• Journal of the Korean Society of School Health
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• v.31 no.2
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• pp.117-126
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• 2018

Purpose: The leading cause of death among teenagers in Korea is suicide. Also, it is known that mental health of Korean adolescents identified based on the levels of perceived stress or depression is very poor. The purpose of this study was to examine the current status of student mental health programs in Korea and the associated problems and to explore ways to make the programs more effective. Methods: The subjects of the study were a total of 115 school nurses and school counselors in elementary, middle and high schools. The study examined the current status and the associated problems of school mental health programs as well as the needs for teacher training programs related to student mental health. Results: Few mental health programs other than counseling for at-risk students were being carried out. The problems associated with student mental health management were, in terms of management, 'accountability in case of incidents such as student suicide' and 'parents uncooperative in their kid's mental health management (visit to hospital, etc.)' and, in terms of manpower, 'unclear R&R between school nurses and school counselors' and, more fundamentally, 'the lack of human resources.' The needs for teacher training programs related to student mental health were very high and the content required most was 'ways to manage stress of students and teachers themselves,' followed by 'interpersonal conflicts management & conservational skills,' and 'ways to manage student mental illness.' Conclusion: In conclusion, to increase the effectiveness of student mental health programs, we should move on from the current system which focuses only on early discovery and intervention to a more comprehensive system that includes preventive approaches, while having clearer R&R and more workforce dedicated to student mental health programs and attracting more parental cooperation and support.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.472-485
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• 2019

Purpose: This study aimed to develop and evaluate the effectiveness of an adapted health literacy self-management intervention for elderly cancer patients undergoing chemotherapy. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol and was based on Fransen et al's causal pathway model. A quasi-experimental trial was conducted on a total of 52 elderly patients (26 in an experimental group and 26 in a control group) undergoing chemotherapy in Korea. The intervention consisted of seven sessions over 5 weeks. The experimental tool for this study was an adapted health literacy self-management intervention, which was designed to promote a reduction in the symptom experience and distress of elderly cancer patients through the promotion of self-management behavior. To develop efficient educational materials, the participants' health literacy was measured. To educate participants, clear communication and the teach-back method were used. In addition, for the improvement of self-efficacy, four sources were utilized. For the promotion of self-management behavior, five self-management skills were strengthened. Data were collected before and after the intervention from June 4 to September 14, 2018. The data were analyzed with SPSS/WIN 21.0. Results: Following the intervention, self-management knowledge and behavior and, self-efficacy significantly improved in experimental group. Symptom experience and distress decreased in the experimental group compared to the control group. Conclusion: The self-management intervention presented in this study was found to be effective in increasing self-management knowledge and behavior and, self-efficacy, and ultimately in reducing symptom experience and distress for elderly patients undergoing chemotherapy.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.351-361
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• 2010

Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

• Korean Journal of Health Education and Promotion
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• v.32 no.4
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• pp.37-46
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• 2015

Objectives: This study was conducted to expand evidence-base for the effectiveness of lifestyle intervention programs to prevent the onset of diabetes and cardiovascular diseases. Methods: Seven intervention studies between 2006 and 2014 at Korea Association of Health Promotion were analyzed. All the studies were randomized controlled trials(RCTs) and included multi-component behavioral interventions. The participants of the programs were 2,172 adults with risk factors regarding metabolic syndrome criteria. The proportions of normalized participants were compared within and across the studies using odds ratio effect sizes. Results: The reductions in the prevalence of metabolic syndrome were from 49.6% to 65.1% in intervention groups, and from 38.7% to 52.3% in comparison groups. Significant differences in effectiveness between groups were found in two studies, one in 2006 with odds ratio of 1.69(p<0.01) and another in 2009 with odds ratio of 2.36(p<0.001). Proportions of normalized participants were higher in blood pressure(31.9% to 52.5% in the intervention groups and 23.0% to 43.3% in comparison groups) than other risk factors. Abdominal obesity showed weakest improvement after the intervention in both groups. Conclusions: Lifestyle modification program is an effective method to reduce diabetes and cardiovascular risks in adults by decreasing the prevalence of metabolic syndrome and its components.

