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Review Article

Barriers to alcohol intervention program: a scoping review
Selly Jaimon, Richard Avoi, Mohd Nazri Bin Mohd Daud, Pravina Deligannu, Zulkhairul Naim Bin Sidek Ahmad
Korean J Fam Med 2025;46(4):218-230.   Published online July 20, 2025
DOI: https://doi.org/10.4082/kjfm.25.0055
Excess alcohol intake is associated with many negative effects and is a major cause of mortality and morbidity worldwide. World Health Organization has established a global plan with 10 primary policy areas and interventions and six important action areas to reduce alcohol’s negative effects. However, alcohol intervention programs face several challenges that can hinder their success in assisting patients with alcohol consumption reduction and cessation. The objective of this scoping review was to identify the barriers to the implementation of alcohol intervention programs. The Joanna Briggs Institute recommendations and PCC (participants, concepts, context) eligibility criteria were used for the review. A combination of search phrases was used to narrow the literature search to 2014–2024 English-language papers and original research articles with full access. After removing duplication, 3,846 articles remained from the 5,128 found. After further exclusions, 19 eligible studies were included in this review. Five main barriers to care were identified: service-level barriers, barriers to care seeking, stigma, socio-cultural barriers, and external barriers. Robust regulations and implementation are necessary to effectively address service levels and external barriers. To enhance help-seeking behaviors, alcohol screening should be implemented, strict management policies for alcohol use disorders should be enforced, and accessible alternatives should be provided. Additionally, public health initiatives should focus on changing societal perceptions to counteract alcohol normalization. These efforts must involve both communities and workplaces.

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  • Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
    Joung Sik Son
    Korean Journal of Family Medicine.2025; 46(4): 215.     CrossRef
  • 2,314 View
  • 50 Download
  • 1 Web of Science
  • 1 Crossref
Original Articles
Knowledge and Risk Behaviors Regarding Human Immunodeficiency Virus Transmission among Portuguese Healthcare Students
Bárbara Joana Alvarenga Carvalho, António Miguel da Cruz-Ferreira
Korean J Fam Med 2023;44(1):35-43.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.22.0012
Background
Human immunodeficiency virus (HIV), the agent responsible for acquired immunodeficiency syndrome, remains a worldwide public health problem. Therefore, this study aimed to assess Portuguese healthcare students’ knowledge of HIV, identify risk behaviors for HIV transmission, and assess the frequency of HIV testing and its dissemination by general practitioners.
Methods
A cross-sectional observational study was conducted using an anonymous questionnaire published online. The questionnaire was administered to Portuguese healthcare students who voluntarily agreed to participate in the study after clarifying its objectives and procedures.
Results
Most students were aware of the three main HIV transmission routes; however, 66.3% were unaware of the level A recommendation for HIV screening in adolescents and adults. In addition, 59.6% of the students were never informed by their general practitioner about HIV screening tests or risk behaviors for HIV transmission. Of the sample, 78.9% had never been tested for HIV infection. Of the 74.6% of sexually active students, 82.0% had or had already had unprotected sex (without a condom). Men showed riskier sexual behaviors than women. None of the inquiries reported intravenous drug use, and most students (69.9%) never shared personal objects.
Conclusion
General practitioners and awareness campaigns need to alert and disseminate HIV screening tests. Sexual health and risk behaviors should be addressed more frequently in schools to educate this population because prevention is the best strategy against HIV transmission/contraction.

Citations

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  • Sexual awareness, high-risk sexual behaviors and HIV testing: a cross-sectional survey among university students in Xuzhou, Jiangsu
    Hualing Li, Qi Wu, Qinghan Li, Enze Gao, Dehui Yin
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • 3,719 View
  • 76 Download
  • 1 Web of Science
  • 1 Crossref
Healthy Beliefs regarding Breast Cancer Screening in Iranian Women Health Volunteers: A Path Analysis
Fatemeh Salmani, Mitra Moodi, Azam Yousefi, Ensiyeh Norozi
Korean J Fam Med 2021;42(2):132-139.   Published online May 28, 2020
DOI: https://doi.org/10.4082/kjfm.20.0001
Background
In Iran, 82% of breast cancer cases are diagnosed in late stages, resulting in low survival rates. In the present study, the Stages of Change Theory and Health Belief Model were used as theoretical frameworks for assessing Women Health Volunteer readiness to act on different breast cancer screening behaviors.
Methods
A total of 1,410 Women Health Volunteers were enrolled in this cross-sectional study. The breast self-examination (BSE) and mammography stages of change were measured independently. A standardized questionnaire based on the Health Belief Model was used to assess their beliefs about breast cancer screening methods. A path analysis using PASW SPSS ver. 18.0 (SPSS Inc., Chicago, IL, USA) was used to test the effects of individual beliefs on breast cancer screening stages of change.
Results
Most participants were classified in the pre-contemplation stage of breast cancer screening behaviors. Perceived barriers, benefits, and susceptibility emerged as BSE stages of change predictors. No beliefs were significant mammography stages of change predictors.
Conclusion
Iranian Women Health Volunteers had a very low adherence to common BSE and mammography practices. Healthy beliefs have a strong association with the stages of change for performing BSE, but not for mammography. The impact of health beliefs on an individual’s readiness to act on different breast cancer screening methods may vary with respect to the type of screening method.

Citations

Citations to this article as recorded by  
  • SAĞLIĞIN SOSYAL BELİRLEYİCİLERİNİN MEME KANSERİ BİLGİ DÜZEYİ VE TARAMALARINA ETKİSİ: BİR SİSTEMATİK DERLEME
    Özlem Durmuş, Keziban Avcı
    Eskişehir Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi.2025; 10(2): 246.     CrossRef
  • Analysis of the Distribution Characteristics and Influencing Factors of Apparent Temperature in Chang–Zhu–Tan
    Dongshui Zhang, Junjie Liu, Yanlu Xiao, Xiuquan Li, Xinbao Chen, Pin Zhong, Zhe Ning
    Sustainability.2025; 17(16): 7225.     CrossRef
  • Mammography screening status of women aged 40 and older in eastern Iran using the precaution adoption process model (PAPM)
    Mahbobe Sadat Sahebi, Gholamreza Sharifzadeh, Mitra Moodi
    Scientific Reports.2025;[Epub]     CrossRef
  • Exploring Theoretical Models and Frameworks Used to Explain Factors Influencing Breast Cancer Screening Participation: A Scoping Review
    Dandan Zheng, Pichitra Lekdamrongkul, Xiaofen Gao, Aurawamon Sriyuktasuth
    International Journal of Women's Health.2025; Volume 17: 5639.     CrossRef
  • 5,948 View
  • 121 Download
  • 4 Web of Science
  • 4 Crossref
Psychological and Sociodemographic Predictors of Fertility Intention among Childbearing-Aged Women in Hamadan, West of Iran: An Application of the BASNEF Model
Khadijeh Bandehelahi, Sahar Khoshravesh, Majid Barati, Leyli Tapak
Korean J Fam Med 2019;40(3):182-187.   Published online January 14, 2019
DOI: https://doi.org/10.4082/kjfm.18.0008
Background
Fertility and childbearing are the most important determinants of population variation around the world. This study was conducted with the aim of determining the psychological and sociodemographic factors predicting fertility intention among women referred to comprehensive health centers in Hamadan based on the beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model.
Methods
This descriptive analytical study was performed in comprehensive health centers in Hamadan in 2016. Through a multi-stage sampling method, 484 women were enrolled in the study. The data collection tool was a selfreport questionnaire based on the constructs of the BASNEF model. Data were analyzed using linear regression, independent t-test, and a one-way analysis of variance using IBM SPSS software ver. 22.0 (IBM Corp., Armonk, NY, USA).
Results
The mean±standard deviation of the women’s age was 31.85±6.13 years. The variables of motivation to comply (β=0.228), enabling factors (β=0.162), subjective norms (β=0.134), and attitude (β=0.122) were the predictors of fertility intention in women. This model was able to explain 16.8% of variance in behavioral intention. Also, lower age, higher education, shorter duration of marriage, and having a daughter resulted in a greater fertility intention.
Conclusion
It seems that designing and implementing educational programs to improve attitudes, promoting positive subjective norms, and enhancing enabling factors can play a major role in increasing fertility intention in women.

