• Title/Summary/Keyword: Korean Medicine Chronic Disease Management Program

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Accessible Strategy of the Registration & Management of Hypertension and Diabetes Mellitus Patients through the Public-Private Partnership: Policy Implications Fron the Hongcheon-gun Case (민관협력을 통한 고혈압.당뇨병 등록.관리사업의 접근 전략: 홍천군 사례의 정책적 함의)

  • Byun, Do-Hwa;Kim, Eun Jeong;Park, Myung-Bae;Son, Hyo-Rim;Park, Hye-Kyong;Kim, Chun-Bae
    • Korean Journal of Health Education and Promotion
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    • v.30 no.4
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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.

Caring Types in Mothers of Children with Athma : Q Methodology (천식 환아 어머니의 돌봄 유형: Q 방법론 적용)

  • Oh Won Oak
    • Child Health Nursing Research
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    • v.6 no.1
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    • pp.89-102
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    • 2000
  • Asthma is one of the most common chronic disease of childhood. Although an improved understanding of the pathophysiology of asthma has had a positive impact on the treatment and management of the disease, there has been a gradual but significant increase in asthma mortality. Also, mother's caring type is the essential factor in management of the child with asthma. The purpose of this study is to identify and understand the caring patterns of mathers of children with Athma by Q methodology. As a research method, 35 Q-statements were collected through individual interviews and review of related literatures. 37 subjects were interviewed and the data were analyzed by the PC QUANL program with principal component analysis. The were 3 different caring types classified as follows : Type I was the therapeutic compliance obeying type, compliancing medication and preventing cold etc. Type II was the physical strengthening type, taking Chinese medicine and folk remedy etc. Type III was the environment control type, managing house and environment clearly and ventilating room air etc. Therefore, it needs considering above each type in nursing care of the family and children with asthma.

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Factors Associated with Physical Functioning among Community-Dwelling Older Adults (우리 나라 재가노인의 신체적 기능상태별 관련 요인)

  • Choi, Kwi-Sook;Lee, Yun-Hwan
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.325-332
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    • 1999
  • Objectives: The aim of this study is to identify major factors associated with physical functioning among the Korean elderly. Methods: Data come from a survey of a nationally representative sample of 2,058 older people aged 60 years or elder living in the community. A hierarchical functioning scale was constructed, using upper and lower body mobility, IADLs, and ADLs. Socioeconomic characteristics, chronic conditions, measures of health status, health service use, and social support were analyzed to explore their influence on functioning. Polytomous logistic regression analysis was conducted to identify major contributing factors to different levels of functioning. Results: Persons of older age, female, with chronic diseases (heart disease, stroke, fracture/dislocation) were consistently more likely to show a higher degree of functional limitation. There were variations, however, among other factors; e.g., those with arthritis were more likely to be only mildly impaired, but not moderately or severely impaired. Conclusions: Older Korean adults living in the community with impaired functioning constitute persons with diverse characteristics. Policy and program activities need to address specific needs of older people in different functioning states.

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The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon (인천광역시 의원기반 건강포인트제도가 고혈압·당뇨병 환자의 지속치료에 미치는 영향)

  • Cheong, Won;Yim, Jun;Oh, Dae-Kyu;Im, Jeong-Soo;Ko, Kwang Pil;Park, Ie Byung
    • Health Policy and Management
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    • v.23 no.4
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    • pp.427-433
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    • 2013
  • Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.

Self-Care, Symptom Experience, and Health-Related Quality of Life by COPD Severity (만성 폐쇄성 폐질환의 중증도에 따른 자가관리, 증상경험 및 건강관련 삶의 질)

  • Kang, Gui-Jung;Kim, Myung-Hee;Hwang, Sun-Kyung
    • Korean Journal of Adult Nursing
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    • v.20 no.1
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    • pp.163-175
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    • 2008
  • Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

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Effects of an intensive asthma education program on asthmatic children and their caregivers (천식 환아와 보호자를 대상으로 한 집중 교육 프로그램의 효과)

