BACKGROUND: To understand why primary physicians prescribe antibiotics for some cases of acute upper respiratory infections and to explore the factors that influence their prescribing. METHODS: Qualitative analysis of semi-structured interviews. Participants were 12 primary physicians in the maximum variety sample. RESULTS: Interviewees were identified the problems of antibiotics abuse and misuse in Korea. Primary physicians were certain that patients will benefit from antibiotics and prescribe for the patients' expectation of fast relief. Doctors are mostly comfortable with their prescribing decisions by their clinical experiences. They are also more likely to prescribe antibiotics in pressures of time and in competitive clinical environment. CONCLUSION: Multiple factors are involved in primary physicians' decision of their prescribing for acute upper respiratory infections. Further interventions to reduces prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations. Repeating evidence for lack of effectiveness and lack of efficiency in general might be helpful.
Anti-Bacterial Agents* ; Humans ; Korea ; Prescriptions ; Respiratory Tract Infections

When taking into account for social, economic, health disparities over the life courses among older adults, we should observe how such disparities arise and how they are maintained over the generations. The first part of this paper addressed the framework and approaches for understanding lifetime influences on late life disadvantages of health. The second part presented specific examples of late life disparities and their potential sources including chronic diseases, cognitive functions and disabilities. Context was considered to be broad and included early life experiences, descendants of generations and family influences. The third part addressed the roles of specific contextual influences. The final section of this review summarized the limitation of life course approaches and implementations for intervention. For geriatric medicine, it should be expanded into the focus of medical interventions and research of earlier age, with a wider range from individual to community and society, together with various other factors.
Adult ; Chronic Disease ; Family Characteristics ; Humans ; Life Change Events

BACKGROUND: Verifying the effect of frailty on health-related quality of life may help us better understand the impact of frailty. The present study explored the relationship between frailty and health-related quality of life in community-dwelling Korean elderly. METHODS: Older adults aged 65 years or older recruited by judgment sampling of the population of Seocho-gu in Seoul were surveyed in 2011. The Korean frailty index measure developed by the Korean Geriatric Society was used as the outcome variable. Proportional odds model was used to evaluate the relationship between health-related quality of life (HRQoL) and frailty. RESULTS: We found that, after adjusting for sociodemographic covariates, being prefrail or frail significantly increased the proportional odds for lowering health-related quality of life than being nonfrail. In addition, of the five components of health-related quality of life, the magnitude of the adverse effects of frailty on HRQoL was largest for pain/discomfort, with anxiety/depression being the second largest. CONCLUSION: Compared to persons who are not frail, older Korean individuals identified as frail and prefrail exhibit significantly lower HRQoL scores. This association between Korean frailty measures and the generic measure of the HRQoL may offer new information to better understand frailty within its broader context.
Adult ; Aged ; Humans ; Judgment ; Quality of Life

BACKGROUND: The concept of frailty has been extended to include social factors such as poverty and social support networks. The frailty index developed for elderly Canadians was recently examined in terms of the current broader concept of frailty. The present study explored the relationship between social support networks and frailty in Korean elderly individuals aged 65 years or older. METHODS: A total of 1,874 people aged 65 years or older were recruited by judgment sampling of the population of Seocho-gu in Seoul and surveyed in 2011. The Korean Frailty Index, developed by the Korean Geriatric Society, was used as an outcome variable. A proportional odds model was used to evaluate the relationship between social support networks and depressive symptoms. RESULTS: The prevalence of frailty and pre-frailty were 7.7% and 25.5%, respectively. A total of 9.9% of older adults lacked a social network, and 13.6% were deficient in social support. Social support networks were associated with frailty. Adjusting for sociodemographic factors (age, sex, marital status, economic status, and education), lack of a social network and support were associated with increased odds of frailty (social network: odds ratio 2.15, 95% confidence interval 1.58-2.92; social support: odds ratio 2.01, 95% confidence interval 1.54-2.63). CONCLUSION: Consistent with the concept of frailty being broadened to include social factors, frailty among elderly individuals was found to be influenced by social support networks.
Adult ; Aged ; Humans ; Judgment ; Marital Status ; Odds Ratio ; Poverty ; Prevalence

