| Be Long Cho | 26 Articles |
Background
We assessed the frequency and severity of hypoglycemia in type 2 diabetes mellitus patients treated with sulfonylurea monotherapy or sulfonylurea+metformin. Methods We conducted a retrospective, observational, cross-sectional study in 2011 and 2012 including patients with type 2 diabetes mellitus aged ≥30 years who were treated with ≥6 months of sulfonylurea monotherapy or sulfonylurea+metformin at 20 university-affiliated hospitals in Korea. At enrollment, glycated hemoglobin (HbA1c) was assessed; participants completed self-reported questionnaires describing hypoglycemia incidents over the past 6 months. A review of medical records up to 12 months before enrollment provided data on demographics, disease history, comorbidities, laboratory results, and drug usage. Results Of 726 enrolled patients, 719 were included (55.6% male); 31.7% and 68.3% were on sulfonylurea monotherapy and sulfonylurea+metformin, respectively. Mean±standard deviation age was 65.9±10.0 years; mean HbA1c level was 7.0%±1.0%; 77.8% of patients had hypertension (89.4% used antihypertensive medication); 60.5% had lipid disorders (72.5% used lipid-lowering medication); and 52.0% had one or more micro- or macrovascular diseases. Among patients with A1c measurement (n=717), 56.4% achieved therapeutic goals (HbA1c <7.0%); 42.4% (305/719) experienced hypoglycemia within 6 months of enrollment; and 38.8%, 12.9%, 12.7%, and 3.9% of patients experienced mild, moderate, severe, and very severe hypoglycemia symptoms, respectively. Several reported hypoglycemia frequency as 1–2 times over the last 6 months. The mean number of very severe hypoglycemia episodes was 3.5±5.5. Conclusion Among type 2 diabetes mellitus patients treated with sulfonylurea-based regimens, glycemic levels were relatively well controlled but hypoglycemia remained a prevalent side effect. Citations Citations to this article as recorded by
Background
Colorectal cancer has the fourth prevalence of carcinoma and the fourth cause of death from malignant neoplasm, which has been increasing in Korea. In this study, we tried to investigate the association of dietary intake of calcium anddistal colorectal adenomatous polyps known as precursors of colorectal cancer. Methods: 2,456subjects who visited Health Promotion Center in one university Hospital in Seoul Korea from June 2003 to June 2006 got sigmoidoscopy and completed 24-hour dietary recall. Results: Among the selected 2,408 subjects, the prevalence of distal colorectal adenoma found in sigmoidoscopy was 12.54%. After adjusting for age, and total serum cholesterol by multiple logistic regression, the odds ratio of the male subjects who have the highest quintile of dietary intake of calcium was 0.512 (95% CI: 0.305-0.859 P = 0.011) compared with the lowest. Conclusion: In male subjects, highest quintile of dietary calcium density was associated with the low risk of distal colorectal adenomatous polyps.
Background
In spite of its high prevalence and social impact, pain in the elderly has not been managed appropriately. Understanding the multidimensional aspect of pain is crucial in its effective management. Patients with chronic pain are known to be more profoundly affected by psychological and social factors. We, therefore, classified chronic pain patients and especially focused on the relationship between pain and stress. Methods: The subjects were 149 persons older than 60 years attending a certain geriatric college. A survey was peformed employing the Korean version of Geriatric Pain Measure (GPM-K), the Korean Version of Brief Pain Inventory (BPI-K), the Elderly Life Stress Inventory (ELSI), the Perceived Stress Scale (PSS), the Geriatric Depression Scale Short Form-Korea Version (GDSSF-K), and the Revised Chalder's Fatigue Scale (Fatigue). Results: A total of 103 people, who completed both the questionnaires on pain and stress were enrolled. There was a significant correlation between GPM-K and ELSI (ELSI: r=.38, P＜ 0.01). In chronic pain patients, not only ELSI, but also PSS was correlated with GPM-K (ELSI: r=.37, P＜0.01, PSS: r=.25, P=0.04). Conclusion: There was a significant correlation between GPM-K and ELSI in the elderly. In chronic pain patients, it was more closely associated with GPM-K. We, therefore, believe that stress management can be useful in the management of pain, especially in the management of chronic pain patients. (J Korean Acad Fam Med 2008;29: 418-423)
Background
: The causes of eosinophilia are allergies, parasite infections, medications, skin diseases, and others. But, the etiologies of eosinophilia and variables associated with eosinophilia are not well known in Korea. Methods : This study included patients in a health check up at a general hospital from May 21, 1995 until February 14, 2004. Through self-report, serology, and stool exam, variables associated with eosinophilia were tested. Results : In the eosinophilic group, 5% were helminth infected, and more of C. sinensis infection were found the eosinophilic group with 3.9% compared to the non- eosinophilic group with 1.2% (P＜0.05) Associated variables with eosinophilia were old age, high BMI, drinking, smoking, the season of testing helminth infections, and Clonorchiasis infection. But allergy was not associated with eosinophilia. The odds ratios for eosinophilia after adjustment were 2.280 (1.694∼3.068) in helminth infections and 2.391 (1.716∼3.331) in Clonorchiasis infection. Conclusion : In the eosinophilic group, 5% were helminth infected, and more C. sinensis infection was found. Associated variables with eosinophilia were old age, high BMI, drinking, smoking, the season of testing, helminth infections, and Clonorchiasis infection. But allergy was not associated with eosinophilia.