Citations

Citations to this article as recorded by  
  • The effect of motivational interviewing on attitude and intention for childbearing in healthcare provider women
    Akram Rahimi, Moslem Taheri, Maryam Dafei, Fatemeh ZareMobini
    BMC Psychology.2025;[Epub]     CrossRef
  • Examining the Relationship between Parents' Spiritual Health and the Desire to Have Children: A Systematic Review
    Rasoul Raesi, Hossein Shamsi Gooshki, Seyed Saeed Tabatabaee, Abolfazl Khoshi, Seyed Hassan Saadat, Salman Daneshi, Saied Bokaie, Kiavash Hushmandi
    The Open Public Health Journal.2025;[Epub]     CrossRef
  • The Relationship Between Social Determinants of Health and Attitudes Towards Childbearing with the Mediation of Social Support Among Women of Reproductive Age: A Path Analysis
    Fereshte Ghahremani, Mahbobeh Ahmadi Doulabi, Zohreh Mahmoodi, Malihe Nasiri
    Iranian Journal of Psychiatry and Behavioral Sciences.2025;[Epub]     CrossRef
  • “May we not orchestrate our own misfortune”: a qualitative study on perception about causes and prevention of occupational injuries among bricklayers and carpenters in Osun State, Nigeria
    Temitope Olumuyiwa Ojo, Nisha Naicker, Funmilayo Juliana Afolabi, Adedeji Ayodeji Onayade
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Examining the impact of an educational intervention on enhancing different aspects of health-promoting behaviors: using the BAZNEF model
    Sahar Mohammad Nabizadeh
    Health Education.2025; 125(5): 553.     CrossRef
  • Investigating the Effect of Educational Intervention Based on the BAZNEF Model on the Improvement of Various Dimensions of Quality of Life in University Students
    Maryam Mohammadi, Sahar Mohammadnabizadeh
    Advances in Health and Behavior.2025; 8(1): 312.     CrossRef
  • Factors affecting subsequent dose of COVID-19 vaccine uptake based on BASNEF model among older adults
    Majid Barati, Hanieh Jormand, Salman Khazaei, Saeed Bashirian, Mohadeseh Sadri, Maryam Afshari
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • Immediate Antecedents of Intentions for Having Children in Southeast Iranian Women
    Javad Ghasemi, Mansoureh Safizadeh, Zahra Khajeh, Nouzar Nakhaee
    Korean Journal of Family Medicine.2023; 44(5): 289.     CrossRef
  • Attitude of childless married women towards childbearing in Zanjan, Iran
    Fereshteh Naderipour, Jamileh Abolghasemi, Tahereh Dehdari, Roghayeh Nouri
    Payesh (Health Monitor) Journal.2023; 22(3): 335.     CrossRef
  • Factors affecting childbearing intention in women employees in Birjand: Application of the theory of planned behavior
    Toktam Alizadeh, Mitra Moodi, Fatemeh Salmani, Asieh Moudi
    Journal of Education and Health Promotion.2023;[Epub]     CrossRef
  • Spatial Variations in Fertility Desire in West Africa
    Ezra Gayawan, Fidelia Dake, Justin Dansou, Olusegun Sunday Ewemooje
    Spatial Demography.2022; 10(2): 359.     CrossRef
  • Factors Affecting Fertility Intention Among People Living with HIV in Kunming, China
    Yingwu Guo, Yingrong Du, Sanguan Lerkiatbundit, Jun Liu, Jingsong Bai, Yongrui Yang, Yin Yang, Aihui Wu, Virasakdi Chongsuvivatwong
    HIV/AIDS - Research and Palliative Care.2022; Volume 14: 265.     CrossRef
  • Understanding the rationales behind childbearing
    Babak Moeini, Amir Erfani, Majid Barati, Amin Doosti-Irani, Hatam Hosseini, Mokhtar Soheylizad
    Journal of Education and Health Promotion.2022; 11(1): 119.     CrossRef
  • Effect of Training Program on Snack Consumption in Elementary School Girls: Application of the BASNEF Model
    Zahra Jalili, Zahra Saboohi, Reza Tavakoli
    Journal of Education and Community Health.2021; 8(1): 3.     CrossRef
  • The association of psychological well-being and fertility intention in parents of children with intellectual disability: A foundation for reproductive education
    Sepideh Sheidanik, Mitra Savabi-Esfahani, Amir Ghamarani, Amir Erfani
    Journal of Education and Health Promotion.2021;[Epub]     CrossRef
  • Determinants of fertility intentions among women of reproductive age in South Africa: evidence from the 2016 demographic and health survey
    Olusegun Sunday Ewemooje, Elizabeth Biney, Acheampong Yaw Amoateng
    Journal of Population Research.2020; 37(3): 265.     CrossRef
  • The Effect of Home Base Physical Activity Program based on the BASNEF Model on Motor Recovery in Patients with Stroke
    Fatemeh Esteki-Ghashghaei, Mohammad Saadatnia, Fariborz Khorvash, Hossein Shahnazi
    Home Health Care Services Quarterly.2020; 39(3): 154.     CrossRef
  • 9,370 View
  • 123 Download
  • 13 Web of Science
  • 17 Crossref
Knowledge, Attitude, Exposure, and Future Intentions toward Exclusive Breastfeeding among Universiti Sains Malaysia Final Year Medical and Dental Students
Noraini Mohamad, Norkhafizah Saddki, Khairun Nadzirah Khairul Azman, Ida Dahlia Ab Aziz
Korean J Fam Med 2019;40(4):261-268.   Published online January 9, 2019
DOI: https://doi.org/10.4082/kjfm.18.0021
Background
Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia.
Methods
A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest.
Results
Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding.
Conclusion
Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.

Citations

Citations to this article as recorded by  
  • Amamentação e suas dimensões: uma revisão integrativa sobre conhecimento de estudantes da área da saúde
    Patricia Lima Pereira Peres, Maria Helena do Nascimento Souza, Thaís Emanuele da Conceição, Rosane Harter Griep, Rafael Braga Esteves, Antonella Nespoli, Donatella Valente, Giovanni Galeoto
    Revista Brasileira de Enfermagem.2025;[Epub]     CrossRef
  • Breastfeeding and its dimensions: an integrative review of health students’ knowledge
    Patricia Lima Pereira Peres, Maria Helena do Nascimento Souza, Thaís Emanuele da Conceição, Rosane Harter Griep, Rafael Braga Esteves, Antonella Nespoli, Donatella Valente, Giovanni Galeoto
    Revista Brasileira de Enfermagem.2025;[Epub]     CrossRef
  • CONHECIMENTO DOS ESTUDANTES DE MEDICINA SOBRE ALEITAMENTO MATERNO
    Jasmin Januth Vieira, Anna Clara Piccin Henriques De Souza, Joyce de Freitas Souza, Ester Queiroz Galavotti, Wanêssa Lacerda Poton
    REVISTA FOCO.2023; 16(4): e1690.     CrossRef
  • Conocimiento y actitudes sobre los beneficios de la lactancia materna en universitarios
    Juan Alejandro Hernández-Pérez, Miguel Ángel Hernández-Hernández, María de los Ángeles Ramírez-Trujillo
    CienciaUAT.2021; : 42.     CrossRef
  • 30,767 View
  • 181 Download
  • 1 Web of Science
  • 4 Crossref
Pelvic Floor Muscle Exercise Education and Factors Associated with Implementation among Antenatal Women in Hospital Universiti Sains Malaysia
Juliawati Muhammad, Rosediani Muhamad, Nik Rosmawati Nik Husain, Norwati Daud
Korean J Fam Med 2019;40(1):45-52.   Published online January 7, 2019
DOI: https://doi.org/10.4082/kjfm.17.0136
Background
Pelvic floor muscle exercise is effective for pelvic floor muscle dysfunction. Despite the high prevalence of pelvic floor muscle dysfunction in women in the community, pelvic floor muscle exercise recognition is low in Malaysian society; thus, this intervention is not frequently used . This study assessed the knowledge of, attitudes towards, and use of pelvic floor muscle exercise among antenatal women before and after educational classes. The study also determined factors associated with exercise practice.
Methods
An interventional study was conducted in 121 antenatal women selected through systematic random sampling between June and December 2010. Baseline knowledge of, attitude towards, and practice of pelvic floor muscle exercise were assessed using self-administered validated questionnaires at first visit and at 2 months postpartum. All participants attended two exercise education classes on their next two visits before delivery. A paired ttest and multivariate analysis were used for data evaluation.
Results
The mean pre-intervention scores for knowledge, attitudes, and practice were 24.98, 24.25, and 3.51, respectively, with statistically significant mean score increments after intervention (P<0.001). The mean differences were 4.67 (95% confidence interval [CI], 3.86–5.49), 3.77 (95% CI, 3.05–4.50) and 3.45 (95% CI, 2.90–4.00) for knowledge, attitudes, and practice, respectively. Lack of baseline information on pelvic floor muscle exercise was significantly associated with practice change following an educational class.
Conclusion
Education is effective in improving knowledge of, attitude towards, and practice of pelvic floor muscle exercise. There is a need for greater effort to increase exercise awareness in our community, especially during antenatal class.

