The desirable change of KAP aimed at the prevention and early diagnosis of the disease. In Korea, Hypertension and Diabetes have been the major chronic disease. Especially, Hypertension and Diabetes are related to over-weight and diet behavior, which can be prevented through weight control and dietary treatment. Therefore this study the KAP for Hypertension and Diabetes in a rural area. The survey of the KAP were performed to a rural population of 288 in Namwon, Cheonbuk, Korea. The self-questionnaire was consisted of 15 questions of knowledge, 10 questions of attitude, and 15 questions of practice. To analyze the data, the score of knowledge was taken 1 when they were right. The scores of attitude and practice were taken from 4 to 1 by 4 scale. The results were as follows. 1. The mean of knowledge for Hypertension was 10.4(sd=3.28) and that of attitude was 31.5(sd=4.05), that of practice was 42.3(sd=6.14). In Diabetes, knowledge mean was 9.1(sd=3.51) and that of attitude was 31.2(sd=3.81), that of practice was 41.6(sd=6.21). The knowledge for Diabetes was lower than that for Hypertension. 2. To compare the scores by sex, the score of male's knowledge was higher than female's. However, in case of practice score, female's was higher than male's. And the scores of attitude were not different between male and female. This results were shown that the practice did not always derived from the knowledge. Although they have a little knowledge for disease, they are able to conduct the desirable practice when the importance for disease are increased. Therefore we thought that desirable practice derived from the combination of significance and knowledge for Hypertension and Diabetes.
The frequency of the hypertension is increasing as the life level is improved and an average span of the life is extended since we approached modern stage. The hypertension is also dangerous disease which raises fatal complication for example with the bleeding aproplexy and the ischemic attack. The medicinal treatment about the hypertension is required patients to take continually. The acupuncture have been introduced because a medicine-chemical treatment hasn't good influence on the human body. It recently has been processed that studies acupuncture effect for blood pressure and have been found out that blood pressure go down. The object of this study observe the effect of LR3 acupuncture on hypertension in Renal Hypertension RAT induced by 2K1C. The 2K1C model was based on renin-angiotensin system. We put the silver clip in renal artery to induce renal hypertension. We try to observe that LR3 acupuncture influence on the blood pressure and c-fos expression in CVLM, NTS, RVLM. In results, the blood pressure was decreased during acupuncture than before acupuncture, after acupuncture. The heart rate was also decreased during acupuncture than before acupuncture, after acupuncture. The LR3 acupuncture significantly effects on blood pressure and heart rate (P<0.05). The increased expression of c-fos was shown in CVLM, NTS, but not in RVLM. In conclusion, LR3 was relived the action of control upon the hypertension and related with medulla, particularly CVLM, NTS. It needs to be closely examined pharmacological mechanism and studied combination with other acupoints.
This study was conducted to examine health behaviors in hypertensive patients and the factors that would affect these healthy life-styles. and to provide basic data for effective and continuous hypertension control in private medical facilities. Among those patients diagnosed as hypertension who had visited the Department of Internal Medicine of Yeungnam University Hospital during the two month period from August 2 to September 30, 1999, the present study included 222 patients who were in more than one month after the initial diagnosis of hypertension and those who had hypertension for less than 10 years. Using a structured questionnaire, the present study was conducted by a self-administered survey method, and the obtained data were analyzed with t-test, $x^2$-test and one-way analysis of variance using the SPSS statistical program. The scores on knowledge related to hypertension were higher as the education level of a patient was higher(p〈0.05). As for occupation, those who performed office or management jobs showed higher scores than those who were into manufacturing jobs, and as for economic status, although those patients who were in middle class showed highest scores, however, no statistical significance was observed. The scores of knowledge on hypertension was higher when the family history of hypertension was present(p〈0.05). The scores of health-related behaviors were higher with higher education level and higher economic status, higher in those with family history of hypertension, and higher in those with office or management jobs than those who had manufacturing jobs(p〈0.05). Blood pressure measurement on regular basis was performed most frequently in those who were between 50-59 years old with 83.3% and was least frequent in those who were older than 70 years old with 50%(p〈0.05). The frequency of regular blood pressure measurement was higher with higher education level, higher economic status, higher in those with family history of hypertension, and the highest in those with management position with 93.5%, however, on statistical significance was observed. Changes in health-related behaviors after hypertension diagnosis were higher with higher education level, higher economic status, and in those patients performed office or management work. In particular, diet change was observed in female and higher economic status and smoking cessation was observed in 60-69 years old. Housewives and office workers or managers have taken exercise more regularly and those who had management jobs and had high scores on knowledge related to hypertension would participate health education program more actively. Thus, for improving health-related behaviors for continuous management of hypertension, changes in health-related behaviors can be followed through conduction health education to improve understanding of knowledge related to hypertension as the method of helping to improve changes in health life-styles in those with little education and those in low economic status.
Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.
Objectives : To identify potential correlation between patients' expectations and clinical outcome in a randomized control study of acupuncture. Methods : In a clinical trial of acupuncture for hypertension, 60 participants with pre and mild hypertension were randomized into an acupuncture group and a control group. After randomization, all participants were asked to rate their expectation for the intervention on a scale of 0 to 10. To analyze the effect of expectation on clinical outcome, change of blood pressure was compared between high and low expectation groups. Results : There was no significant difference of baseline blood pressure between low expectation group and high expectation group. Proportion of acupuncture group and control group was also not different between low and high expectation groups (p = 0.638). The change of systolic blood pressure was -1.55 mmHg in low expectation group and -3.07 mmHg in high expectation group, and it was not significantly different (p = 0.54). There was no significant difference in the change of diastolic blood pressure between two groups (p = 0.58), with -3.24 mmHg in low expectation group and -2.34 mmHg in high expectation group. Conclusion : In this study, the expectation of intervention (including acupuncture treatment) was not associated with the effect of intervention.
