No abstract available.
Education*

PURPOSE: This ethnograpy was done to explore patterns of health care behavior in patients with chronic health problems. METHODS: The participants were 15 patients with chronic hepatitis B and 2 family members. Among the patients 4 had progressed to liver cirrhosis and liver cancer. Data were collected from iterative fieldwork in a department of internal medicine of I hospital. Data were analyzed using text analysis and taxonomic methods. RESULTS: Illness and disease, relationship between health care givers and clients, and communication patterns between health professions and clients were discussed as the context of health care behavior. Health care behavior of the participants was categorized by its focus: every day work centered, body centered, organ centered, and pathology centered. CONCLUSION: Participants' health care behavior was guided by folk health concept and constructed in the sociocultural context. Folk etiology, pathology, and interpretation of one's symptoms were influencing factors in illness behavior. These findings must be a cornerstone of culture specific care for the chronic diseases.
Activities of Daily Living ; Adult ; Aged ; Asian Continental Ancestry Group ; Attitude to Health ; Communication ; Family Relations ; Female ; *Health Behavior ; Hepatitis B, Chronic/complications/*psychology ; Humans ; Interviews as Topic ; Liver Cirrhosis/etiology ; Liver Neoplasms/etiology ; Male ; Middle Aged ; Physician-Patient Relations ; *Qualitative Research ; Republic of Korea

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.
Aged ; *Asian Americans ; Delivery of Health Care ; Female ; Health Personnel ; Hepatitis B, Chronic/*ethnology/etiology/psychology ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Republic of Korea/ethnology ; Social Stigma

PURPOSE: We studied the accuracy of high resolution computed tomography in staging chest wall/fissural invasion of peripheral lung cancer. MATERIALS AND METHODS: HRCT findings in 27 patients with suspected chest wall (n=18) or fissural (n=16) invasion of peripheral lung cancer were correlated with surgical and pathologic findings. The HRCT images were restrospectively evaluated for pleural thickenings adjacent to mass, maximal contact length (cm) between mass and chest wall/fissure, angle between the mass and chest wall/fissure, ratio of maximal contact to mass diameter, abnormality of extrapleural fat layer, mass extension across the fissure and fissural irregularity adjacent to mass. Various CT findings and the presence or absence of chest pain were correlated with surgical and pathologic findings. RESULTS: For the evaluation of chest wall invasion, abnormality of extraphleural fat layer was the most useful finding (sensitivity 100 %, specificity 36 %, accuracy 61 %). The remaining HRCT findings proved to have high sensitivity but low specificity, and a high false positive rate. For chest pain, sensitivity was 43 % and specificity, 82 %. In cases without chest pain, the positive predictive value of extraphleural fat abnormality was 44 % ; in the absence of chest pain and extrapleural fat abnormality,positive predictive value was zero. The evaluation of transfissural tumor invasion using variable HRCT findings proved to be accurate, especially when the criteria of mass extension across the fissure and fissural irregularity adjacent to the mass were used (accuracy 81 % and 75 %, respectively). CONCLUSION: Using the finding of 'extrapleural fat abnormeality', HRCT was accurate in the staging of chest wall invasion and its predictability was betten than that of other results obtained with conventional CT. Chest pain had high specificity but low prevalence, and extrapleural fat abnormality was more valuable in cases without chest pain. HRCT proved to be accurate in the evaluation of transfissural invasion of lung cancer using the findings 'fissural cross' and 'fissural irregularity'.
Chest Pain ; Humans ; Lung Neoplasms* ; Lung* ; Prevalence ; Sensitivity and Specificity ; Thoracic Wall* ; Thorax*

No abstract available.