Background
: Obesity has been generally diagnosed by 'Body Mass Index (BMI)' in primary care. Recently the use of Bioelectrical Impedance Analyzer' has become popular in Korea to evaluate body fat rate (BFR), as cost is inexpensive and the method to use is simple. As a result, the opposed finding of normal BMI and elevated BFR vice versa in same individuals are being encountered frequently. We designed this study to find out the characteristics and cardiovascular risk of people in these groups. Methods : The medical records of health promotion center were obtained and 22,704 applicants visitor who undeerwent health risk questionnaire, screening tests and physical examination for cardiovascular disease were reviewed. Results : After adjusting for age, sex, exercise and education level, cardiovascular risk such as hypertension, DM, and hypercholesterolemia, LDL tended to increase linearly and HDL tended to decrease linearly with increase of BFR or BMI. In comparison with normal BMI and BFR group, the odds ratios of normal BMI and elevated BFR group or vice versa were increased. Conclusion : If either one of BMI or BFR of a person was elevated, even though the other was within normal range, the cardiovascular risk of that person was shown to be high.
Background
: There is a lack of data on Korean average VO2max values. This study attempted to yield average values of VO2max corresponding to each age group of Koreans. This study was also designed to investigate the factors associated with VO2max. Methods : From May 1st 1996 to January 30th 2000, we recruited 21,458 subjects who visited the health promotion center at one university hospital. We obtained the data related to age, exercise by self-administered questionnaire and weight, height and blood pressure by instrumental measurements and hemoglobin, cholesterol by overnight fasting blood sampling. VO2max was estimated by submaximal bicycle ergometer test. Results : The number of research subjects was 21,458: males 12,646 (58.9%) and females 8,812 (41.1%) and the average age was 48.6 (SD: ±10.05) years with age span from 20 to 79 years. The average VO2max was 26.4 (SD; ±6.77) (ml/kg/min) for men and was 19.8 (SD; ±5.94) (ml/kg/min) for women. Relating to factors such as age, VO2max, SBP, DBP, cholesterole, Hb, and body mass index, there were significant statistical differences between sex (p＜0.05). For both sexes, VO2max decreased as age, cholesterol, BP and BMI increased. Regular exercise group showed significantly a higher VO2max than non-exercise group for both sexes. Conclusion : The average VO2max values for Koreans, according to sex and age group are reported in this study. The decreasing VO2max may be attributed to increasing age, BP, cholesterol, BMI and non-exercise.
Backgrounds: The Third Report of the Adult Treatment Panel (NCEP-ATP III) has newly introduced the clinical diagnosis guideline of the metabolic syndrome which is characterized by clustering of the CHD risk factors. The purpose of this study was to estimate the prevalence of the metabolic syndrome in Korean adults by the newly introduced guideline and to evaluate possible risk factors with the syndrome.
Methods : The subject of this study included 3,873 adults (males 2,144, females 1,729) aged 20 years or older who visited the Health Promotion Center of SNUH. Among the subjects, we excluded those who did not have records of physical parameters, blood test results and who were on current medications except antihypertensives and oral hypoglycemic agents. We estimated the prevalence of the metabolic syndrome in Korean adults according to the ATP III waist-circumference guideline, Asia-Pacific waist- circumference, and Body Mass Index (BMI), respectively, and calculated the age-adjusted prevalence of the metabolic syndrome using the direct standardized method. While applying the Asia-Pacific waist circumference, we estimated the prevalence of the metabolic syndrome by age group and the prevalence of the individual abnormalities of the metabolic syndrome. To identify variables associated with the metabolic syndrome, we used the multiple logistic regression method to estimate the prevalence odds ratios for the metabolic syndrome vs. the non-metabolic syndrome. Results : The age-adjusted prevalence of the metabolic syndrome in Korean adults was 9.3% when ATP III waist-circumference was applied, 15.4% for Asia-Pacific waist-circumference, and 18.6% for body mass index (BMI). The highest prevalence of the individual criteria among the metabolic syndrome diagnostic criteria in men was hypertension, followed by hypertriglyceridemia, abdominal obesity, high fasting blood glucose, and low HDL-cholesterolemia. And in women, it was also hypertension, followed by abdominal obesity, low HDL- cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. The prevalence increased from 3.8% among participants aged 20 through 29 years to 27.1% for ages 60 through 69 years and 31.6% for ages above 70 years. Females, increasing age, increased BMI, current smoking, physical inactivity were higher risk factors for the metabolic syndrome, but mild drinking was a lower risk factor for the metabolic syndrome. Conclusion : These results show that the metabolic syndrome is highly prevalent although less prevalent than in American adults. The family physician should focus on the screening and comprehensive management of the metabolic syndrome.
