• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.122-136
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• 2000

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

• Journal of agricultural medicine and community health
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• v.12 no.1
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• pp.5-27
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• 1987

It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

• Journal of agricultural medicine and community health
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• v.39 no.4
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• pp.209-221
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• 2014

Objectives: The objective of this study was to identify the effects of area-based health promotion initiatives with community participation and partnerships conducted in Sabong-Myeon, Jinju City for three years. Methods: We used data from the '2008 Sabong-Myeon Health Survey' and the '2011 Health Plus Happiness Plus Community Health Survey'. The study comprised 520 systematically sampled individuals, composed of 300 adults in 2008 and 200 adults in 2011. We compared some health behavior and mental health indicators as well as social capital levels between these two surveys. Results: The prevalences of smoking and walking exercise in 2011 were significantly higher than those in 2008. The prevalences of high risk alcohol consumption in men, stress perception, depressive symptoms experience, and suicide ideation were significantly lower than those in 2008. The proportion of people having a high level of social capital in 2011 was significantly higher than that in 2008, regardless of sex or marital status. However, the difference in the proportion was not statistically significant among people with a high educational background. Conclusions: This study suggested that the 3 years' implementation of area-based health promotion initiatives conducted in Sabong-Myeon might help to improve the mental health and social capital level of this community. The long-term health effects of area-based health promotion initiatives with community participation and partnerships need to be studied further, and lessons from these initiatives can be obtained by adapting proper evaluation methods.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.199-214
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• 1996

To investigate the factors which affecting the cognitive function and depression of the 65 or more age group, the authors surveyed for the subjects in the region of Taejon and nearby Taejon area. 729 studied subjects were tested for cognitive function with MMSE and depression with GDS. The main results were followings; In the studied subjects, the rate of normal cognitive function was 56.8%, the rate of mildly impaired was 24.1% and the rate of severe impairment was 19.1%. The cognitive function level was closely related to the depression score. As the age increased, the cognitive function was more impaired. Sexual difference was also existed in the cognitive function level and the depression score. After adjusting the effect of age, the variables such as sex, marital status, education level, past job, instrumental ability of daily living, regular physical exercise, frequencies of going out the house, chest discomfort, visual and auditory disturbance, and dizziness had the significant relationship with cognitive function impairment. Among these variables instrumental ADL, age, visual disturbance, and sex showed statistical significance in the logistic regression model. In the multiple stepwise regression, the variables which had significant relationship to depression score were education level, frequencies of going out house, current job and house work activity, regular physical exercise, instrumental ADL, self-rated health and nutritional status, dimness, visual disturbance, and chest pain. In conclusion, main characteristics which had close relationship to the cognitive function and depression symptoms in the studied subjects were physical function and self rated health status.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.239-254
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• 1996

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the $20\sim29years$ old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 100,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked $1\sim5$ years in the factories were 33.0%. Those who were much for them workload were 43.9% and who worked more than 8 hours a day were 73.9%. Those who were disatisfied with their job and pay were 31.9% and 50.6%. The workers who responsed ventilation condition of their worksites were bad were 51.9% and the dissatisfed with working environment of their worksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.1%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to $80\sim90dB$ were 30.3%, $90\sim100dB$ were 26.4% and $50\sim70dB$ were 19.2%. 5. Workers' stress symptoms were significantly related to marital status and their monthly income(p<0.05). Workers who were single and had lower monthly income showed higher PSI (Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to $1\sim2$ days hight-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSI scores were significantly related to severe tinnitus and perceived hearing losso(p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSI scores(p<0.01). Workers who reported that they did not feel they need earplugs showed. significantly higher PSI scores (p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSI scores(p<0.01). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder(p<0.001). 5. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were perceived hearing loss$(R^2=0.160)$, noise exposure level in worksite$(R^2=0.110)$, realtionship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total $R^2$ of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.

• Journal of Preventive Medicine and Public Health
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• v.31 no.2 s.61
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• pp.323-334
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• 1998

To investigate determinants of health care utilization of the physically disabled over 20 years old in age living in Taegu city, a self-administered questionnaire survey was carried out for 337 disabled persons with chronic illness from April to July, 1997. Health care utilization .ate was 81.9%(69.1% for hospital or clinic and 12.8% for pharmacy). Marital status, job, health concern, and response to illness showed statistically significant relationship with health care utilization(p<0.05). By path analysis, job, economic status, medical security type and response to illness had a significant direct effect on health care utilization(p<0.05), however, health concern and regular source of care had an indirect effect. The reasons of no health utilization were due to economic problem(31.1%), no symptom(18.0%), inconvenience to seek care or no accompanying persons to be helped(14.8%), unseriousness of the severity of the illness(14.8%), too busy to be treated or no free time(8.2%), hopeless prognosis to be treated(6.6%) in order. In conclusion, it is recommended that the program for expanding medicaid, improving socioeconomic status by getting a job and health education to increase the health concern toward physically disabled should be implemented to increase health care utilization rate.

