• 제목/요약/키워드: tailored medicine

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Facilitator Psychological Constructs for Mammography Screening among Iranian Women

  • Taymoori, Parvaneh;Moshki, Mahdi;Roshani, Daem
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7309-7316
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    • 2014
  • Background: While many researchers often use a theoretical framework for mammogram repeat interventions, it seems they do not apply an identified mediation analysis method. The aim of this study was to determine the mediators of mammogram replication behavior in two tailored interventions for non-adherent Iranian women. Materials and Methods: A sample population of 184 women over 50 years old in Sanandaj, Iran, was selected for an experiment. Participants were randomly allocated into one of the three conditions: 1) an intervention based on the Health Belief Model (HBM) 2) an intervention based on an integration of the HBM and selected constructs from the Theory of Planned Behavior (TPB), and 3) a control group. Constructs were measured before the intervention, and after a 6-month follow-up. Results: Perceived self-efficacy, behavioral control, and subjective norms were recognized as mediators in the HBM and selected constructs from the TPB intervention. Perceived susceptibility, severity, barriers, self-efficacy and behavioral control met the criteria for mediation in the HBM intervention. Conclusions: This study was successful in establishing mediation in a sample of women. Our findings enrich the literature on mammography repeat, indicating key intervention factors, and relegating redundant ones in the Iranian populations. The use of strategies to increase mammography repeat, such HBM and TPB constructs is suggested to be important for maintaining a screening behavior, once the behavior has been adopted.

서울시 지역주민의 인구.사회경제적 특성별 정신건강 실태 및 스트레스 (Mental Health and Stress by Socio-Demographic Characteristics among Seoul Citizens)

  • 손애리;김태경;류은정;오경재;안동현
    • 보건교육건강증진학회지
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    • 제27권1호
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    • pp.71-80
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    • 2010
  • Objectives: This study furthers the currents understanding of mental health status and stress level among Seoul citizens and to identify differences according to socio-demographic variables for developing mental health programs. Methods: The study subjects using cluster-stratified sampling method were 1234 adults over 19 years old from 17 dong, S-Ku in Seoul City. A cross-sectional study with face-to-face interview was used to collect data. A questionnaire measuring socio-demographic variables, Symptom Checklist-90-Revised (SCL-90-R) and psychosocial wellbeing index-short form (PWI-SF) was utilized. Results: Three findings in this study were discussed: (1) The rate of clinical mental health was low in contrary to that of border group which was high and the rate of high risk group of stress was 68.1% (men 67.0%, women 69.0%); (2) The mental health and the stress level was significantly higher among female, elderly, lower education level, divorced, and lower family income; and (3) In Pearson correlation analysis, stress were correlated to all 9 symptoms of SCL-R. Conclusion: The findings suggest that the future intervention of Mental Health programs should be carefully designed and tailored by socio-demographic variables.

I Do Not Even Say "It" - a Mixed Methods Study on Breast Cancer Awareness of Omani Women

  • Alkhasawneh, Esra;Siddiqui, Saad T;Leocadio, Michael;Seshan, Vidya;Al-Farsi, Yahya;Al-Moundhri, Mansour S
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2247-2254
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    • 2016
  • Background: The incidence of breast cancer is rising in Oman, and the disease is diagnosed at late stages, when treatment success is limited. Omani women might benefit from better awareness, so that breast cancer can be detected early and treated. This study was conducted to assess Omani women's levels of breast cancer awareness and early detection practice, and explore factors which might influence these levels. Materials and Methods: A mixed methods study was conducted in 2014, including a quantitative survey of 1,372 and a qualitative assessment of 19 Omani women, aged ${\geq}20years$ from five Omani governorates using convenient sampling. Demographic information and scores for awareness levels were used in a multivariate regression model to investigate factors associated with awareness. Thematic analysis and interpretive description were used to analyse the qualitative data. Results: The overall means for early detection and general awareness scores were 0.58 (SD 0.24) and 0.46 (SD 0.21), respectively. General awareness was significantly associated with age, education, income and familiarity with cancer patients (p<0.05), while early detection was significantly associated with age, marital status and education. A majority of women (59.5%) agreed with a belief in 'evil eye' or envy as a risk factor for breast cancer. Women discussed various factors which may empower or inhibit awareness, including the cultural-religion-fatalistic system, personal-familial-environmental system, and healthcare-political-social system. Conclusions: The overall low scores for awareness and early detection, and the survey of local beliefs highlight a severe necessity for a contextually-tailored breast cancer awareness intervention programme in Oman.

