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The Correlation Study on Loneliness, Feeling and Social Support of the Elderly in Rural Area (농촌노인의 고독감, 우울과 사회적 지지와의 관계)

  • Cho, Yoo-Hyang
    • 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.

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Perceptions of Caregivers and Medical Staff toward DNR and AD (Do Not Resuscitate (DNR)와 Advance Directives (AD)에 대한 환자 보호자와 의료인의 인식)

  • Lee, Sun Ra;Shin, Dong-Soo;Choi, Yong-Jun
    • Journal of Hospice and Palliative Care
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    • v.17 no.2
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    • pp.66-74
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    • 2014
  • Purpose: This study is aimed to investigate perceptions of caregivers and medical staff toward do not resuscitate (DNR) and advance directives (AD). Methods: Participants were 141 caregivers and 272 medical staff members from five general hospitals. A questionnaire used for the study consisted of 20 items: 14 about DNR perceptions, three about AD, one each for age, gender and employment. Results: Both medical staff and caregivers strongly recognized the need for DNR and AD, and the level of recognition was higher with medical staff than caregivers (DNR ${\chi}^2=44.56$, P=0.001; AD ${\chi}^2=16.23$, P=0.001). The main reason for the recognition was to alleviate sufferings of patients in the terminal phase. In most cases, DNR and AD were filled out when patients with terminal conditions were admitted, and patients made the decisions by consulting with their guardians. Medical staff better recognized the need and for growing demand for guidelines for the DNR and AD decision making process than caregivers (${\chi}^2=7.41$, P=0.0025). Conclusion: This study showed that patients highly rely on their caregivers when making decisions for DNR and AD. Thus, it is important that patients and caregivers are provided with objective information about the decisions. Since participants' strong support for DNR and AD was mainly aimed at alleviating patients' suffering, further study is needed in the association with hospice care. Medical staff also needs to understand the different views held by caregivers and fully consider the disparity when informing patients/caregivers to make the DNR and AD decisions.

An Analysis of the Use of Media Materials in School Health Education and Related Factors in Korea (학과보건교육에서의 매체활용실태 및 영향요인 분석)

  • Kim, Young-Im;Jung, Hye-Sun;Ahn, Ji-Young;Park, Jung-Young;Park, Eun-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.2
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    • pp.207-215
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    • 1999
  • The objectives of this study are to explain the use of media materials in school health education with other related factors in elementary, middle, and high schools in Korea. The data were collected by questionnaires from June to September in 1998. The number of subjects were 294 school nurses. The PC-SAS program was used for statistical analysis such as percent distribution, chi-squared test, spearman correlation test, and logistic regression. The use of media materials in health education has become extremely common. Unfortunately, much of the early materials were of poor production quality, reflected low levels of interest, and generally did little to enhance health education programming. A recent trend in media materials is a move away from the fact filled production to a more affective, process-oriented approach. There is an obvious need for health educators to use high-quality, polished productions in order to counteract the same levels of quality used by commercial agencies that often promote "unhealthy" lifestyles. Health educators need to be aware of the advantages and disadvantages of the various forms of media. Selecting media materials should be based on more than cost, availability, and personal preference. Selection should be based on the goal of achieving behavioral objectives formulated before the review process begins. The decision to use no media materials rather than something of dubious quality usually be the right decision. Poor-quality, outdated, or boring materials will usually have a detrimental effect on the presentation. Media materials should be viewed as vehicles to enhance learning, not products that will stand in isolation. Process of materials is an essential part of the educational process. The major results were as follows : 1. The elementary schools used the materials more frequently. But the production rate of media materials was not enough. The budget was too small for a wide use of media materials in school health education. These findings suggest that all schools have to increase the budget of health education programs. 2. Computers offer an incredibly diverse set of possibilities for use in health education, ranging from complicated statistical analysis to elementary-school-level health education games. But the use rate of this material was not high. The development of related software is essential. Health educators would be well advised to develop a basic operating knowledge of media equipment. 3. In this study, the most effective materials were films in elementary school and videotapes in middle and high school. Film tends to be a more emotive medium than videotape. The difficulties of media selection involved the small amount of extant educational materials. Media selection is a multifaceted process and should be based on a combination of sound principles. 4. The review of material use following student levels showed that the more the contents were various, the more the use rate was high. 5. Health education videotapes and overhead projectors proved the most plentiful and widest media tools. The information depicted was more likely to be current. As a means to display both text and graphic information, this instructional medium has proven to be both effective and enduring. 6. An analysis of how effective the quality of school nurse and school use of media materials shows a result that is not complete (p=0.1113). But, the budget of health education is a significant variable. The increase of the budget therefore is essential to effective use of media materials. From these results it is recommended that various media materials be developed and be wide used.

