• Journal of Yeungnam Medical Science
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• 제40권2호
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• pp.218-222
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• 2023

A holistic approach to diabetes considers patient preferences, emotional health, living conditions, and other contextual factors, in addition to medication selection. Human and social factors influence treatment adherence and clinical outcomes. Social issues, cost of care, out-of-pocket expenses, pill burden (number and frequency), and injectable drugs such as insulin, can affect adherence. Clinicians can ask about these contextual factors when discussing treatment options with patients. Patients' emotional health can also affect diabetes self-care. Social stressors such as family issues may impair self-care behaviors. Diabetes can also lead to emotional stress. Diabetes distress correlates with worse glycemic control and lower overall well-being. Patient-centered communication can build the foundation of a trusting relationship with the clinician. Respect for patient preferences and fears can build trust. Relevant communication skills include asking open-ended questions, expressing empathy, active listening, and exploring the patient's perspective. Glycemic goals must be personalized based on frailty, the risk of hypoglycemia, and healthy life expectancy. Lifestyle counseling requires a nonjudgmental approach and tactfulness. The art of diabetes care rests on clinicians perceiving a patient's emotional state. Tailoring the level of advice and diabetes targets based on a patient's personal and contextual factors requires mindfulness by clinicians.

• Nutrition Research and Practice
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• 제17권5호
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• pp.1007-1018
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS: Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ² test to validate the test. RESULTS: There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS: The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

• 한국아동복지학
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• 제59호
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• pp.209-234
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• 2017

본 연구는 학업중단의 원인을 학교로 보고, 고등학생의 학업중단이 학교마다 학교특성과 학업중단의 영향요인이 다를 것으로 보았다. 이에 학교에 초점을 맞춰 전국 고등학교의 학업중단 추세를 확인하고, 고등학교 학업중단의 변화양상에 따른 유형을 종단적으로 탐색하였다. 그리고 도출된 유형별로 학교의 일반적 특성을 예측하고, 학업중단에 영향을 미치는 주요 요인(학교폭력, 학교상담)의 변화 추이를 살펴보면서 학업중단에 대한 학교의 장기간의 노력과 결과를 되짚어 보았다. 이를 위하여 KERIS EDSS의 "중등학교 정보공시데이터"를 활용하였고, 연구에서는 2012년부터 2016년까지 전국 고등학교의 5년 간 자료를 최종 모형에 투입 분석하였다. 연구는 네 가지 목적에 의해 수행되었고, 그에 따른 결과는 다음과 같다. 첫째, 고등학교의 학업중단에 대한 종단적인 변화양상을 탐색하기 위하여 잠재성장모형으로 분석한 결과, 시간이 지날수록 전국 고등학교의 학업중단은 감소하는 추세를 보였다. 둘째, 고등학교의 학업중단 변화양상에 따른 유형을 성장혼합모형으로 분석한 결과, 학업유지형, 학업중단감소형, 학업중단지속형과 같은 3가지 유형이 도출되었다. 셋째, 도출된 유형별 학교의 일반적 특성을 다항로지스틱 분석으로 예측한 결과에서는 국공립일수록, 전문계고일수록, 국영수 기초학력미달 학생 수가 많을수록 학업중단지속형에 속할 확률이 높았고, 전체학생 수가 많을수록 학업유지형이나 학업중단감소형에 속할 가능성이 높은 것으로 나타났다. 마지막으로 도출된 세 유형별로 학교폭력과 학교상담의 변화추이를 다 집단 성장혼합모형으로 분석한 결과에서 특히 학업중단감소형의 추이가 주목된다. 학업중 단감소형은 초기에 높았던 학교폭력 심의건수와 가해학생 수가 시간이 지날수록 매년 감소하는 양상을 보였고, 이와 함께 학교의 전문상담교사 배치수를 매년 늘리고, 또래상담을 지속적으로 활성화시켰음을 확인하였다. 이러한 점이 초기 학업중단이 가장 높았던 고등학교가 학업중단감소형 학교가 된 이유일 것으로 사료된다.

• 대한한방부인과학회지
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• 제36권4호
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• pp.78-95
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• 2023

Objectives: This study aims to analyze the results of the 2022 Gyeonggi-do Oriental Medicine Fertility Treatment Support Project, review the outcomes and satisfaction of Oriental Medicine fertility support initiatives, and propose progressive fertility treatment support strategies by comparing them with the results of the past three years. Methods: Total of 242 women and 205 spouses participated in the Korean Medicine fertility treatment support project, which encompassed herbal medicine, acupuncture, and counseling treatments over a 3-month period, followed by a 3-month post-treatment follow-up. Data pertaining to patients' general, demographic, and fertility-related characteristics were collected before treatment initiation. During treatment, information regarding the treatments administered by Korean medical doctors was recorded, along with post-treatment outcomes and satisfaction levels. Safety assessments included pre- and post-treatment blood tests and monitoring for adverse events. Results: Among the 242 female subjects, 209 successfully completed the treatment program. Of these, 35 (16.7%) achieved pregnancy, with 30 (15%) attaining pregnancy through herbal monotherapy. Out of the 35 pregnancies, 17 were maintained, while 10 resulted in miscarriage. Notably, 83.8% of patients expressed satisfaction with the treatment outcomes. An analysis spanning three years revealed a continuous increase in the average age of patients, surpassing 38 years in 2022, a critical point in fertility decline age. Additionally, there was a notable rise in the prevalence of patients with a history of gynecological issues, advanced spouse age, and semen abnormalities, which is assumed to have contributed to the decrease in the pregnancy success rate. Conclusions: This study compares the clinical results of the 2022 Gyeonggi-do Korean Medicine Fertility Treatment Support Project with those of the past three years. Based on these findings, recommendations are made to enhance the project, including stricter age criteria for patient selection, enhanced specialized treatment tools for medical doctors, and combining Korean Medicine treatment and medical assisted reproductive technologies, all aimed at increasing pregnancy success rates. These results provide a foundation for the development of fertility support projects and related policies.

