• Journal of Home Health Care Nursing
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• v.5
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• pp.73-83
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• 1998

This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.287-301
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• 2004

Objectives: The development of internet programs for smoking cessation was motivated to quit smoking in the large group of smokers. This personalized program consisted of tailored message to consider the smokers characteristics, and contain the informations on the outcomes of smoking cessation and the skills to be used in the quit attempts. The purpose of this study was to develop the internet management program and information push-delivery system for smoking cessation to encourage the personal intention to quit smoking. Methods: We conducted in 3 steps as developing push service to encourage intention of smoking cessation, analyzing problems of smoking cessation program through the pilot test and suggesting improvements by implication stages. Results: This program is delivered for 30 days. if the participants do not fail to quit smoking. The contents consisted of 13 stages which were divided on starting period. practical period, maintenance period and success period. And push service afforded the tailored message to participants using their e-mail. According to the evaluation of pilot test, the problems of internet information push-delivery service for smoking cessation were the over-tasks per visiting time, recording style of participants, difficulty of terms and sentences, lack of visual effects, absence of follow-up module and unsuitable link with main homepage. Improvements were divided on 3 stages by implication period. The first stage included the immediate improvements as improving link with homepage, modifying menu of smoking information and upload file of notice part. The second stage included the short term improvements as alleviating condition of withdrawal, coordinating start stage of retrial, modifying errors of information push-delivery service and addition of educational materials. The third stage included the long term improvements as development of follow-up module, cost-effectiveness evaluation, reducing contents quantity, introduction of checking style, compensation of graphics effect and review for SMS utilization. Conclusions: This program contribute to improving smoking cessation rate. Therefore this program should be tested in a community to evaluate the effectiveness. To promote the effectiveness, this program should be developed the contents and the strategies for various targets, and established the follow-up system for ex-smokers.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.21-31
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• 2002

The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

• Journal of Environmental Health Sciences
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• v.42 no.1
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• pp.41-52
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• 2016

Objectives: Scrub typhus is one of the most prevalent vector-borne diseases. It is caused by Orientia tsutsugamushi, which is transmitted when people are bitten by infected chigger mites. This study aims at quantifying the association between the incidence of scrub typhus and meteorological factors in Jeollabuk-do Province over the period 2001-2015. Methods: Reported cases of scrub typhus were collected from the website of the Disease Web Statistical System supported by the Korea Centers for Disease Control and Prevention (KCDC). Simultaneous meteorological data, including temperature, rainfall, relative humidity, and sunshine duration were collected from the website of the National Climate Data Service System by the Korea Meteorological Administration. Correlation and regression analyses were applied to identify the association between the incidence of scrub typhus and meteorological factors. Results: The general epidemiological characteristics of scrub typhus in Jeollabuk-do Province were similar to those nationwide for sex, age, and geographical distribution. However, the annual incidence rate (i.e., cases per 100,000) of scrub typhus in Jeollabuk-do Province was approximately four times higher than all Korea's 0.9. The number of total cases was the highest proportion at 13.3% in Jeonbuk compared to other regions in Korea. The results of correlation analysis showed that there were significant correlations between annual cases of scrub typhus and monthly data for meteorological factors such as temperature and relative humidity in late spring and summer, especially in the case of temperature in May and June. The results of regression analysis showed that determining factors in the regression equation explaining the incidence of scrub typhus reached 46.2% and 43.5% in May and June. Using the regression equation, each 1oC rise in the monthly mean temperature in May or June may lead to an increase of 38 patients with scrub typhus compared to the annual mean of incidence cases in Jeollabuk-do Province. Conclusion: The result of our novel attempts provided rational evidence that meteorological factors are associated with the occurrence of scrub typhus in Jeollabuk-do. It should therefore be necessary to observe the trends and predict patterns of scrub typhus transmission in relation to global-scale climate change. Also, action is urgently needed in all areas, especially critical regions, toward taking steps to come up with preventive measures against scrub typhus transmission.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.198-208
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• 2002