Purpose: This research aims to identify the physio-psychological effects of applying a qi massage program as an independent complementary intervention for employees with hypertension in a workplace. Methods: A quasi-experimental design was employed using a nonequivalent control group with pre- and post-tests. The study was performed from August 18 to October 10, 2008 on hypertensive employees being treated with a qi massage program in a company. The control group was recruited first to prevent treatment diffusion. The experimental group was subsequently recruited and received individual treatment for 30 minutes. Collected data was analyzed using SPSS16.0 version. ${\chi}^2$-test, Mann-Whitney U test, Wilcoxon signed ranks test, Fisher's exact test and paired t-test were implemented in order to examine the effects of individual intervention on patients who are treated with the qi massage program. Results: The experimental group showed a greater improvement in systolic blood pressure, diastolic pressure, stress, and quality of life than did the control group. Conclusion: A qi massage program may be implemented as a complementary intervention to effectively treat hypertensive persons.
Experiments were performed to determine the effects of the Shiryungtang (SRT) liquid extract on the hypertension and the hyperlipidemia induced by cholesterol in Sprague-Dawley rat(SDR) and Spontaneous Hypertensive rats(SHR). The results were obtained as follows : 1. The blood pressures of Sample A, B were decreased significantly compared with control group. First day, in case of Sample B, the blood pressure depressed after 1 and 2 hour. 2. After 11days of feeding with SRT, the blood pressure was decreased significantly in the treated group as compared with the control group. 3. After 11days by fed with SRT, the cholesterol had no significant in all treated group compared with the control group. 4. After 11days by fed with SRT, the triglyceride had no significant in all treated group compared with the control group. 5. The cholesterol of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in all treated group compared with the control group. 6. The triglyceride of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in all treated group compared with the control group. 7. The HDL-cholesterol of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in all treated group compared with the control group. 8. The phospholipid of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in Sample B of the treated group. 9. The total lipid of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in Sample B of the treated group. 10. The total protein of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in Sample B of the treated group. 11. The albumin of hypercholesterolemic rat induced by feeding with cholesterol was decreased significantly in all treated group compared with the control group. With the above result, it is thought that Shiryungtang can be applied effectively to the hypertension and hyperlipidemia.
It has been suggested that plasma renin activity (PRA) and its response to volume depletion may be abnormal in that it shows little or exaggerated change in patients with chronic renal failure and hypertension. Intravenous furosemide stimulation test was performed in 46 control subjects and 51 patients with chronic renal failure and/or malignant hypertension in order to evaluate PRA response. In contrast to the consistent increase in PRA in control subjects (from $2.5{\pm}1.95\;to\;4.5{\pm}2.51ng/ml/hr$), no consistent increase was observed in patients with chronic renal failure, especially in those who showed favorable response to antihypertensive therapy (from $2.5{\pm}2.21\;to\;2.9{\pm}2.46ng/ml/hr$). But poor responder to antihypertensive treatment showed considerably higher PRA before and after furosemide stimulation (from $4.9{\pm}1.96\;to\;6.4{\pm}1.71ng/ml/hr$) than the responder group did. Moreover, this group seemed to retain the ability to increase PRA in response to intravenous furosemide stimulation. Thus it became apparent that responder group was unable to increase PRA normally in response to furosemide as well as volume depletion, while poor responder seemed to retain that ability. Thus intravenous furosemode may serve as a convenient way to differenfiate those who might be benefited by conservative antihypertensive measures from those who would require more drastic measures such as bilateral nephrectomy for their optimal blood pressure control.
Purpose: The purposes of this study were to describe the pattern of type D personality, to compare the life style and quality of life between type D personality and non-type D personality patients, and to investigate the factors influencing quality of life in patients with hypertension. Methods: A cross sectional, descriptive study was used. The participants in this study were 193 outpatients who were diagnosed with hypertension at two university hospitals in urban area, Korea. The data was collected from December, 2006 to January, 2007. Type D personality was measured by the DS-14 scale. Results: The prevalence of type D personality was 83.9%. Patients of type D personality were significantly different in educational status, monthly income, fat intake and exercise, and had a lower overall quality of life than patients of non-type D personality. Under controlled general characteristics and life style factors, multiple linear regression analysis was performed. The most significant factor influencing quality of life in hypertensive patients was type D personality, and this factor explained their quality of life with a variance of 14.8%. Conclusions: Various programs for psychological intervention are required to control for the distressed personality of patients with hypertension. Further studies should be conducted prospectively on a larger patient population.
Purpose: The purpose of this study was to determine the effects of 6 months lifestyle coaching program for adults with hypertension. Methods: The study utilized the one-group pretest-posttest design. The subjects were recruited from a corporation group member of a private health maintenance organization. The data of 35 subjects who completed the program out of initial 114 subjects were analyzed for this study. The program included 6 times of monthly face-to-face visits and additional short messages by cellular phone. They were given education for self-management of hypertension and coaching for lifestyle modification. Dependent variables were measured at the beginning and at the end of 6months program and compared by paired t-test. Results: There were significant reductions in systolic and diastolic BP, BMI, total cholesterol, and fasting blood sugar. Among the variables in life style, significant changes were shown in alcohol consumption (frequency and quantity) and exercise (frequency and duration). Conclusion: This study showed that 6 months lifestyle coaching program has potential for positive outcomes on BP control and modifying lifestyle for adults with hypertension. However, additional study is needed to find sustainability of lifestyle and the long-term effect of the program with larger sample.
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