• 보건행정학회지
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• 제31권1호
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• pp.46-55
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• 2021

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion: For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

• 정신신체의학
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• 제15권1호
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• pp.3-6
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• 2007

진료현장에서 불안증상은 흔하게 접하는 정신과적 병리이다 불안증상과 내과질환의 동시 이환은 비단 진단적인 문제뿐 아니라, 예후와 치료결과에도 관련된 문제이다. 내과질환에 동반된 불안증상은 상황에 따라 치료되어야 하며, 필요한 경우에는 약물치료가 필요하다. 불안을 조절하기 위해 사용되는 약물은 모두 치료제로 고려될 수 있으며, 내과질환의 종류, 이학적 상태 및 불안 정도에 따라 적절한 항우울제나 항불안제를 선택할 수 있다. 경우에 따라서는 항정신병약물이나 직접적인 항불안작용이 없는 약물을 선택할 수도 있다. 환자의 상태에 따라서 불안증상 조절을 위한 약물 사용에 각별한 주의가 필요하다.

• 대한간호학회지
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• 제15권2호
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• pp.5-15
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• 1985

This study was conducted for the purpose of fin-ding out the variance explaining the medical facilities utilization behavior, which is defined adaptation behavior Process by focal, contextual, residual stimuli in Roy's Adaptation Model. What kinds of characteristics can explain adaptation behavior in Roy's Model? And which is the relative importance of input variables? For this analysis, stepwise multiple regression and path analysis was used. The data come from the 1981 Baseline Household Interview Survey in remote rural area. The findings of the analysis can be summarized as follows: First, Total variance of independant variables for adaptation behavior, that is medical facilities utilization including clinic, drug store, health center, herb medicine was shown 16.2 percent. The most important variable which explain the dependent variable was the occurance of illness with the Ra of value 0.112. The illness symptom, living level, regular care source was shown important variables with relatively high the R²value and significant beta coefficient. Second, in the path analysis of variables which is selected important variables, the occurance of illness was shown variable which has the highest direct effect which 0.297 path coefficient. Also the education level of household was shown variable which has the highest indirect effect through living level and the occurance of illness in causal model. Third, This analysis suggests that the occurance of illness belonging focal stimuli are more influenced than others. To sum up, It is seem to the occurance of illness, illness symptom belonging focal stimuli have high explanation ability through direct effect, education level of household among contextual stimuli have explanation ability through indirect effect.

• 보험의학회지
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• 제27권1호
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• pp.14-17
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• 2008

• Journal of Preventive Medicine and Public Health
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• 제47권6호
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• pp.327-335
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• 2014

Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

• 가정∙방문간호학회지
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• 제19권1호
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• pp.46-54
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• 2012

Purpose: The purpose of this study is to analyze the concept of recovery in relation to those living with mental illness and provide a better understanding to the definition, perspectives, and paradigm of recovery in phenomenon, as a conceptual knowledge. Methods: A literature review was conducted to define the concept of recovery from a mental illness by using key words, "recovery", "mental health and illness", "concept analysis" and "recovery-oriented nursing", and searching the Cumulative Index to Nursing and Allied Health Literature, PubMed, Cochrane library and RISS4U database. Concept analysis of recovery was done, by using the Walker and Avant's framework of concept analysis. Results: Attributes of recovery for those living with mental illness included regain, life reconstruction, hope, adjustment, and health. Antecedents of recovery from mental illness included instilling hope, recovery vision, belief, peer support, recovery-oriented services, empowerment, personal accountability, education, human rights and culture. The consequences, as meanings of recovery included self-esteem, hopeful life, positive adjustment, and healthy life. Conclusion: Concept of recovery is important for a nurse to understand when caring for a person living with mental illness. This concept of recovery from mental illness may apply to future studies to develop a recovery-oriented nursing intervention.

• 유통과학연구
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• 제14권7호
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• pp.21-31
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• 2016

Purpose - With globalization, medical tourism has developed as a new industry, which attracts practitioners and academics to have more interest in researches on customers' behavior. This research was to investigate empirically WOM effects on the intention of Chinese customers when they select an international medical tourism destination. Interestingly, WOM effects on their choice and decision process may vary by the extent of their severity of illness. Research design, data, and methodology - The data was collected from 1,747 potential Chinese residents in main districts of China. Moderated regression analysis was used to estimate WOM effects on Chinese customers' choice intention. Results - Results imply that WOM determinants of tie strength, credibility, and vividness do interact with medical tourism information and affect customers' intention for health care abroad. Results also reveal that the severity of illness plays a critical moderating role in customers' decision process. Conclusions - WOM and the severity of illness are important moderators for Chinese customers to make a decision for medical tourism. It provides some implications for service organizations for developing and implementing marketing strategies in international health care markets.

