• 대한간호학회지
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• 제19권1호
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• pp.5-23
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• 1989

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.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.155-164
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• 2002

본 연구는 일개 보건지소에 등록된 고혈압 환자의 치료율 및 관리율을 구하고 치료지속성과 관련성이 있는 변수를 파악하고 치료중단 이유를 조사하기 위하여 2000년 11월 이전에 군남면 보건지소에 등록되어 치료받고 있는 고혈압 환자 295명을 대상으로 하여, 의무기록조사와 전화설문조사를 병행하여 실시되었다. 그 결과는 다음과 같다. 1. 대상자 295명중 남자가 108명(36.6%), 여자가 187명 (62.7%)이었으며 평균연령은 남자 64.6세, 여자 66.3 세로 여성에서 더 높았다(p<0.05). 2. 대상자의 54.9%가 지속적인 치료를 받는 것으로 조사되었고, 간헐적 치료군이 19.3%, 치료중단군이 25.8%였다. 3. 성, 연령, 의료보장, 거주지 등 연구대상자의 특성중 거주지로부터 보건지소까지 이동시 소요되는 시간만이 치료지속성과 통계적으로 유의한 관련성이 있었다(p<0.01). 3. 치료중단의 이유로는 증상 또는 몸의 불편함이 없어서가 23.9%를 차지하였고 그 다음으로 타의료기관 이용(18.4%), 교통의 불편(17.9%), 약국 이용(14.9%), 거동 불가능(7.5%), 경제적인 이유(6.0%), 보건지소 서비스에 불만족(4.4%) 순이었다. 4. 전체 대상자 295명의 평균 치료혈압은 $144.9{\pm}12.9/86.9{\pm}8.6mmHg$이었고, 이들 중 평균 치료혈압 이 140/90mmHg 미만으로 적절히 조절되는 환자는 32.5%였다. 이러한 연구결과를 종합해 볼 때, 보건지소 고혈압 환자들의 낮은 치료율, 관리율을 개선하기 위해서는, 적극적인 추후관리와 고혈압에 대한 환자의 잘못된 인식을 교정해주는 효과적인 보건교육을 포함하는 보다 체계적인 고혈압 관리 사업이 요구된다고 하겠다.

• 대한간호학회지
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• 제17권3호
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• pp.204-217
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• 1987

It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t＝-5.29, df＝62, p＝.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t＝2.72, df＝62, p＝.009, for diastolic blood pressure t＝1.95, df＝62, p＝.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r＝-.2981, p＝.008, for diastolic pressure r＝-.1720, p＝.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

• Journal of Preventive Medicine and Public Health
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• 제32권2호
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• pp.215-227
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• 1999

Objectives: To investigate compliance of hypertension patients using modified Theory of Reasoned Action(TRA). Methods: The data were collected for 7-12 April 1997, by interviewing 190 Hypertension patients in Hwachon, Kangwon-do. The analytical techniques employed include contingency table analysis and logit analysis. Results: 15.1% of patients were unaware of the fact that he/she has hypertension and 11.2% did not know that he/she should take drug. 20.8% of patients took drug continuously, 20.1% had drug intermittently, and 53.1% had never have treatment. In the contingency table analysis, several variables were found to be significantly related to patient compliance. They included variables for attitude towards the consequences of taking drugs, normative beliefs, systolic BP at the enrollment, knowledge of how to take hypertensive drugs, variables for general health behavior and experience with having health worker's home visit. The logit analysis was performed by two steps. first step uses experience with drug treatment of hypertension as the dependent variable, and second step uses continuity of treatment. Included in the predictors that are significantly related to the former analysis are subjected norms produced by combining normative beliefs and motivation to comply, knowledge of how to take hypertensive drugs, and opinion about natural recovery of diseases. The only significant determinant of continuous treatment was knowledge of how to take hypertensive drugs. Conclusions: The results of analysis suggest the usefulness of TRA as a framework for the study of compliance of hypertensive patients. The findings have some practical implication as well. One is that efforts for enhancing compliance should be directed not only patients but also to other persons influencing patient's attitude and behavior. It also suggest that correct understanding of hypertension treatment is essential to perform the appropriate patient role.

• 대한한의학회지
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• 제33권1호
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• pp.12-23
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• 2012

Objectives: This study evaluated clinical trials of acupuncture treatment for hypertension and to assess their methodology and results. Methods: Eight Korean databases and four international databases were searched for clinical trials of acupuncture treatment for hypertension up to June 2011. Study quality was assessed using the risk of bias (ROB) tool. Results: Twenty-four trials of acupuncture for hypertension were included. There were 14 randomized and 1 non-randomized controlled trials and 9 before-after studies. The most frequently used acupuncture points were zsnli (ST36), qch (LI11), fngch (GB20), snynjio (SP06), snjin (LI03) and hgu (LI04). In more than half of the studies, needle retention time was 20~30 minutes. Compared to baseline, change of blood pressure after treatment was significant in all studies. However, the results of effect on blood pressure between acupuncture and control were not consistent. Conclusions: There is insufficient evidence to suggest that acupuncture is an effective treatment for hypertension. Further well-designed clinical trials will be required to evaluate the effects and safety of acupuncture treatment for hypertension.