Citations

Citations to this article as recorded by  
  • A Scoping Review of Quantitative Assessments of Women’s Bladder Health Knowledge, Attitudes, and Beliefs
    D. Yvette LaCoursiere, Shayna D. Cunningham, Camille P. Vaughan, Lisa Kane Low, Haitao Chu, Alayne D. Markland, Diane K. Newman, Sheila Gahagan, Jean F. Wyman
    Journal of Women's Health.2025; 34(9): 1099.     CrossRef
  • Pelvic floor muscle exercise practice and its determinants among postpartum women in Central Ethiopia: as a strategy for preventing pelvic floor disorders
    Mebratu Demissie Senbeta, Aberash Beyene Derribow, Aynalem Belay, Ayana Benti Terefe, Mangistu Abera
    Scientific Reports.2025;[Epub]     CrossRef
  • Epidemiological Profile and Attitudes of Pregnant Women Toward Urinary Incontinence: A Single-Center Cross-Sectional Study
    Andy-Müller Nzinga Luzolo, Elie Dilu Mabiala, Inès Bilo Mbaki, Patient Ngereza Kibimbi, Nene Bope Matshinga, Ra-Shin Kasonga
    International Urogynecology Journal.2024; 35(3): 521.     CrossRef
  • Attitude and concerns on antenatal pelvic floor exercises among pregnant women in Ibadan, Nigeria
    Oluwatimilehin Azeezat Yusuf, Olatunji Okikiola Lawal, Gbolahan Oladele Obajimi, Kelechukwu Peter Ughagwu, Iseoluwa Philip Owoeye, Boluwaduro Ogooluwa Alebiosu, Victoria Oyindamola Moradeyo, David Oluwasayo Babalola, Offorbuike Chiamaka Bianca, Yusuf Olat
    Journal of West African College of Surgeons.2024; 14(3): 295.     CrossRef
  • Knowledge, attitudes, and practices of pelvic floor muscle exercises among pregnant women visiting public hospitals
    Javeria Saeed, Laiba Abdullah
    Journal of Basic & Clinical Medical Sciences.2023; 1: 12.     CrossRef
  • Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia
    Merete Kolberg Tennfjord, Belayneh Ayanaw Kassie, Zelalem Mengistu Gashaw, Mengstu Melkamu Asaye, Haymanot Alem Muche, Tibebu Tadesse Fenta, Kalkidan Nigussie Chala, Karolina S. Mæland
    International Journal of Environmental Research and Public Health.2023; 20(5): 4201.     CrossRef
  • Hemşire ve Ebelerin Kadınlara Pelvik Kas Egzersizi Öğretimine Yönelik Uygulamaları
    Cansu KARADENİZ BENLİ, Nedime Gül DOĞAN ÖZDEMİR, Özen KULAKAÇ
    Samsun Sağlık Bilimleri Dergisi.2023; 8(1): 157.     CrossRef
  • Knowledge, attitudes, and practice of pelvic floor dysfunction and pelvic floor ultrasound among women of childbearing age in Sichuan, China
    Xiaoli Wu, Xiaohong Yi, Xiu Zheng, Zeling Chen, Junxi Liu, Xiong Dai
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Knowledge, attitude and practice towards pelvic floor muscle training among childbearing women
    Nur Fairuz Mohd Fauzey, Siti Mariam Muda, Haliza Hasan, Zalina Nusee, Muzaitul Akma Mustapa Kamal Basha
    Archivio Italiano di Urologia e Andrologia.2023;[Epub]     CrossRef
  • Effectiveness of a Pelvic Floor Muscle Exercise Intervention in Improving Knowledge, Attitude, Practice, and Self-Efficacy among Pregnant Women: A Randomized Controlled Trial
    Parwathi Alagirisamy, Sherina Mohd Sidik, Lekhraj Rampal, Siti Irma Fadhilah Ismail
    Korean Journal of Family Medicine.2022; 43(1): 42.     CrossRef
  • Troubles pelvipérinéaux de la période périnatale : état des connaissances des femmes, une revue systématique
    M. Charrié, S. Billecocq
    Progrès en Urologie.2021; 31(4): 204.     CrossRef
  • Importance of a pelvic floor lifestyle program in women with pelvic floor dysfunctions: A pilot study
    Véronique Blanchard, Krystel Nyangoh-Timoh, Xavier Fritel, Arnaud Fauconnier, Anne-Cécile Pizzoferrato
    Journal of Gynecology Obstetrics and Human Reproduction.2021; 50(4): 102032.     CrossRef
  • KEPT-app trial: a pragmatic, single-blind, parallel, cluster-randomised effectiveness study of pelvic floor muscle training among incontinent pregnant women: study protocol
    Sherina Mohd Sidik, Aida Jaffar, Chai Nien Foo, Noor Azimah Muhammad, Rosliza Abdul Manaf, Siti Irma Fadhilah Ismail, Parwathi Alagirisamy, Amalina Farhi Ahmad Fazlah, Zailiza Suli, Felicity Goodyear-Smith
    BMJ Open.2021; 11(1): e039076.     CrossRef
  • Association of Knowledge and Presence of Pelvic Floor Disorders and Participation in Pelvic Floor Exercises: A Cross-sectional Study
    Sophia Delpe Goodridge, Leah P. Chisholm, Jessica Heft, Siobhan Hartigan, Melissa Kaufman, Roger R. Dmochowski, Thomas Stewart, William Stuart Reynolds
    Female Pelvic Medicine & Reconstructive Surgery.2021; 27(5): 310.     CrossRef
  • GEBE KADINLARIN PELVİK TABAN KAS EGZERSİZLERİ HAKKINDA BİLGİ VE İNANÇLARI
    Hatice KAHYAOĞLU SÜT, Burcu KÜÇÜKKAYA
    Samsun Sağlık Bilimleri Dergisi.2021; 6(3): 525.     CrossRef
  • Pelvic floor muscle training programme in pregnant Nepalese women—a feasibility study
    Ranjeeta Shijagurumayum Acharya, Anne Therese Tveter, Margreth Grotle, Bimika Khadgi, Ingeborg Hoff Braekken, Britt Stuge
    International Urogynecology Journal.2020; 31(8): 1609.     CrossRef
  • Urinary incontinence and its association with pelvic floor muscle exercise among pregnant women attending a primary care clinic in Selangor, Malaysia
    Aida Jaffar, Sherina Mohd-Sidik, Foo Chai Nien, Gan Quan Fu, Nor Hazlin Talib, Peter F.W.M. Rosier
    PLOS ONE.2020; 15(7): e0236140.     CrossRef
  • 8,656 View
  • 169 Download
  • 13 Web of Science
  • 17 Crossref
Effects of Brief Advice from Family Physicians on the Readiness to Change of Korean Male At-risk Drinkers
Bora Kwon, Jong Sung Kim, Sung Soo Kim, Jin Gyu Jung, Min Yeong Kim, In Gyu Song, Kwang Mi Youn
Korean J Fam Med 2012;33(3):157-165.   Published online May 24, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.3.157
Background

This study examined the effects of the method of delivery of brief advice on the readiness to change in at-risk drinkers.

Methods

The participants were 103 at-risk male drinkers who visited Chungnam National University Hospital for general health examinations. Baseline data on drinking behavior, readiness to change drinking behavior, and sociodemographic characteristics were obtained from a questionnaire. Family physicians gave two minutes of advice by telephone or in-person. The brief advice comprised a simple statement that the patient's drinking exceeded the recommended limits and could lead to alcohol-related problems. It also included advice to moderate one's drinking. One month later, the readiness to change was assessed again by telephone. The improvement in the readiness to change according to each method of delivery was investigated.

Results

Initially, among the 58-patient in-person advice group, 12 patients were in the precontemplation stage, 38 in the contemplation stage, and 8 in the action stage. One month after the advice was given to the patients, the distribution had changed significantly (P < 0.001) to 1, 21, and 36 patients, respectively. Among the 45-patient telephone advice group, 7 patients were in the precontemplation stage, 32 patients were in the contemplation stage, and 6 patients were in the action stage before the advice. The distribution had changed significantly (P < 0.001) to 1, 17, and 27 patients, respectively, 1 month after the advice.

Conclusion

These results suggest that brief advice by family physicians is effective in improving the readiness to change of at-risk drinkers, regardless of the delivery method.

  • 4,372 View
  • 17 Download
Attitude of Korean Primary Care Family Physicians Towards Telehealth
Ji-Eun Kim, Yun-Mi Song, Joo-Hyun Park, Jae-Ri Lee
Korean J Fam Med 2011;32(6):341-351.   Published online September 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.6.341
Background

Recently, a revised telehealth legislation that allows direct doctor to patient teleconsultation was proposed in Korea. However, there have been some debates. This study aimed to examine the attitude of primary care physicians towards telehealth.

Methods

A questionnaire asking attitude towards telehealth and revised telehealth legislation was self-administered to 1,988 registered members of Practitioners Council of Korean Academy of Family Medicine. A total of 218 complete responses by family physicians were included in the study.

Results

Large proportion (60.6%) of participants disagreed to the main clause of revised telehealth legislation, which allowed doctor to patient teleconsultation. Participants tended to expect that negative outcomes are more likely to occur than positive outcomes after the enforcement of the revised telehealth legislation. Around 50% of participants had an intention to adopt telehealth just as soon (4.6%) or afterwards (45.4%). The majority of participants suggested that; primary care clinic as the most appropriate telehealth facility (75.4%); patients with low accessibility to medical care (74.3%) as the best target of telehealth service; and tele-radiology (61.9%) or tele-pathology (41.3%) as the most applicable medical field for telehealh service. Around 89% of participants suggested telehealth service fee to be similar or higher than current medical consultation fee.