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A Study on Hypertension Management of Community Health Practitioner Posts (보건진료소 고혈압 관리사업의 실태)

  • Kwon, Myung-Soon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.155-169
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    • 2003
  • Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.

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The Relation of BMI, Smoking and Drinking with Biomedical Parameters in 20s and 30s Men (20~30대 성인 남성에서 체질량지수, 흡연량 및 음주량과 혈액검사치의 관련성)

  • Kim, Chul-Gyu
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.10
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    • pp.4425-4433
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    • 2011
  • The purpose of this study was to explore the relation of BMI, smoking and drinking with biomedical parameters in 20s and 30s men. This was a retrospective exploratory study and the subjects were 603 men who participated in health check-up for clinical trial at a tertiary hospital between October 2006 and June 2011. RBC, hemoglobin(Hb), hematocrit(Hct), triglyceride(TG), uric acid(UA), ALT in obese group were significantly higher than those of normal weight group. WBC and Hb in smokers were significantly higher than those of nonsmokers, protein in smokers was significantly lower than that of nonsmokers. Platelet in moderate smokers who smoke 10~19 cigarettes a day was significantly higher than that of nonsmokers and light smokers who smoke below 10 cigarettes a day, albumin in moderate smokers was significantly lower than that of nonsmokers and light smokers. TG in moderate smokers was significantly higher than that of nonsmokers, and blood glucose(BG) in moderate smokers was significantly lower than that of nonsmokers. AST and ALT in drinkers who drink over 10g a day were significantly higher than those of nondrinkers. In regression, BMI was significant factors of increasing RBC, Hb, Hct, total cholesterol(TC), TG, BG, UA, AST and ALT. Smoking amount was significant factors of increasing WBC, Hb, Hct and TG, and was significant factors of decreasing BG and Ca. Smoking amount was significant factors of increasing TC, AST and ALT, and was significant factors of decreasing WBC. In conclusion, there was significant relations of BMI, smoking, and drinking with biomedical parameters such as Hb, TC, TG, and ALT in young-aged men. Therefore, practice of healthy lifestyle activities to include preventing obesity and heavy drinking, and quitting smoking needs to the 20s and 30s men for preventing lifestyle disease.

The Cross-talk Mechanisms of Constitutive Androstane Receptor (CAR) in the Regulation of its Activity, Energy Metabolism, Cellular Proliferation and Apoptosis (Constitutive Androstane Receptor (CAR)의 활성, 에너지 대사 및 세포의 증식과 사멸의 조절에 대한 CAR의 cross-talk 기전)

  • Min, Gyesik
    • Journal of Life Science
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    • v.30 no.2
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    • pp.211-220
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    • 2020
  • The activity of CAR can be regulated not only by ligand binding but also by phosphorylation of regulatory factors involved in extracellular signaling pathways, cross-talk interactions with transcription factors, and the recruitment, degradation, and expression of coactivators and corepressors. This regulation of CAR activity can in turn have effects on the control of diverse physiological homeostasis, including xenobiotic and energy metabolism, cellular proliferation, and apoptosis. CAR is phosphorylated by the ERK1/2 signaling pathway, which causes formation of a complex with Hsp-90 and CCRP, leading to its cytoplasmic retention, whereas phenobarbital inhibits ERK1/2, which causes dephosphorylation of the downstream signaling molecules, leading to the recruitment to CAR of the activated RACK-1/PP2A components for the dephosphorylation, nuclear translocation, and the transcriptional activation of CAR. Activated CAR cross-talks with FoxO1 to induce inhibition of its transcriptional activity and with PGC-1α to induce protein degradation by ubiquitination, resulting in the transcriptional suppression of PEPCK and G6Pase involved in gluconeogenesis. Regulation by CAR of lipid synthesis and oxidation is achieved by its functional cross-talks, respectively, with PPARγ through the degradation of PGC-1α to inhibit expression of the lipogenic genes and with PPARα through either the suppression of CPT-1 expression or the interaction with PGC-1α each to induce tissue-specific inhibition or stimulation of β-oxidation. Whereas CAR stimulates cellular proliferation by suppressing p21 expression through the inhibition of FoxO1 transcriptional activity and inducing cyclin D1 expression, it suppresses apoptosis by inhibiting the activities of MKK7 and JNK-1 through the expression of GADD45B. In conclusion, CAR is involved in the maintenance of homeostasis by regulating not only xenobiotic metabolism but also energy metabolism, cellular proliferation, and apoptosis through diverse cross-talk interactions with extracellular signaling pathways and intracellular regulatory factors.

