• Title/Summary/Keyword: Chronic Disease Management

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A Study on Therapeutic Compliance of Hypertensive Patients in a Rural Health Subcenter (일개 농촌지역 보건지소 고혈압 환자의 치료지속성)

  • Song, Min-Keun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.155-164
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    • 2002
  • Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

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Topic Modeling Insomnia Social Media Corpus using BERTopic and Building Automatic Deep Learning Classification Model (BERTopic을 활용한 불면증 소셜 데이터 토픽 모델링 및 불면증 경향 문헌 딥러닝 자동분류 모델 구축)

  • Ko, Young Soo;Lee, Soobin;Cha, Minjung;Kim, Seongdeok;Lee, Juhee;Han, Ji Yeong;Song, Min
    • Journal of the Korean Society for information Management
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    • v.39 no.2
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    • pp.111-129
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    • 2022
  • Insomnia is a chronic disease in modern society, with the number of new patients increasing by more than 20% in the last 5 years. Insomnia is a serious disease that requires diagnosis and treatment because the individual and social problems that occur when there is a lack of sleep are serious and the triggers of insomnia are complex. This study collected 5,699 data from 'insomnia', a community on 'Reddit', a social media that freely expresses opinions. Based on the International Classification of Sleep Disorders ICSD-3 standard and the guidelines with the help of experts, the insomnia corpus was constructed by tagging them as insomnia tendency documents and non-insomnia tendency documents. Five deep learning language models (BERT, RoBERTa, ALBERT, ELECTRA, XLNet) were trained using the constructed insomnia corpus as training data. As a result of performance evaluation, RoBERTa showed the highest performance with an accuracy of 81.33%. In order to in-depth analysis of insomnia social data, topic modeling was performed using the newly emerged BERTopic method by supplementing the weaknesses of LDA, which is widely used in the past. As a result of the analysis, 8 subject groups ('Negative emotions', 'Advice and help and gratitude', 'Insomnia-related diseases', 'Sleeping pills', 'Exercise and eating habits', 'Physical characteristics', 'Activity characteristics', 'Environmental characteristics') could be confirmed. Users expressed negative emotions and sought help and advice from the Reddit insomnia community. In addition, they mentioned diseases related to insomnia, shared discourse on the use of sleeping pills, and expressed interest in exercise and eating habits. As insomnia-related characteristics, we found physical characteristics such as breathing, pregnancy, and heart, active characteristics such as zombies, hypnic jerk, and groggy, and environmental characteristics such as sunlight, blankets, temperature, and naps.

Influence of Lifestyle-Related Diseases on the Oral Health of the Rural Elderly in Korea (일부 농촌지역 60세 이상 노인의 생활습관병이 구강건강에 미치는 영향)

  • Park, Jung-Hye;Lee, Hee-Kyung;Lee, Kyeong-Soo;Jang, Eun-Jin
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.249-259
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    • 2010
  • Objectives: The purpose of this study was to analyze the influence of four lifestyle-related diseases, diabetes, hypertension, obesity and hypercholesterolemia, on oral health in the rural elderly in Korea. Methods: We enrolled 399 subjects over 60 years of age over a six year period, year 2000-2006/ year 2001-2007. All subjects received a routine health examination as part of a program conducted by the National Health Insurance Corporation at Seongju-gun Public Health Center in Gyeongsangbuk-do Province, South Korea. All subjects were surveyed and examined to determine their general and oral health statuses. Results: Our results suggest that the duration of lifestyle-related diseases has a significant influence on oral health. The following factors were all significant in the results of analyses: duration of diabetes, tooth decay, which teeth had decayed, missing and filled teeth(DMFT), duration of hypertension, and duration of obesity and hypercholesterolemia(p<0.05). Our results also suggest that the number of lifestyle related diseases has a significant influence on oral health. Subjects with more than two diseases had significantly greater numbers of missing teeth and greater numbers of DMFT(p<0.01). The results of simple regression analysis indicate that patients exhibiting longer durations of diabetes also exhibit more tooth decay, and that patients exhibiting longer durations of hypertension and obesity are characterized by greater numbers of missing teeth. The longer the duration of any of the four lifestyle-related diseases we considered, the more DMFT we observed. Multiple regression analyses also demonstrated that longer duration of lifestyle-related disease was associated with greater numbers of missing teeth. As the number of lifestyle-related diseases increased, DMFT also increased. Conclusions: In summary, lifestyle-related diseases such as diabetes, hypertension, obesity and hypercholesterolemia have significant influences on oral health in the elderly. In this context, the prevention and management of lifestyle-related disease is critical for the maintenance and promotion of oral health.