Conclusion

The majority of family physicians participating in this study were not in favor of the revised telehealth legislation. However, the majority of the participants had an intention to adopt telehealth to their practice and held clear opinion about practical aspects of telehealth.

Citations

Citations to this article as recorded by  
  • Reimagining Radiology: A Comprehensive Overview of Reviews at the Intersection of Mobile and Domiciliary Radiology over the Last Five Years
    Graziano Lepri, Francesco Oddi, Rosario Alfio Gulino, Daniele Giansanti
    Bioengineering.2024; 11(3): 216.     CrossRef
  • Beyond the Clinic Walls: Examining Radiology Technicians’ Experiences in Home-Based Radiography
    Graziano Lepri, Francesco Oddi, Rosario Alfio Gulino, Daniele Giansanti
    Healthcare.2024; 12(7): 732.     CrossRef
  • Patient Preparation and Positioning in Diagnostic Imaging: The Collaborative Roles of Radiology Technicians and Nursing Staff
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Validation of the Korean Integrative Medicine Attitude Questionnaire (IMAQ)
Jung-Ha Kim, Jung-Bok Lee, Duk-Chul Lee
Korean J Fam Med 2011;32(3):197-204.   Published online March 31, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.3.197
Background

To develop a Korean version of the Integrative Medicine Attitude Questionnaire (IMAQ) in order to evaluate physician attitudes toward integrative medicine/complementary and alternative medicine (CAM).

Methods

We developed a Korean IMAQ through careful translation of the 28-item questionnaire developed by Schmidt et al. A web-based survey was sent via email to 118 primary care physicians in Korea. The complete respose rate wasa 52.5%. The questionnaire's reliability and validity were verified using Cronbach's α, factor analysis, and discriminant analysis.

Results

Although the Korean IMAQ exhibited excellent internal consistency, its validity was insufficient. Our results suggest that Western and Korean physicians may have different understandings of CAM and the concept of holism, as factor analysis showed that incorrectly classified items were mainly part of the holism conceptual domain. Furthermore, the sum of the items within the holism conceptual domain was not significantly different for physicians who had previously received CAM education.

Conclusion

This study developed and tested the first Korean IMAQ. We found that this version of the questionnaire lacks sufficient validity and requires further modification.

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  • Attitudes of medical students toward the practice and teaching of integrative medicine
    Gerard Flaherty, Jenny Fitzgibbon, Peter Cantillon
    Journal of Integrative Medicine.2015; 13(6): 412.     CrossRef
  • The use of complementary and alternative medicine (CAM) in children: a telephone-based survey in Korea
    Jung-Ha Kim, Chung-Mo Nam, Moo-Young Kim, Duk-Chul Lee
    BMC Complementary and Alternative Medicine.2012;[Epub]     CrossRef
  • Complementary and Alternative Medicine Education for Medical Profession: Systematic Review
    Nana K. Quartey, Polly H. X. Ma, Vincent C. H. Chung, Sian M. Griffiths
    Evidence-Based Complementary and Alternative Medicine.2012; 2012: 1.     CrossRef
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A Comparison of Clinical Oncologists and Family Physicians toward Complementary and Alternative Medicine in South Korea: Perceptions, Attitudes and Physician-Patient Communication.
Do Bum Chung, Yoon Jung Chang, Se Na Kang, Su Yeon Kye, Young Ho Yun, Dong Ryul Lee
Korean J Fam Med 2010;31(1):24-34.   Published online January 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.1.24
Background
Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. Methods: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. Results: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have suffi cient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline(37.0%). Conclusion: The results of this study showed that most physicians did not have sufficient information regarding CAM(87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.

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    Sanghee Kim, Myung-Nam Lee, Senah Lee
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Family Physicians' Perception on Hearing Impaired People.
Jin Wook Choi, Hee Kyung Joh, Sung Ki Lee, Hyun Jin Do, Seung Won Oh, Youl Lee Lym, Jae Kyung Choi, Hyuk Jung Kweon, Dong Yung Cho
J Korean Acad Fam Med 2008;29(9):675-686.   Published online September 10, 2008
Background: Hearing impaired people have a lot of difficulty in communicating when they visit medical institutions. This study was to reveal the family physicians' perception and attitude for the hearing impaired people, and the effect of those factors on the actual physicians' practice behavior for the disabled. Methods: We sent questionnaires by post mail to 1,000 members listed in the 2007 address book of the Korean Association of Family Medicine. Results: Among the total of 90 family physicians who had answered, 72 (80.8%) had willing attitude to treat the hearing impaired people, and the most important reason was that it was essentially a doctor's duty. In the group who were unwilling to treat the disabled, the most principal reason was that they were not equipped with sufficient facility and medical system. Gender was the only factor affecting the physicians' attitude significantly and the female doctors had a higher intention to treat the hearing impaired people than male doctors (P=0.035). Age, location of hospital, number of patients, practical experience of hearing impaired people had no significant effect on doctors' attitude. The number of physicians who volunteered to participate for the hearing impaired people's health promotion personally was significantly higher in the group of treatment intention (P=0.007). Nevertheless, few physicians had the willingness to equip the hospital facility for the hearing disabled, even in the group of willingness to treat the disabled. The most important reason was that very few disabled patients visit their clinic, and so forth they felt no necessity to improve and re-organize their clinical environment. Conclusion: Most family physicians are willing to treat hearing impaired people. But even in the willing group, almost all of them are unwilling to improve or equip the medical facilities for the hearing impaired people personally, because only a few disabled people visit the primary care hospital in the real practice. (J Korean Acad Fam Med 2008;29:675-686)
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Effects of a School-based Obesity Prevention Program in Adolescents.
Sang Joon Yun, Kayoung Lee
J Korean Acad Fam Med 2008;29(8):585-594.   Published online August 10, 2008
Background
We aimed to evaluate the effect of school- based obesity prevention and management program applied to adolescents in a middle school on body mass index (BMI), weight-related attitude, eating behavior and physical activity of adolescents. Methods: A total of 664 adolescents (14.7±0.9 years old) in a middle school located in Busan were study subjects. The obesity prevention and management program was conducted for 6 months, from March to September, 2005. Their weight and height were measured and their weight-related attitude, eating habit and physical activity were assessed using a questionnaire at baseline and after 6 months. Their weight status was classified into under-, normal-, and overweight according to their BMI at baseline. Results: The prevalence of underweight and overweight was 6.2% and 19.3%, respectively. Among the adolescents with overweight, the BMI significantly decreased after 6 months compared to the BMI at baseline (P<0.05), while the BMI was not significantly changed over 6 months among the under- and normal weight groups. The adolescents were more likely to become highly concerned about obesity-related problems (P=0.002) and actively participating in obesity prevention program (P=0.007) after 6 months compared to those attitude at baseline. The BMI significantly decreased in the adolescents whose eating behavior or physical activity were improved compared to their counterparts (P<0.05). Conclusion: The 6-months program for obesity prevention and management seemed to reduce BMI in overweight adolescents and raise concern about obesity related problems and promote participation in obesity prevention program in adolescents as a whole. Further long-term intervention studies need to be implemented. (J Korean Acad Fam Med 2008;29:585-594)
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Preferences for Addressing Title to Patients and Physicians' Attire in a Medical Office.
Seong Hoo Ahn, Ji Hye Jung, Jong Won Jin, Hyun Chul Kim, Se Jung Kim, Min Kyu Choi, Yong Kyun Roh
J Korean Acad Fam Med 2008;29(5):349-353.   Published online May 10, 2008
Background
Most patients feel uneasy about visiting a clinic and thus the trust on their physicians can be affected by the physicians´ attire, attitude and greeting. We aimed to investigate the difference between patients´ and physicians´ preferences to attires and greetings in clinics. Methods: We conducted a questionnaire survey on 394 outpatients in a university hospital and on 169 doctors from five university hospitals. We questioned to the outpatients about their preference for physicians´ dress style, how to address them and the method of greeting. We also questioned to the doctors about their own attire, attitude and etiquette. Results: The patients preferred to be called 'OOO Nim' (54.0%), 'OOO Ssi' (29.2%), 'Hwanjabun' (16.2%) and 'Sunsaengnim' (2.5%). However, the physicians were used to calling patients 'Hwanjabun' (39.2%), 'OOO Nim' (29.6%), 'OOO Ssi' (24.5%) and 'Sunsaengnim' (1.2%) (P<0.001). Both the patients and the physicians preferred physicians′to wear white-gown (70.3% vs 78.7%) in a medical office. Inside the gown, a shirt and a necktie (66.2% vs 71.6%) were favored in both groups. Compared to the patients, the physicians thought that their attitude (23.1% vs 45.6%) and their attire (49.7% vs 55.6%) had a great effect on their professionalism. Conclusion: We found that the patients wanted to be called 'OOO Nim', but 'Hwanjabun' was most commonly used by the physicians. Both the patients and the physicians preferred white-gown. We also found that the physicians′ attire and attitude were strongly associated with their professionalism. (J Korean Acad Fam Med 2008;29:349-353)
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Weight-related Factors Associated with Active Attitude Toward Weight Loss in Overweight Children and Parents.
Ji Sun Park, Soo Kyoung Lee, Jung Won Park, Tae Jin Park, Kayoung Lee
J Korean Acad Fam Med 2007;28(3):179-186.   Published online March 10, 2007
Background
The purpose of this study was to find the weight-related factors related to active attitude towards weight loss in children who are overweight or obese and their parents. Methods: A total of 252 elementary school children who were overweight or obese and their parents were surveyed on weight-related attitudes for one month in May 2003 in Kimhae. The definition of overweight and obesity was based on age and sex-specific Korean children's BMI references established in 1998. Results: Among the total, 64.5% of children and 76.4% of parents thought frequently about losing weight in children. Among the total, 52.8% of children and 47.6% of parents tried losing weight in children more than three times. In children, the factors related to frequent thoughts of losing weight were gender, body mass index (BMI), body dissatisfaction index, and the score of eating attitude (P<0.05). Parents' thought about their children's losing weight and the efforts to persuade their children to lose weight were related to children's frequent thought about losing weight. The children's factors related to trying to lose weight by themselves were age, BMI, and the score of eating attitude. The parent's factors related to children trying to lose weight were body dissatisfaction index of their children by parents, parent's eating attitude score, parent's thought about children's losing weight and making efforts to persuade children to lose weight by parents. The children's eating attitude was related to frequent thoughts about losing weight (odds ratio 1.05, 95% CI 1.03∼1.07) and trying to lose weight more than 3 times (odds ratio 1.02, 95% CI 1.003∼1.04) after adjusting for other factors. Likewise, parents' effort to persuade their childrento lose weight was related to children's effort to lose weight (odds ratio 2.62, 95% CI 1.34∼5.1). Conclusion: Active attitude towards losing weight in overweight or obese children was related to parent's attitude to wards losing weight. (J Korean Acad Fam Med 2007;28:179-186)
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Patient-centered Attitudes in Primary Care Patients.
Sun Wook Hwang, Chang Jin Choi
J Korean Acad Fam Med 2006;27(12):998-1004.   Published online December 10, 2006
Background
: As the society changes to consumer-oriented trend, physician-patient relationship is in need of change. Patients tend to be highly satisfied when their physicians show more patient centered view or have similar character with their own. There have been studies on the patient-centeredness of medical students and physicians in Korea, but none was performed on the patient's patient- centeredness. The aim of this study was to investigate attitudes toward patient-centeredness and its associated factors in patients who visited local family practitioner's clinics.

