The purpose of this study is to estimate the minimum optimal scale(MOS) of the self-employed health insurance associations. Considering the high proportion of operating expenses, the author have selected 254 regional health insurance associations from the 1990 Finance Report of the self-employed health insurance programs. both a quadratic function and a hyperbolic function were chosen for the analysis. The dependent variables are the average maintenance cost per insured person and per household, and the independent variables are the number of insured members and of household. The minimum optimal scale was obtained from the differentiation of the quadratic function. Major findings are summarized as follows: 1. The M.O.S. was calculated as 166,174 members (27,442 households) for the rural self-employed health insurance associations and 258,462 members (75,446 households) for the urban. Providing that both the rural and urban health insurance associations would e integrated, the M.O.S. be found to become 231,687 members (68,101 households) 2. Compared with the optimal minimum scale, the magnitude of the current health insurance association found to be much smaller, less than half of the optimal scale. 3. In order to reduce the operating cost, it is necessary to enlarge the operational scale of self-employed health insurance associations.
Family Characteristics ; Humans ; Insurance ; Insurance, Health* ; Korea* ; Urban Health

The purpose of the study was to find the sociopsychological factors predicting the intention of compliance with the dietary regimen in diabetes with a questionnaire. Data were collected from 282 adult noninsulin-dependent diabetics in Seoul, Kyoggida, and Kyongsangbukdo in Korea. Stepwise multiple regression analysis was conducted with predictor variables from theories of the Health Belief Model, Social Cognitive Model, The Theory of Reasoned Action, and Social Support. The behavioral intention of compliance with the prescribed diet was the independent variable. Subjects norm self-efficacy knowledge about diet therapy, outcome expectation, relationship with medical team, threat of deterioration of disease, and social support were the independent variables, The mean score of behavior intention was high ie 35.3 out to 42. Subjective norm and self-efficacy were the significant variables to predict the intention of dietary compliance. These variables comprised 39% of the common variance. To increase dietary compliance by influence of the referents and improve self-efficacy significant referents must be included and concrete and practical methods to follow the dietary regimen must be provided in nutrition education.
Adult ; Compliance* ; Diet ; Diet Therapy ; Education ; Humans ; Intention ; Korea ; Seoul ; Surveys and Questionnaires

The purpose of this study was to find the sociopsychological factors influencing the compliance of dietary regimen in diabetes by using focus group interviews. The data were collected from fifty three diabetes patients in eleven focus groups from September 1997 to March, 1998 in Seoul and Suwon Korea. The interviews were tape-recorded and the contents of the interviews were analysed by researchers. The subjects knew the causes, complications, and therapies of diabetes although they were incorrect at times . Patients had a wide range of outcome expectations from very optimistic to pessimistic. They recognized diabetes as a disease which needs life-time care, and they though that good care could provide a normal life. One the other hand they thought diabetes could lead to death through complications, and cause financial problems as well as social isolation. As for self-efficacy they recognized the importance of compliance to diet regimen but they thought the diet therapy was very difficult and were not very willing to follow it. They felt medical professionals, especially doctors, were influential for the therapies. However they frequently felt counselling provided by doctors was insufficient in time and content and led to attitude problems. They felt support from families and others was often insufficient and inadequate. Nutrition education fostering outcome expectation, social support, and self-efficacy is needed to increased compliance. The most influential referents were medical professional including doctors, nurses, dieticians, so their role in diet therapy should by emphasized.
Compliance* ; Diabetes Mellitus ; Diet ; Diet Therapy ; Education ; Focus Groups* ; Foster Home Care ; Gyeonggi-do ; Hand ; Humans ; Korea ; Nutritionists ; Seoul ; Social Isolation

