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"Hee Chul Kang"

Erratum

Correction: The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients
Myung Hwa Yang, Seo Young Kang, Jung Ah Lee, Young Sik Kim, Eun Ju Sung, Ka-Young Lee, Jun-Su Kim, Han Jin Oh, Hee Chul Kang, Sang Yeoup Lee
Korean J Fam Med 2017;38(5):311-312.   Published online September 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.5.311

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  • Perception of and Practice in Salt and Fruit Consumption and Their Associations with High Blood Pressure: A Study in a Rural Area in Bangladesh
    Fakir M. Amirul Islam, Carrie K. Wong, Mohammad Arzan Hosen, Jahar Bhowmik
    Applied Sciences.2023; 13(3): 1622.     CrossRef
  • Lowering blood pressure by changing lifestyle through a motivational education program: a cluster randomized controlled trial study protocol
    Fakir M Amirul Islam, Elisabeth A. Lambert, Sheikh Mohammed Shariful Islam, M. Ariful Islam, Dip Biswas, Rachael McDonald, Ralph Maddison, Bruce Thompson, Gavin W. Lambert
    Trials.2021;[Epub]     CrossRef
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  • 2 Web of Science
  • 2 Crossref
Original Articles
The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients
Myung Hwa Yang, Seo Young Kang, Jung Ah Lee, Young Sik Kim, Eun Ju Sung, Ka-Young Lee, Jun-Su Kim, Han Jin Oh, Hee Chul Kang, Sang Yeoup Lee
Korean J Fam Med 2017;38(4):173-180.   Published online July 20, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.4.173
Background

Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.

Methods

This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.

Results

Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.

Conclusion

Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

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  • Lifestyle Modification, the Effective but Neglected Strategy in Lowering Blood Pressure
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  • Correction: The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients
    Myung Hwa Yang, Seo Young Kang, Jung Ah Lee, Young Sik Kim, Eun Ju Sung, Ka-Young Lee, Jun-Su Kim, Han Jin Oh, Hee Chul Kang, Sang Yeoup Lee
    Korean Journal of Family Medicine.2017; 38(5): 311.     CrossRef
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  • 37 Web of Science
  • 39 Crossref
Delirium in the Final Weeks of Terminally Ill Cancer Patients.
Hi Jung Cho, Hyun Ki Kim, Kyung Kon Kim, Yu Il Kim, Sang Yeon Suh, Kyung Hee Cho, Hee Chul Kang, Bang Bu Youn
Korean J Fam Med 2009;30(4):285-291.   Published online April 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.4.285
Background
s: In terminally ill cancer patients, delirium must be considered to be important clinically and for the quality of life. We reviewed cases of delirium in hospitalized cancer patients with the aim to recognize and treat delirium. Methods: We reviewed retrospectively the medical records of patients admitted with terminal cancer from April 2003 to April 2004 in the department of family medicine, National Health Insurance Corporation Ilsan Hospital. A total of 71 patients were evaluated with age, sex, oncological diagnosis, metastases, morphine (oral morphine equivalents/day, OME) use and amount, sedatives use, duration from delirium to death, and laboratory fi ndings. Analysis was conducted to fi nd the characteristics of delirium patients and to quantify the relationship between delirium and predicting factors. Results: Among 71 cases, those patients who developed delirium were 41 (57.7%). Among them, gastric cancer was the most common diagnosis with 10 patients (24.4%), followed by colon and lung cancers (9: 22%, 5: 12.2%). The patients receiving sedatives or morphines were 24 (58.5%) and 28 (68.3%), respectively. The mean amount of morphine was 168.6 ± 125.5 mg OME/day. Hyperbilirubinemia (4.2 ± 9.2 mg/dL) and hyponatremia (132.5 ± 4.5 mM/L) were found. Not only bone metastasis and the use of morphine or sedatives but serum Na were signifi cant (P = 0.047; P < 0.001; P = 0.069; P = 0.029). By logistic regression analyses, the occurrence of delirium was increased with decreased serum Na (odds ratio [95% CI] 0.798 [0.649-0.981]) and increased use of sedatives (5.955 [1.080-32.835]).Conclusion: In terminally ill cancer patients, the risk factors of delirium were bone metastasis, the use of morphine or sedatives, and serum Na level. Among these, the use of sedatives and serum Na level were independent risk factors.