Methods : The subjects were 359 patients who visited 10 local family practitioner's clinics from March 1 to July 1, 2005. Our survey utilized PPOS (Patient-Practitioner Orientation Scale) which composed of Sharing (sharing information, take part in decision making) and Caring (respecting one's feelings, interpersonal relationships) subscale. It also included demographic variables and health status by self questionnaire. Factors affecting patient-centeredness was analyzed via the t-test, ANOVA and Pearson Correlation.

Results : The total PPOS score was 3.85. The Sharing and Caring subscales were 3.68 and 4.02, respectively. We found that the patients, who were functionally healthier, younger than 40 years old, college-educated, and earning higher income, were significantly more patient-centered.

Conclusion : The patients' desire to obtain medical information and to take part in decision making (Sharing) were lower than that of patients' expectations for gaining respect of one's feelings and interpersonal relationships (Caring). The patients, who were healthier, younger, more educated, and earn more income, were shown to be significantly more patient-centered.
  • 1,538 View
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Patients' Attitudes toward Proactive Screening for Sexual Dysfunction.
Dong Wook Shin, Jong Seung Kim, Kang San Jung, Cheol Min Lee, Jae Kyung Choi, Min Su Park, Dae Hyun Yoon, Bong Yul Huh
J Korean Acad Fam Med 2006;27(8):637-644.   Published online August 10, 2006
Background
: Although proactive screening for sexual dysfunction in primary care has been emphasized as an important part of comprehensive care, doctors seldom ask their patients about their sexual function. Worry about patients' responses was reckoned as a major barrier, but few studies have dealt with how patients feel and what they want. This study was aimed to describe and analyze the attitudes of patients toward proactive screening for sexual dysfunction.

Methods : A set of self-administered questionnaire was given to every patients who visited a family medicine clinic in a university hospital for 2 weeks from March 16, 2005.

Results : A total of 185 patients were analyzed. Among them, 72.4% were willing to consult their physician when they were in trouble with their sexual function, and 84.3% said proactive screening for sexual dysfunction was necessary. Many patients did not care about 'when to be asked' and wanted to be asked in face-to-face interview rather than by a questionnaire. Sentence emphasizing that every patient is given the same question was most preferred.

Conclusion : Patients' attitude toward proactive screening for sexual dysfunction in primary care was generally positive. Patients preferred to be asked ;I ask every patient about his sexual problem. If you're OK, I ask you about your sexual problem.; regardless of timing, during the interview.
  • 1,808 View
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Family Physician's Knowledge of and Attitude towards Spouse Abuse in Korea.
Dae Gyeun Kim, Soon Ok Kim, Jun Su Kim, Jun Hyun Yoo, Jung Kwon Lee
J Korean Acad Fam Med 2006;27(7):540-548.   Published online July 10, 2006
Background
: The primary physician may be the first or the only professional who may come in contact with victims of spouse abuse. But little is known about family physician's knowledge of and attitude towards spouse abuse in Korea. Therefore, this study was conducted.

Methods : We selected 191 doctors from the participants of the 2003 annual meeting of the Korean Academy of Family Medicine (KAFM). We distributed a 5 paged questionnaire them to fill out and analyzed 125 cases among them. The questionnaire included social demographic characteristics, individual knowledge of and attitudes toward spouse abuse, individual practice experience, education and training experience, and others.

Results : We found a significant relationship between doctor's knowledge of spouse abuse and intervention after coming in contact with the victim. Also, this study showed that 31.8% of doctors intervened and traced the spouse abuse cases actively after physical treatment of victims, but none of the cases were reported to the police. Among the total 64.7% of the doctors explained that they did not want to intervene because they were afraid of getting involved in a legal situation. Some of the doctors who had prior educational experience concerning spouse abuse showed very significant high rate of actual intervention (P=0.0112).

Conclusion : The more educational experience on spouse violence the doctors had, the more active intervention they showed. Therefore, we need to intensify the practical educational program along with the training medical program targeting medical practitioners. Of course we need to request sacrifice from doctors based on moral principles, but we also need systemic aid and reform to legal system to minimize burden to doctors.
  • 1,597 View
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Effect of Attitude of Parents and School on Smoking Status in High School Students in a Small City.
Cheol Lee, Bok Sang Ko, Moo Sik Lee, Mi Young Lee
J Korean Acad Fam Med 2006;27(4):278-287.   Published online April 10, 2006
Background
: Adolescent smoking is one of the most serious social problems. This study was conducted to investigate the effect of the attitude of parent and school on smoking status and to help to reduce the smoke rate in high school students.

Methods : Data was collected by self-administered questionnaire between September and October 2002. The study subjects were 977 students of 7 high schools in the Nonsan area. The data was analyzed by using the SPSS program which included t-test, X2-test and logistic regression test.

Results : The smoking rates were 18.1% of general school students and 20.8% of vocational school in males, while 2.6% of general school students and 7.9% of vocational school in females. The mean starting age for the first cigarette was 15.3±1.9 in males and 15.6±1.3 in females. The mean age for regular smoking was 16.0±1.3 in males and 16.2±1.3 in females. Multiple logistic regression analyses indicated that the smoking rate increased in males (OR=2.75), early age for the first cigarette (OR= 7.04), small family (OR=8.60), high family income (OR= 1.95), colleague smoking (OR=5.68), strict attitude by school (OR=0.28) and loss of one's parents (OR=2.58). Among smokers, 71.4% of male smokers and 75% of female smokers wanted to quit.

Conclusion : This study suggests that the strict attitude of parents on their children's smoking decreased the smoking rate, while the stern attitude of school on their students increased it. Therefore, in order to decrease smoking rate, the strict attitude of parents on smoking should be continued and the attitude of school will have to consider aspects of students' characteristics and their interests when they propose to practice a school-based education program. It may have an effect on smoking prevention and reduction of the smoking rate.
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Family Physician's Knowledge, Attitude, Experience and Training on Breastfeeding.
Hai Lim Kim, Hong Soo Lee, Young A Oh, Su Yun Kim
J Korean Acad Fam Med 2006;27(2):120-127.   Published online February 10, 2006
Background
: Breastfeeding is not common in Korea despite its known benefits. The role of family physicians is important in promoting breast-feeding since they can provide prenatal and postnatal care on lifelong basis. This paper analyzed a survey of family physicians on their knowledge, attitude, experience, and training concerning breastfeeding.