폐위(肺痿)와 상소(上消)의 관계에 대한 소고(小考) - 『황제내경(黃帝內經)』과 『금궤요약(金匱要略)』을 중심으로 - (A Study on the Relation Between Lung Atrophy Syndrome and Upper Wasting Thirst - Focusing on Huangdineijing and Jinguiyaolue -)

  • 백유상;김도훈
    • 대한한의학원전학회지
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    • 제33권2호
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    • pp.1-12
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    • 2020
  • Objectives : In this paper, lung atrophy syndrome[肺痿] in 『Huangdineijin(黃帝內經)』 and 『Jinguiyaolue(金匱要略)』 were compared, followed by examining its relation with upper wasting thirst[上消]. Also, ways in which psychological factors that contribute to lung atrophy syndrome could cause upper wasting thirst were studied. Methods : Verses from 『金匱要略·肺痿肺癰咳嗽上氣病脈證治』 and 『素問·痿論』 were analyzed based on various annotators's opinions to determine the cause and mechanism of lung atrophy syndrome and its relationship with upper wasting thirst. Results : In 『Jinguiyaolue(金匱要略)』, lung atrophy syndrome is described as the heat of the upper body entering the lungs to dry it out. The description in 『Suwen(素問)』 differs in that it accompanies atrophy symptoms, but the mechanism is the same. Lung atrophy syndrome in 『Jinguiyaolue』 could come from wasting thirst, while wasting thirst can be accompanied in deficiency caused by chronic lung atrophy syndrome. Heat in the lungs is caused by psychological factors where the person has lost its subject of possession or was unable to attain what was desired. When expanded to include heart atrophy syndrome[心痿] and lung atrophy syndrome[肝痿], the reason for upper wasting thirst could include immense sadness or excessive indulgence in pleasure due to unmet desires. Conclusions : Although diabetes and wasting thirst are not identical, application of wasting thirst pattern differentiation to diabetes treatment and management could lead to tailored treatment of each patient. Moreover, the five zhang pattern differentiation from the 『Suwen(素問)』 could increase treatment efficacy when applied to conditions caused by stress and emotional disorder, which are increasingly playing larger roles in causing wasting thirst, or diabetes.

단일만성질환과 복합만성질환 의료급여수급자의 사례관리요구도 비교 (Comparing the Needs of Case Management between Medical Aid Beneficiaries with Simple and Multiple Chronic Diseases)

  • 안양희;서연옥;함옥경;김희경
    • 재활간호학회지
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    • 제18권2호
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    • pp.98-106
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    • 2015
  • Purpose: The purpose of this study was to compare the needs of case management between Medical aid beneficiaries with simple and multiple chronic diseases (SCD vs MCD). Methods: The study employed secondary analysis method using a cross-sectional data from 2009 case management service enrollees. Data on 35,862 beneficiaries who have chronic disease(s) were used in the description of chronic disease characteristics, and data on 20,392 beneficiaries, excluding those who have depression and/or disabilities, were used to compare the group differences. Results: Mean age was $68.8{\pm}11.63years$, and 73.3% were females. MCD group showed an older age, had more women than SCD group. Self-care ability and appropriateness of health care utilization were significantly different between the groups, but there was no difference in health-related quality of life. In subscales, there were significant differences in general health status, depression, symptom management, healthy lifestyle, hygiene and vaccination, and appropriateness of health utilization. Conclusion: Different characteristics between patients with simple and multiple chronic diseases indicate that different case management approaches are required for these groups. The study results could be used as a basis for the development of case management model tailored to the characteristics and needs of medical-aid beneficiaries.

