• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.39-51
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• 2003

Objectives: The oriental medical care has been getting popular in community health centers because of uniqueness, changing of disease patterns, and increasing of elderly population. From 1998, oriental medical doctors has been working in several rural community health centers for their military obligations. At this point of time, it is necessary to evaluate the oriental public health doctors system. This study was performed to investigate the utilization patterns, the degree of satisfactions, needs of oriental medical care service provided by community health center in a designated Gun area. This study focused on the need for extending over Myun area of community health center's oriental medical care services. Methods: Person-to-person interview survey method through a structured questionnaire was done by a personnel at a oriental medical care service room in a Gun community health center. The major statistical method used for the analysis were the t-test, ANOVA, and logistic analysis. Results: The total number of responded subjects in this study was 163 residents. Among these 65.0% were aged 61 or over, and only 13.5% recognized themselves were healthy. 73.7% of the respondents demanded establishment of more oriental medical care services provided by community health center to other Myun area. Factors affecting the need for enlargement of oriental medical care service room were education level, subjective awareness of access to community health center, and cost satisfaction of oriental medical service provided by community health center. Thus, a resident who had graduation of middle school achievement or above(OR=3.35), had a long way to center(OR=2.47), satisfied with oriental medical service cost(OR=2.78) had demonstrated increased chance of need by logistic regression analysis.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.1-14
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• 2005

Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

• The Korean Nurse
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• v.31 no.4
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• pp.77-99
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• 1992

The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.187-194
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• 2015

Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

• Journal of agricultural medicine and community health
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• v.46 no.2
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• pp.78-88
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• 2021

Objectives: This study aimed to investigate health risk awareness pertaining to fine dust exposure and the use of face masks in farmers, as well as their attitude toward education regarding fine dust-related respiratory disease prevention. Methods: In total, 295 farmers were interviewed in a survey using a structured questionnaire to obtain data on general characteristics, farming-related characteristics, health risk awareness pertaining to fine dust exposure, attitude toward education on fine dust-related respiratory disease prevention and the use of face masks. This study was analyzed the correlation between the perceived susceptibility to fine dust exposure and willingness to participate in education on fine dust-related respiratory disease prevention. Results: The mean score for perceived susceptibility to fine dust exposure was 3.8 (out of 5), and the participants were highly willing to receive education on fine dust-related respiratory disease prevention. In Multiple response analysis of reactions to exposure to fine dust generated during work, 221 participants responded that they practiced at least one preventive action; participants gave a positive response to "wearing masks" (56.1%), "personal hygiene, such as hand washing." (52.9%). In terms of education methods, 94 (33.6%) participants preferred to learn online or via text messages. Conclusions: The significant correlation between the perceived susceptibility to fine dust exposure and willingness to participate in education on fine dust-related respiratory disease prevention shows the importance of promoting education on prevention. The results of this study can help understand as reference for education on fine dust-related respiratory disease prevention.

• Journal of agricultural medicine and community health
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• v.37 no.4
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• pp.215-222
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• 2012

Objective: A prediabetes hemoglobin A1c (HbA1c) level of 5.7%-6.4% is considered a risk factor for diabetes mellitus and cardiovascular disease (CVD) in the USA. In this study, we assessed the HbA1c and visceral fat levels as CVD risk factors in health check-up examinees who were not yet diagnosed with diabetes. Methods: Totally, 507 study subject were categorized as per criteria of the American Diabetes Association, depending on whether the HbA1c level was ${\geq}5.7%$ or <5.7%. Lipid levels, blood pressure, BMI (kg/$m^2$), total abdominal, and visceral fat levels were measured by computed tomography. Results: The mean of HbA1c in the male group was larger than the mean in the female group and their values were, respectively, $6.03{\pm}0.82%$ and $5.88{\pm}0.72%$(p<0.05). Only the mean values of age and visceral fat area were different between $HbA1c{\geq}5.7%$ and <5.7% in both male and female group(p<0.05). Visceral fat levels were significantly associated with HbA1c in the group of HbA1c ${\geq}5.7%$ (odds ratio=1.005, 95% CI 1.002~1.008). Conclusions: Visceral fat levels were significantly higher and correlated with the group which HbA1c level is ${\geq}5.7%$. This finding suggests that subjects who have high levels of HbA1c should be carefully monitored during prediabetes and should have chance to have health education programs.