Spiritual Needs of Hospice Patients (호스피스 환자의 영적 요구)

  • Han, Young-Mi
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.39-48
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    • 2000
  • Purpose : The purpose of the study is to disclose the spiritual needs of hospice patients. Method : The questionaire survey was carried out on 49 hospice patients and 40 caregivers who were in the 9 hospice institutions from lune to August in 1999. Results : In the patients, mean scores of the spiritual needs were significantly higher in the group with stomach cancer, college education, christians, $8{\sim}14$ days of hospice care and the group thinking that religion was important, and in the caregivers in the group of religions besides christianity and lives under $3{\sim}5$ years of medical treatment. In the total average of the spiritual needs, the patients's average was significantly lower than the caregiver's. Among the different categories, the patient's needs were highest in the area of meaning of life and the hope, the caregiver's needs in the love and the concern. However, both groups were low in the religion area. In the items of the love and the concern, the patient was highly responding to the 'wanting someone to give warm concern in conversation' and the caregiver was highly responding to the 'giving a warm response to questions on the sad and hard time'. And also, the patient was lowly responding to the 'wanting more concerns to him than other patients', and the caregiver was low responding to the 'patients wanting warm response in conversation'. In the categories of religious area both group were highly responding to the 'wanting to be helped to relax out of all'. And they gave lowest response to the 'wanting to introduce a book to know God'. In the area of meaning of life and hope, the both groups gave highest response to the 'wanting to be guided to have the hope' and lowest to the 'wanting to have opportunity to reconcile the person with bad relationship'. Conclusion : Summing up the above results, personal in-depth conversation is necessary to understand more deeply the spiritual needs of hospice patient. Moreover the hospice team needs to have more systematic approach to find out the spiritual needs of hospice patients.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

The Effects of Smoking Cessation Coaching Program based on Motivation Stage to Stop Smoking of Patients at a Public Hospital (금연동기단계에 따른 코칭프로그램이 환자 금연에 미치는 영향)

  • Kwak, Mi-Young;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.4
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    • pp.188-198
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    • 2016
  • This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

Comparison of the mental health, metabolic syndrome and nutrient intake by Gender in Problem drinkers ; Based on The Fifth(2010-2012) Korean National Health and Nutrition Examination Survey (성별에 따른 문제음주자의 정신건강, 대사증후군과 영양소 섭취; 제 5기(2010-2012) 국민건강 영양조사를 중심으로)

  • Choi, Young -Sil
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.8
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    • pp.5159-5168
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    • 2014
  • The study examined the relationship among metal health, metabolic syndrome and nutrient acceptance according to gender. Implemented until 2010-2012, the 5th Korean National Health and Nutrition Examination Survey, as an original document, was used for the study. The target was problem drinkers with more than 12 points under AUDIT. Regarding mental health, it was classified into stress, depression and suicidal impulse. Metabolic syndrome was defined when three causes of BMI, waist circumference, FBS, HDL and BP were out of the normal range. The nutrient intake was obtained to confirm the energy intake of nine non-nutrients (Nutrient adequacy ratio: NAR) and the proper intake of the average non-nutrient (Mean adequacy ratio: MAR). These variables were analyzed by frequency, cross analysis and multiple regression analysis through SPSS18.0. In the general features, there was a significant difference according to age, occupation and marital status. In mental health, stress, depression and suicidal impulse were examined. Metabolic syndrome was dependant on FBS, HDL and BP. The nutrient acceptance depended on calcium, vitamin A, thiamine, riboflavin, niacin, vitamin C, and MAR. Logistic regression analysis performed on the variables showed significant differences. Stress, depression, and thoughts of suicide was significantly higher in men aged 19-29 years, and women aged 30-49 years. In the case of the male, those who employed have metabolic syndrome more than those who unemployed. In terms of female, those who were belonged into the middle - low economic level have undergone with metabolic syndrome. In the part of a Mean adequacy ratio(MAR), the male who unmarried, employed, were in the middle low economic levelwere higher. In the case of the female, it was higher for those who were in the middle - low economic level. Overall, an effective way of planning the solution regarding mental health, metabolic syndrome and nutrient intake can be found by considering these features.