Purpose: : The study was conducted to examine effects of nurses’ communication styles perceived by surgical patients and their anxiety and uncertainty on patient satisfaction. Methods: : Data were collected by using a structuralized questionannaire which consists of nurses’ communication style tool, State trail Anxiety Inventory(STAI), Mishel Uncertainty in Illiness scale, and patient satisfaction tool targeting on 276 surgical patients who were hospitalized in general wards from July 24, 2020 to December 18, 2020. The data analysis was done with the correlation analysis and the multiple regression analysis. Results: : Nurses’ communication style perceived by surgical patients has found to have the most informative communication styles and the least authoritative communication style. And the variable which has the most effect on patient satisfaction was the affective communication style(β=.35, p<.001), followed by nurse communication importance perceived by surgical patients(β=.15, p=.001). And surgical patients' anxiety (β=-.15, p=.011) and uncertainty(β=-.13, p=.024) has found to have a negative effect on patient satisfaction. Conclusion : The patient satisfaction got higher when the surgical patients perceived the Affective & informative communication styles among nurses’ communication styles, and when they perceived the nurses’ communication as important.

Some coercive aspects of culture in the medical field that have traditionally been regarded as routine practice are now gradually changing in the aftermath of the MeToo movement that has come to Korea, due to improved awareness of sexual violence. It is important for the medical community to endeavor to eradicate sexual violence by implementing the measures against sexual violence proposed by medical organizations, including the Korean Medical Women's Association. The medical field should undergo a self-purification process, so that medical personnel can change themselves and their own behavior in the context of the medical profession, which is a noble occupation that deals with life-and-death matters. As such, essential elements of the training system of doctors should be maintained. Developing action plans to properly deal with sexual violence incidents in medical institutions can be considered the first step in this process.
Korea ; Occupations ; Sex Offenses

Some coercive aspects of culture in the medical field that have traditionally been regarded as routine practice are now gradually changing in the aftermath of the MeToo movement that has come to Korea, due to improved awareness of sexual violence. It is important for the medical community to endeavor to eradicate sexual violence by implementing the measures against sexual violence proposed by medical organizations, including the Korean Medical Women's Association. The medical field should undergo a self-purification process, so that medical personnel can change themselves and their own behavior in the context of the medical profession, which is a noble occupation that deals with life-and-death matters. As such, essential elements of the training system of doctors should be maintained. Developing action plans to properly deal with sexual violence incidents in medical institutions can be considered the first step in this process.

A retrospective clinical study on 63 cases of intussusception in infants and children, who were admitted to the department of pediatrics and surgery from May, 1974 to Feb. 1978, was done. The prognosis of this disease is dependent upon early diagnosis and treatment but the causatio of this disease is not clear yet. It is a relatively common disease and we think it is worthwhile to analyze our won cases. The results were : 1. Among 63 cases, 37 were admitted to the department of pediatrics and 36 were admitted to the department of GS. 2. In age distribution, 85% of the patients were under 1 year of age and the peak incidence was 3~9 months of age. 3. Male was predominant than female. Male to female ratio was 2.8:1 4. The 58.8% of the patients were above 50 percentile of body weight comparing with Korean standard data. 5. In the aspect of the etiology, 96.9% of the cases were idiopathic and only 3.1% of the cases had organic causes. 6. The 4 cardinal symptoms were abdominal pain(93.7%), vomiting(90.%), bloodymucous stool(80.1%) and abdominal mass(74.6%) 7. Among the cases, colocolic type was 33.3%, ileocolic type was 22.2% and ileocecal type was 20.6% 8. The 71.4% of the cases were reduced successfully by barium enema. 9. Recurrence rate was 4.8%.
Age Distribution ; Barium ; Body Weight ; Child* ; Early Diagnosis ; Enema ; Female ; Humans ; Incidence ; Infant ; Intussusception* ; Male ; Pediatrics ; Prognosis ; Recurrence ; Retrospective Studies

BACKGROUND: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. METHODS: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. RESULTS: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. CONCLUSION: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.
Biomedical Technology ; Chronic Disease ; Classification ; Delivery of Health Care ; Health Expenditures* ; Health Status ; Insurance ; Korea ; National Health Programs* ; Stents