Methods : The survey was carried out by e-mail enquiry to the residents and board-certified physicians registered in the Korean Academy of Family Medicine. The enquiry was developed by Gary L. Freed composed of 18 questions about knowledge, attitudes, experience, and training. The answers to the questions were analyzed to give frequency and the associations between the variables.

Results : Among the total, 64% of the residents and 76% of the physicians answered yes to whether breastfeeding was the best means of feeding an infant under 6 months of age. Also, 83% of the residents and 85% of physicians answered it was right to quit breastfeeding completely when breast abscess developed. The breastfeeding promotion was done more frequently by those who had personal experience. They had higher rate of educating patients than those who did not (28% vs. 9%, P<0.0001). Despite its importance, 86.5% of the residents and 77.6% of the physicians answered that they did not have enough opportunity to learn about breastfeeding during their training years.

Conclusion : Although family physicians are required to play a role in promoting breastfeeding, they are insufficiently trained under the current system. Therefore, it is necessary to develop a training program to educate the residents on breastfeeding.
  • 1,643 View
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Knowledge and Attitudes of Family Physician and Oncologist toward Cancer Pain Management in Korea.
Young Ho Yun, Sang Min Park, Kiheon Lee, Ki Young Son, So Yeon Chung, Dae Seog Heo, Si Young Kim, Young Seon Hong, Bong Yul Huh
J Korean Acad Fam Med 2005;26(7):397-403.   Published online July 10, 2005
Background
: Two representative groups of family physicians and oncologists were surveyed concerning their knowledge and attitudes toward cancer pain management (CPM).

Methods : A questionnaire, designed to assess knowledge (13 items) and attitudes (6 items) toward CPM, was sent to 2,200 members of Korean Association of Family Medicine and 800 members of Korean Cancer Association.

Results : Three hundred and eighty eight family physicians (17.6%) and one hundred and forty seven oncologists (18.4%) responded and completed the questionnaire. They had inadequate knowledge toward CPM, especially, chance of respiratory depression, tolerance to adverse effect, ceiling effect, risk of addiction, and use of adjuvants. Most of the physicians had positive attitude toward importance of CPM, best judge of pain severity, and priority of CPM but had negative attitude toward concerns about potential problem of addiction and earlier prescription of maximum dose of opioid. Family physicians displayed more lack of knowledge about CPM in 9 of 13 items and more negative attitudes toward 4 of 6 items. Adjustment for demographic characteristics and experiences in cancer patients with pain showed that while family physicians had poor knowledge of tolerance to confusion, they had more adequate knowledge on the effect of antidepressant and had positive attitude towards best judge of pain severity and priority of CPM. Poor knowledge about CPM was rated by 66.3% of physicians as the most important barrier to adequate CPM.

Conclusion : These findings that most of the physicians had poor knowledge and negative view toward CPM suggest a continuous need for comprehensive education program focused on CPM for physicians.
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Investigation of Smoking Rate, Habits and Attitudes towards Smoking in Lawyers of Korea.
Eun Jung Chung, Jee Kyoung Joung, Hong Gwan Seo, Sun Ha Jee
J Korean Acad Fam Med 2005;26(5):269-275.   Published online May 10, 2005
Background
: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes towards smoking in lawyers with those of medical doctors.

Methods : This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded.

Results : Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%.

Conclusion : In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.
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Primary Care Physicians Attitudes Toward Medically Unexplained Symptoms.
Seung Yeop Cheong, Cheol Hwan Kim, Eun Ju Sung, Ho Cheol Shin, Yong Woo Park, Yu Il Kim, Eun Jung Lee, Jung Il Jang
J Korean Acad Fam Med 2005;26(1):15-21.   Published online January 10, 2005
Background
: The medically unexplained symptoms present one of the most common problems in medical practice and the role of primary care physicians is becoming greater to manage them. Our goal was to investigate how the primary care physicians conceive and deal with patients complaining of medically unexplained symptoms (MUS).

Methods : A group of 840 primary care physicians, 524 internist and 316 family physicians in Seoul were surveyed. The questionnaire regarding the perception and the way of consultation about MUS was posted by mail.

Results : A total of 180 questionnaires were collected via mail and fax. Ten of them were uncompleted, and the response rate was 22%. Over half of the respondents felt that the consultation of MUS was difficult and they were concerned about the possibility of overlooking some of organic problems (57.6%). Average consultation rate of MUS in daily practice was 14%. The anxiety toward failure of treatment was the most common concern during the MUS consultation. Seventeen percent answered they knew the efficient method to deal with MUS patients. Respondents complained of the deficiency of contents and experiences to deal with MUS during the period of training (80%). More family physicians compared to internists perceived patients with MUS to have personality problems and they often tended to prescribe psychotropic drugs. Family physicians also answered that the training courses provided proper knowledge and contents regarding MUS consultation more than the internists.

Conclusion : MUS consultation imposes a burden on primary care physicians. Therefore, continuing education not only for residency but for post graduates should be considered for effective management for MUS.
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What Health Problems Do Korean Women Think Is Important?.
Sun Mi Yoo, Yun Mi Song, Min Seon Park, Jeong Hee Yang, Eun Young Choi, Jung Jin Cho
J Korean Acad Fam Med 2003;24(11):986-993.   Published online November 10, 2003
Background
: The aim of this study was to investigate the health problems which women feel important and what they want to know from their doctors in the family practice clinics.
Methods
: The subjects were all female patients who visited the family practice clinics at the four hospitals in which some members of the Study Group for Women's Health in Korean Academy of Family Medicine worked from December 10 to 15, 2001. We surveyed by self-administered questionnaire on important health topic, health care services they woud like to receive, what they expected from their doctors, what topics they have difficulty in discussing with, the doctors preference of physician's gender. We analyzed the results by age groups; 19∼44, 45∼64, and 65 years old and over.
Results
: A total of 437 women answered the questionnaires, whose mean age was 49.4 year. Health topics that women felt important were osteoporosis, stress, cervical cancer, arthritis, and stroke, which varied with the age groups and recent health perception. The provision of health care services which they desired were in the order of treatment, prevention and health promotion, and diagnosis, which varied with the age groups and recent health perception. What they expected from their doctors were in the order of giving accurate diagnosis, explaining the treatment plan, and answering their questions. They had difficulty undergoing physical exam undressed, gynecological exam, and discussing on their sexual problems.
Conclusion
: Women who visited the family practice clinics felt differently on important health problems according to the age groups. Overall, they wanted to receive health services on the treatment, prevention and health promotion of osteoporosis, stress, cervical cancer, and arthritis.
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Factors Related to the Compliance of Hormone Replacement Therapy for Menopausal Women.
Kyeong Ho Park, Eun Suk Jun, Hwansik Hwang, Hoonki Park, Jung Kwon Lee
J Korean Acad Fam Med 2003;24(4):353-359.   Published online April 10, 2003
Background
: Hormone replacement therapy (HRT) is the most effective treatment for climacteric symptoms. It also has definitive role in reducing or preventing the risk of osteoporosis. However, compliance with HRT is very poor. This study was conducted to know the compliance of hormone replacement therapy and investigate the determining factors for compliance.

Methods : Review of charts and telephone questionnaires were completed among 107 women who had received HRT in a family medicine clinic at a university hospital. Compliance was determined by the medication availability ratio (MAR): (HRT treated days)/(total number of observed days). An individual with MAR less than 0.75 was considered as partial compliance, and more than 0.75 was considered as complete compliance group.

Results : The average age of 107 subjects was 57.4 years. Among the 107 study subjects, 59 persons (55.1%) were compliant with HRT. Mean observation period was 17.6 months. The compliance with HRT was 60.9%, 55.1%, 49.6% at 12, 24, 36 months, respectively. The compliance was higher in high-perception group compared to low- perception group (P=0.01). Education level, presence of osteoporosis, hysterectomised state, difference in doctor and past fracture history were not associated with compliance. The reasons for starting HRT were physician's recommendation, osteoporosis prevention, treatment of menopausal symptoms, and influence of mass media, in descending order.

Conclusion : The compliance with HRT was 61% at one- year treatment and 50% at three-year teatment period. Positive attitude for HRT was related to higher compliance with HRT. Patient education on HRT is essential for successful compliance of HRT.
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A Survey on the Knowledge, Attitude, and Practice of Separation of Prescribing and Dispensing Medicine: Among Patients of Family Medicine Clinic in an University Hospital.
Hyuk Jung Kweon, Kyung Wan Rho, Hyeong Su Kim, Dong Young Cho, Myong Sei Sohn, Bang Bu Yoon
J Korean Acad Fam Med 2002;23(10):1188-1201.   Published online October 10, 2002
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Attitude and knowledge of residents on domestic violence.
In Goo Lee, Yu Jin Paek, Min Su Park, In Sun Park
J Korean Acad Fam Med 2002;23(3):344-352.   Published online March 1, 2002
Background
: Nowadays there is an upsurge of, social concern on domestic violence. The role of doctors in the prevention and screening of domestic violence is becoming important. Therefore, we selected medical residents to find out about the attitude and knowledge of doctors on domestic violence.