• Journal of agricultural medicine and community health
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• v.44 no.1
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• pp.28-38
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• 2019

Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.134-144
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• 2008

Purpose : This study aimed to investigate body shape perception, weight control behaviors and eating habits of adolescent girls in urban, suburban and rural areas of Korea to obtain basis for establishing adequate weight control program for adolescent. Methods : From May 2002 to November 2002, a cross-sectional questionnaire survey and physical examination were conducted to examine body shape perception, weight control behaviors, eating habits and health status of 2,891 adolescent girls and 891 boys in Seoul, Ansan and Paju. Results : The proportion of underweight adolescent girl was decreased in rural area than in urban area. 46.3% of girls considered themselves to be somehow or very obese. Notably 3.2% of underweight girls considered themselves obese. 57.9% were unsatisfied with their own body shape. The proportion of dissatisfaction increased with age and body mass index (BMI), but there were no differences among area. The experiences of weight control increased by age, BMI and dissatisfaction of own body shape. The eating attitudes test-26 (EAT-26) score of girls was significantly higher than that of boys. The girls with high risk of eating disorder were 10.9%. And risk factors of eating disorder were living in urban area, severe stress for weight control excessive expenditure for appearance and think themselves unhealthy. Conclusion : The findings of this study demonstrate that there were serious impairment of body shape perception of adolescent girls and unhealthy, inadequate weight control behaviors were widely done. Therefore adequate weight control program for adolescent girl should be established promptly.

• Journal of Preventive Medicine and Public Health
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• v.33 no.2
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• pp.199-207
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• 2000

Objectives : This study was peformed to identify the risk factors related to the development of hypertension in a rural area. Method : Total of 3,573 subjects in Chung-Song County were interviewed and examined in 1996. The study cohort comprised 2,580 hypertension-free subjects aged above 20. One-year follow up was completed for 1,781 subjects(69.0%) in 1997. General characteristics(age, gender, education level, economic status, marital status), the family history of hypertension, diet, alcohol, smoking, coffee, stress, past history of oral contraceptive and menopausal status in female, height, weight, waist and hip circumference, baseline blood pressure, and serum total cholesterol were considered as risk factors. Results : Multivariate analysis using logistic regression model indicated that age(RH=1.50, 95% CI; 1.15-1.96), the family history of hypertension(RR=2.11, 95% CI; 1.04-4.26), waist-hip ratio(WHR) (RR=2.09, 95%, CI; 1.15-3.79), and baseline systolic blood pressure(130-139/<120mmHg)(RR=3.34, 95% CI; 1.47-7.60) were significant risk factors associated with the development of hypertension above the borderline level in male. In female, age(RR=1.06, 95% CI; 1.03-1.09), change in menopausal status$(no{\rightarrow}yes/no{\rightarrow}no)$ (RR=3.32, 95% CI; 1.01-10.87), baseline systolic blood pressure(120-129/<120mmHg: RR=2.00, 95% CI; 1.02-3.90)(130-139/<120mmHg: RR=2.64, 95% CI; 1.34-5.20) and baseline diastolic blood pressure(85-89/<80mmHg)(RR=4.09, 95% CI; 1.86-8.96) were identified as risk factors. Conclusions : Age and high normal blood pressure were significant risk factors for the development of hypertension above the borderline level. In addition, the family history of hypertension and WHR in men, and the change of menopausal status in women might be significant risk factors in Korea.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).