  • Seo, Kang Jin;Kim, Gun Ha;Yu, Byung Keun;Yeo, Yun Ku;Kim, Jong Hoon;Shim, Eu Ddeum;Yoon, Mi Ri;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.188-203
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    • 2008
  • Purpose : Asthma is one of the most common chronic childhood disease. Education of asthmatic children and their families about asthma and its management may improve disease control, reduce symptoms, and improve school performance. The aim of the study was to evaluate the effects of an intensive asthma education program in asthmatic children and their families on outcome measure of asthma management behavior scale, knowledge about asthma, self efficacy scale and quality of life. Methods : Fifteen asthmatic children and their families were invited the intensive asthma education program which including allergen avoidance, management of asthma, correct use of the inhalation devices and control of exercise-induced asthma (study group). Fifteen asthmatic children and their families those who did not participate this program were served as control group. Participants were asked to complete a written questionnaire before and 3-month after the program. Results : After completing the intensive education program, significant improvement of the childrens asthma management behavior scale (27.1 vs. 32.2, P=0.011), belief and knowledge about asthma (14.2 vs. 17.9, P<0.001), self efficacy (47.9 vs. 49.7, P=0.091) and quality of life (79.6 vs. 88.6, P<0.001) was noted in the study group by measuring questionnaires. There are increasing tendencies in parental asthma management behavior scale and knowledge about asthma. Conclusion : This intensive asthma education program is effective in improving asthma control, self efficacy and quality of life of asthmatic children. This should serve as a national model for family-based programs for asthmatic children and their families.

Health Management Experience of Residents through Participation in the Community Based Hypertension and Diabetes Registry Program (지역사회 고혈압·당뇨병등록관리사업 참여를 통한 주민의 건강관리경험)

  • Park, Mi Kyoung;Park, Hyeung Keun;Kim, Hyun Ju;Kim, Ok Jin;Gong, Moon Yeon
    • Research in Community and Public Health Nursing
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    • v.32 no.4
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    • pp.518-528
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    • 2021
  • Purpose: This study was conducted to explore the healthcare experience of residents participating in the Community-Based Hypertension and Diabetes Registry Program. Methods: This study used qualitative content analysis. Data were collected from in depth interviews of fifteen participants, who either participated in the program hosted by the Training Center for Hypertension and Diabetes for more than two years or participated in an intensive one-on-one education program. Results: The results showed that the core theme in healthcare of participants was 'Proactive healthcare with attention and systematic guidance of experts'. The positive reinforcement of staffs and the improvement of self-efficacy through effective close management were found to be positive influencing factors of participation. The theme consisted of the following categories: 'Participation in the program with positive expectations on healthcare', 'Interest in body and health', 'Vitality in life', 'Confidence in dealing with disease', 'Thankfulness for close care and attention', and 'Desire for continuous care'. Conclusion: When establishing policies on managing chronic diseases, a strategy that reflects the results of the study is required. It is necessary to build up emotional relationship among stakeholders, and expand opportunities for close healthcare such as one-on-one customized training, and mutual cooperation with various organizations in the local community.

Effects of Chronic Disease Management Based on Clinics for Blood Pressure or Glycemic Control in Patients with Hypertension or Type 2 Diabetes Mellitus (고혈압·당뇨병 환자의 혈압·혈당 조절에 미치는 의원 기반 만성질환관리사업의 효과)

  • Cheong, Won;Yim, Jun;Oh, Dae-Kyu;Im, Jeong-Soo;Ko, Kwang Pil;Kim, Yun Mi
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.108-115
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    • 2013
  • Objective: This study aimed to examine the effects of chronic disease management program based on clinics for blood pressure control or glycemic control in patients with hypertension or type 2 diabetes mellitus in Incheon. Methods: An observational follow up study was done on 11,501 patients registrated at clinics from January 1st to December 31st, 2010 in Incheon. Experience of education and mandatory laboratory tests were assessed with the registration data and income status was identified by National Health Insurance data. The odds ratio and 95% confidence intervals were derived from logistic regression models. Results: The experience of education has a positive effect for blood pressure control in the non-control group with hypertension at the time of registration (Odds ratio 1.357, confidence intervals: 1.112~1.655). The experience of mandatory laboratory tests has a positive effect for blood pressure control in the control group with hypertension at the time of registration (Odds ratio 1.738, confidence intervals: 1.387~2.178). But the effects of the experience of education and mandatory laboratory test in patients with type 2 diabetes mellitus were not identified. Conclusions: This study revealed the relationship between the experience of education or mandatory laboratory testing and blood pressure control in patients with hypertension.