Background
: This study was designed to compare the usual self-checked blood pressure measuring methods by hypertensive patients with standardized methods. Methods : From May to August 2002, we surveyed 137 hypertensive patients who performed self blood pressure measurements with a self-administered questionnaire. We defined 14 standard methods from the six most frequently recommended guidelines. We asked patients how often they calibrated their sphygmomanometer, and how they learned to measure blood pressure. Also, their upper arm circumferences were measured. Results : The percentage of correct preparations for BP measurement was over 80%, but that of correct technique was low. For example, 'reading from the arm with higher BP by more than 10 mmHg' (4.4%), 'placing midline of the bladder over the arterial pulsation' (21.5%), and 'waiting 2 or more minutes between readings' (21.9%). Only 11.2% of the patients have ever had calibrated their sphygmomanometers. In 20.2% of hypertensive subjects, upper arm circumferences were greater than 30 cm which made blood pressure measurement with a 24 cm-sized bladder incorrect. Conclusion : As shown in previous studies, the methods of blood pressure measurement were incorrect in many aspects. Therefore, systematically educating hypertensive patients to measure blood pressure by correct methods and recommending to use a proper-sized cuff are essential.
Background
: According to different characteristics of health dimensions and its consisting item contents, valid and useful health status assessment tool for the elderly is rare. Because of the continuous increase in elderly population with functional disability in Korea, the need for a valid Korean health status assessment tool for the elderly is growing. Therefore, we have attempted to develop a Korean Health Status Measure for the Elderly in this study. Methods : We gathered important health related items from 671 individuals aged 60 years and over to form item pool with interview. Then we classified all items into representative items according to its meaning with the experts in geriatrics. With these representative items we constructed a preliminary questionnaire. After wards we performed a pilot study for evaluating understandability, accessibility, item analysis, reliability and for detecting other modifiable limitations. After completing the pilot study we finally developed the Korean Health Status Measure for the Elderly (KoHSME V1.0) Results : The number of collected health related items were 2,500 in the item pool. After classification of items in the pool, 40 representative items were selected for constructing preliminary version of the KoHSME. And we added 3 items of ‘general health perception’ dimension to 40 common representative items to construct a preliminary version of the KoHSME. It took an average of 18.8 minutes to complete the preliminary questionnaire by the elderly in the pilot study. Most responders (90.9%) thought the questionnaire was not difficult to understand. After the pilot study we added 2 items (wearing clothes, pain frequency) and omitted 1 item (eating). Finally, the KoHSME V1.0 questionnaire consisted of 44 items and 6 domains such as physical function, emotional function, social function, pain, sexual function, and general health perception. All items were Likert scale except pain intensity item, which was visual analogue scale. Conclusion : The KoHSME V1.0 to assess health status and quality of life for the Korean elderly was developed. We think the KoHSME V1.0 is a reliable instrument for assessing health related to quality of life in the elderly. After documenting the validity, the KoHSME V1.0 can be a useful tool for comprehensive assessment of health status in the eelderly and for the medical outcome study.
Background
: Because of improvement of economic state and eating habit changes in Korea, 60-70% of gallbladder stones are cholesterol stones. As ultrasonography was used increasingly, detection of asymptomatic gallstone were increased. There has been few studies about asymptomatic gallstone in Korea. So, this study was designed to obtain associated factor of prevalence of asymptomatic gallstone. Methods : We screened adults over 20 years who were visited the Health Promotion Center in a university hospital from May 1995 to May 1999. Subjects were defined as case group(584 subjects) who were diagnosed gallstone by abdominal ultrasonogaphy by radiologist. Control group(1153 subjects) were selected by random sampling from visitors of the Health Promotion Center. Every subjects were assessed with respect to gender, age, height, weight, fasting blood glucose, serum total cholesterol, high density lipoprotein-cholesterol, triglyceride. Social-Economic state, smoking were assessed by self-administered questionnaires. Associated factor of prevalence of asymptomatic gallstone were analyzed by Chi-square test and multiple logistic regression. Results : Age, BMI(Body Mass Index), fasting blood glucose were associated with gallstone by Chi-square test(P<0.05). Multiple logistic regression showed that prevalence of asymptomatic gallstones was increased by age (>40 years old) and were associated with BMI (>25㎏/㎡), fasting blood glucose. Conclusion : Associated factors of prevalence of asymptomatic gallstone were increased by age (>40 years old) and were associated with BMI (>25㎏/㎡), fasting blood glucose, and were not different from those in West countries. Further studies will be needed about associated factors according to the composition of gallstone and developing from asymptomatic gallstone to symtomatic gallstone.