Citations

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  • Risk factors for delirium in advanced cancer patients: A systematic review and meta-analysis
    Yating Guo, Yan Mu, Tingting Wu, Qian Xu, Xiuxia Lin
    European Journal of Oncology Nursing.2023; 62: 102267.     CrossRef
  • Validation of Modified Models of Objective Prognostic Score in Patients With Advanced Cancer
    Seok-Joon Yoon, Sang-Yeon Suh, Yusuke Hiratsuka, Sung-Eun Choi, Sun-Hyun Kim, Su-Jin Koh, Shin Ae Park, Ji-Yeon Seo, Jung Hye Kwon, Jeanno Park, Youngmin Park, Sun Wook Hwang, Eon Sook Lee, Hong-Yup Ahn, Shao-Yi Cheng, Ping-Jen Chen, Takashi Yamaguchi, Sa
    Journal of Palliative Medicine.2023; 26(8): 1064.     CrossRef
  • Association between Principal Diagnosis with Mental Diseases among Inpatients
    Sung-Soo Kim
    Journal of Health Informatics and Statistics.2022; 47(1): 57.     CrossRef
  • Retrospective Cohort Study on the Administration of Sedative for Delirium in Terminally Ill Cancer Patients and Survival Time
    Hyoung Sook Park, Dae Sook Kim, Eun Hee Bae, Jung Rim Kim, Jung Hwa Seo, Jung Mi Yun
    The Korean Journal of Hospice and Palliative Care.2016; 19(2): 119.     CrossRef
  • Risk Factors Related to Development of Delirium in Hospice Patients
    Hae Jin Ko, Chang Ho Youn, Seung Eun Chung, A Sol Kim, Hyo Min Kim
    The Korean Journal of Hospice and Palliative Care.2014; 17(3): 170.     CrossRef
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  • 5 Crossref
Predictors of High Peak Serum CK Levels in Doxylamine Intoxication.
Hea Jung Shin, Sung Kyung Lee, Kyoung Kon Kim, Kyung Hee Cho, Yong Joon Kang, Hee Chul Kang, Bang Bu Youn
J Korean Acad Fam Med 2004;25(3):216-223.   Published online March 10, 2004
Background
: Because doxylamine succinate (DS) is an over-the-counter medicine, it can be obtained easily and is frequently used in suicidal attempts. Patients usually recover without serious complications, but occasionally rhabdomyolysis and even death can occur in DS intoxication. In this study, the authors tried to find out the independent predictors of high peak serum CK levels, i.e. probable rhabdomyolysis in DS intoxication.

Methods : The medical records of 41 patients who visited a hospital for DS intoxication from January 1, 2002 to April 30, 2003, were reviewed retrospectively.

Results : In the group of DS only, initial occult blood of urine (P=0.003), initial WBC count (P=0.003) and confusion (P= 0.007) were the best predictors of the peak serum CK level (r2=0.724). In the group of DS with other drugs intoxication, initial creatinine level (P=0.003) and initial occult blood of urine (P=0.007) were the best predictors of the peak serum CK level (r2=0.784). In the cases of rhabdomyolysis patients, the time taken for the CK level to be increased over 1,000 IU/L was 1.9±0.6 days.

Conclusion : In DS only intoxication, occult blood in initial urine analysis, initial high WBC count and confusion can be thought of as useful clinical predictors for high peak serum CK level case. In DS with other drugs intoxication, initial creatinine level and initial occult blood of urine can be considered as the best predictors. More than 2 days will be needed for the observation of serious complications in DS intoxication.
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Clinical Study of Patients with Fever and Fever of Unknown Origin.
Joeng Gwan Kwon, Jae Ho Lee, Kyung Kon Kim, Jong Han Kim, Hee Chul Kang, Bang Bu Yoon
J Korean Acad Fam Med 1998;19(3):301-311.   Published online March 1, 1998
Background
: Family physicians in their on primary practice frequently encounters patients with fever, which is one of the common symptoms. Fever is an important symptom and can occur in mild disease, common cold, influenza, acute pharyngotonsillitis or can originate from a particular severe disease, such as bacterial endocarditis, malignant lymphoma and SLE, which need more aggressive management. Therefore, we studied patients who were admitted with short-term fever or long-term fever to find out their causes of febrile diseases and to compare the differences with previous other studies.

Methods : 601 patients with fever above 37.2 degree centigrade or those who were transferred from other hospitals due to long-term fever were enrolled from Jan. 1991 to Jun. 1997. Patients' medical records were reviewed and classified according to disease, sex, age. Srandardization of Petersdorf's rule for F.U.O. was used.