Sleep Disturbance, Physical Activity and Health Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자의 수면장애, 신체활동 및 건강관련 삶의 질)

  • Lee, Haejung;Lim, Yeonjung;Jung, Hee Young;Park, Hye-Kyung
    • 한국노년학
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    • v.31 no.3
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    • pp.607-621
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    • 2011
  • Purpose The purpose of this study was to examine the relationship between physical activities, sleep disturbance, and health related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). Methods A descriptive survey design used pretest dataset of COPD symptom management intervention study (N=245). Measures included the international physical activity questionnaire, the COPD and asthma sleep impact scale, and the St. George's respiratory questionnaire of HRQOL. The data were analyzed using descriptive analysis, t-test, ANOVA, Pearson correlation coefficients, and simultaneous multiple regression by the SPSS WIN 18.0 program. Results The mean scores (SD) of HRQOL and sleep disturbance were 36.04 (19.43) and 14.33 (6.20), respectively. About 32% of participants were physically inactive. The multivariate approach showed the patients who have more sleep disturbance (β=.27), lower levels of FEV1 % predicted (β=-.23), lower physical activities (β=-.19), lower household income (β=-.16), and diagnosed longer than 5 years (β=.14) reported lower HRQOL (R2=.34). Conclusion The findings of this study suggest that improving the quality of sleep and physical activities can be efficient strategies for HRQOL in patients with COPD. Future research in enhancing HRQOL through improving sleep quality and physical activities is needed.

Evidence and suggestions for establishing vitamin D intake standards in Koreans for the prevention of chronic diseases

  • Kim, Jung Hyun;Park, Hyoung Su;Pae, Munkyong;Park, Kyung Hee;Kwon, Oran
    • Nutrition Research and Practice
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    • v.16 no.sup1
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    • pp.57-69
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    • 2022
  • BACKGROUND/OBJECTIVES: Vitamin D is produced in the skin during sun exposure and is also ingested from foods. The role of vitamin D needs to be considered in the prevention and management of various diseases. Moreover, since the majority of Koreans spend their days indoors, becoming susceptible to the risk of vitamin D deficiency. The current study aims to prepare a basis for determining dietary reference intake of vitamin D in Korea, by reviewing the evidence against various diseases and risks. MATERIALS/METHODS: Literature published in Korea and other countries between 2014 and 2018 was prioritized based on their study design and other criteria, and evaluated using the RoB 2.0 assessment form and United States Department of Agriculture Nutrition Evidence Library Conclusion Statement Evaluation Criteria. RESULTS: Of the 1,709 studies, 128 studies were included in the final systematic analysis after screening. To set the dietary reference intakes of vitamin D based on the selected articles, blood 25(OH)D levels and indicators of bone health were used collectively. Blood vitamin D levels and ultraviolet (UV) exposure time derived from the Korean National Health and Nutrition Examination Survey were analyzed to establish the dietary reference intakes of vitamin D for each stage of the life cycle. The adequate intake levels of vitamin D, according to age and gender, were determined to be in the range of 5-15 ㎍/day, and the tolerable upper intake level was established at 25-100 ㎍/day. CONCLUSIONS: The most important variable for vitamin D nutrition is lifestyle. A balanced diet comprising foods with high contents of vitamin D is important, as is vitamin D synthesis after UV exposure. The adequate intake level of vitamin D mentioned in the 2015 Dietary Reference Intakes for Korean (KDRI) remained unchanged in the 2020 KDRI for the management of vitamin D nutrition in Koreans.