• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.845-852
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• 2015

Cancer illness representations and screening history among residents of Kolkata, India, were investigated along with socio-demographic characteristics in an effort to understand possible motivations for health behavior. A total of 106 participants were recruited from community locations in Kolkata, India and completed surveys including demographics, the illness perception questionnaire-revised (IPQ-R), and previous experience with cancer and screening practices. Participants were 51.5% college educated, 57% female, 51.5% full-time employed with average age of 32.7 years (R: 18-60 years). Descriptive statistics were generated for the subscales of the IPQ-R, cancer-screening practices and cancer experience. Correlation analyses were conducted to investigate associations between cancer representations and socio-demographic variables. Univariate ANOVAs were calculated to determine gender differences in IPQ-R subscales and differences between participants who knew someone diagnosed with cancer versus those who did not. While 76% of participants knew someone with cancer, only 5% of the sample engaged in cancer screening. Participants perceived cancer as a serious illness with negative emotional valence. Younger age (r(100)=-.36, p<0.001) and male gender (F(1, 98)=5.22, p=0.01, ${\eta}_2$=0.05) were associated with better illness coherence. Males also reported greater personal control (F(1, 98)=5.34, p=0.02, ${\eta}_2$=0.05) were associated with better illness coherence. Low screening rates precluded analyses of the relationship between illness representations and cancer screening. Cancer was viewed as a threatening and uncontrollable disease among this sample of educated, middle class Kolkata residents. This view may act as a barrier to seeking cancer screening. Public awareness campaigns aimed at improving understanding of the causes, symptoms and consequences of cancer might reduce misunderstandings and fear, especially among women and older populations, who report less comprehension of cancer.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.25-39
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• 1985

This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.167-174
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• 2016

One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.2
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• pp.320-327
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• 2006

This study was written in order to help understanding of listening diagnosis to vocal sound and speech. The purpose of listening diagnosis is that we know states of essence(精), Qi(氣) and spirit(神). Vocal sound and speech are made by Qi and spirit. Vocal sound originates from the center of the abdominal region(丹田) and comes out through vocal organs, for example lung, larynx, nose, tongue, tooth, lip and so on. Speech is expressed by vocal sound and spirit. They are controled by the Five Vital organs(五臟). Various changes of vocal sound and speech observe the rules of yinyang. For example, if we consider patient likes to say or not, we can diagnose heat and coldness of illness. If we consider he speaks loudly or quietly, we can diagnose weak and severe of illness. If we consider he speaks clearly or thick, we can diagnose inside and outside of illness. If we consider he speaks damp or dry, we can diagnose yin and yang of illness. If we consider change of voice, we can diagnose new and old illness. Symptoms of changes of five voices, five sounds, dumbness and huskiness are due to abnormal vocal sound, and symptoms of changes of mad talk, mumble, sleep talking and so on are due to abnormal speech.

• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.479-487
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• 2006

Purpose: The purposes of this study were to measure the degree of uncertainty in illness, hope, and spiritual well-being and to examine the relationship among uncertainty in illness, hope, and spiritual well-being of cancer patients. Method: The data were derived from answers to questionnaires obtained from 93 cancer patients at one general hospital in J area from April 6, 2004 to May 8, 2004. The collected data were analyzed by SSPS 10.0. Results: The mean score of uncertainty in illness of cancer patients was 55.96. The mean score of hope of cancer patients was 79.77, and spiritual well-being was 55.20. Uncertainty in illness of cancer patients was related negatively to hope(r=-.57, p=.000). Also uncertainty in illness of cancer patients was related negatively to spiritual well-being(r=-.57, p=.000). However, hope of cancer patients was related positively to spiritual well-being(r=.67, p=.000). Conclusion: Higher uncertainty in illness was related to lower hope and spiritual well-being of cancer patients. Based upon these results, nurses should help patients to improve their hope and spiritual well-being through mediation of uncertainty in illness.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.1
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• pp.3-8
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• 2012

Understanding the biopsychosocial model of illness is crucial for any meaningful advance of health. The maintenance and promotion of health is achieved by different combinations of physical, mental, social and spiritual well-being. Health is not an objective of living. It is not only a state, but also a resource for everyday life. Health is a positive concept that emphasizes personal and social resources, as well as physical capacities. Understanding the biopsychosocial model of health and disease is very important in the medical system. George Engel challenged the medical profession to reconsider a strict biomedical approach to medical education and care, and to embrace a "new medical model," the biopsychosocial model. He argued that humans are at once biological, psychological, and social beings who behave in certain ways that can promote or harm their health. Although understanding the biopsychosocial model of illness is important, Korea's medical system have mainly been focusing on the biomedical model of illness. I would like to highlight the importance of biopsychosocial model of illness for Korea's medical system and real clinical field according to the 20th anniversary of Korean Society of Psychosomatic Medicine.