국내 돼지오제스키병의 혈청학적 감시활동(surveillance)을 위한 표본크기 (Sample size for serological surveillance of Aujeszky's disease in Korea)

  • 김으뜸;박선일;박최규;권창희
    • 대한수의학회지
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    • 제47권4호
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    • pp.417-423
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    • 2007
  • Serological surveillance programs in animal populations are becoming increasingly important to estimate prevalence of a specific disease and subsequently to document disease-free status in a region or a country. For these purposes, the programs need to be based on both theoretical and economical aspects from the designing phase. From Aujeszky's disease (AD)-eradication program point of view, group of animals (aggregates, herds) not individual animal is the more important sampling unit of concern. In this study the authors therefore attempted to compute an appropriate sample size tailored to a current surveillance program against AD, assuming that the goal of this program is either herd-level prevalence estimation or documentation of AD-freedom. For prevalence estimation, assuming a finite population with imperfect sensitivity (Se) and specificity (Sp) of ELISA kit for AD diagnosis, the number of herds present, expected herd prevalence, and desired accuracy for a certain level of confidence, sample size was estimated at herd-level in the first stage and individual animal-level in the second stage. A two-stage sampling design was used to calculate a sample size to indicate AD-freedom. In this instance, the computation was based on the possible detection of a predetermined prevalence at a certain herd-level Se and Sp. This study indicated that the sample size varied with predetermined confidence, tolerance, Se and Sp at herd- and animal-level, and within- and among-herd prevalence. In general, smaller sample size was required to estimate AD prevalence than to document of AD-freedom. Compared to individual-based samples, two-stage sampling strategy requires a larger sample size to show disease-freedom. Statistical considerations including herd-level test characteristics when designing surveillance program also are further discussed.

하지에 시행한 박근 유리 판 이식술 - 32예 분석 - (Gracilis Muscle Free Flap Transplantation in the Lower Extremities - 32 Cases Snalysis -)

  • 이준모;김학지;김용민;박재규
    • Archives of Reconstructive Microsurgery
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    • 제13권1호
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    • pp.58-62
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    • 2004
  • Purpose: To cover the exposed tendons and bones after trauma and cure the concomitant osteomyelitis in the lower extremities, gracilis muscle free flaps are frequently preferred. 32 cases of gracilis muscle free flap we had done were analysed according to the indications, specification of flap length and width, pedicle length, vessels used in the anastomosis and final healing after at least over 1 year follow up. Materials and methods: From August 1995 through November 2002, we have performed 32 cases of gracilis muscle free flap transplantation with the general microsurgical procedures in the lower extremities. Open fracture of the middle and distal tibia were 12, exposed heel 6, crushing injury in the foot 5 cases, open fracture of the ankle 4, chronic osteomyelitis of the tibia 3 and osteomyelitis of the tarsal bones 2. Tailored flap length were ranged from 16 cm to 4 cm, width were from 5cm to 4cm. Pedicle length averaged around 4 cm. Anastomosis of one artery and two veins in both of donor and recipient were performed in 17 cases and one artery and one vein in 15 cases. Results: All flaps were survived, except 2 cases. Final flap healing was satisfactory to both of the patients and microsurgeon. Conclusion: Gracilis muscle free flaps are frequently chosen to cover the exposed components and cure the osteomyelitis in the lower extremities.

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버스운수업 종사자의 뇌심혈관질환 예방을 위한 개별상담 효과: 이차자료분석 (The Effects of Individual Counseling for Bus-drivers to Cerebrovascular and Cardiovascular Disease Prevention: Secondary Data Analysis)

  • 정혜선;엄미정;장인순
    • 한국직업건강간호학회지
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    • 제24권4호
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    • pp.281-289
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    • 2015
  • Purpose: This study was conducted to examine the effects of individual counseling for bus-drivers on cerebrovascular and cardiovascular disease prevention. Methods: The one-group pretest-posttest design was used. This study presents a secondary analysis of data collected in 'contents of cerebrovascular and cardiovascular disease prevention program for bus-drivers in one workplace in Seoul, Korea. The data were collected from 56 bus drivers, using questionnaires from September 10th to November 20th, 2014. The analysis was conducted with ${\chi}^2$ test and paired samples t-test using SPSS/Win 21.0. Results: After the intervention, the participants showed a significant decrease in the level of systolic blood pressure (p=.003) and a significant increase in the total cholesterol level (p=.030). The distribution of cardiovascular risk groups changed after the intervention: 5.3% decreased in the high risk group, 16.1% decreased in the medium risk group, and 3.5% decreased in the low risk group, while 25.0% increased in the normal group. Conclusion: The comprehensive individual counseling including simple screening, tailored education and counseling is effective to manage their lifestyle risk factors, resulting in better maintenance of their health as well as preventing cerebrovascular and cardiovascular disease.

