• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.53-69
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• 1999

A descriptive correlation study was done to provide a basic data for comprehensive nursing care by analyzing the relationship between spiritual wellbeing, hope and perceived health status of the elderly. 195 respondents who lived at their homes and 148 respondents who lived at the facilities for elders such as nursing homes and elder's rehabilitation centers were selected and their age was over 60 years old. Paloutzian and Ellison(1982)'s spiritual wellbeing scale, Nowotny(1989)'s hope scale and Northern Illinois University's health self rating scale was used. From August 10th to August 25th, 1998, ready made questionnaires were handed out by researcher to those who can fill it out and for those who cannot fill out the questionnaires alone, the researcher read it and finished by interview. This study used Pearson's correlation coefficient for the hypothetic test and the average point and standard deviation of spiritual wellbeing, hope, and perceived health status were checked. To find out the difference between spiritual wellbeing, hope, and perceived health status by general characteristics ANOVA and Tukey test were used. The results are as follows : 1. The mean score for spiritual wellbeing of the elders was 42.27($SD{\pm}9.67$) in a possible range of 20-80. The average point of spiritual wellbeing was 2.11($SD{\pm}0.97$) point to 4 point full marks. The mean score of religious wellbeing was 21.37($SD{\pm}7.02$) and that of existential wellbeing was 20.90($SD{\pm}4.63$) in a possible range of 10 - 40. The average point of religious wellbeing was 2.14($SD{\pm}0.70$)points and existential wellbeing was 2.09($SD{\pm}0.46$) points to 4 point full marks. 2. The mean score for hope was 67.16($SD{\pm}12.28$) in a possible range of 29-116. The average point of hope was 2.31($SD{\pm}0.42$) points to 4 point full marks. 3. The mean score for perceived health status was 8.72($SD{\pm}2.49$) in a possible range of 4-14. 4. In testing the hypothesis concerning the relationship between spiritual wellbeing and hope, there was a statistically positive correlation(r=0.5209, p=0.0001). 5. In testing the hypothesis concerning the relationship between spiritual wellbeing and perceived health status, there was a statistically positive correlation(r=0.1427, p=0.0081). 6. In testing the hypothesis concerning the relationship between hope and perceived health status, there was a statistically positive correlation(r=0.2797, p=0.0001). 7. There were significant differences in spiritual wellbeing according to sex, religion, and present occupation. 8. There were significant differences in hope according to residential places, age, religion, educational level, family status, average monthly pocket money. 9. There were significant differences in perceived health status according to residential places, sex, age, educational level, present occupation and family status. From the above results it can be concluded that: There was a positive correlation between spiritual wellbeing and hope, spiritual wellbeing and perceived health status, hope and perceived health status. When the nurse implicate the nursing intervention which can be promote the spiritual wellbeing and hope, elder's perceived health status also can be improved.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.120-131
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• 2024

Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.421-425
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• 2012

Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.

• Health Policy and Management
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• v.28 no.3
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• pp.195-196
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• 2018

The Korean Academy of Health Policy and Management (KAHPM) has shown remarkable achievements in the field of health policy and management in Korea for the last 30 years. The KAHPM consists of experts in various fields of health policy and management, and has been the leading academic discussion forum for health policy agendas of interest to the public. Health Policy and Management (HPM), the official journal of the KAHPM, published the first issue of volume 1 in October, 1991 and is publishing the second issue of volume 28 as of 2018. Currently, it is one of Korea' main journals in the field of health policy and management. HPM has published a special issue in commemoration of the 30th anniversary of the KAHPM. The HPM invited authors, including former presidents of the KAHPM and current board members, to write about main issues in health policy and management. Although the HPM tried to set up an invited author on all subjects in the health policy and management field, 19 papers are published, that completed the peer review process by August, 2018. The authors of the special issue of the 30th anniversary of the KAHPM include six former presidents, a senior professor, and 12 board members. The subjects of this issue are reform of the healthcare delivery system, health insurance and medical policy, reform of health system governance, the role of National Health Insurance Service (NHIS), the Korea Institute for Health and Social Affairs (KIHASA) and the National Evidence-based healthcare Collaborating Agency (NECA), ethical aspects of health policy change, regional disparities of healthcare, healthcare accreditation, new healthcare technology evaluation system, globalization of the healthcare industry, the epidemiological investigator system, the quarantine system, safety and disaster, and official development assistance. There are some remaining topics to deal with for the KAHPM: aged society, anti-smoking, non-infectious disease, suicide, healthcare resources, emergency medical care, out-of-pocket money, medical fee payment system, medical aid system, long-term care insurance, industrial accident compensation insurance, community-centered health welfare system, and central government and local government of health. The HPM will continue to publish review articles on the main topics in health policy and management. This is because the KAHPM, which has been the leading academic society of Korea's health policy and management for the last 30 years, feels responsible for continuing its mission for the next 30 years.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.143-152
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• 2008