OBJECTIVES: Most studies about multiple roles and women's health suggested that combining with paid job, being married and having children was more likely to improve health status than in case of single or traditional roles. We investigated whether there was better health outcome in multiple roles among Korean women coinciding with previous studies of other nations. METHODS: Data were from the 2005 Korea National Health & Nutritional Examination Survey, a subsample of women aged 25-59 years (N=2,943). Health status was assessed for self-rated poor health, perceived stress and depression, respectively based on one questionnaire item. The age-standardized prevalence of all health outcomes were calculated by role categories and socioeconomic status. Multiple logistic regression was used to assess the association of self rated health, perceived stress, and depression with multiple roles adjusted for age, education, household income, number of children and age of children. RESULTS: Having multiple roles with working role was not associated with better health and psychological wellbeing. Compared to those with traditional roles, employed women more frequently experienced perceived stress, with marital and/or parental roles. Non-working single mothers suffered depression more often than women with traditional roles or other role occupancy. Socioeconomic status indicators were potent independent correlates of self-rated health and perceived stress. CONCLUSIONS: Employment of women with other roles did not confer additional health benefit to traditional family responsibility. Juggling of work and family responsibility appeared more stressful than traditional unemployed parental and marital role in Korean women.
Adult ; Depression ; Female ; *Gender Identity ; *Health Status ; Health Surveys ; Humans ; Korea ; Male ; Middle Aged ; Women's Health/*ethnology

BACKGROUND: The purpose of this study was to evaluate the applicability of the Korean version of Fall Efficacy scale(FES) and Activities-specific Balance Confidence Scale(ABC) to Korean older adult through an examination of instrument`s internal consistency and validity METHOD: A sample of 90 Korean older adults who lived in a community completed a survey instrument which included Korean version of FES and ABC. Because of comparable data derived from each scale, fear of falling and quality of life, activity daily living were included. Concurrent validity, criterion validity and correlational validity were tested. Reliability was tested by internal consistency, test-retest method. RESULTS: Cronbach`s alpha was 0.9043 in FES, and 0.99623 in ABC. Test-retest correlations in all scales were higher than 7.0. Statistically significant association was found between fear of falling and both scales. Correlation coefficient between Quality of life(SF-8) and ABC was -0.142(p=0.049). Both FES and ABC are correlated significantly each other. CONCLUSION: The Korean version of FES and ABC appears to be a reliable and valid method for meas- uring fear of falling. These instruments may be useful in assessing the independent contribution of fear of falling. ABC scale may be more useful to detect loss of balance confidence in more highly functioning seniors.
Adult ; Humans ; Quality of Life ; Reproducibility of Results* ; Weights and Measures

OBJECTIVES: This study describes trends in the socioeconomic disparities in breast cancer screening among US women aged 40 or over, from 2000 to 2005. We assessed 1) the disparities in each socioeconomic dimension; 2) the changes in screening mammography rates over time according to income, education, and race; and 3) the sizes and trends of the disparities over time. METHODS: Using data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2000 to 2005, we calculated the age-adjusted screening rate according to relative household income, education level, health insurance, and race. Odds ratios and the relative inequality index (RII) were also calculated, controlling for age. RESULTS: Women in their 40s and those with lower relative incomes were less likely to undergo screening mammography. The disparity based on relative income was greater than that based on education or race (the RII among low-income women across the survey years was 3.00 to 3.48). The overall participation rate and absolute differences among socioeconomic groups changed little or decreased slightly across the survey years. However, the degree of each socioeconomic disparity and the relative inequality among socioeconomic positions remained quite consistent. CONCLUSIONS: These findings suggest that the trend of the disparity in breast cancer screening varied by socioeconomic dimension. ontinued differences in breast cancer screening rates related to income level should be considered in future efforts to decrease the disparities in breast cancer among socioeconomic groups. More focused interventions, as well as the monitoring of trends in cancer screening participation by income and education, are needed in different social settings.
Adult ; Age Factors ; Aged ; Behavioral Risk Factor Surveillance System ; Breast Neoplasms/*radiography ; Female ; *Healthcare Disparities ; Humans ; Mammography/*utilization ; Mass Screening/*trends ; Middle Aged ; *Social Class ; Socioeconomic Factors ; United States

