PURPOSE: To investigate the effect of cardiac knowledge and cardiac self-efficacy on health behaviors after controlling for influences from associating factors of health behaviors in patients with coronary artery diseases (CADs). METHODS: A descriptive correlational and cross-sectional design was used. Subjects with CADs were recruited from outpatient clinics of three academic medical centers. The cardiac knowledge, cardiac self-efficacy, and health behaviors were measured by Coronary Heart Disease Awareness and Knowledge Questionnaire, Cardiac Self-Efficacy Scale, and Health-Promoting Lifestyle Profile II respectively. The data collected were statistically analyzed by descriptive statistics, t test, Kruskal-Wallis test, analysis of variance, Pearson's correlation analysis, and the hierarchical multiple regression analysis. RESULTS: A total of 157 subjects were recruited for this study. The mean age of subjects was 59.38 +/- 10.04 years, and three-fourths (75.2%) were male. Subjects showed relatively low cardiac knowledge, moderately high cardiac self-efficacy, and moderate level of health behaviors. The overall model significantly explained 48% of variance in health behaviors (F = 14.52, p < .001). Among predictors, age, education, smoking status, experience of receiving patient education, and cardiac self-efficacy significantly affected health behaviors, and cardiac self-efficacy had the greatest effect on health behaviors (beta = .39). However, cardiac knowledge had no statistically significant influence on health behaviors after controlling for the other factors. CONCLUSION: The findings suggested that cardiac self-efficacy was shown to be the most influencing factor on health behaviors but cardiac knowledge had no influence on health behaviors. The nursing interventions tailored on the patient characteristics should be developed in order to improve the health behaviors of patients with CADs.
Academic Medical Centers ; Ambulatory Care Facilities ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Health Behavior ; Health Status ; Humans ; Life Style ; Male ; Patient Education as Topic ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. METHODS: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. RESULTS: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. CONCLUSION: This study demonstrates that VRI can be safely applied to patients with pneumonia.
Academic Medical Centers ; Ambulatory Care Facilities ; Body Temperature ; C-Reactive Protein ; Cause of Death ; Communicable Diseases ; Hematologic Tests ; Humans ; Leukocyte Count ; Pneumonia ; Primary Health Care ; Respiration ; Thorax ; Vibration

Healthcare accreditation, which in the Republic of Korea is based on Article 58 of the Medical Service Act of July 2010, is an evaluation system designed to improve the quality of medical services and secure patient safety. Although ambulatory health organizations such as clinics comprise the majority of all health facilities, because they are not currently evaluated, securing quality and patient safety nationwide is not possible under the existing system. This article reviewed the accreditation programs of ambulatory health organizations in leading countries such as the United States and Australia in order to propose a successful model for Korea. The Accreditation Association for Ambulatory Health Care of the Unites States is a private, non-profit organization established in 1979. Similarly, Australian General Practice Accreditation Limited is a non-profit organization established in 1997 to deliver services to support general practices in Australia. Both are independent professional organizations and perform accreditation programs by a self-regulatory system. As healthcare quality improvement and accreditation have the characteristics of professional service activities, a self-regulatory approach rather than a government-controlled one, and process-oriented evaluation rather than structure-focused evaluation, are known to be effective. We expect an accreditation program for clinics in Korea to be established using a self-regulatory approach by an independent professional organization, not by the government, in the near future.
Accreditation* ; Ambulatory Care Facilities ; Australia ; Benchmarking* ; Delivery of Health Care* ; General Practice ; Health Facilities ; Korea ; Organizations, Nonprofit ; Patient Safety ; Quality Improvement ; Quality of Health Care ; Republic of Korea ; Societies ; United States

According to law the employer who has over 50 workers in his enterprise should employ an occupational physician as industrial health manager. The main role of the occupational physician is emphasized to the prevention of occupational diseases rather than the treatment and he should be the team leader of industrial health personnel. But this ideal system in terms of stipulations has lots of problems in operation. Therefore this study was designed to prove the attitude of reception, real condition and work content of the occupational physician in enterprise. The survey was done in 500 stratified random sampled enterprises over the country from July through September in 1987 by mailing questionnaire. As a result of the response from 145 enterprises, more than 85% of enterprise displaced occupational physicians. Among the occupational physicians 43% of them has no allowance for their working as industrial health managers and are payed less than 100,000 won monthly. And 66% of them visited only once a month or none enterprise, where they were nominated as a occupational physician managers. The major work content of occupational physician was doing outpatient clinic or regular physical examination rather than prevention of occupational disease. And it shows a deep discrepancy with the object of law or the expect of enterprise in which industrial hygiene and health education are more stressed for prevention of occupational diseases. The most of industrial workers showed no interest in work of occupational physician. As a conclusion, the current system of industrial health manager has maintained on paper formally and is apt to fall into making outward show. It is urgent for government and enterprise to find a solution which can be practically used the system of occupational physician. The work content of occupational physician is required high advanced knowledge and experience, and it should be operated dual system by special field and nonspecial field.
Ambulatory Care Facilities ; Health Education ; Jurisprudence ; Korea* ; Occupational Diseases ; Occupational Health ; Physical Examination ; Postal Service ; Questionnaires