This study was conducted to investigate preference for convenience food and dietary attitude in college students in Seoul and Kyunggi-do area. This study used a questionnaires as instrument tool. Thequestionnaire consisted of socio-demographic characteristics of the subjects, the valuation of preference for convenience, the concern of nutrition, and the dietary attitude. The subject were 199 males and 137 females. The mean age of subjects was 22.4+/-2.3year. The results have been summarized as follows Male students preferred more convenience food than females. Male students liked chicken, ice cream, ramyeon, pizza.hamburgerandfemalestudentslikedchicken,pizza, ice cream, ramyeon.hamburger. The kinds of convenience foods for a substitute meal were ramyeon, hamburger, bread, potato in male group and female group had frequently ramyeon, hamburger, bread, rice cake for a substitute meal. Male students were more likely to eat ramyeon (p<0.01) and purchased sabalmyeon The subjects used to purchase sabalmyeon as main convenience food at convenient store The score of preference for convenience food in male group was higher than female group. The score of attitude toward balanced diet in female group was higher than male group(p<0.01). In scores of concern for nutrition information, balanced diet, and nutrition knowledge, Female group had higher scores of concern for nutrition information, balanced diet, and nutrition knowledge than that of male group (p<0.01).There was no significant difference in the degree of preference for packing types, however, Male group tended to prefer more micro wave type than female group. The persons to affect the consumption of convenience food were friends. There was no significant difference in the time of purchase convenience food, however, Male tended to purchase convenience food at the time of snack than female group. As a results, proper nutritional education and qualitative development of convenience food are required in order to improve the consuming attitude of consumers and their preference for convenience food.
Bread ; Chickens ; Diet ; Education ; Fast Foods ; Female ; Food Preferences ; Friends ; Gyeonggi-do* ; Humans ; Ice Cream ; Male ; Meals ; Surveys and Questionnaires ; Seoul* ; Snacks ; Solanum tuberosum

Background/Aims: Esophageal cancer is not an uncommon cancer in Korea, however, the prognosis still remains very poor with a 5 year survival rate bemg less than l0% mainly becauae of the delayed diagnosis. Although chromoscopy with lugol solution has been received to diagnose the esophageal cancer in an early stage without difficulty, its clinical use has not been popular yet in Korea. This study was performed prospectively to evaluate the usefulness of the chromoscopy for the detection of superficial esophageal cancer in risk patients for esophageal cancer. Methods: Ninety-five patients were selected among persons who received gasiroscopy at Asan Medical Center between Jan. 1996 and May 1996 and were prospectively included for chromoscopy. Inclusion criteria for the chromoscopy were patients older than 60 years of age with smoking history of more than 30 packyears, and/or past or family history of cancers. After conventional endoscopic examination, lugol solution was sprayed to stain the glycogen granules in the epithelial cells. The size of unstained lesion was measured and stainability was classified into 5 grades. All lesions unstained were biopsied for histological diagnosis.(continue...)
Chungcheongnam-do ; Delayed Diagnosis ; Epithelial Cells ; Esophageal Neoplasms* ; Glycogen ; Humans ; Korea ; Prognosis ; Prospective Studies ; Smoke ; Smoking ; Survival Rate

BACKGROUND AND AIMS: Bleeding from a peptic ulcer is one of the common and serious complications associated with the rate of reported mortality, which ranges from 5% to 10%. Endoscopic therapy is effective in controlling active bleeding and reducing the emer-gency surgery, the immediate mortality rate and the incidence of early rebleeding. But few recent studies have documented the long-term recurrent bleeding rate after discharge in patients with bleeding peptic ulcers. The aim of this study was to determine the long-term recurrent bleeding rate and factors predisposing to recurrent bleeding. METHODS: Eighty-eight patients with bleeding peptic ulcers discharged after medical treatment between Dec. 1990 and Jul. 1992 were included in this study and retrospectively followed up with medical records and telephone interviews. The end point of follow-up was recur-rent hemorrhage, surgery for treatment of ulcer complication, or death. RESULTS: By July 1997, retrospective follow-up was available in 76 patients. Recurrent bleeding occurred in 23 patients (30.3%) with bleeding peptic ulcers and the median follow-up period was 69 months (range, 1 ~79 months). The estimated cumulative recurrent bleeding rate after 1, 2, 3, 4, 5 and 6 years was 11.8%, 14.5%, 19.9%, 24.2%, 27.2% and 34.2%, respectively. There was no difference between the recurrent bleeding group and the non-recurrent bleed-ing group according to age, sex, prior NSAIDs use, previous history of bleeding or pepticulcer, site of ulcer, stigmata of recent hemorrhage at initial examination, method of treatment and amount of transfusion. CONCLUSION: Recurrent bleeding occurred in one-third of patients with bleeding peptic ulcers after 6 years of follow-up and one-third of recurrent bleeders rebled within 1 year. The factors predisposing to recurrent bleeding in the long-term follow-up could not be found. Therefore, further studies designed to identify factors predisposing to recurrent bleeding are needed and the evaluation of Helicobacter pylori status in bleeding peptic ulcer is needed because Helicobacter pylori is an important factor of peptic ulcer recurrence.
Anti-Inflammatory Agents, Non-Steroidal ; Christianity ; Follow-Up Studies ; Helicobacter pylori ; Hemorrhage* ; Humans ; Incidence ; Interviews as Topic ; Medical Records ; Mortality ; Peptic Ulcer* ; Recurrence ; Retrospective Studies ; Ulcer