Results : 601 patients were randomly selected among which 301 were males and 300 females. Males were 147 and females 147 young adult patients as compared to 154 males and 153 females were elderly patients. According to disease category, the number of infections, connective tissue diseases, neoplastic diseases and other diseases were 442(73.5%), 14(2.3%), 87(14.5%) and 21(3.5%), respectively. The number of diseases of undetermined case was 37(6.2%). The most frequent disease was pneumonia with 103(31.1%). UTI and tuberculosis were the 2nd and 3rd most common diseases. The total number of F.U.O. patients was 82(13.6%). According to the disease categories there were 29(35.4%) in infections, 2(2.4%) in connective tissue diseases, 12(14.6%) in neoplasms, 2(2.4%) in others and 37(45.2%) in unknown origin. The most common disease in the classification of sex and age of F.U.O. was infections and tubrculosis.

Conclusion : In the clinical study of febrile patients admitted from Jan. 1991 to Jun. 1997 through medical record review, the disease category in the order of frequency was infection, neoplasm, connective tissue disease and the distribution of F.U.O was same result. In comparison with other study, the order of connective tissue disease and neoplasm was different in other hospital study but same result was taken in comparison with Petersdorf's study.
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Relationship of body fat, lipid, blood pressure, glucose in serum to waist-hip ratio between obese and normal body mass index group.
Hee Chul Kang, Sang Man Kim, Bang Bu Yoon, Seung Rae Kook, Young Su Park, Yoan Keou Ko, Deuk Joo Lee
J Korean Acad Fam Med 1997;18(3):317-327.   Published online March 1, 1997
Background
: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI).

Methods : We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the Healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men.

Results : Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI<25kg/m2. But in BMI>25kg/m2, men had higher(P<0.01) triglyceride at WHR?0.9. Women had higher(P<0.05) triglyceride, systolic and diastolic blood pressure at WHR?0.8.

Conclusion : We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI?25kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.
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A baseline study on satisfaction rate and cognition rate on oriental care and occicental medical care.
Sung Sil Kwon, Chul Dong Oh, Seung Real Yang, Haeng Hun Lee, Hee Chul Kang, Eu Sik Chung
J Korean Acad Fam Med 1992;13(11):891-900.   Published online November 1, 1992
Background
: Family physicians should be sensitive to patient's cognition, belief, and explanatory model on health and disease which derive from their cultural background. And nowadays, there happen many discussions on merging of oriental medical care and occidental medical care, so we need concern and understanding on oriental medicine. In this context, we made this inquiry to find out patient's rates of satisfaction and cognition on Occidental medical care and oriental medical care, and to prepare data base for approach to patient's ethnomedical model.

Methods : We made up a questionnaire of 15 questions, repectively 5 questions professional competency, doctor's personal quality, and cost and convenience, and get a survey of patient's rate of satisfaction and cognition about these provisions with same questionnaire, and let the responders write answer by himself or herself. At this survey, the respondents were 400 outpatients of Occidental polyclinic, oriental polyclinic, Occidental private clinic, oriental private clinic(100 respectively).

Results : The patients of oriental general hospital and private clinic showed higher satisfaction rate at orental medical care than those of Occidental general hospital and private clinic, and the patients of occidental general hospital and private clinic had higher cognition rate at oriental medical care than those of oriental general hospital and private clinic.(P<0.01) The respondents of all hospitals and clinics showed greater satisfaction rate at oriental medical care in all following specific questions : 'Occidental(oriental) medicine is fitter for Korean physical constitution.', 'Occidental(oriental) medical doctors are better at explanation.', 'We can get better hearer at occidental(oriental) hospitals.', 'The doctors of Occidental(oriental) medicine are interested only in making money.', 'I have affinity for the perspective on human body of Occidental medicine.', 'Waiting time is too long in occidental(orental) hospitals.', and so on.(P<0.01) The satisfaction rate at the question, 'It is easier to go to the drugstore for medication rather than to bother with Occidental(oriental) doctors.' was higher at occidental private clinic(P<0.01) than oriental private clinic, and the satisfaction rate at the question, 'Many people cannot go to Occidental(oriental) clinic due to time.' was higher at oriental hospital.(P<0.01)