Healthy Korea 2010 : Role of the Health Educator (Healthy Korea 2010추진과 보건교육 인력 활용 전략)

  • Choi, Eun-Jin
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.89-109
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    • 2004
  • The Korean Government has produced the Health Plan 2010 aimed at setting up healthy Korea objectives, policies on preventing chronic diseases, reshaping the country's health and medical infrastructure. The policy goal targets the people's healthy life expectancy at 75 by 2010, and includes healthy life practice measures including health education, health improvement services, and disease management measures, in achieving the objectives. Also, the plan provides life cycle-based health improvement and disease prevention services, as well as pushes ahead with projects with greater ripple effects in each area. To this end, the government is simultaneously pushing to operate an experts-centered health promotion committee and establishing the infrastructure including the augmentation of national health improvement funds. Through its Health Plan 20 I 0, the Korean Government will exert efforts to achieve its policy objectives as addressed in the measures by enhancing the national potential health and providing systematic disease prevention services.

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A Study of the Application of Folk Medicine in Patients with Diabetes Mellitus (당뇨병 환자의 민간요법 시행에 대한 실태조사)

  • Um, Dong-Chun;Lee, Young-Shin
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.72-81
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    • 1997
  • Korean society is a mix of western and traditional cultures. Even though the patients try to recover through both aspects, hospital only utilizes a western approachs. When they have suffered from a chronic disease, especially diabeties meliitus(DM), application of folk medicine is more varied but the nurses are unaware of the practices. This study was done to describe the current use of the folk medicine with which the patients with DM have had an experience and to identify the relationships between the westernized medical care and folk medicine application. The 244 patients with non-insulin dependent diabetes millitus who participated were interviewed at a DM education clinic in a 1500-bed hospital. The results of the study are as follows: 1. 54.1%(N=133) of the participated patients in this study have had a folk medicine. 2. 44 kinds of folk medicine were used for the treatment of DM. Among them 14 items were used by more than two people and the rest were used by one person. Among the used items, 70.4% consisted of various types of plants, 11.4% was animal material and 18. 2% was the mixed group. As a single item, Commelina Communis(Dalgaebi) was the most frequently used(62.8%), followed by the root of Rosa rugosa(Haedangwha) 14.3%, and Youngi mushroom 13.6%. 3. In the analysis of the relationships between the general characters of the patients with regular fol1ow-up(F-U), self blood sugar test(BST) and folk medicine usage: 1) The higher the educational back ground patient had, the lower the folk medicine usage was ($X^2$=14.265, P=.003). 2) The more complex their treatment was($X^2$=24. 016. P=.000). and the longer they had suffered from DM($X^2$=75.739, P=.000), the fewer they visited regular F-U. On the other hand, they did self-BST well($X^2$=7.722, P=.021 : $X^2$=14. 775, P=.002) and had more folk medicine($X^2$=33.382, P=.000 ; $X^2$=43.410, P=.000). 3) If they had suffered many symptoms, they had fewer regular F-U ($X^2$=13.192. P=.001). On the other hand, they had more folk medicine($X^2$=6.070, P=.048). 4) The group of family history($X^2$=6.801. P=.009) and the group of DM education experience($X^2$=15.678, P=.000) carried out self BST well. DM education group used more folk medicine($X^2$=8.680, P=.003). In conclusion, DM education should be grouped according to the treatment type and suffering period. Then the management of DM would be effective and the vague application of folk medicine would be decreased.

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A Study on Body Mass Index ( BMI ) , Nutrients Intake and Serum Lipid Components of Industrial Male Workers (일부 지역 산업체 남성 근로자들의 체적지수 , 영양소 섭취상태 및 혈청지질 성상에 관한 연구)

  • Lee, Seong-Hui;No, Suk-Ryeong
    • Journal of the Korean Dietetic Association
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    • v.5 no.1
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    • pp.10-20
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    • 1999
  • This study aimed at investigating correlation of nutrients intake and serum lipids of industrial workers. 226 for adult aged 20yr~59yr (average age 35.9yr) were selected as subjects during 6 months, from June to December, 1997. Nutrients intake was investigated by questionnaire, 24-hour recall method. Antropometric assessments, serum lipids and blood pressure of the subjects were investigated. The results as follows ; In total subjects, calories, calcium, vitamin A, vitamin $B_1$, and vitamin $B_2$ were below Korean RDA(recommended dietary allowances) and protein, iron, vitamin C, niacin and phosphorus were above Korean RDA. Distribution of BMI groups were underweight groups(7.9%), normalweight groups(63.3%) and overweight groups(28.8%). In BMI groups, intakes of calories, carbohydrates, protein, fats, iron, niacin and potassium of overweight groups were higher than those of other groups, significantly(P<0.001). Intakes of calcium of underweight groups were lower than those of other groups, significantly(P<0.05). BMI increased with age. Total cholesterol, triglyceride, apo(b) and atherogenic index of overweight groups were higher than those of other groups, significantly(P<0.001). Calories, carbohydrates, protein, fats, iron, vitamin $B_1$, vitamin $B_2$, niacin, natrium and potassium were positively correlated with BMI, significantly(P<0.001). Calcium and vitamin C were positively correlated with BMI, significantly(P<0.01). vitamin A and phosphorus were positively correlated with BMI, significantly(P<0.05). Total lipid, total-chol., triglyceride, apo(b) and atherogenic index were positively correlated with BMI, significantly(P<0.001). HDL-chol. were negatively correlated with BMI, significantly(P<0.001). Above results, the more BMI and age increased, the worse patterns of serum lipid, so that increased atherogenic index that increased risk of atherosclerosis and degenerative chronic disease connected with serum lipid. After classified by BMI, age and lipid pattern, it will be managed individually for health management of industrial workers. Development and application of efficient program will be urgent for harmonious nutrition counseling and guidance.