• 보건교육건강증진학회지
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• 제30권4호
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• pp.111-123
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• 2013

Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

• Korean Journal of Acupuncture
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• 제27권1호
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• pp.1-12
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• 2010

Objectives: The purpose of this study is to gain the objective indicators for the classification of hypertension by oriental medical pulse diagnosis, through finding out the parameters which can distinguish the pulse of hypertensive patient from that of normal subject, and characterizes the wiry pulse of hypertension. Methods: 30-59 yr, male, 946 healthy volunteers and 35 hypertensive patients were enrolled in this study. All the hypertensive patients were taking medicine to control the blood pressure and the blood pressure of the hypertension group was not statistically different from that of the normal healthy group. Data were acquired using 3 dimensional pulse imaging analyser(DMP-3000, DAEYOMEDI, KOREA) and analysed according to the age bands and the applied pressure levels. Results: 1. RAI/t, w/t and t2/t decreased with the levels of applied pressure and increased with age in the normal healthy group, not in the hypertension group. 2. RAI/t, w/t, t2/t were significantly higher in the hypertension group than the normal healthy group in the 30-age band, and elasticity coefficient was higher in the hypertension group than the normal healthy group in the 40-age band. 3. Researches on the patients without hypotensive agents are needed to figure out whether these parameters are the components of hypertensive wiry pulse. Conclusions: Analysing the radial pulse at 5 applied pressure levels using 3 dimensional pulse imaging analyser may be useful to differentiate the pulses of the hypertensive patients from those of the normal subjects, and characterize the hypertension.

• 한국학교ㆍ지역보건교육학회지
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• 제21권1호
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• pp.61-74
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• 2020

Objectives: This study aims to examine hypertension patients' quality of life by using the data of the 7^th Korea National Health and Nutrition Examination Survey (1^st year, 2016), identify the factors related to this, and utilize the results as basic data for intervention that can improve hypertension patients' quality of life. Methods: For the research subjects, this study extracted 1,531 patients who were diagnosed with hypertension by a doctor from the total sample of 8,150 participants of the 7^th Korea National Health and Nutrition Examination Survey, and selected 1,072 patients with no missing value in the variables to be analyzed as the final research subjects. The SPSS(version25.0) program was used for the analysis of the collected data. Then, this study used a backward elimination multiple regression analysis method that applied complex sample, to examine the factors related with the finally estimated quality of life. Results: The results of this study revealed that hypertension patients' quality of life was related with age, occupation, spouse, household income, weight gain, restriction of activity, subjected health status, perceived stress, and presence of comorbidity. The final model explained 37.0% of the variance (Wald F=30.012 p<.001). Conclusions: When an intervention program is implemented for the improvement of hypertension patients' quality of life in the future, it will be effective to construct the program according to age group, employment, marital status and household income. As for the program operation, patients should get help therefrom to control weight, facilitate activities and relieve their stress, and they should be also motivated to feel healthy. Furthermore, education should be offered so that they appropriately manage their underlying disease at an early stage.

• Journal of Nutrition and Health
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• 제40권4호
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• pp.347-361
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• 2007

The purpose of this study was to analyze and evaluate dietary intake between with and without hypertension. Study subjects were more than 30 years old adults (n = 3,806) who participated in the 2001 Korea National Health and Nutrition Examination Survey. People who have 'self-recognition about hypertension' and 'having diet for hypertension' were excluded. Using the WHO standard, subjects were divided into the hypertensive group (SBP> 140, DBP> 90) and the normal group (SBP< 140, DBP< 90). The Body Mass Index (BMI) and the Waist-Hip Ratio (WHR) of a hypertensive group were higher than those of a normal group (p < 0.01). The distribution of the subjects for smoking, alcohol consumption, exercise, stress, preference of salty food were not significantly different between a normal group and a hypertensive group (p>0.05). Dietary intakes were investigated by the 24-hour recall method. When food and dish intakes analyzed by sociodemographic factors, normal group consumed more fruits than those of a hypertensive group. Statistical significant were shown at female group, residences in metropolitan area and having elementary school education (p<0.05). Hypertensive group consumed more alcoholic beverages than those of a normal group at 'age 39-39', 'aged 50-64', 'high economic status', 'low economic status' and 'residences in metropolitan' (p<0.05) The amount of intakes for fat, potassium, thiamin, vitamin C and alcohol were significantly different between the normal group and the hypertensive group (p<0.05). The highest score of the Dietary diversity score (DDS) was 4 in both normal group and hypertensive group. Normal group showed high Nutrition Density (ND) of vitamin C and hypertensive group showed high ND of sodium. In summary, these results showed that significant difference for people with hypertension were intakes of fruits, alcohol, thiamin, vitamin C. And these results differed by sociodemographic groups. Therefore, the differential approach in each group is demanded for prevention and control of the hypertension.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.48-52
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• 2024

Backgrounds/Aims: Splenectomy is the most frequently performed procedure as definitive management or as part of shunt surgery or devascularization in portal hypertension. Splenectomy is technically challenging because of the frequent coexistence of multiple collateral varices, splenomegaly, poor liver function, and thrombocytopenia. Early arterial ligation and late mobilization (EALDEM) is the traditional method for splenectomy in portal hypertension. Early spleen mobilization offers good control of the hilum. We aim to compare the effect of the early mobilization and delayed arterial ligation (EMDAL) technique with that of the conventional splenectomy technique in patients with portal hypertension. Methods: During the study period from September 2011 to September 2022, 173 patients underwent surgical intervention for portal hypertension at our institution. Among these patients, 114 underwent the conventional method of splenectomy (early arterial ligation and late splenic mobilization) while 59 underwent splenectomy with the EMDAL technique. Demographics were compared between the two groups. Intraoperative and postoperative outcomes were analyzed using the Mann-Whitney test in each group. A minimum follow-up of 12 months was performed in each group. Results: Demographics and type of surgical procedure were comparable in the two surgical method groups. Median blood loss was higher in the conventional group than in the EMDAL method. The median duration of surgery was comparable in the two surgical procedures. Clavien-Dindo grade III/IV complications were reported more frequently in the conventional group. Conclusions: The splenic hilum can be controlled well and bleeding can be minimised with early mobilization and delayed arterial ligation.