만성 B형 간질환 환자의 정신사회적 측면 (The Psychosocial Aspects of the Patients with Chronic Hepatitis B)

  • 김진성
    • 정신신체의학
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    • 제8권1호
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    • pp.3-10
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    • 2000
  • 연구목적 : 저자는 만성 B형 간질환 환자의 정신과학적 측면과 사회학적 측면을 관찰해 보고자 본 연구를 실시하였다. 방법 : 저자는 1966년부터 1999년까지의 Medline database에 등록된 B형 간질환에 관한 모든 문헌들을 고찰하였다. 결과 : 만성 B형 간질환 환자와 관계되는 정신과학적 측면은 섬망, 전반적인 의학적 상태에 기인하는 정신병(특히 조증), 불안, 우울, 적응장애, 알코올 남용과 의존, 및 약물남용과 의존 등이다. 만성 B형 간질환 환자와 관계되는 사회학적 측면은 간염보균자로서의 낙인문제, 감염과 연관된 죄책감, 증가된 가족들의 부담에 대한 죄책감, 대인관계의 소외와 철수, 성장애, 직업상실 및 의료진의 치료 거부등이다. 결론 : 만성 경과를 거치는 B형 간염환자의 여러 가지 정신과학적 사회학적 문제로 볼 때, 적절한 조기의 교육적 상담 개업이 필요하다고 하겠다. 적절한 교육적 상담 개입은 간염으로부터 간경화 간암으로의 진행과정에 B형 간염환자의 치료의 순응도를 높이고 나아가 악화의 과정을 예방할 수 있다.

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A Cross-sectional Study of Cancer Knowledge and Beliefs Among Faith-based Chinese in the USA Versus Taiwan

  • Hou, Su-I;Cao, Xian
    • Journal of Preventive Medicine and Public Health
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    • 제52권1호
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    • pp.60-65
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    • 2019
  • Objectives: This study examined cancer knowledge, beliefs, and practice among faith-based Chinese in the USA versus Taiwan to gain better understandings on how environment and culture might play a role for tailored cancer education programs. Methods: A self-administered survey included a validated 10-item Cancer Screening Belief Scale (CSBS), an 8-item Cancer Screening Knowledge Test (CSKT), and a 14-item cancer Warning Signs Test (CWST) was administered. Participants were recruited from 9 Chinese churches (5 in the USA and 4 in Taiwan). Results: A total of 372 Chinese participated, 50% lived in the USA and 50% in Taiwan. Mean age was 44.31 (standard deviation, 14.74), 60% males, and majority had college education (85%). Taiwan participants scored higher on both CSKT (6.13 vs. 5.52; p<0.001) and CWST (6.80 vs. 5.38; p<0.001). Although perceived screening benefits and barriers were similar, Taiwan participants endorsed higher on screening norms (11.67 vs. 10.82; p<0.001). Taiwan participants also indicated more doctor recommending cancer screenings (42.1% vs. 29.6%; p=0.015), USA participants were more likely to have had annual health exams (65.4% vs. 48.9%; p=0.002). Regression results showed that those resided in the USA were 2.38 times more likely to report annual health exams. Married status (odds ratio [OR], 2.85), college education (OR, 2.38), doctor's recommendation (OR, 2.87), no family cancer history (OR, 2.47), and those with lower barriers were significant factors on annual health exams. Conclusions: Taiwan participants scored higher on cancer knowledge and screening norms, while more USA participants reported annual health exams. Taiwan's universal healthcare might play a role on the different healthcare seeking patterns.