• Journal of Preventive Medicine and Public Health
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• 제31권2호
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• pp.293-309
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• 1998

The purpose of this study is to compare the level of health-related quality of life and relating factor between institutional elderly and community living elderly. The subjects were 390 from Sanatorium or Nursing home and 467 from the community in Kwangju. The results are followed : 1) A comparison of ADL between two groups, institutional elderly and community living elderly, resulted in that community elderly were more significantly independent in the areas of bathing and transfer than institutional elderly. 2) A comparison of IADL between two groups resulted in that : Community elderly were more independent in the areas of using telephone and transportation, food preparation, house keeping, and doing laundry. Institutional elderly were more independent in the area of handling finances. 3) In the case of poor health-related quality of life, institutional elderly showed 2.4 times in the dimension of physical fitness, 1.8 times in daily activity, 2 times in social activity, 2 times in pain, 26.7 times in social support, and 0.4 times in subjective quality of life higher than community elderly There was no significant differences in the rest of dimensions. 4) In institutional elderly, the analysis of variables related to the health-related quality of life resulted in that; The relating factors were sex, education, and chronic illness in the dimension of physical function. Direct contact with family or significant others in the dimension of social activity. Chronic illness in the dimension of pain and perceived health status. Direct or indirect contact with family or significant others over the phone or through letters in the dimension of social support. 5) The analysis of variables related to the health-related quality of life showed that community elderly has more relating variables in each area than institutional elderly. The relating factors were age, sex, and chronic illness in the dimension of physical function. Education and chronic illness in the dimension of emotional status. Age and chronic illness in the dimension of daily activity and social activity Education and chronic illness in the dimension of pain and perceived health status. Sex, education, family size in the dimension of social support. Education and chronic illness in the dimension of subjective quality-of-life. Throughout general daily activity, community elderly showed more satisfactory results than institutional elderly, but in the subjective area of health-related quality of life, such as subjective quality of life, institutional elderly group showed more positive results. And community elderly had more relating factors than institutional elderly. For the health care of the elderly that focused on quality of life, new approaches considering the characteristics of both group, institutional and community living elderly, are needed.

• 정신신체의학
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• 제3권2호
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• pp.214-221
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• 1995

There appears to be an increased incidence of anxiety symptoms in association with certain medical illness. It is usually assumed that certain medical disorders are directly associated with anxiety symptoms in that the pathophysilolgy of the medical illness somehow causes the anxiety symptoms. However, the pathophysilolgies of many such medical illnesses as well as anxiety are not known and no discrete group of medical illnesses is clearly more likely to produce anxiety symptoms than any other Moreover, anxiety symptoms may be the representation of other psychiatric symptoms, like depression and delirium. Though it is important to differentiate primary and other causes(secondary) of anxiety clinically, the clear differentiation is somewhat arbitrary, as the confusion of mind-body dichotomy. for the purpose of accurate treatment of anxiety symptoms relating medical illness, this review article focuses on those clinical features and mechanisms of anxiety that are potentially useful in differential diagnosis.

• 근관절건강학회지
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• 제6권1호
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• pp.85-99
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• 1999

Chronic disease such as rheumatoid arthritis is believed to induce a significant psychosocial stressors. The concept of illness intrusiveness-illness induced life style disruptions-was hypothesized to affect psychosocial status. And demographic, socioeconomic, disease and social characteristics were hypotehsized to affect illness intrusiveness. Hierarchial multiple regression analyses were used. As a result, among the demographic factors gender was identified as contributor to directly increase the psychosocial stress and education level was identified to affect the psychosocial stress through illness intrusiveness. Among socioeconomic factors, the burden about the cost of medical treatment was found to indirectly affect the psychosocial stress through the illness intrusiveness. Also income and job were found to affect directly the psychosocial status. Among the disease characteristics, only the pain level was identified to increase the psychosocial stress through the illness intrusiveness. Among the social characteristics, perceived social support is identified to increase the psychosocial stress through the illness intrusiveness. Based upon these results, some suggestions were made for minimizing illness intrusiveness in rheumatoid arthritis and future research.