• Therapeutic Science for Rehabilitation
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• v.12 no.1
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• pp.51-63
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• 2023

Objective : This study aimed to analyze the association between lifestyle and medical expenses of older adults with mental illness using claims data. Methods : We conducted secondary data analysis using the older adult cohort database provided by the Korea National Health Insurance Service. The lifestyle and medical expense variables were extracted from the cohort database. We used a generalized linear model to examine the association between lifestyle and medical expenses. Results : In total, 32,853 records were extracted. The results showed that smokers had medical expenses (estimate = -218,255, p = .037). As the number of days of walking increased, medical expenses significantly decreased (estimate = -58,843, p < .0001). Furthermore, as the number of days of drinking decreased, medical expenses increased (estimate = 692,289, p < .0001). Conclusion : This study analyzed the estimates of medical expenses according to lifestyle among older adults with mental illness. Smoking and exercise were negatively associated with medical expenses. These results suggest the importance of a healthy lifestyle for older adults with mental illness. In addition, this study can be used as clinical evidence for lifestyle management programs to improve physical and mental health.

• Child Health Nursing Research
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• v.15 no.4
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• pp.350-358
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• 2009

Purpose: This study was done to better understand how sick children and their families define chronic illness; what behaviors they used for managing chronic illness; and how they perceived the socio-cultural context of Korea. Methods: This study was a secondary analysis of qualitative studies. Articles on children with a chronic illness and their families located in electronic databases were selected for review. Twenty one qualitative studies were reviewed. Qualitative studies that had used an analysis tool, the Family Management Style Framework were reviewed. Results: Children with chronic illness and their families tended to accept illness as a negative outcome and thought that they were deprived of the context of normality. In the traditional Korean family style, parents-in-law demand absolute obedience from their daughter-in-law, leading to a conflict between the two parties, which, in turn, may have negatively affected their perceptions of chronic illness. Western and oriental medical treatments were used, and participants sought an array of folk remedies. Conclusion: Culturally specific findings can help to better understand the difficulties faced by children with a chronic illness and their families and can provide invaluable input into the development of culturally appropriate and sensitive nursing interventions.

• Korea Journal of Hospital Management
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• v.25 no.2
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• pp.45-56
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• 2020

Purpose: The purpose of this study is to investigate medical care behaviors influencing accuracy of the payment based New diagnosis-related groups (DRG) compared to fee for service (FFS) in hospitalized patients with medical illness. Methodology: In order to estimate the difference in medical costs between New DRG and FFS depending on medical care behaviors, medical records and hospital claims data (n=4,232) were utilized, which were collected from a single public hospital during the first-half of 2018. Data were analyzed by descriptive statistics, t-test, chi-square test, and multivariate binary logistic regression. Findings: The average difference in medical costs between New DRG and FFS were KRW 506,711±13,945 with incentives and KRW -51,506±12,979 without incentives, respectively. Forty-four point two percent (44.2%, n=1,872) of total subjects were shown to have negative compensation in overall medical costs with New DRG compared to the costs with FFS. Medical care behaviors that affected on the negative compensation were the presence of severe bed sores on admission, medical consultations, death, operations, medications and laboratory or imaging tests with unit price over KRW 100,000, hospital-acquired complications or underlying comorbidities, elderly patients (≧65 years), and hospitalized for more than average inpatient days defined by New DRG (p<0.001). The difference in average medical cost between New DRG and FFS for a group with mild illness was KRW -11,900±10,544, whereas it was KRW -196,800±46,364 for a group with severe illness (p<0.0001). Practical Implications: These findings suggest that New DRG payment model without incentives may incompletely cover the variation of medical costs in real clinical practice. Therefore, policy makers need to consider that the current New DRG reimbursement should be focused and refined to improve accuracy of payment on medical care resources utilized in severe and complex medical conditions.

• Journal of Korean Medical classics
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• v.26 no.4
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• pp.341-354
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• 2013

Objective : The main idea of this article is to investigate the shamanistic medical activities through the traditional Chinese classics in the Zhou Dynasty. The ancient shaman played a bridge role between human beings and supernatural things like ghosts. Even though he didn't have the super power, the ancients believed that he could take care of all kinds of illness. Therefore, it can be said that the medicine of the Zhou Dynasty was still under the shamanism although it had already started to be specialized and professionalized. Method : This article is going to look into the detailed aspects of the shamanistic medical activities, for example, divination of illness, Zhuyou(祝由), shamanistic preventive medicine, and so on, through the traditional Chinese classics of Zhou Dynasty. Result : The medical knowledge of that time stayed in the early stage, so it was simple and raw. Also it had scientific and unscientific characters in itself at the same time. That's why it could be included in the shamanism. And about the shamanistic medical activities seen on underground written attestations, they will be offered through another article of mine, entitled A Research of Shamanistic Medical Activities on Underground Written Attestations in the Zhou Dynasty(兩周出土文獻所見之醫療巫術考察), which is being written now. Conclusion : From beginning of the Eastern Zhou period, the medicine gradually got to be specialized. And then specialized medical treatments and shamanistic medical activities began to be divided as the different two occupations. However, it is an unchangeable truth that the ancient shaman played an important role in the Chinese traditional medicine. Therefore, it can be said that he was in the very special position in the Chinese traditional medicine.