Purpose: Specific bacteria are believed to play an important role in chronic periodontitis. Although extensive microbial analyses have been performed from subgingival plaque samples of periodontitis patients, systemic analysis of subingival microbiota has not been carried out in a Korean population so far. The purpose of this study was to investigate the prevalence of 29 putative periodontal pathogens in Korean chronic periodontitis patients and evaluate which pathogens are more associated with Korean chronic periodontitis. Material and Methods: A total of 86 subgingival plaque samples were taken from 15 chronic periodontits(CP) patients and 13 periodontally healthy subjects in Korea. CP samples were obtained from the deepest periodontal pocket (>3 mm probing depth[PD]) and the most shallow periodontal probing site ($\leq$3 mm PD) in anterior tooth and posterior tooth, respectively, of each patient. Samples in healthy subjects were obtained from 1 anterior tooth and 1 posterior tooth. Polymerase chain reaction (PCR) of 16S ribosomal DNA (rDNA) of subgingival plaque bacteria was performed. Detection frequencies(% prevalence) of 29 putative periodontal pathogens were investigated as bacterium-positive sites/total sites. Results: With the exception of Olsenella profuse and Prevotella nigrescens, the sites of diseased patients generally showed higher prevalence than the healthy sites of healthy subjects for all bacteria analyzed. Tanerella forsythensis (B.forsythus), Campylobacter rectus, Filifactor alocis, Fusobacterium nucleatum, Porphyromonas endodontalis and Porphyromonas gingivalis were detected in more than 80% of sites with deep probing depths in CP patients. In comparison between the sites (deep or shallow PD) of CP patients and the healthy sites of healthy subjects, there was statistically significant difference(P<0.05) of prevalence in T.forsythensis (B.forsythus), C.rectus, Dialister invisus, F.alocis, P.gingivalis and Treponema denticola. Conclusion: Our results demonstrate that the four putative periodontal pathogens, T.forsythensis (B.forsythus), C.rectus, P.gingivalis and F.alocis are closely related with CP patients in the Korean population.

• Journal of the Korean Society of Food Culture
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• v.11 no.3
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• pp.305-316
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• 1996

The purpose of this study was to find out how much they have several aspects of food related knowledge and eating behaviors of high school students in Sungnam area. The self-administrated questionnaire was used. The result were as follows: 1. The average height of boys and girls was $172.6{\pm}0.7$ cm and $156.3{\pm}1.5$ cm respectively. The average weights of them were $62.4{\pm}0.5$ kg (male) and $47.2{\pm}0.8$ kg (female). BMI (Body Mass Index) of them were $20.74{\pm}0.14$ (male), $18.82{\pm}0.28$ (female). The average age is 16.7 years old. 2. The 66.5% of the subjects were spent more than one-third of their pocket money in buying on light meals during three times a week. There were significant differences between income level of family. Boys spent more money on each meal than girls. And significant differences were also obserbed by their residence area and Bundang residences spent more in buying snacks. 3. The rate of skipping meals was 51.2% in boys compared with 68.0% in girls. The frequencies of buying snacks instead of main meal were high in girls. Time limits in eating may possibly be the main reason for skipping meals (59.8%), especially in the morning. Skipping a breakfast becomes general eating habits in high school students, because of pressure for time to go to school. 4. It is required that parents should be taught to prepare balanced lunch box for their children because the rate of students who prepared two lunch boxes are 49.4%. 5. The students took snacks once or twice a day. They usually bought snacks in school concessions (51.8%) and they selected items of snack instinctivly. The girls ate snacks during lunch break time (31.7%) and after dinner (23.6%). Boys ate snacks after dinner (29.1%). Preference of foods were different by sex. Boys preferred bread (31.7%), milk and otherdairy products (80.8%), cola and soda (42.0%) as their snacks between meals. Girls selected biscuit, chip, beverage, coffee as their snacks, frequently. 6. BMI value of the group who ate between meals more than three times a day was lower $(18.78{\pm}0.65)$ than that of the group who ate nothing between meals $(20.71{\pm}3.79)$. 7. As for the nutritional knowledge, the students generally had higher correct rate of answer about which nutritive components of food has (76.6%). But they had lower knowledge on questions of nutritive values in food (10.6%). There was a meaningful relation between favorite food and nutritional knowledge. In conclusion, there were some problems on nutritional knowledge and eating habits among the high school students. Therefore, it was required that girls should be learned to recognize the importance of breakfast and needed to select balanced meals and snacks. And it was required that the nutrition education should be complemented to motivate and improve practical eating behaviors.

• Journal of agricultural medicine and community health
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• v.22 no.2
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• pp.277-293
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• 1997