Methods : From 2000 March to October, we surveyed questionnaires to residents. The contents included the attitude on the victims, assailants and the children of domestic violence, whether they had the will to report domestic violence to the police or not, and finally the knowledge about the law on domestic violence.

Results : Among 210 residents, 95 (45.2%) answered. Almost 90% of the subjects agreed to the necessity of social intervention on the assailants. And most residents agreed that the psychosocial impact of domestic violence to the exposed children was important. 65 (68.4%) residents said they would report to the police when they recognized victims of domestic violence during their consultation. 27-68% answered correctly about the law related to domestic violence. 40% agreed to the need of education for domestic violence.

Conclusion : The residents had little knowledge on domestic violence law. Therefore, it is essential for residents to be educated accordingly. The factors of marital status and sexual difference of doctors on domestic violence should be investigated.
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Attitudes of medical students and housestaff toward euthanasia.
Joo Tae Kim, Kyung Chul Kim, Dong Hyeok Shin, Hang Suk Cho, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2001;22(10):1494-1502.   Published online October 1, 2001
Background
: Medical decisions concerning the prolongation of life. the right to die and euthanasia are among the most extensively discussed issues within medicine and law today. The purpose of this study was to evaluate the attitudes of medical of students and housestaff toward euthanasia.

Methods : From July 15 to september 15 of the 1998, the responses of 180 medical students and 132 housestaff to a self-adbministered questionnaire were analyzed to identify attitudes toward euthanasia. Over 312 respondents about attitudes toward euthanasia, the analysis of differences between proportions was made by the Chi-square test.

Results : About 69.9% of the respondents thought euthanasia should be legalized. The findings suggest that Buddhists (77.5%) and non-religious groups (88.1%) tend to support euthanasia more than Christians. Futhermore, medical students (74.4%) support euthanasia more than housestaffs(63.6%), male(75.1%) more often than female(57.9%). about 73.1% of the respondents said that active euthanasia is not justifiable, and 79.2% said that they do not like performing active euthanasia. In respect to passive euthanasia, 69.0% said that it is not ethically justifiable, but 63.0% would perform this as if it were legal. Housestaffs of internal medicine (76.9%) were more willing to do euthanasia than pediatrics (70.0%), surgery (63.6%), family practice (53.8%) and Ob/Gyn(33.3%).

Conclusion : Respondents have positive attitudes toward legalization of euthanasia.. Most considered that passive euthanasia is not morally justifiable. But if it were legalized, they would still be disturbed by active euthanasia. The opinions of physician and medical students directly affect patient care and their attitudes must be considered if clear plicies are to be developed concerning euthanasia.
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Employee's knowledge and attitudes towards no-smoking policy in a hospital.
Seong Won Kim, Hong Kyoon Lee
J Korean Acad Fam Med 2000;21(9):1139-1149.   Published online September 1, 2000
Background
: Although institution of the no-smoking areas have been required in hospitals since 1995, It has not been evaluated. This study was conducted to assess the effectiveness of the current no-smoking areas, and to collect employee's opinions about no-smoking policy in th hospital.

Methods : The self-administered anonymous survey was distributed to all employees of a university hospital in January 1999. Respondents were asked about their smoking status, awareness and compliance of the no-smoking areas, perception of tobacco smoke during work, preference for the type of no-smoking policy. Differences in outcome vairables' distribution by sex, smoking status, and occupation were analyzed using x² analysis.

Results : The overall response rate for the survey was 65.3%(670/1026). Among the total, 77.9% were females, and mean age of the respondents was 31.6 years(±80). While the overall smoking prevalence was 10.6%, men's prevalence was 46.6%. Although the awareness of the no-smoking areas was high in most areas, the rate of which all of the 10 no-smoking areas had been well kept was only 15.2%, 47.% of non-smokers reported that they could still smell some tobacco smoke while on duty. While 65.5% agreed on the opinion that penal regulations should be strengthened in order not to violate no-smoking areas, only 32.1% agreed on the current policy without penalty. 80% of smokers replied that they would follow the strict no-smoking policy.

Conclusion : The current no-smoking areas was not well observed. However, most employees wanted the no-smoking policy with penal regulation. Therefore, this survey could provide a solid foundation to implement a strict no-smoking policy.
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Reliability and validity of Korean templer's death anxiety scale, death depression scale and sense of symbolic immortality scale.
Mi Ryung An, Ye Kyung So, Byung Su Ko, Young Eun Choi, Jae Yong Shim, Hye Ree Lee
J Korean Acad Fam Med 2000;21(7):893-900.   Published online July 1, 2000
Background
: Means to measure death anxiety, death depression and sense of symbolic immortality with approved validity and reliability does not yet exist in Korea.

Methods : Existing English questionnaires such as Templer Death Anxiety Scale (TDAS), Death Depression Scale (DDS), Sense of Symbolic Immortaligy Scale (SSIS) were translated into Korean by 5 translators, and then reviewed by 3 non-participants of translation for collegial summary and this summary was counter-translated again by another 2 non-participants. Another 3 non-participants of translation and counter-translation were chosen to examine the two sentences of each item. Then reexamination was done by retranslating and counter-translating the parts with errors. After pretest on ordinary people. The completed questionnaires were given to medical students, residents and nurses of a university hospital. Pastors and missionaries were selected as comparison group.

Results : Kuder-Richardson or Cronbach-α that represent internal consistency of TDAS, DDS and SSIs was 0.69, 0.84 and 0.78. The three sentences that lowered internal consistency of SSIS was deleted. BDI and DDS showed a positive correlation (0.32, P=0.02), suggesting proved construct validity. Correlation coefficient that proves construct validity of TDAS and DDS was 0.54 (P<0.01), of SSIS and TDAS -0.23(P=0.04), of SSIS and DDS -0.29(P=0.01). The TDAS and DDS(P<0.01), DDS and BDI(P=0.02) have shown a positive correlation were shown. There was significant difference in the score of SSIS(P<0.01). The same results in cases where the 3 sentences was deleted.

Conclusion : Korean versions of TDAS, DDS and SSIS were reliable and valid.
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Attitude of cancer patients, their primary care givers and doctors toward end-of-life care.
Jae Yong Shim, Youn Seon Choi, Yong Joon Kang, Hyun Sang Cho, Hang Suk Cho
J Korean Acad Fam Med 2000;21(4):489-497.   Published online April 1, 2000
Background
: Decision about life sustaining treatments ought to be based on the patient’s in formed preferences. This study was to see if there were any differences in acceptance by patients, their primary care givers and doctors for end-of-life care according to situations, and if any, to analyse the factors related with different attitudes.

Methods : A structured questionnaire survey of end-of-life care preferences was performed on 162 cancer patients and their primary care givers in four university hospitals and one general hospital from March 1, 1999 to February 29, 2000. A similar survey was done for doctors practicing at the above, hospitals during the same period to investigate their attitudes toward providing end-of-life care to an assumed nearly bed ridden patients. ANOVA, t-test and Wilcoxon rank sum test were used to compare acceptance of intervention among the groups or according to the various situations. Factors presumed to be related to the acceptance were sought and analysed by stepwise multiple regression.

Results : The difference in acceptance of intervention between the primary care giver group and the doctor group was not significant in almost every situation, showing significantly higher than the patient group(P=0.001). All three groups showed higher acceptance when a therapeutic intervention rather than a diagnostic test was proposed(P=0.001). When expected survival was 30 days rather than 7 (P=0.01), and when the therapeutic intervention was thought as non-invasive rather than invasive (P=0.001). The less anxious the patient was , the higher the acceptance. From the patient. Patients with a religion had higher acceptance rate than non-religious patients. Primary care givers who expected sure of the disease accepted more of the postulated care than those who did not (P<0.05). Wives of mother-in-laws of patients showed lower acceptance than those in other relationship(P<0.05). The longer the patient had been diagnosed with cancer, the higher the acceptance of the primary care giver (P<0.1). Direct relatives showed higher acceptance than that of collaterals(P<0.01). Family doctors specializing in family medicine had lower acceptance than doctors of other specialties and interns(P<0.05)

Conclusion : The acceptance of intervention by patients was lower than that of primary care givers and doctors and depended on the expected survival and the type, of intervention.
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Changing trend of knowledge, attitude and perception for AIDS among freshmen: Comparing KAP between the year 1993 and 1999.
Ou Soo Park, Hyun Rim Cho, Byung Sung Kim, Jang Won Won, Dae Hyun Kim, Jun Mo Seo, Jae Hong Park
J Korean Acad Fam Med 2000;21(2):194-202.   Published online February 1, 2000
Background
: Acquired immune deficiency syndrome (AIDS) is becoming more prevalent in the world, but there is no definite treatment method and no proved vaccine available. Therefore, prevention is the best method to lessen it and blocking it's transmission route is the most effective method. We conducted a survey on the changing trend of knowledge, attitude and perception for AIDS between the year 1993 and 1999 among freshmen of a university.
Method: The subjects were 2,340 freshmen of a university in Seoul and the study period was one month from Jan. 16 to Feb. 15 1999. The survey had been done with pre-designed questionnaire methods which was same to the one in 1993. Total 2,305 cases were analyzed and compared with the results in 1993 excluding 35 cases with insufficient responses.

