BACKGROUND: Family physicians help the patients to be adapted to a new life cycle with anticipatory guidance. But the later life of empty nest stage seems to be the most stressful since during this time is made preparation of his/her own death. Anticipatory guidance in later life for death is not encouraged because after death, the patient no longer exists. METHODS: From August 1, 1995 to August 31,1995, we gathered the data by the means of questionnaire to persons aged over 60 who visited the department of family medicine and geriatric center in Yong-dong Severance Hospital. The questionnaire was consisted of demographic factors, attitude toward death, fear of death, preparation of death in aspect of his/her own and also in his/her family. RESULTS: The total 104 subjects responded to the questionnaire, consisting of 58 males and 46 females. To the question asking the attitude tpward death, 71(67.6%)answered death as a spiritually new life, 39(37.1%)as an end of life and 11(10.5%)as just and event in life. 75(72.1%)persons insisted the need of preparation of death, and the content of the preparation were consideration of the family 35(33.3%), preparation of mind 34(32.4%), devotion to religion 33(31.4%), arrangement of fortune 19(18.1%). The answer about the fear of death was 42(40.0%)and the reasons for fear were pain of death 26(24.8%), separation from the family 19(18.1%), uncertainty of the nature after death 17(16.2%), suffering of the family 10(9.5% ) in rank order. The contents of preparation of death as family were being together with dying person 57(45.7%), evangelizm 32(30.5%), helping arrangement of life 30(28.6%), and the answer about fear of death of family were pain of death 40(37.1%), regret 31(26.5%), lack of preparation of after death 22(21.1%), loneliness after separation 14(13.3%). CONCLUSIONS: Family physicians should recognize death as one of the life cycles because the most persons insist of the need of preparation of death. So family physician can help the the patient prone to death by anticipatory guidance with stimulation of performance of developmental tasks.
Demography ; Female ; Humans ; Life Cycle Stages* ; Loneliness ; Male ; Physicians, Family ; Uncertainty ; Surveys and Questionnaires

No abstract available.
Glaucoma* ; Manometry* ; Mass Screening*

No abstract available.
Female ; Humans ; Prevalence*

No abstract available.
Humans

BACKGROUND: Pharmacological stress tests for the diagnosis of GH deficiency are unpleasant, labor intensive and potentially dangerous. Reports on urinary GH measurement for the assessment of GH have been published after highly sensitive immunoassaies were developed. The aim of this study was to determine whether a 24- hour urine GH as an alternative method for GH assessment were reliable in predicting GH deficiency defined by L-dopa stimulation test. METHODS: Thirty women, ages 45 to 67, were studied. L-dopa stimulation tests were performed with an ingestion of 500 mg of L-dopa. Serum GH and IGF-1 were measured by a radioimmunoassay using commercially available reagents and uGH was estimated from the 24-hour urine. Then, the mean and its distribution of uGH values were compared according to the GH status defined by L-dopa stimulation test. RESULTS: The correlation between the uGH and the peak values after L-dopa stimulation test was significant (r=0.46; p<0.01). The mean value of uGH in the GH deficiency group was significantly lower than that of the normal group P<0.05). But because of the broad overlap of uGH in the two groups uGH showed no good separation GH deficiency from normal group although uGH reflects GH status significantly. CONCLUSION: uGH reflects GH status significantly, but because of broad overalp uGH couldn't separate GH deficiency form normal group defined by L-dopa stimulation test.
Diagnosis ; Eating ; Exercise Test ; Female ; Growth Hormone* ; Humans ; Indicators and Reagents ; Insulin-Like Growth Factor I ; Levodopa ; Radioimmunoassay