PURPOSE: This was to describe the emotions that patients face when diagnosed with cancer to know the problems and coping styles that cancer patients experience during the treatment. METHOD: The qualitative method was used for this study. The participants were 90 cancer patients at five general hospital in Pusan, Korea. Data were collected by interviews with a semi-structured questionnaire from November 2000 to June 2001, and were analyzed using the modified constant comparative method. RESULT: The most common emotions on the diagnosis of cancer were shock(36.7%), followed by despair(25.6%), acceptance(24.4%), denial(18.9%), complaint(16.7%), and fear(8.9%). The problems identified were the unpleasantness and physical discomfort related with the treatment(50.0%), the feelings of burden(41.1%), finance/occupation(38.8%), and fear of the future(26.6%). Coping styles to problems that the subjects have faced on the course of the treatment were compliance(36.6%), health care(31.1%), positive thinking(22.2%), despair/avoidance(15.5%), seeking social support(6.6%), information seeking(3.3%) and self-control(2.2%). CONCLUSION: It is very important to develop nursing interventions which can mitigate shock that patients experience, can help cancer patients to have hope for the future and to positively cope with cancer.

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic

We evaluated the role of endoscopic laser therapy and strip biopsy in the treatment of gastric flat adenoma. Over a period of three years, l6 adenomas in 13 patients were ablated with laser irradiation, while 10 adenomas in 7 patients were removed with strip biopsy. The size of adenomas, which ranged from 0.5 cm to 3.5 cm in diameter(mean 1.7 cm) showed no significant difference between the two treatment groups. All of the adenomas were successfully treated with either method and no complications occurred such as bleeding or perforation. The overall one-year recurrence rate was 6.2%. The recurrent adenoma was retreated successfully. We conclude that both endoscopic laser therapy and strip biopsy are safe and effective modalities in the treatment of gastric flat adenoma, but strip biopay may be preferred over laser therapy because the former enables us to examine the resected specimen.
Adenoma* ; Biopsy ; Follow-Up Studies* ; Hemorrhage ; Humans ; Laser Therapy ; Recurrence ; Stomach

We evaluated the role of endoscopic laser therapy and strip biopsy in the treatment of gastric flat adenoma. Over a period of three years, l6 adenomas in 13 patients were ablated with laser irradiation, while 10 adenomas in 7 patients were removed with strip biopsy. The size of adenomas, which ranged from 0.5 cm to 3.5 cm in diameter(mean 1.7 cm) showed no significant difference between the two treatment groups. All of the adenomas were successfully treated with either method and no complications occurred such as bleeding or perforation. The overall one-year recurrence rate was 6.2%. The recurrent adenoma was retreated successfully. We conclude that both endoscopic laser therapy and strip biopsy are safe and effective modalities in the treatment of gastric flat adenoma, but strip biopay may be preferred over laser therapy because the former enables us to examine the resected specimen.
Adenoma* ; Biopsy ; Follow-Up Studies* ; Hemorrhage ; Humans ; Laser Therapy ; Recurrence ; Stomach