Background : As the effect of the families on the individual’s health and disease is profound, it is very important to care patients based on the understanding of their families. The family function assessment tool to evaluate the families objectively and easily is necessary for this purpose. Many instruments have been developed in other countries and we have used these instruments without verification. Therefore, there is a question whether they are appropriate to the Korean families. The family function is especially important to the family with adolescents because adolescents are characterized by psychological instability. My purpose of this research is to develop an instrument to assess the function of the Korean families and this research is made on the Korean families with adolescents. 1,600 middle and high school students and 1,600 of their parents were selected for this study. They were asked to describe 5 kinds of each good and bad family relationship to collect primary basic data. These data were arranged to items based on the established scales and subscales. Secondary basic data were collected from another 200 students and their 200 parents to complement the items. Preliminary instrument items were selected by the frequency of the responses and the judgment of the author. Through discussions with experts, the preliminary instrument was established. Accessibility was tested and factor analysis was done for the preliminary instrument. After this process,, the main instrument was formulated. For the primary basic data, 2,382 people answered (response rate 74.4%) and 10,267 responses and 298 kinds of items were collected. There was no additional item from the secondary data collection. The preliminary instrument was made of 58 items selected from 298 items. It takes 8 minutes to complete this instrument in average and 97% of the subjects had no difficulty in completing it. The main test instrument, developed after factor analysis, was made of 7 scales with 40 items.
BACKGROUND Much time and cost have been consumed for just a treatment of a simple disease and inappropriate management has taken place because of misjudgement by laymen. To establish a desirable health care system, need for the usual-medical-provider system (U.MP. system) has been suggested. This study was performed to find some data that would be helpful to establish the U.MP. system by surveying some factors influencing on choosing care providers of children. METHODS 440 questionnaires were gathered from surveys administered to the parents of the students in a primary school. The period for study was 1 week of September in 1999 and the response rate was 88.0%. The questionnaire was composed of sociodemographic variables, a question for having U.MP. and some factors related with choosing U.MP. RESULTS The fourth and fifth decade of age showed higher proportion for having U.MP. than sixth decade. The proportion of having U.MP. was also higher in respondents with higher educational attainment and higher income. The proportion of visiting local clinics or hospitals was about 65.7% in groups having U.MP., whereas the proportion was about 41.5% in group not having U.MP., The frequency of visiting local clinics or hospitals for a year was higher for groups having U.MP., compared with groups not having U.MP.. The factors related with choosing U.MP. were `doctors who explain the disease in detail and easily', `doctors who provide care meticulously', and `effective treatment'. CONCLUSION To establish the U.MP. system, a kinder attitude and care would be necessary for doctors who will provide care to the patients and their family.
Background : Electricardiographic variables such as changes in the ST-T segment, and increased QT interval have been found to predict the occurrence of myocardial ischemia, But disadvantages of most of these variables have poor reproducibility and require analysis of all ECG leads. If electrocardiographic T axis properly predicts myocardial ischemia, it can be used as a useful marker for diagnosing myocardial ischemia in primary practice.
Methods : We selected 147 persons, who visited the emergency room or an outpatient clinic because of chest pain, in whom coronary angiography was performed. We reviewed their medical records. Electrocardiographic T axis was classified as normal, borderline and abnormal T axis. We identified the relation between cardiovascular risk factors and electrocardiographic T axis, and also, the relation between ischemic electrocardiographic variables and T axis, We examined the relation between coronary angiographic results and electrocardiographic T axis.
Results : The sensitivity and specificity of electrocardiographic T axis was 26.7% and 86.9%, respectively. The positive predictive value and negative predictive value was 81.8% and 35.1%, respectively. The proportion of hypertension was 41.2% in normal T axis group, 65.5% in borderline T axis group, and 34.4% in abnormal T axis group, which was statistically significant(P=0.032). The relation between coronary angiographic results and electrocardiographic T axis was not statistically significant. The subjects with abnormal T axis were associated with ST depression (P=0.016).
Conclusion : The T axis abnormality was not useful for screening myocardial ischemia, but it was useful to rule out other diseases due to its high specificity.
Background : Osteoporosis is an important and common medical problem in postmenopausal women. Depression is another major public health concern. Due to the high prevalence of both depression and osteoporosis, even a weak association between them might result in a greater health problem. We have investigated whether depression is associated with bone mineral density (BMD) in peri- and postmenopausal women.
Methods : The study subjects who visited the office of family medicine department and the health screening and diagnosis center in one general hospital from January to May, 2000 were selected. BMD was measured at the lumbar spine using Dual Energy X-ray Absorptiometry. We evaluated the depression scale using the Beck Depression Inventory. The subjects who had disorders known to interfere with bone metabolism or those who had taken medication related to depression were excluded from the study.
Results : Significant positive correlation were noted between BMD and height and weight (P<0.05) but no correlation was found with depression in perimenopausal women. In postmenopausal women, significant negative correlation was noted between BMD and age, and postmenopausal duration and depression. Significant positive correlation was found between BMD and height and weight (P<0.05).
Conclusion : Our results showed that depression was associated with BMD in postmenopausal women which was independent of other factors strongly associated with osteoporosis.