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A Study on the Health Promoting Behavior of University Students (대학생의 건강증진행위에 대한 연구)

  • Yeoum, Soon-Gyo;Her, Eunn-Hee;Chung, Yeoun-Kang;Kown, Hye-Jin;Kim, Kyung-Hee;No, Eune-Sun;Han, Kyung-Soon;Han, Seung-Eui
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.396-409
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    • 1998
  • The purpose of this study is to inquire into the degree of health promotion activity of university students, and to confirm the general factors of health promotion behavior in order to offer basic data for a nursing strategy to improve health promotion behavior. For this research, data was collected from university men and women through questionnaires from February 18 to March 20 in 1998. The author develop a measuring instrument on the basis of related reviews of health promoting behavior in the prevention of chronic disease, as well as accounting for demographic factors, biological factors, and circumstanctial factors. The content validity of the instrument was authenticated by two professors of the science of nursing,. and the reliability was confirmed by a 'cronbach' ${\alpha}'$ after moditying the content through a pre-test on 30 students. 475 persons were analyzed in terms of an average, percentage, t-test, ANOVA by 'SPSS-PC'. The analyzed data was the following. 1. The acting degree of health promoting behavior was 3.26 point out of 6. Among the sub-levels of health promoting behavior, the order of importance was the following. self-actualization (4.62), interpersonal(4.60), stress management (4.0l), nutrition(3.68), responsibility(3.1l), liquid and cigaretles ues(2.85), and exercise (2.33). 2. The differences in health promoting behavior according to subject's general character were the following. Age(F=6.012, p=.003), major (F=7.243, P=.000), sex(t=7.60, P=.000), religion(F=2.454, p=.045), living status(F= 2.849, p=.024), health concern of parents(F= 7.596, P=.000), taking health programs(F= 2.710, p =.007), case history of the family( t = -1.980, p=.048). Health promoting behavior is affected by a higher age, majoring in the social sciences, having religion, male, living in the relatives' home, having to take health programs and a higher health concern of the parents. Suggestions: 1. The degree of health promoting behavior appears low in this study. It is crucial, therefore, to develop a health program to improve health promoting behavior and to study how to center the daily health life of students.

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A Case of Descending Necrotizing Mediastinitis (하행 괴사성 종격동염의 치험례)

  • Lee, In Soo;Choi, Hwan Jun;Lee, Han Jung;Lee, Jae Wook;Lee, Dong Gi
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.351-355
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    • 2009
  • Purpose: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. Methods: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient : signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum - assisted closure(VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. Conclusion: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.

A study on the correlation of sexual function, depression, and sleep quality in hemodialysis male patients (혈액투석 남성 환자의 성기능, 우울, 수면의 질의 상관관계 연구)

  • Han, Ol;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.645-655
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    • 2020
  • This is a descriptive study investigating the relationships between sexual function, depression, and sleep quality in male hemodialysis patients. The participants of this study consisted of 134 outpatients who were diagnosed with end stage chronic kidney disease and who had undergone hemodialysis. The data were collected from June 10, 2019, to October 30, 2019. The collected data were then analyzed using descriptive statistics, the mean from independent sample t-tests, one-way analysis of variance (ANOVA), the Scheffe test, and Pearson's correlation coefficient using SPSS version 21.0. The lower the overall satisfaction, the lower the sexual function and the higher the degree of depression (r=.-19, p=.028). The greater the depression, the lower the quality of sleep (r=.60, p<.001). This study shows it is necessary to develop a program including symptom management to reduce depression in male hemodialysis patients. When developing nursing interventions to improve sexual function and quality of sleep, it will be necessary to develop a program that includes people who help the subjects.

Breast Cancer Characteristics and Survival Differences between Maori, Pacific and other New Zealand Women Included in the Quality Audit Program of Breast Surgeons of Australia and New Zealand

  • Campbell, Ian;Scott, Nina;Seneviratne, Sanjeewa;Kollias, James;Walters, David;Taylor, Corey;Roder, David
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2465-2472
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    • 2015
  • Background: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. Materials and Methods: BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December $31^{st}$ 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Results: Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. Conclusions: NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of comorbidity and biological factors.