• 대한간호학회지
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• 제30권5호
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• pp.1195-1206
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• 2000

The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

• Journal of Nutrition and Health
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• 제43권3호
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• pp.273-284
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• 2010

본 연구에서는 12주간 중년 비만여성을 대상으로 체중조절 프로그램 (영양교육 및 상담, 운동요법)을 실시하여 식습관, 혈액성분, 체성분의 변화를 살펴보고자 하였다. 영양 교육실시 후 식습관에서는 식사의 규칙성, 간식섭취횟수, 외식횟수 및 식사속도 등이 긍정적으로 개선되었다. 혈액지질 성분과 혈압에서는 총콜레스테롤, 중성지방, LDL-콜레스테롤, 수축기 혈압이 유의적으로 감소하였으며, 동맥경화지수와 이완기 혈압도 유의적인 차이는 없었지만 감소하였다. 비만지표인 BMI와 WHR (허리-엉덩이 둘레비)이 유의적으로 감소되어 체중이 감량됨을 알 수 있었고 체지방률, 지방량도 유의적으로 감소되었으며, 근육량은 유의적인 차이는 없었지만 약간의 증가를 가져와서 장기적으로 체성분의 긍정적인 변화를 기대할 수 있었다. 이상의 결과를 미루어 효율적인 비만관리를 위해서는 획일적인 방법보다는 대상자들의 특성을 고려하여 식행동 개선에 초점을 맞춘 영양교육 및 상담과 아울러 운동요법을 병행하여관리가 이루어져야 할 것으로 생각된다. 그러기 위해서는 각 영역의 전문가들의 긴밀한 협조와 노력으로 실질적인 건강향상을 위한 체계적인 비만관리 프로그램이 이루어져 비만을 예방하고 건강지표 향상을 가져와 국민건강 증진에 도움이 될 것으로 본다.

• Clinical and Experimental Pediatrics
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• 제54권6호
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• pp.246-252
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• 2011

Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

• Journal of Nutrition and Health
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• 제46권2호
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• pp.156-165
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• 2013

This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged $47.2{\pm}6.6$ years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, < 59%), medium-compliance group (MC, 59-70%), and high-compliance group (HC, > 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p < 0.05, p < 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p < 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p < 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p < 0.05). The change of fruit serving size showed a significant increase in the HC group (p < 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p < 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group.

• Journal of Korean Biological Nursing Science
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• 제22권4호
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• pp.232-248
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• 2020

Purpose: The purpose of this study was to develop and apply a motivation-strengthening obesity management program for obese subjects with visual impairment and evaluate its effects. Methods: The program development and evaluation periods were from March to August 2018. The study design was an experimental study of non-equality, control repeat design. 25 subjects in the experimental group participated in the 12-week obesity management program and the 26 people in the control group did not. Results: The motivation-strengthening obesity management program included stretching exercises for 30 minutes in the morning five times a week. In addition, counseling, education, and group discussions were continued once a week for motivational strengthening. Special custom exercises for blind patients were also completed once a week simultaneously. Both of these activities were continued for 50 minutes a week for a total of 12 weeks. Measurements were recorded periodically to identify the sustained effects of the program. The obese subjects with visual impairment improved their knowledge of obesity, perceived disability, self-efficacy of exercise, and quality of life related to obesity through the motivational obesity management program. Waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood sugar were also improved in obese subjects. Conclusion: The study findings indicate that this program could be an active intervention for the control of weight gain in participants with visual impairment. Therefore, the motivation-strengthening program based on the ADDIE (Analysis, Design, Development, Implementation& Evaluation) model could be an effective strategy for better health outcomes of obese subjects with visual impairment.

• 초등상담연구
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• 제5권1호
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• pp.205-226
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• 2006

The purpose of this study was to find out the relations between 6th graders' negative cognitive process and anger experience and aggressiveness. To achieve the goal, it conducted a test to examine children's negative cognitive process, anger experience, aggressiveness targeting 100 children of 6th grade in C elementary school, Gyeonggj province. Then it conducted SPSS 12.0 statistical program to get the results of correlation analysis and regression analysis. The outcomes were as follows. First, there was a meaningfully positive relation between a negative cognitive process and anger experience. In other words, children having more negative cognitive process seemed to experience the feelings of anger more often, this presented the important role of cognition while getting into a temper Second, it reported a positive relation between anger experience and aggressiveness. Children who have experienced anger more often showed more violent behaviors, especially there were more significant positive relations between trait-anger and aggressiveness compared to state-anger and aggressiveness. This could explain some possibilities that children with high level of trait-anger might outrage more often than others by recognizing the situations as anger stimulants. Third, when conducting a regression analysis, a negative cognitive process made an effect on anger experience which affected aggressiveness. However, it did not show a negative cognitive process making a direct effect on aggressiveness. This is considered that children could experience an anger while evaluating an event or object in a negative way based on individual belief, and emotional linguistic behavioral aggressiveness would be formalized as they express the sparked fury either internally or externally. In conclusion, this study proved that there were close relations between children's negative cognitive process and anger experience and aggressiveness. A negative cognitive process affects anger experience, and anger experience affects aggressiveness afterwards. A negative cognitive process affects aggressiveness through anger experience indirectly, and especially trait-anger among anger experience is the main factor to influence on aggressiveness. With consideration of these results, it is believed that mediation is important key to moderate the negative cognition and trait-anger in order to diminish children's aggressive behaviors. This study has a meaning to provide searching for manifold mediating methods between negative cognition and trait anger, with a fundamental resource.