The purposes of the study were to develop an instrument for family value and to identify the relationships of family value, family hardiness, and family adaptation by appling the family value scale to family with cancer children. The study was conducted in three phases. 1) A survey was conducted from July 20 to August 20, 1999 and 18 items of general family value scale was modified from the data of 153 fathers and 164 mothers. 2) In-depth interviews were made with 29 parents of cancer children from April 20, 1998 to May 20, 1999 to develop family value scale with cancer children, and 12 statements were developed. 3) The final survey was conducted from July 18, 2000 to August 30, 2000 and the data from 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics were analyzed to identify the relationships of the concepts. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, and Regression for path analysis. The study findings are as follows. The psychometric testing of general family value scale was Cronbach's alpha = 0.78. The reliability of the family value scale with cancer children showed the reliability as Cronbach's alpha = 0.73. Demographic characteristics showing significant correlations were cancer children's age, period of illness, period after completing treatment, mother's age, mother's education level, monthly income, payment type, confidence with health professional, and severity of children's illness. The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=0.33, p < .001), and negatively related with family hardiness(r=-0.21, p < .001). Family strains was negatively related with family hardiness(r= -0.41, p < .001) and family adaptation(r=-0.46, p < .001). Correlations of family hardiness was positive with family value with cancer children(r=-0.31, p < .001), and negative with general family value(r=-0.16, p < .01). Family hardiness was positively related with family adaptation(r=0.35, p < .001). The causal relationship between study variables showed that family strains predicts general family value( gamma =0.12, t=2.02), family value with cancer children predicts family hardiness( gamma =0.31, t=6.30), family strains predicts family hardiness( gamma =-0.40, t=-7.70), family value with cancer children predicts family adaptation( gamma =-0.23, t=-4.11), and family hardiness predicts family adaptation( gamma =0.43, t=7.78).
Ambulatory Care Facilities ; Child* ; Education ; Fathers ; Health Occupations ; Humans ; Mothers ; Parents ; Psychometrics ; Statistics as Topic ; Child Health

BACKGROUND: With proper management, hypertensive patients can maintain their health and prevent complications. But poor compliance is a main problem for management of hypertension. This study was designed to investigate the reasons among hypertensive patients who did not initiate antihypertensive medication despite recommendations. METHODS: Questionnaires were used for hypertensive patients who visited a health care center and an outpatient clinic of family medicine department in a university hospital, from March to July, 1998. The non-medicated(noncompliant)group were those who had not taken antihypertensive drug at all with high blood pressure(higher than 160mmHg at systolic, or 100mmHg at diastolic phase initially and hypertensive range on the follow up), despite doctor's recommendations. The medicated(compliant) group were those hypertensive patients who had taken antihypertensive drug well and visited the clinic regularly at least for 9 months during the recent 12 months. RESULTS: The total number of the noncompliant was 65, and the compliant 57. The mean age of the noncompliant was 50.8, and the compliant 58.0 years old. The mean blood pressure in the noncompliant was 162.6/106.6mmHg, higher than in the compliant 138.1/85.7mmHg. The main reasons refusing antihypertensive drug were fearful feeling for `lifelong medication'(47.7%), followed by complications from drugs(30.8%). The reason for delaying treatment with antihypertensive drug is that the noncompliant showed more tendency to think `It would be the same', or `better than starting medication early' than the compliant. For the complications from drugs, 59.5% of the noncompliant answered. `I'm not sure, but it'll be not good', and those who answered `it'll be not bad to have medication' seemed to be less than in the noncompliant. CONCLUSION: The patients who had been recommended but did not start on medication had less knowledge about the benefits of medication. We can assume that they are refusing antihyper-tensives because of their excessive anxiety about complications of and lifelong medication.
Ambulatory Care Facilities ; Anxiety ; Blood Pressure ; Compliance ; Delivery of Health Care ; Humans ; Hypertension ; Surveys and Questionnaires

BACKGROUND: No-show is a major obstacle for proper management in outpatient clinic. This study was performed to evaluate the effectiveness of a reminding telephone call on the compliance after no-show patients in family practice. METHODS: A nurse in family practice called to 590 non-compliant patients who did not visit on the appointment day for 80 days. A single telephone call attempt was directed primarily to the patient or family members for them to make another appointment. The outcome measure was an increased attendance rate within 3 months after telephone calling. RESULTS: The completed telephone contacted group (N=242) and failed group (N=348) were well balanced for all study variables except age. The attendance rate of 60.7 % in the completed group, regardless of who was contacted by telephone, was 40.7 % greater than 23.0 % attendance rate in the failed group. In the univariate analysis, attendance for patients who lived near the clinic (within 1 hour ) was better (45.3%) than that for any group (P = .02). In the logistic regression analysis, only the telephone call reminder was an independent predictor of attendance (Adjusted OR=5.03, P<0.001). CONCLUSION: Telephone reminder is a very effective method of increasing attendance in a hospital-based family clinic. The reminder is a consistently effective intervention whether the message is delivered to the patient or the family member.
Ambulatory Care Facilities* ; Compliance ; Family Practice ; Humans ; Logistic Models ; Outcome Assessment (Health Care) ; Outpatients* ; Telephone*