Background : Increased bone turnover results in bone loss after menopause. After menopause, the major cause of bone loss is estrogen deficiency. Rate of bone loss seems to increase after menopause and then formation coupled with resorption is also increased. Antiresorptive drugs are known to be helpful in preventing bone loss. Alendronate is one of antiresorptive drugs for the treatment of osteoporosis which results in a decrease in bone turnover. Some papers report about nonresponders to antiresorptive drugs, and screening people early is very important to optimal management. There are no available data of Korean people. Therefore, this study evaluated the effects of alendronate in Korean postmenopausal osteoporosis patients after 3 months of treatment.
Methods : We studied 96 women with postmenopausal osteoporosis (bone mineral density{BMD} T score<2.5) who visited Climacteric Clinic in Samsung Cheil Hospital from Jan. 1999 to Jul. 1999. Subjects were stratified in to 3 group: Group 1 treated with alendronate (Fosamax ; MSD, Rahyway, NJ, USA) 10mg/day and estrogen, Group 2 treated with calcitonin nasal spray 100 IU every other day and estrogen, and Group 3 treated with estrogen alone for 3 months. We measured serum marker of bone formation (osteocalcin [BGP]), and marker of bone resorption (deoxypyridinoline [DPYD] from urine at baseline and 3 months after treatment.
Results : The mean difference in change of markers among the three groups at the end of study that were significant were BGP 25.7±4.8% and DPYD 23.3±2.3%. DPYD known as bone resorption marker showed a significant response in alendronate and estrogen therapy group than estrogen alone group (P<0.05). Also, BGP showed response to estrogen alone, and calcitonin and estrogen group, but its responsiveness was lesser than alendronate therapy.
Conclusion : Our data showed that using alendronate with estrogen in patients of osteoporosis further prevents bone resorption. Therefore, we conclude that alendronate therapy with estrogen is helpful managing osteoporosis patients.
Background : Although the rate of smoking in adults is decreasing, its rate in adolescents keeps increasing gradually. Especially, smoking in adolescents is a serious problem that may be deeply related to drug abuse and is the main cause of a number of diseases. Anti-smoking program is essential to prevent this matter. Therefore, analysis of smoking status and its related factors in adolescents in a region where such as a program was performed may be useful.
Methods : Questionnaire-survey was performed on 1,516 students of six high schools in a city who wished to participate in the anti-smoking program and analyzed the results concerning smoking status and the related factors on 1,380 students which consisted of 862(62.5%) males and 518(37.5%) females who completed the questionnaire.
Results : Smoking prevalences were 40.1% in males and 17.6% in females. Height, weight, educational level of parents and occupation of father were assessed. In the case of male students, the taller they were the more they smoked. In the case of female students, the higher their mother’s educational level the more they smoked. Siblings’ and close friends’ smoking status had influence on smoking in both males and females. Drinking status affected smoking status in both males and females. The total mean of knowledge and attitude score was 1.39 and 1.32, respectively. There was a significant difference in men’s knowledge and attitude score and in women’s attitude score categorized by smoking status. The men’s knowledge and attitude scores were significantly higher than women’s. In the results of regression, the knowledge score had a negative coefficient and the attitude score had a positive coefficient as the dependent variable was smoking status in males, and the same results were shown in females. The attitude score, drinking status and close friends’ smoking status were factors that influenced smoking in males and the knowledge score, the attitude score, drinking status, close friends’ smoking and siblings’ smoking in females.
Conclusion : If we apply these results in school-based anti-smoking program, it will be an effective program for high school students.
Background : The number of illegal migrant workers has been increasing in Korea since late 1997 in what was called the IMF era. This study was conducted to evaluate and to recognize the medical utilization and health Status for migrant workers in Korea. The goal of this study was to understand the epidemiological characteristics of the migrant workers and family physician’s role as a health provider and gate keeper to them and to provide basic data for public health policy.
Methods : In September 1999, self-administered questionnaires were distributed to the migrant workers in Seoul, Sung-Nam, Pucheon and An-Yang. We classified the reasons for clinical encounters and the prescribed drugs by reviewing the medical records of all patients who visited a clinic of shelter for migrant workers in Sung-Nam from January to December 1998 and analyzed the report according to death certification of the shelter for migrant workers in Sung Nam from 1994 to September 1999
Results : The major distribution of nationality were from China, Mongo, and Bangladesh(86.9%). They were mostly between 30 and 39 years old, males are, and unmarried. Most had high school education. The average income was 756,700 won and the average working hours were 11.5 hours per day in migrant workers being in worse condition than those of Korean workers. Classified according to systems, the respiratory(21.2%), musculoskeletal(20.6%), digestive(15.8%), and cardiovascular(12.5%) symptoms were common. Repayment for death was different between before(87.7%) and after IMF era(13.0%), in late 1997. Average medical expenditure was 43,552 won comprising 5% of the total income of subjects only. Most of them did not benefit from medical insurance.
Conclusion : Migrant workers’ situation seemed poor. The patterns of the disease’ were similar to those who visit family medicine clinics in general. Family physicians should take more interest in providing a more effective and better care to migrant workers.
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