee, Myung-Koo
    • Journal of radiological science and technology
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    • v.27 no.3
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    • pp.59-69
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    • 2004
  • By studying on the characteristics of cancer patients who receive radiotherapy and the attitudes of medical social workers, this thesis aims to suggest of requirements for medical social work intervention. The study was conducted using SPSS 10.0 for Windows to analyze data taken from a survey involving 90 cancer patients receiving radiotherapy in 4 general hospitals in Daejeon city. The data were collected form Oct. 1st to 15th, 2003, and its analyses used averages, correlation, and regression. The results were summarized as follows ; 1. The average family income in 67.8% of the cases was less than 2,000,000 won, which is a lower income bracket. In the disease characteristics, fatigue ware the highest (2.78) in the side effects of radiotherapy, which most patients were receiving alongside other forms of treatment. 2. It was shown that cancer patients receiving radiotherapy receive a high level of psychological and social support from doctors and other medical staffs, and that they also received a high average (4.38) of individual care and encouragement from family members. 3. In the psychosocial status, the need for financial assistance in the form of a national aid program or an expansion of medical insurance was great, especially in the need for house keeping service and night nurses. The need for psychosocial counselling rose following rises in treatment side effects and depression. Information for cancer patients was especially needed in the areas of treatment plans, treatment costs, and side effects of radiotherapy. The need for information rose in accordance with an elongation of hospital treatment and an escalation of care from family members.

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Health Promotion Through Healthy People 2010 ("2010년대 건강한 시민" 정책을 통한 미국의 건강증진 방향)

  • Cho, Jung H.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.17-58
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    • 2004
  • 뉴저지주 보건교육/건강 증진정책을 논하기전에 건강증진과 보건 교육사의 뜻을 먼저 기술하기로 한다. 건강증진이란 일상 사회생활과 행동과학의 응용에서 시작하며 교육의 효율적 작전 및 기술, 질병 역학 조사, 개인 및 가족단위 건강 위해 행위 절감, 사회연관 구축망 조성, 그리고 적게는 이웃, 더 나아가 조직체계 및 지역 사회의 네트웍 실시등을 실시한다. 보건교육 및 건강증진 전문가란 ' 전국 보건교육 인증 위원회(NCHEC) ' 에서 채택된 다음 7개 활동 영역에서 개인적, 그룹, 각주단위, 그리고 범 국가적 조직에서 종사하는자로 한다. 개인 및 지역사회 보건 교육 필요성 분석- 계회, 실행, 효율성 평가, 사업 진행 조정, 자문, 컴뮤니케이션 등의 활동범위를 들 수 있다. 공인 보건 교육사(CHES)란 대학 및 대학원에서 보건 교육학 소정의 필수 과목을 이수하고 학.석사 소지자로서 ' 전국 보건 교육 인증 위원회 ' 에서 그 자격을 인정 받고 공인 자격 시험에 합격한자로 한다. 합격자는 자기 성명뒤에 CHES란 칭호를 부치며 매 5년마다 75단위이상 인정된 전문 직업 보수 교육을 받아야 한다. 보건 교육사 고용 분야는 연방, 주, 지방 정부의 보건 교육사(10-15%) 및 건강 증진 전문가로 종사하며; 이들은 지역 사회 조직화, 프로그람 기획, 공공사업 마켓팅, 메디아, 컴뮤니케이션 자질을 갓추어야 하며; 상해 예방, 학교 보건, 지역 사회 영양 실태 향상, 그 외 모든 건강 증진과 질병 예방에 일익을 담당 하여; 의사, 간호사, 약사, 영양사,환경 위생사드의 전문분야종사자들괴 한팀이 되어 지역 사회 보건 사업에 기여한다. 쥬저지 보건 교육사들은 주법령 8조 '||'&'||' 보건행정 표준 시행령 ' 에 따라 포괄적 보건교육/건강증진 프로그램을 개발하여 총체적으로 조절 관장한다. 특희 ' 미국 학술원 의료 연구원 ' 에서 제정한 ' 10대 필수 공중 보건 사업 ' 에 기준을 두고; 1) 개인 및 지역사회 필수 보건 여건 분석 평가, 2) 보건 교육 이론에 따른 사업 계획 설정, 3) 교육 전략과 보건문제 발굴에 따라 일반 대중 대상 보건 교육 실행 (프로그람 기획, 연수 교육, 미디어 캠페인, 공중보건 향상책 옹호), 4) 사업 진행 과정 정리, 그 결과에 대한 영향력과 결과 평가, 5) 프로그램진행, 인사 및 예산관리 참여, 6) 근무향상을 위한 보수교육 프로그램 개발, 7) 보건 의료 업무 종사자 상호 협조성 향상 훈련, 8) 지역 사회자원 밭굴, 9) 적절한 고객 의뢰 체제 시행, 10) 위기 관리 컴뮤니케이션 체제 개발실시, 11) 일반 대중에게 공중 보건 향상 고취, 12) 각종 협력 지원금 신청서 작성 제출, 13) 문화/인종적으로 적절한 시청각 교재 발굴, 15) 질적 및 양적 보건교육/건겅증진책 연구 실시, 16) 비 보험 가담자, 저 보험자, 빈곤자, 이민자 색출 선도, 17) 관활 구역내 상재하는 각 건강증진 프로그램 밝혀 내서 불필요한 중복 회피등이다. 그 외에도 보건 교육사들은 사회 복지 단체인 미국 암 협회, 미국 심장 협회,미국 폐장 협회 등 각종 사회 복지 비영리단체 와 자선 사업 단체들과 긴밀희 협조하거나 그 단체 임직원으로서 건강 증진 사업에 종사한다. 병원 및 의료기관에선 임직원 보수 교육, 환자의 질병 예방및 건강증진 교육, 그리고 의료 사업장내 건장 증진업무에 종사한다. 건강 유지 의료 기관(HMO)에선 예방주사, 정기검진 촉진등을 통한 입원일수 절감, 응급실 사용도 절감등으로 의료비 감축, 삶의질 향상상에 종사한다. 사업장 보건 교육사는 스트레스 관리, 금연 및 흡연 중단선도, 체중 절감, 종업원 건강증진 생활화참여 유치, 컴뮤니케이션 개발, 마켓팅, 질병 예방등에 그 전문 직업적 노하우를 사업체 건강 증진 프로그램 개발에 접목한다. 뉴저지 2010년대 건강 증진책은 5대 목표 설정하여 현재 시행하고 있다. 특이한점은 2001년 9.11사태 이후 연방정부와 주정부의 상당한 예산 지원을 그랜트 지원금 형식으로 받아 연방, 주정부, 지방 정부, 의료 기관등에서 일사 불란하게 생물/화학/방사성 테러에 대비하는데 보건 교육사들은 시민 인지도 향상과 위기관리 컴뮤니케이션 영역에서 활약한다. 총체적인 보건 교육/건강 증진책은 다음 천년간 뉴저지 건강증진 백서와 미연방 정부 건강증진 2010에 준하여 설립한 뉴저지 건강 증진 2010 에 의한다. 그 모델을 보면; 1) 생활 습관 향상으로 위해 행위 절제; 적절한 영양 섭취 와 과체중화 차단 불필요한 투약 절제와 그 관리 흡연 탐익 절감, 금연, 흡연관련 신체/정신적 피해 관리/치료 습관성 약물 중독 조기발견 예방 낙상 예방 폭력, 의도적/비의도적 상해 예방 2) 심장질환, 암, 뇌졸중, 당뇨, 폐염, 인프루엔자등 주사망원인 질병 조기 발견 예방 책 마련; 독감.폐렴 예방 주사 실시 3) 보건 교육 대상과 표적 설정 특히 보건사업 참여 동반자 발굴하여 그 동참과 책임분담 책려; 주. 지방 정부기관, 의료 종사자, 의료 보험 업자, 대학 등 교육 기관, 연구 기관, 교육자, 지방 보건소, 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구., 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구.