The number of hemodialysis patients and dialysis facilities is increasing each year, but there are no surveillance programs validating that the services and equipment of each hemodialysis unit meet specified safety and quality standards. There is a concern that excessive competition and illegal activities committed by some dialysis facilities may violate patients' right to health. Contrastingly, developed countries often have their own survey program to provide initial certification and monitoring to ensure that these clinics continue to meet basic requirements. Because hemodialysis units provide renal replacement therapy to critical patients suffering from severe chronic renal failure, appropriate legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Therefore, several standards providing minimum requirements for the area of hemodialysis unit, equipment for emergency care, physician and nurse staffs, water purification and quality management are urgently needed.
Ambulatory Care Facilities/*standards ; Health Manpower ; Humans ; Renal Dialysis/*standards ; Republic of Korea

OBJECTIVES: The aim of study was to examine the prevalence of night eating syndrome(NES) and its correlates in schizophrenic outpatients. METHODS: The 14 items of self-reported night eating questionnaire(NEQ) was administered to 201 schizophrenic patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating, and weight-related quality of life using Beck's Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. RESULTS: The prevalence of night eaters in schizophrenic outpatients was 10.4%(21 of 201). Comparisons between NES group and non-NES group revealed no significant differences in sociodemographic characteristics, clinical status and BMI. Compared to non-NES, patients with NES reported significantly greater depressed mood and sleep disturbance, more binge eating pattern, and decreased weight-related quality of life. While 'morning anorexia' and 'delayed morning meal'(2 of 5 NES core components in NEQ) were not differed between groups, 'nocturnal ingestions', 'evening hyperphagia', and 'mood/sleep' were more impaired in NES group. CONCLUSION: These findings are the first to describe the prevalence and its correlates of night eaters in schizophrenic outpatients. These results suggest that NES has negative mental health implications, although it was not associated with obesity. Further study to generalize these results is required.
Ambulatory Care Facilities ; Bulimia ; Depression ; Eating* ; Humans ; Mental Health ; Obesity ; Outpatients* ; Prevalence* ; Quality of Life

The purpose of the study was to develop and test the model for the quality of life in mothers of children with nephrotic syndrome. A hypothetical model was constructed on the basis of previous studies and a review of literature. The conceptual framework was built around ten constructs. Exogenous variables included in this model were mother's health, father's health, marital intimacy, mother's attitude on children, economic state, side effect of steroid, severity of illness and social support. Endogenous variables were mother's burden and quality of life. Empirical data for testing the hypothetical model were collected by using a self-report questionnaire from 152 mothers of children with nephrotic syndrom at the outpatient clinics and in the hospital. The data was collected from May, 1999 to August, 1999. Reliability of the seven instruments was tested with Cronbach's alpha which ranged from 0.71 - 0.92. For the data analysis, SPSS 8.0 WIN program and LISREL 8.20 WIN program were used for descriptive statistics and covariance structural analysis. The results of covariance structural analysis were as follow : 1.The hypothetical model showed a good fit with the empirical data.[x2 = .56, df = 3, p = .90(p > .05 ), GFI = .99, AGFI = .99, RMSR = .005.] 2. For the parsimony of model, a modified model was constructed by deleting 1 variable and excluding 2 paths according to the criteria of statistical significance and meaning. 3.The modified model also showed a good fit with the data[x2 = 2.83, df = 7, p = .90( p > .05 ), GFI = 1.00, AGFI = .97, RMSR = .011]. The result of the testing of the hypothesis were as follows : 1.Mother's health( gamma 21 = .26, t = 4.16), father's health( gamma 22 = .19, t = 2.92), marital intimacy( gamma 23 = .26, t = 4.13) and social support( gamma 28 = .12, t = 2.03) had a significant direct effect on the quality of life. 2. Mother's burden( beta 21 = -.20, t = -3.10) had a significant negative direct effect on the quality of life. 3. Mother's attitude on children( gamma 14 = -.34, t = .-4.57), mother's health( gamma 11 = -.22, t = -2.96) and side effect of steroid ( gamma 16 = -.23, t = .-2.69) had a significant direct negative effect on the burden. The result of this study showed that mother's health, marital intimacy, mother's burden, father's health, and social support had a significant direct effect on the quality of life. Mother's attitude on children, mother's health, and side effect of steroid had a significant direct effect on mother's burden. These six variables, mother's health, marital intimacy, father's health, social support, mother's attitude on children and side effect of steroid were identified as relatively important variables. The results of this study suggest, it needed to determine the nursing intervention will alleviate mother's burden and promote a greater quality of life in mothers of children with nephrotic syndrom.
Ambulatory Care Facilities ; Child* ; Humans ; Mothers* ; Nephrotic Syndrome ; Nursing ; Quality of Life* ; Statistics as Topic ; Child Health