BACKGROUND: Recently preventive clinical care has been proved important to the health. A number of recommendations or programs for preventive health services have been developed. The government made laws for health promotion of the people and for medical check-up for the insured in the district medical insurance association, who had been alienated from reimbursement for periodic health examination. As a result, above 95% of Korean people could took the periodic health check-up by this legislation. According to the national data, however, about 20% of the insured participated in the health screening program which was carried for the first time by the district medical insurance association in 1995. The reason that the compliance of health screening program was much lower than expected has not been clear yet. The purpose of this study is to define the facors affecting on the compliance of the health screening program. METHODS: Two hundreds of compliers and as many non-compliers of the health screening program was selected by the stratified sampling in one district medical insurance association which consisted of one town and eight township within the National Capital region. The telephone survey was performed from June 1 to 15 in 1996. The questionnaire was framed by health belief model with other demographic data. The data was analyzed by chisquare test, wilcoxon rank sums test, and logistic regression for the comparison of the characteristics between compliers and non-compliers. RESULTS: There was no difference of demographic data and medical history of chronic disease between compliers and non-compliers. 73.3% of the subjects knew they had been the expectant examinee of the health examination, and among them, 68% took the health examination. However, 53% of non-compliers did not know that they had been the expectant examinee. The most common reason that non-compliers didnt took the health examination was they didnt know(43.5%). Among 73 families of compliers which had more than 2 expectant examinees of the health screening program, 44 families(60.3%) had more complier other than study subjects. In contrast, among 74 families of non-compliers, only 7 famiies(9.5%) had more complier other than study subjects. Compliers showed lower reliability of the health screening program than non-compliers. Non-compliers had more perception about the severity of the target disease for the examination and had more confidence about self health status than compliers. There was no difference of the answer about the benefit of the health examination, perceived susceptibility about target disease, cue to action, and perceived barriers. The odds ratio of compliance of other family member was 21.2, perceived severity, 0.70, and cue to action, 1.36. CONCLUSIONS: The main reason of low compliance of health screening program for the insured in the district mecical insurance association was lack of public information. By the fact that non-compliers had more perception about the severity of the target disease and there was no difference of perceived benefit of the health examination between two groups, public information should be focused on the benefit and efficacy of periodic health check-up than severity and susceptibility of target disease. Because the health screening program on study subjects was carried for the firt time, only compliers had experience of the examination. The fact that compliers relied on the examination less than noncompliers meant that the examinees was satisfied much less than expected. Therefore, further study of the expectation of the examinees about the health examination is expected.
Chronic Disease ; Compliance* ; Cues ; Emigrants and Immigrants ; Health Promotion ; Humans ; Insurance* ; Jurisprudence ; Logistic Models ; Mass Screening* ; Odds Ratio ; Preventive Health Services ; Telephone ; Surveys and Questionnaires

No abstract available.

No abstract available.

No abstract available.
Humans ; Outpatients*

BACKGROUND: The prevalence of hepatitis C in blood donors have been reported to be 1.5% to 2.0% and 85 90% of post transfusion hepatitis patients show anti HCV positive results. Most agree that hepatitis C is readily spread by way of contact with blood, but a discernible history of parenteral exposure is identified in only 40% to 50% of cases. Thus other possible nonparenteral routes of transmission such as vertical, sexual and intrafamilial contact transmission need to be explored. In this study, we investigated the clinical characteristics of anti HCV seropositives and the infection patterns of hepatitis C in their families not only by anti HCV but also by HCV PCR to explore the possibility of HCV infection through nonparenteral household contact. METHODS: Past history, physical examination, liver function tests, HCV PCR, hepatitis B viral markers, abdominal ultrasonography and liver biopsy were done in 161 anti HCV seropositives from May, 1991 to August, 1996. Of the 161 seropositives, 42 seropositives' family members, 98 subjects, were available for investigation by anti HCV, HCV PCR and liver function tests to document intrafamilial HCV infection;their respective relationships to the index seropositive were noted. RESULTS: The 161 anti HCV seropositives were classified as follows:34 in the carrier group(21.1%), 41 in the acute hepatitis group (25.5%), 32 in the chronic hepatitis group(19.9%), 24 in the liver cirrhosis group(14.9%) and 30 in the hepatoma group(18.6%). The positive rates of HCV PCR were 55.2% in total, 46.1% in the carrier group, 55.0% in the acute hepatitis group, 76.4% in the chronic hepatitis group, 40.0% in the liver cirrhosis group, and 42.8% in the hepatoma group. The 98 family members were all anti HCV seronegative. The positive rates of HCV PCR in these family members were 10.2% in total, 7.1% in spouses, 28.6% in siblings, and 8.3% in children. CONCLUSION: Anti HCV seropositives were in various clinical states of liver disease due to HCV infecton. Although none of the family members showed anti HCV positive results, HCV PCR was positive in 10.2% of the family members indicating the need to perform HCV PCR to detect HCV infection.
Biomarkers ; Biopsy ; Blood Donors ; Carcinoma, Hepatocellular ; Child ; Family Characteristics ; Hepatitis B ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Function Tests ; Physical Examination ; Polymerase Chain Reaction* ; Prevalence ; Siblings ; Spouses ; Ultrasonography