Results : Among the questions about knowledge for AIDS the increasing trend was found in 13 items "AIDS is caused by a virus", "AIDS can be contracted by light kissing with AIDS patients", "AIDS can be contracted by hugging AIDS patient", "AIDS can be contracted by using AIDS patient's belongings", and so on. The decreasing trend was found in items "All homosexuals are apt to get AIDS", "Most of AIDS patients die of the disease", "AIDS patients are easy to contract other diseases", and "AIDS can be contracted by other sexually-transmitted viruses".

Conclusion : The freshmen entered in 1999 knew the transmission route of AIDS relatively well. They thought tat AIDS was not a serious disease but they could get ADIS. The changing trend showed that public education had a considerable effect on students' knowledge and attitude for AIDS.
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Comparision of doctors' experience with and attitudes toward complementary and alternative medicine between western medicine and korean traditional medicine in office-based settings.
Young Ho Khang, Moo Song Lee, Hee Jo Koo, Wee Chang Kang, Byung Mook Lim, Sang Il Lee
J Korean Acad Fam Med 1999;20(9):1106-1117.   Published online September 1, 1999
Background
: Primary care physicians(PCPs) and oriental medical doctors(OMDs), as primary healthcare providers, could directly affect patients' use of complementary and alternative medicine(CAM). This study was carried out o compare the practice experience with, the knowledge about, and the attitudes toward CAM between PCPs and OMDs in Korea.

Methods : A total of 502 PCPs and 500 OMDs in urban area of Korea were selected by the proportionate quota and systematic sampling method. Face-to-face interviews were done with structured questionnaire.

Results : The rate of practice experience with and referral rate of CAM were reported 13.7% and 38.6% in PCPs, 76.8% and 85.4% in OMDs respectively. OMDs evaluated the efficacy of each CAM higher than PCPs. Both doctors had wide variations of knowledge in how to practice each CAM. However more than half OMDs knew how to practice chiropractic, taping therapy. aromatherapy, and iridology respectively, about 30% of PCPs high colic/enema and chiropractic. PCPs had more negative attitudes toward CAM and the advertisement of the other professional medicine(Korean traditional medicine) than OMDs. OMDs more strongly supported the natural healing process, health-disease continuum, and psychological effect on health, and opposed Descares' view on human body than PCPs.

Conclusion : This study showed OMDs had more experience with, knowledge about, positive attitudes toward, and supportive health concepts to CAM than PCPs. CAM practice would be diffused with chiropractic, taping therapy, aromatherapy, and iridology in OMDs; high colic/enema and chiropractic in PCPs.
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The attitude and behavior if primary physicians in seoul toward alternative medicine.
Hyun Kook Yoon, Jin Ha Kim, Sang Woo Oho, Young Ho Yoon, Tai Woo Yoo
J Korean Acad Fam Med 1999;20(1):71-78.   Published online January 1, 1999
Background
: Alternative medicine is defined as a non-orthodox therapeutic practices including chiropractic, acupuncture, herbal medicine, faith spiritual therapy or as all sorts of medical care that do not follow the medical community standards. Patients do not think of modern medicine as the absolute solution to their health problems and they will sometimes ask for complementary therapy and in want of referral to alternative practitioner. We have investigated the primary physician's attitude and behavior towards alternative medicine.

Methods : Randomly selected 770 practitioners, in primary care practice in Seoul, were questioned from July to September in 1996 about the attitude to wards alternative medicine, the reasons and symptoms when referring, and experience in alternative medicine practice.

Results : 150 questionnaires were returned and among them 139 completed one(18.1%) were analyzed. Among 770 doctors, 35(25.2%) have refereed patients to alternative practitioner before and more referrals were made when they worked together closely or had some prior training. The belief of special effect of alternative medicine on certain disease was the first reason to refer. Other reasons were for herbal medicine, acupunture, and chiropractics in the order of sequence. The standard way to learn alternative medicine was to attend seminars available through certain institutions. On referral either chronic pain or musculoskeletal disease were the most chief complaints or main diseases of patients. 15 doctors(10.8%) had some experience in practicing an alternative approach and the patient subjects were more likely to be women, and there was increased tendency to be working with another doctor, and to have been trained for such practice. The items used by alternative practitioners were acupuncture, herbs in the order of sequence.
Conclusions:Alternative medicine is accepted somewhat by primary physicians in Seoul although the rate of referral and practice is lower than 54% compared to 16% in Canada.
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The knowledge and attitude of menopause and hormone replacement therapy among the middle aged women.
Sung Ja Cho, Min Seon Park, Be Long Cho, Tae Wee Yeo, Bong Yul Huh
J Korean Acad Fam Med 1998;19(10):811-819.   Published online October 1, 1998
Background
: Hormone replacement therapy(HRT) has an established role in reducing cardiovascular risk and in preventing osteoporosis. But compliance with HRT is not good as expected. Therefore, so we assessed perimenopausal women's knowledge and attitude towards menopause and HRT too.

Methods : Questionnaires were provided to the students' mothers of a high school located in Seoul from June 10th to 15th, 1996. General characteristics and routine breast examination, routine Pap smear, the knowledge and practice of high calcuim diet for preventing osteoporosis, their menstrual pattern, the information source of HRT, in attitude for HRT, and the reasons for refusing.

Results : Among 560 women, 362 women(64.6%) responsed, and the mean age was 45.5 years. For osteoporosis prevention, they knew milk(74.7%) were, anchovy(27.4%), calcium(23.6%). HRT(7.4%) were beneficial. And almost(91.8%) all subjects answered that menopause was a natural course and 40.5% of women answered that physical change after menopause could not prevent. Among 34 postmenopause, 5(14.2%) received HRT and 48(20.3%) answered that they would receive HRT, and 57(24.1%) answered that they would not receive HRT. The reasons for refusing HRT were that menopause was a natural course, therefore devoiding the need for artificial hormone therapy(22.4%), increased incidence of breast cancer(21.8%), and that lack of information for HRT(13.9%). The association was not proven between the attitude for HRT and regular Pap smear, regular breast examination, exercise, oral intake for osteoporosis prevention.

Conclusion : Almost all of the respondents recognized that menopause was a natural course. And the effectiveness of diet and exercise in preventing osteoporosis was more well known compared to HRT.
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Reasons Why Patients and Families Choose Medical Dispute.
Hang Suk Cho, Sun Hee Lee, Myong Sei Shon, Seong Hee Yang, Hye Ree Lee
J Korean Acad Fam Med 1998;19(3):274-291.   Published online March 1, 1998
Background
: Medical dispute is increasing and its effect on society is serious, but reasonable settlement system is absent. Nevertheless patients and families choose medical dispute. But there is little research on patients and their families who choose to settle by medical dispute. Therefore this study examines the impact of medical malpractice to patients and their families and their reasons for choosing medical dispute after mishap.

Methods : Data were collected from 234 subjects who inquired of Medical Malpractice Family Association about malpractice suit. Questionnaire was composed of demographic characteristics, characteristics of hospital, characteristics of medical malpractice, degree of satisfaction with explanation and attitude of the treating doctor, effect of medical malpractice on patients' life and reasons that patients and their families choose to settle by medical dispute. Factor analysis with varimax rotation was carried out to reduce the reasons to a smaller number of clearly interpretable factors. Multiple regression analysis was carried out to identify the variables relevant to these main themes.

Results : Degree of satisfaction with doctor's explanation and attitude was less than 10%. Over 60% of respondents stated that medical malpractice seriously affected their lives. Four main themes emerged from the factor analysis of reasons for dispute which includes dissatisfaction with doctor's attitude, wanting to prevent similar incident in the future, call to account, and compensation. The relative importance in the order of frequency was wanting to prevent similar incident in the future, dissatisfaction with doctor's attitude, call to account, followed by compensation. Multiple regression analysis was used to identify the variables relevant to these four main themes. Clinical specialty group and degree of satisfaction on attitude were significantly associated with the dissatisfaction with doctor's attitude. Clinical specialty group, patient's condition, effect of medical malpractice on life and degree of satisfaction on attitude were significantly associated with the call to account. Academic career, clinical speciality group, patient's condition, effect of medical malpractice on life and degree of satisfaction on attitude were significantly associated with the compensation.

Conclusion : From the above results, the reasons patients and their families choose to settle by medical dispute were diverse and associated with demographic characteristics, doctor's attitude, effect of mishap on life, et. al.
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