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Types of malocclusion and oral health effect index(OHIP-14) according to recognition of orthodontic treatment (부정교합 종류에 따른 교정치료의 인식과 구강건강영향지수(OHIP-14))

  • Yoon, Hyun-Seo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.434-442
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    • 2017
  • The purpose of this study was to examine the influence of type of malocclusion and orthodontic treatment awareness on quality of life among orthodontic patients in the region of Busan as well as to develop an educational program tailored to the type of malocclusion as a way to improve quality of life. A survey was conducted for approximately 6 months from December, 2015, and the answer sheets from 472 respondents were analyzed. The most common painful area was the teeth, and this case was most predominant in the respondents with level 2 malocclusion, who differed from others in that regard (p<0.001). Regarding the relationship between satisfaction with orthodontic treatment and quality of life, respondents who were more satisfied currently and who were neither quite confident nor quite unconfident were ahead of their counterparts in quality of life. Concerning the reason for receiving orthodontic treatment, quality of life was lower among patients who started to receive treatment due to pronunciation problems (p=0.013), chewing difficulty (p<0.001), and temporomandibular joint click sound (p<0.001). With regard to influential factors on oral health-related quality of life, time for starting to receive orthodontic treatment was most influential (p<0.001), followed by current satisfaction (p<0.001), changes in confidence (p=0.003), self-rated teeth status (p=0.008), and type of occlusion (p=0.019). Therefore, accurate analysis of the oral health status of orthodontic patients and customized oral health education are required to improve quality of life even during the period of orthodontic treatment.

Relationship between Occupational Accident Service, Pain, and Life Satisfaction of Industrial Accident Compensation Insurance Beneficiaries (산업재해보험 급여수급자의 통증과 산업재해서비스 및 생활만족간의 관계)

  • Jang, Yu Mi
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.4
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    • pp.45-51
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    • 2022
  • This study aims to provide basic data on socioeconomic and social activities from the point of view that disability or disease accompanying the suffering of industrial accident subjects is directly related to individual socioeconomic activity and is a major variable affecting current health and daily life satisfaction. The purpose of this study is to investigate the relationship between pain and life satisfaction and to suggest basic data for economic and psychological rehabilitation of industrial accident insurance beneficiaries by linking factors affecting life satisfaction with industrial accident services. As a result of the study, it was found that workers' compensation insurance benefit recipients had an effect on their daily life satisfaction after becoming an industrial accident patient due to industrial accident pain. There was a positive(+) relationship between rehabilitation services and medical counseling services. Occupational accident pain lowers self-esteem, which is a characteristic of an individual, and even if current health improves, satisfaction with daily life decreases. The importance of industrial accident-related services can be seen in that the satisfaction of daily life is increased through rehabilitation services and medical consultation services. In addition, it was indirectly confirmed that satisfaction with rehabilitation services and health can be improved as a result of continuing attempts to improve self-esteem suitable for patients in various problems and situations after an industrial accident.

How Much should the Poor Pay for their Health Care Services under the National Health Insurance System? (계층간 진료비 본인부담의 형평성에 관한 연구)

  • Kim, Hak-Ju
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.113-133
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    • 2004
  • Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

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