This study was conducted to provide basic materials required to enforce and develop welfare policies, as well as the health system, for the aged, by surveying the status of health care utilized by the daily increasing old population and the importance of receiving physical therapy. Data that need in this research was gathered from over ages of 65, during the period from Jan 4, 1996 to Jan 31, using the inquiries previously made by geriatric researchers and through literatures investigator by this writer. The data were analyzed by $X^2$, Z-test, Likert scale. The findings were as follows : 1) General characteristics of subjects. People in the age group between 65 and 69 were 55.6% and the highest number, while male were 37% and female 63%. Analysis of income group disclosed 60.6% whose monthly income, including the pocket money given by children, was less than 200,000 won. 91.1% of the elderly people surveyed owned houses; only 36.4% live with spouses; while 15.6% live alone. 2) Characteristics with respect to utilization of health care institution. 56% of the total medical institutions used by the elderly people were clinics and the rates of chronic disease and musculoskeletal disease were 73.2%. 3) Characteristics with respect to approach of health care institution. 45.1% of the respondent stated it took 20 minutes to arrive at hospital, and bus accounted for 48.6% of all transportation means used to go to hospital. 4) Degree of cognition with respect to the rights of geriatric patients. (1) There is no financial support from the government for geriatric patients(71.4%). (2) Government financial support is needed for geriatric patients(95.3%). (3) Have never been regionally surveyed or called upon for interviews with respect to treatment desire and problems relating to geriatric patients(87.2%). (4) Health and medical policies for geriatric patients must be established rapidly(98.4). (5) Expansion and construction of specialized medical facilities for geriatric patients such as elderly hospital and medical center are needed(90.2%). (6) Government's welfare policies for the elderly people is insufficient(82.0%) 5) Degree of cognition on importance of physical therapy with respect to geriatric patient. (1) Physical therapy is considered most effective in treating geriatric patients(82.9%). (2) Physical therapists specializing in only elderly people must be need of separately(76.2%). (3) It is desirable for medical specialists to visit geriatric patients at home to provide physical therapy(82.9%). (4) Hospitals specializing in physical therapy for geriatric patient are required(85.6%). Based on the result for this research, the following suggestions are presented to facilitate the utilization of health care institution for the welfare of geriatric patients. Medical facilities such as elderly hospital and geriatric patient's medical center specializing in elderly people must be constructed as early as possible; and home-visiting physical therapist system must be important to treat chronic geriatric patients; our government must establish policies to provide the old ages with means for the health care and curing chronic diseases, and carry out the plans of reasonable distribution and effective untilization of medical resources.

• Journal of Fashion Business
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• v.1 no.2
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• pp.46-54
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• 1997

The purpose of this study is to understand women's wear manufacturing industries. First, the study was to investigate the present production systems and how much the automatic facility are by comparing them. This study enhanced more efficient, stable, and suitable work line. This intern will direct the way in which automatic facilities will be created. Second, through this study on the general character of the inspectors, the ratio of impaired goods, and the reasons for unsatisfactory goods, I intended to find out a way to decrease the impaired goods and to produce competitive and high quality goods. The results of the survey can be summarized as follows; 1. The result of the research on the automatic industrial facilities shows that the majority of the factories (77.4%) are 40% below the automatic facility rate. The reasons for this according to order are that was a deficit in money, no reason for expensive machines, and lack of the technique and the number of workers required to handle the machines. 2. At this time, the most required equipments are shown according to its importance; automatic sewing machine, automatic cutting machine, automatic spreading machine, and finishing & pressing machine. So in the women's wear manufacturing industries, they think that they need more automatic cutting machine, automatic spreading machine in the cutting field rather than high price automatic machine in the sewing field such as pattern former, pocket welting, automatic sleeve connecting machine and automatic label connecting machine. 3. The result of the research in the goods quality shows that the average impaired rate is 12.7% at the first inspection. In addition the average rate for complete impaired rate is 1.52%. The line system shows that it has a impaired rate that is double the rate of the pair system. Because of this, the industries plan to combine the line system and pair system to create an improved and suitable production system which can boost the quality and productivity of the goods. 4. The fabric is the main point of the impaired goods. The factors of the impaired goods in manufacturing are the lack of mental abilities of the worker, impaired fabrics and a lack of cooperation in the working system. Furthermore, there is a lack of technique for new material. 5. To prohibit impaired goods in manufacturing, there need to be a way to educate the workers and to enhance the workers' mind on the productive goods. Also there need to increase in the investments of automatic production machines. Finally there need to be a standardized working line. Therefore, there need to be an improvement on the management of the production of goods, the development of technique and an increase in the education for the workers, with this there will be a decrease in impaired goods, and an increase in better quality of goods to enforce the domestic apparel industries.

• Journal of the Korean Chemical Society
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• v.42 no.5
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• pp.506-511
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• 1998

When the spermine, which is one of the polyamines containing cation in vivo, binds to DNA, it can increase the stability of DNA. At the same time, it can cause B-form to Z-form transformations of DNA. However, because we cannot determine the binding geometry of the spermine to DNA by using spectroscopic methods, nobody can show the accurate binding mechanism of a DNA-spermine complex. Thus, we used DAPI as a spectroscopic probe of spermine, which binding geometry was well known. At the result of base selective binding geometry of spermine to synthetic DNA, the concentration of spermine gets higher, it grows the hydrophobic environment of DAPI which bound the minor groove of adenine-thymine base pair. Simultaneously, spermine seems to bridge the backbones around the minor groove of $poly[d(A-T)_2]$. So that, the intensity of fluorescence spectrum of that shows sudden increasement. In guanine-cytocine base pair, $poly[d(G-C)_2]$, we can suppose that spermine bind to the major groove of that, shoving out the DAPI which is partially intercalated between the base pocket across the major groove of it. In both cases, spermine doesn't show the base selectivity against to DNA.