Conclusion : We could find out that the satisfaction and cognition rates to the oriental medical care are absolutely higher, and patients have affinity to the explanatory model of Oriental medicine. Family Physicians should have a comprehension about this cultural background of patients, and many researches should be done about thought structure and explanatory model on health and disease of Korean and match their content with patient care.
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An analysis of family medicine-based evening practice in general hospital.
Mee Rim Kim, Tae Min Cho, Yong Ho Park, Yeon Joon Choi, Hee Chul Kang, Eui Sik Jung
J Korean Acad Fam Med 1992;13(9):759-767.   Published online September 1, 1992
Background
: Most medical institutions usually do practice in daytime that it is difficult for the ordinary worker or student to visit clinics, and all more is so when family members are willing to visit altogether. Evening practice was set up and has been operated at the department of Family Medicine in Presbyterian Medical Center located in Jeon Ju City to offer medical services to community to inhabitants in their convenient time, in order to increase their work efficiency. Our study was done to evaluate the actual situation and details of evening practice.

Methods : Medical records of a total of 586 visitors who had used evening practice between October 1991 and July 1992 were reviewed. Data including age, sex, month and day of visit, occupation, reason for encounter, clinical studies, procedures, and consultations to other department were collected in detail, and the diagnoses were classified according to ICPC.

Results : Of 586 visitors sex ratio was 1.29:1 with male predominance, age distribution was highest in twenties(35.9%), and company employee was the largest in occupation(29.3%). The number of encounter was counted as much as 683(average 1,165 per visitor), and reasons for encounter were 171 items of which health examination was the first in number(15.9%). Among organ-systemically classified reasons for encounter generalized and unspecified reasons were the most frequent(32.8%). A total of 612 diagnoses were made (average 1.04 per visitor) among 97 kinds of diagnosis. The most common diagnosis was 'no disease', and among the organ-systemically classified diagnosis generalized and unspecified diseases was the most frequent(24.3%). A total of 1,985 diagnostic tests were carried out (mean 3.39 per visitor), the kinds of tests were 32, and the most frequently used test was CBC (11.6%). Consultation to other department was taken in 1.54% of visitors, of which infectious hepatitis was the main problem.(33.3%)

Conclusion : The major reasons to encounter evening practice were health examinations of company employees and medical certificates for employments. We suggest that we should evaluate whether the visitors are satisfied with the family medicine-based evening practice.
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The analysis of clinical contents in primary care in university-based family practice clinics.
Yong Sung Suh, Eun Joo Ahn, Hee Chul Kang, Chul Young Bae, Dong Hak Shin
J Korean Acad Fam Med 1992;13(4):327-334.   Published online April 1, 1992
Background
: The clinical content of family medicine, still an evolutionary process is very important in education and research in family practice. We carried out this study to analyze the clinical contents of primary care at Keimyung University Family Medicine Clinic.

Methods : In order to assess the contents of primary health care, we collected data from University-Based family practice clinics by chart review from June 1990 to July 1990. We used the ICPC coding system to classify the collected date.

Results : The total number of patients was 2981 of whom 1330 were male(44.6%) and 1651 were female(55.4%). The total number of reason for encounter(RFEs) was 4438. The average RFE per patient was 1.48. Among them cough, stomachache, rhinorrhea, for GI medication and headache ranked as most common. They could be classified to have 205 kinds of different diagnoses. The most common 20 diseases were 69.1% of the total. The disease systems were digestive system (30.9%), respiratory system(25.0%), neuromuscular system(16.5%) and circulatory system(7.2%) as per frequency. The diagnostic tests were 45 in number. The referral rate to other specialties was 9.0%, of which there were IM(25.4%), OB&GY(16.6%), OS(14.0%), Neurology(13.6%), GS(9.6%), Psychiatry(7.0%) and Urology(6.2%).

Conclusion : ICPC coding according to visiting purposes, demand for therapy, and health problems appeared to be very easy for primary care physicians to use.
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The relationship between gastroscopic findings and depression.
Mee Eun Lee, Hyoung Woo Ahn, Hee Chul Kang, Chul Young Bae, Dong Hak Shin
J Korean Acad Fam Med 1992;13(2):132-139.   Published online February 1, 1992
Background
: It is known that gastrointestinal systems are very sensitive to psychosocial factors. The studies of correlation between gastrointestinal disorders and psychogenic illness have been performed. We studies the correlation between upper gastrointestinal diseases and depression, and upper gastrointestinal lesions and symptoms.