• The Journal of Korean Society for School & Community Health Education
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• v.8 no.1
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• pp.13-27
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• 2007

The role of school as a key setting for health promotion practices should be empathized. However, there were limitations for the effectiveness of school health promotion practices in Korea because of the lack of recognition about its importance, social support, guiding principles of the school health promotion services by the school health related law, and cooperation between school and community. The purpose of this study was to analyse the advanced cases from The United States, Japan, Europe and Australia, and to evaluate the applicability to school health promotion services in Korea for establishing the strategy for effective implementation of school health promotion program in Korea. Four cases of school health program were selected for analysis, including Coordinated School Health Program and National School Health Strategies in the USA, Healthy Japan21, National School Health Initiative in Australia and the European Network of Health Promoting Schools. Major conclusions were as follows: 1. Advanced cases of school health programs were comprehensive in nature. 2. Integrated school and community health promotion efforts was emphasized. mostly. 3. Governmental agencies played an active role in conducting surveillance activities to monitor priority health risk behaviors, developing school health program and training manual, providing periodic program evaluation. 4. Life skill focused health education was the key component for the comprehensive school health program. For the improvement of efficiency in school health promotion practices, above advanced strategies for school health promotion program would be necessary.

• Journal of Korean Public Health Nursing
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• v.32 no.2
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• pp.235-248
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• 2018

Purpose: This qualitative study examined the participation in ICT-based management from the perspectives of patients with chronic diseases. This study was conducted as one of several studies evaluating the effectiveness of chronic disease management in the Ministry of Health and Welfare. Methods: Focus group interviews were used as its guiding methodology. Group interviews with 16 patients were carried out using semi-structured interview questions developed from a literature review and discussion with researchers. Content analysis was used to analyze the data. Results: A total of 11 sub-themes were extracted through a comparison of the concepts and semantic analysis, and finally, four themes were derived: "Satisfied with systematic management of health care", "Leading in health care", "Understanding the pattern of blood pressure and blood sugar change" and "Adherence to existing health care habits". Conclusion: This study is meaningful in that it used qualitative analysis through FGI to evaluate the effects of an ICT-based chronic disease management project. Based on this study, a mixed-method design study and an intervention study among patients with metabolic syndrome is proposed.

• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.18-30
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• 2017

This study was performed to analyze systematically and validate empirically the influence of korean medicine service quality on satisfaction factors and revisiting intention. The candidates were patients visiting the one korean medicine hospital in Gyeongnam. We took a direct survey collected during 15 days May 1 to 15, 2016. For the survey I distributed a total of 250 questionnaire and used the final 230 of them in verifying this research model except unreliable data. The collected data were used statistics program SPSS WIN 22.0 and the research model were examined by AMOS 18.0. The main research results are follows. First, the most influencing factors on consumer satisfaction were public image factors and then human factors. and then effectiveness factors. Second, the most influencing factors on reuse intention were public image factors and then physical factors. Third, human and effectiveness factors of service quality factors in korean medicine hospital did not effect on revisiting intention directly but, effected on revisiting intention through mediation role of the customer satisfaction. Forth, satisfaction on the significant effect on reuse intention. so satisfaction has proved to be a important factor for reuse intention. The results of this study are expected to contribute to management efficiency and developmental improvement on korean medicine hospital policy and management efficiency and be used as a basis for leading to national health promotion through the development of korean medicine service.

• Journal of Home Health Care Nursing
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• v.31 no.1
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• pp.66-76
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• 2024

Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.

• The Korean Journal of Health Service Management
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• v.9 no.1
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• pp.169-178
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• 2015

This study implemented a health support network project to improve the quality of life of women with musculoskeletal disorders. These activities were intended to analyze the effects of the impact on the quality of life of women with musculoskeletal diseases, continuing to base their future needs for materials and practice so as to provide a method for this purpose. On August 19, 2013 through December, a survey of 320 people living in Seoul included 31 women with symptoms of musculoskeletal disorders. Another, 16 weeks led to a total of 127 people with housewives screened as a subjects for social support networks projects. After the research, the health support network project was implemented, and most musculoskeletal pain was reduced, depression levels were reduced, and a quality improvement was noted in health-related life activities. In particular, mental- health-related quality of life was found to increased. As incidental factors that may cause musculoskeletal disorders, marital status, living with family, low income, and a high depression index were related to low health-related quality of life. Future studies can support continued health at the local business community level rather than with smaller samples. This work can also be supported by follow-up studies to evaluate the effectiveness of program.