Background : This research, as a part of improving management process of college hospital in this rapidly changing circumstances, is searching for the actual state of private clinics referring patients to referral center including college hospitals. Methods : This research examined the sense of satisfaction and requesting degree in using referral center and by analyzing the correlation and differences among factors such as primary factors regarded as selecting ones in referring patients to a referral center in college hospital and expecting factors expected to be supported to patients and cooperative hospitals. Results : The main researched results are as follows. First, as for the primary factors, the differences between cooperative and uncooperative hospitals revealed the fact that choosing target hospital in accordance with cooperative relation and convenient process in referring patients are important. Second, satisfaction rates, analyzed from the paired t-test revealed kindness and convenience as the top priorities, while sending patients back again and benefit of supporting such as the use of facilities were revealed as the least satisfactory aspects, despite the fact that they should be fulfilled through actual service. Conclusion : The recognition of the practitioner is examined and analyzed in this research by examining primary factors in selecting college hospitals, expecting factors expected to be supported to patients and satisfaction degree, which are expected to be used as basic materials for the development of referral center of college hospitals.

• Journal of Preventive Medicine and Public Health
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• v.30 no.2 s.57
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• pp.293-307
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• 1997

In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

• Journal of agricultural medicine and community health
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• v.48 no.4
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• pp.251-261
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• 2023

Objective: Farmers are known to have high prevalence of asthma and chronic obstructive pulmonary disease(COPD). This study aims to investigate the current status of asthma and COPD in domestic and foreign farmers with the ultimate goal of raising awareness of asthma and COPD among farmers and contribute to supporting evidence for the prevention of respiratory diseases in farmers. Methods: The study utilized data from the "Farmer's Occupational Disease Survey," conducted by the Rural Development Administration, to determine the prevalence of respiratory diseases in domestic farmers. The prevalence of asthma and COPD in overseas farmers was evaluated by researching other foreign studies and articles. Results: The prevalence of asthma and COPD in domestic farmers was less than of foreign farmers'. The prevalence of asthma in domestic farmers was high as upto 8.4% and COPD upto 5.5%. Studies from Europe and America showed prevalence of asthma in farmers high as upto 14.8% and COPD upto 17.1%. Conclusions: This study conducted an investigation using the 'Survey on Occupational Diseases and Injuries in Farmers to understand the current status of asthma and COPD in domestic farmers. Due to a lack of relevant domestic research, we examined and compared with the research results on asthma and COPD among overseas farmers. Further research is necessary and preventive measures for respiratory diseases need to be developed.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.62-84
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• 2001

The purpose of the study was to compare patient's satisfaction on the pharmacy services after introducing the new system of separation of dispensing from prescribing medicines, between those filling their prescriptions from the pharmacy nearby hospitals and those from the pharmacy in their resident areas. To measure patient's satisfaction, a questionnaire survey was conducted with 354 outpatients who received prescriptions from any of the three university hospitals located in In-Cheon city. Study results showed that geographic accessibility to pharmacy was a main attribute to select pharmacy. Size of the pharmacy and availability of prescription drugs are the second major reasons for pharmacy selection for the patients from the pharmacy nearby hospital, whereas patronage is the second major reason for those from the pharmacy in resident areas. Overall satisfaction was higher among the patients from the pharmacy in resident areas than those from the pharmacy nearby hospitals, mainly due to better facilities(waiting area, public telephone, etc), kindness, cleanliness, shorter waiting time, and pharmacist's concern about patient's health. On the other hand, the patients of the pharmacy nearby hospitals showed low satisfaction because of long waiting time and the lack of pharmacist's knowledge and information about patients' health status and medication history. Patients visiting the hospital that has pharmacy-hospital cooperation system showed higher satisfaction as compared to those visiting the hospital without such system. This study provided an empirical evidence that it would be more advantageous for patients to receive pharmacy services from pharmacies located in their living areas than from pharmacies nearby hospitals. This implies that there is a strong need for adequate strategies to enhance the role of pharmacies in resident areas under the new system of separation of dispensing from prescribing medications.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.34-51
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• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.216-231
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• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.