Methods : We assessed a group of 291 out-patients who received gastroscopy at the Department of Family Medicine, Dong-San Hospital, school of medicine, Keimyung university, and completed a questionnaire given from April to June, 1991. Data were gathered for epidemiologic status, sex, age, marriage, religion, occupation, education, alcohol, smoking, drug history, and the Zung self-rating depression scale was used to evaluate the patients' depression.

Results : The mean score of the depression scale was 43.40±10.73. Depression is more common in female than in male patients(p<0.01). Smokers had more gastroscopic abnormalities than non-smokers(p<0.05). Twenty symptoms were seen in the patients with upper gastrointestinal diseases. The most common symptom was hunger pain(49.8%), and the next were indigestion, belching, and nausea in that order. The score of depression was 43.44±11.40 for normal, 44.93±9.61 for gastroduodenitis, 38.81±9.14 for erosive gastritis and ulcer, and 55.22±10.96 for miscellaneous.

Conclusion : Depression might occur secondly to chronically recurring gastrointestinal disease. There was no significant difference in the prevalence of depression between normal and abnormal gastroscopic findings. Thus further studies with a larger number of subjects should be performed.
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Prevalence and clinical characteristics of the anti-HCV positive patients who had invreased transaminase levels with negative HBsAg.
Eun Joo Ahn, Tae Ho Chung, Hee Chul Kang, Chul Young Bae, Dong Hak Shin
J Korean Acad Fam Med 1992;13(1):72-78.   Published online January 1, 1992
Background
: There have been a number of researches of hepatitis and parenterally infected NANB viral hepatitis where clonization was successful. Viral hepatitis C would be named by this process, and enzymatic-immunologic tests and serologic tests to diagnose viral hepatitis C were developed.

Methods : Seventy nine patients were selected from those whose HBsAg tests were negative and transaminase levels were abnormal from Jan. 1 to Sep. 30, 1991. We assessed the prevalence and clinical aspects of viral hepatitis C. We divided all patients into anti-HCV positive and negative groups and compared them with regard to symptoms of hepatitis, transaminase level and transfusion history.

Results : 22(27.8%) out of 79 patients showed positive anti-HCV, and the positive rate was highest in the group aged 60~69 years in men and 50~59 years in women. There was no sex difference. The positive rates of anti-HCV in the groups of positive and negative anti-HBc were 28.6% and 25.8%, respectively.

Conclusion : A positive rate of anti-HCV was higher(27.8%) in the patients with negative HBsAg & increased transaminase levels than in normal subjects. But, the number of case is small, so total morbidity is difficult to analyze.
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Comparison of patient's desire, physician's recommendiation andhealth examination cneter's performance on periodic healthexamination.
Bang Bu Youn, Hye Ree Lee, Mi Kyung Oh, Ki Won Kwak, Jong Tae Chung, Hee Chul Kang, Won Kyung Kim
J Korean Acad Fam Med 1991;12(2):1-19.   Published online February 1, 1991
In recent years, increasing attention has focused on providing preventive services that have been associated with dramatic reductions in morbidity and mortality.
To compare the desires of patients, recommendations of physicians and actual performance of health care centers, we surveyed 977 patients from three university based family outpatient clinics and six private family clinics and 59 family physicians by questionnaires and we investigated health care contents that were performed by 23 health care centers in Seoul, in July, 1989.
The results were as follows :
1) Of the 977 patients, 482 patients(49.3%) desired a periodic health examination, even if feeling well. There were no differencies in age, sex, marital status between who desired a periodic health examination and those who did not, but more educated, higher income patients were more desired it.
2) In counselling of periodic health examination, physicians recommended more than patients desired and a few item was performed at health care centers.
3) In physical examination, physicians recommended more than patients desire, and the most selected item was blood pressure by physicians and patients. At health care centers, height and weight, blood pressure, vision, hearing were performed more than patient's desire and physician's recommendation, but oral cavity, mammography, pelvic examination, digital rectal examination were performed less than.
4) In diagnostic procedure, physicians recommended more than patients desire, and patients selected more than counselling and physical examination. At health care centers, laboratory examination through blood and urine samples were performed more than patient's desire and physician's recommendation, but Pap smear(78.9%). mammography(39.1%), barium enema(0.0%) were performed less than.
5) In frequency of selected health care items, patients desired more frequently than physicians recommended, and there was no recommendation about it at health care centers.
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