| Hung Tag Yeoum | 6 Articles |
Background
Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice.Methods: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression.Results: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression.Conclusion: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome. Citations Citations to this article as recorded by
Background
Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). Methods: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. Results: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. Conclusion: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty. (J Korean Acad Fam Med 2007;28:286-291)
Background
: The primary concern of a family physician is the healthcare of patients and their families, with the patient's disease itself being secondary. Family physicians should make efforts to discuss personal issues with their patients. This study examined how many patients were counseled about their private problems, especially family or sexual issues in the private clinics of Cheonan. Methods : The subjects were the patients who visited a practice-based network from April to June in 2003. The data were collected through simple questionnaire about sociodemographic features of patients and their family and sexual problems. Results : Eighty eight patients were studied for a total of 107 cases that consisted of 67 cases of family problems (62%) and 40 cases of sexual matters (38%). The common issues about family problems were `the partners' (23 cases, 21%) and `the patients` children' (29 cases, 27 %). The most frequent sexual problems were 'sexually transmitted diseases' (13 cases, 32.5%), `impotence' (7 cases, 17.5%), 'loss of libido, and unsatisfaction' (6 cases, 15.0%). Most physicians were involved in family and sexual issues with medications, and simple counseling with reassurance. Simple counseling was given for 14 cases (21.0%) for family issues and 18 cases (44.0%) for sexual issues. The patients were treated with medications in 47 cases (70.0%) for sexual and 15 cases (38.0%) for family problems. Conclusion : The most common issue for family problems was their partners and for sexual problems was 'sexually transmitted diseases'. Most family physicians were involved with both simple counseling and medications.
Background
: Although urinary incontinence is a common problem, its prevalence and severity in community is not well established. The main objects of this study were to define the prevalence in adult men and women who came to a primary care office for health care. Methods : Men and women aged 20 years and over who came to family physician's offices seeking health care for any reason during an 2-week period were the subjects of a survey by anonymous questionnaire. Ten family practice offices in Cheonan Practice-Based Research Network parti-cipated. We defined "current significant urinary incontinence' as over any degree of annoying incontinence in the past 12 months. Results : Of the 1,130 responders, 46.3% experienced urinary incontinence. Incontinence was experienced by 26.7% of the men and 50.2% of the women. 'Current significant urinary incontinence' was experienced by 3.7% of the men and 10.12% of the women. Conclusion : Urinary incontinence as a common problem among those seen in primary care settings, and patients hesitate to seek consultation of their problems with physicians. Therefore, family physicians should deal with the symptoms of incontinence more attentively during history taking.(J Korean Acad Fam Med 1999;20:55~61)
Background
: Hypertension is a chronic disorder that causes various complications. It needs proper pharmacologic and non-pharmacologic treatment. But, other studies show there are many traditional and folk remedies about hypertension in Korean. This study was designed to show behavioral patterns of outcomes and side effects of folk remedies in practice-based network. Methods : The study subjects were hypertensive patients visited practice-based network from September to December in 1996. Data were collected through questionnaire about sociodemographic features of patients and types, effect, frequency, and side effects of folk remedies. Results : The responders totalled 160 patients, and those who have tried traditional medicine or folk remedies were 65 patients(27 men and 38 women cases). Information source about remedies were 'family members or friends' in 53.8%, 'TV, magazines, and newspapers' in 13.8%, and 'books that deal with health information' in 3.1%. There were 22 experienced remedies ; the most common remedy was herb medicine. In subjective judgement about anti-hypertensive effect, 6 cases described as 'very effective', 21 as ' somewhat effective', 14 as 'not effective', 17 as 'not sure'. Ten(15.3%) of 65 cases experienced side effects. Conclusion : 40.6% of total responders used traditional or folk remedies, and 15.3% of them experienced side effects, 9.2% of them told that their remedies were 'very effective'. Physicians need to inform patients of side effects of folk remedies and adequate management of hypertension.
Background
: Despite of the medical importance and commercial value of adult immunization which is being embossed, immunization levels remain extremely low. One of the main reason for this may be physicians non-compliance and misinformation. The aim of this study is to provide reference data about primary physicians knowledge and attitude for adult immunization. Methods : The questionnaire was composed of 29 items concerning physicians' knowledge and attitude for adult immunization and we mailed on November 26, 1995 to 1450 physicians of private clinics registered in Korean Medical Association in 1994, and then we analyzed 314(21.6%) question-naires which were returned to us within 3 weeks. Results : Among 314 cases, according to their specialty, general physician 32(10.2%), internist group 166(52.9%), surgeon group 73 (23.2%), minority group 43(13.7%) in number. Recognition rate of each immunization was 95.2% for Hepatitis B, 87.4% for Influenza, 24.5% for Pneumococcs, 96% for Measles. Keeping rate was 83.4% for Hepatitis B, 72.6% for Influenza, 11.5% for Pneumococ-cus. In surgeon group, keeping rate of Hepatitis B vaccine was 85.3%, Influenza vaccine 54.7%. 179(57.2%) physicians answered "absolutely need" of "much important" about adult Influenza immu-nization for healthy life and elderly internist Yubgroup tended to emphasize the importance. roung internist subgroup tended to know more indications. 85(27.1%) physicians have recommended the immunization actively to their patients and their major obstacle to recommendation was "patients' negative attitude" and in internist group, "can not convinced efficacy of immunization" in surgeon group, "out of my duty" in minority group. Only 40(12.7%) physicians answered "absolutely need" or "much important" about adult Pneumococcal immunization. Also, young internist subgroup tended to know more indications. Only 27(87.9%) physicians have recommended Pneumococcal immunization actively to their patients and their major obstece to recommendation was "can not be convinced efficacy of immunization" in internist group, "can not identify the indications" in surgeon group, "out of my duty" in minority group. As many as 247(78.7%) phyicians answered "absolutely need" the Hepatitis B immunization for healthy life and 243(77.6%) have recommended actively to their patients and 76.0% of surgeon, 65.0% of minorities also have recommended Hepatitis B immunization, and their major obstacle to active recommendation was "patients negative attitude" Conclusion : Since the main body of practicing immunization can not be limited to internist, education for adult immunization should be provided to all physician regardless of their specialty. Various adult immunization education programs are essential to eliminate patients negative attitude which, in turn, may improve physicians recommendation rate.
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