OBJECTIVES: This study was conducted to investigate the relationships among job stress, job satisfaction, and mental health in marine officers. METHODS: The researchers gathered data on marine officers working at a harbor in Chungcheong Province, South Korea, using a self-reported questionnaire. Mental health was measured by the Symptom Checklist-90-Revision (SCL-90-R), and general characteristics including socioeconomic factors, job stress, and job satisfaction were measured by structured questionnaires. Multiple regression analysis was performed to investigate the relationships among job stress, job satisfaction, and mental health status according to the symptom dimensions of the SCL-90-R. RESULTS: Among the marine officers, obsessive-compulsive behavior, depression, and somatization were the most problematic symptoms. Those who reported poor health, low job satisfaction, and high job stress had a higher prevalence of psychoticism, somatization, depression, anxiety, and phobic anxiety. CONCLUSIONS: An occupational health system should be introduced that would regularly check the mental health of marine officers in charge of ships and sailors, in order to help reduce their stress levels, enhance their job satisfaction, and thereby improve their mental health.
Anxiety ; Depression ; Humans ; Job Satisfaction* ; Korea ; Mental Health ; Military Personnel ; Occupational Health ; Prevalence ; Ships ; Socioeconomic Factors

Purpose: This study aimed to measure willingness to use (WTU) and appropriate payable cost of visiting nurse service for the elderly and explore their impact factors. Methods: The study included 752 participants selected from data that were completed in 2017 for the elderly aged over 60 nationwide. Logit and Tobit regression analysis were performed to confirm the influencing factors. Results: The study found that 39.1% of the elderly in the community were WTU the visiting nurse service, and they reported that the cost per visit was 12,650 Korean Won. The factors influencing WTU were having less than moderate subjective health status (OR = 1.63, p = .011), being part of a social participating groups (OR = 1.50, p = .046), or participation in senior health promotion programs (SHPPs) (OR = 1.96, p = .003). The cost was also influenced by less than moderate subjective health status (β = 4.37, p = .021), being part of a social participating groups (β = 4.41, p = .028), or participation in SHPPs (β = 4.87, p = .023). Additionally, elderly people living alone who were used as covariates were highly WTU (OR = 2.20, p = .029). Conclusion This study provides evidence to predict demand for visiting nurse service and reflects consumer value in setting the service cost. This is the first study to derive cost from consumers' perspective regarding the service for the elderly. As it is the result of an open-ended survey, follow-up studies are needed to estimate more reliable and reasonable results.

Background: Since the recently announced Community Care Policy, there has been an opinion that Korea needs to establish an alternative medical model such as physician home visits. This study aimed to assess the need and willingness to pay (WTP) for physician home visits among the community-dwelling Korean older population and to determine the most important factors that influence older adults to decide to use a physician home visit service. Methods: A total of 797 people aged 60 years or older who were randomly selected from a nationwide dataset using a multi-stage stratified sampling method answered a questionnaire on the need and WTP for physician home visits. Results: A total of 39.3% of participants reported that they would like a physician home visit when they need help. Among older adults who needed physician home visits (n = 313), the WTP amount for physician home visits was 21,982 ± 17,546 KRW. Logit and Tobit regression analyses showed that the higher valuated need and WTP for physician home visits was associated with a lower level of physical/psychosocial functioning measured by EuroQol-five dimensions score (odds ratio [OR], 1.13; 95% confidence interval [CI], 1.01–1.27; P = 0.035) and a higher level of satisfaction when using community-based services such as public health centers (OR, 1.32; 95% CI, 1.02–1.72; P = 0.034), social welfare centers and Gyeong-ro-dang (OR, 1.61; 95% CI, 1.04–2.50; P = 0.033; β = 8.39; standard error, 3.63; P = 0.021). Conclusion This study provides evidence that the decision to pay for a physician home visit service is based upon the complex interactions among an individual's physical and psychosocial functioning, personal experiences of service utilization, and demographic factors. The value for physician home visits should be qualified based on the empirical data of WTP, which comes from a consumer-centered perspective.