• Journal of agricultural medicine and community health
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• v.15 no.2
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.143-153
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• 2002

This study was performed to examine the want for home-visit health care of health center and health sub-center in rural olders and to provide the basic data to develop strategies for efficient and effective home-visit health care delivery of public health facilities. The questionnaire survey by interview was conducted to 355 olders whose ages were all over 65 years, residing at a rural community, Myun, Gyeongsangbuk- do. Among study population, 64.5% replied that their self-rated health status were 'poor', 14.1% had low ADL and 14.9% had low IADL. Among study population, 73.5% replied that they had health problem which were in need of medical personnel's care. The existence of health problem were significantly different according to sex, age, marital status, health security status, occupation, economic status, circumstances for medical care, self-rated health status, ADL, and IADL(p<0.05). Among olders with health problem which were in need of medical personnel's care, 19.5% wanted to receive the home-visit health care. The degree of want for home-visit health care was higher significantly in olders whose ages were 75-year old or more(p<0.05), jobless olders(p<0.01), the aged persons who were not in harmony with other family members, olders whose self-rated health status were 'poor' and olders with low IADL. The major reasons why they wanted to receive the home-visit health care services were 'they had no helpers when they were sick' (64.7%), 'long distance to the medical facilities from their residence'(23.5%). The medication service was the most need service among home-visit health care services. The reasons why they didn't want to receive the home-visit health care services were 'we could walk and move' (60.0%), 'we wanted to have a direct contact with doctor' (25.7%) in the order of high rate. In multiple logistic regression analysis, the degree of want for home-visit health care were higher significantly in olders who were not in harmony with other family members and olders whose self-rated health status were 'poor'(p<0.05).

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.87-98
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• 2002

This study is to reveal the overall level of loneliness, depression and social supports of the elderly in rural area of Korea. The interview survey was performed in February 2001 with structured questionnaires to 486 respondents of 65 years or more of age who lived in Muan-gun area. The questionnaire was the revised translation of Japanese Elderly Study Which was composed of general characteristics, Japanese Loneliness Scale, abridged General Depression Scale(GDS) and Duke University social support Inventory. The following analyses adopted the analysis of covariate, t-test, and Chi- squire were used for some of the cross- sectional analyses. Average age of 486 respondents was 73.9 years old. 58.0% of the respondents noticed their partner or son as the primary consultant for the stressful situation. 56.2% of the respondents experienced the loss of their marital partner, health and/or friends. Average score of loneliness, GDS and social supports of the respondents that was each $35.54{\pm}8.38$, $7.23{\pm}2.21$ and $26.01{\pm}.90$. The overall level of depression seemed to be low as the 'pleasure to be alive' and 'happiness' scored high while the 'state of anger' and 'ominous presentiment' scored low. The level of loneliness and depression was positively correlated while the relationships were negative between loneliness and support and between depression and social support. These results suggested that social and health promotional programmes be necessary for the elderly of rural area. Further research would be required to specify the necessities.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.265-273
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• 2000

Benign prostatic hyperplasia (BPH) is a highly prevalent, age-related disorder in men which place a considerable burden on health care resources worldwide. While BPH and hypertension are apparently diverse disease processes, they have some features in common(e.g. underlying etiology of the sympathetic nervous system). The purpose of this study is to estimate the prevalence of lower urinary tract symptoms using I-PSS(international prostate symptom score) and to investigate the association of hypertension with I-PSS. This study was carried out to 390 men(40~86 year old) at 3 Myun in Chungju City from July to August, 1997. Subjects answered on questionnaire for I-PSS and were checked age, education, marital status, annual income, blood pressure. The mean age of subjects was 59.8 year old. The mean of I-PSS were increased by age decades(40~49, 50~59, 60~69, 70~86) and it's scores were 4.4, 7.0, 8.2, 12.3 respectively. Strong correlations were observed between the I-PSS and the QUL(quality of life)(P=0.0001). I-PSS(mean-value) were 7.85 in hypertensive group and 8.39 in normotensive group but there was no statistically significance between the two groups(P>0.05). The proportion of mean scoring greater than 8 was 42.5%. There have been reports of association between lower urinary tract symptoms and hypertension, but there was no consistent suggestion that such an association could be casual. The need for high-quality epidemiological information and consequent increased prospects for prevention is obvious.