Background
s: The education by the family physician. is important for more practical primary care medicine education. In this study, we try to know the present state of education and the future and the number of education resource and how to multiply this resource. Methods : we have got the list of family physicians who have their clinic in Seoul by the help of the Korean Academy of Family Medicine. And we performed telephone questionary. We also asked the demographic factors. Results : 134 persons were asked questionary by the telephone. 17 persons were joining in education. Trainee by the 3rd grade hospitals was the major, the next was by 2nd grade hospital, and doctors who did not have the training. 14 persons have begun education by asking of the training hospital, 3 persons wanted it, but none thought it beneficial to them. 44 persons wanted to join education in the future, and there was no difference between the 3rd and the 2nd grade hospital trainee. Conclusion : There was no difference between the 3rd and 2nd grade hospital trainee but 2nd grade hospital trainee was less joining than the 3rd. This shows that the 2nd grade hospital trainee can be the good pool of the future education if there are adequate supply. So many adequate supply is necessary.
Background
: Early detection and treatment for depression are very important. But because of several factors such as practice time etc, primary care physician missed potential depression patients. The Korean version Beck Depression Inventory (BDI) is useful for the detection of depression but the validation study of this tool is not confirmed yet. And so we conducted the validation study of BDI. Methods : From July 1999 to October 1999, 259 patients who visited five family practice center in tertiary or secondary hospital were the study subjects. They have experienced depressive symptoms or had past history of depression during recent one year. The subjects were responded to the questionnaire including BDI, and diagnosed with depression or nondepression according to DSM-IV-PC(interview). The depression patients were retested with BDI. Cronbach α were estimated for internal consistency, and factor analysis were done for validation. Kappa statistics were estimated according to the consistency between BDI and DSM-IV-PC(interview). Using ROC curve, optimal cut-off point were estimated. Results : Depression ad nondepression patients were 205(79.2%), 54(20.8%) each. Cronbach α (total items of BDI) was 0.87. Factor analysis resulted that two factors explained 90.7% of total variance. BDI score of depression, mild depression and nondepression groups were 22.29(±9.68), 14.43(±8.44), 11.68(±6.42) each (F=29.77, df=2, P=0.001). At 13 BDI score on ROC curve, we have known the results of sensitivity 78.3%, specificity 76.5% and positive predictive value 94.2%. Conclusion : We concluded BDI was very useful and convenient easy screening tool for depression in primary care.
No Abstract Available.
Background
: The number of illegal migrant workers has been increasing in Korea since late 1997 in what was called the IMF era. This study was conducted to evaluate and to recognize the medical utilization and health Status for migrant workers in Korea. The goal of this study was to understand the epidemiological characteristics of the migrant workers and family physician’s role as a health provider and gate keeper to them and to provide basic data for public health policy. Methods : In September 1999, self-administered questionnaires were distributed to the migrant workers in Seoul, Sung-Nam, Pucheon and An-Yang. We classified the reasons for clinical encounters and the prescribed drugs by reviewing the medical records of all patients who visited a clinic of shelter for migrant workers in Sung-Nam from January to December 1998 and analyzed the report according to death certification of the shelter for migrant workers in Sung Nam from 1994 to September 1999 Results : The major distribution of nationality were from China, Mongo, and Bangladesh(86.9%). They were mostly between 30 and 39 years old, males are, and unmarried. Most had high school education. The average income was 756,700 won and the average working hours were 11.5 hours per day in migrant workers being in worse condition than those of Korean workers. Classified according to systems, the respiratory(21.2%), musculoskeletal(20.6%), digestive(15.8%), and cardiovascular(12.5%) symptoms were common. Repayment for death was different between before(87.7%) and after IMF era(13.0%), in late 1997. Average medical expenditure was 43,552 won comprising 5% of the total income of subjects only. Most of them did not benefit from medical insurance. Conclusion : Migrant workers’ situation seemed poor. The patterns of the disease’ were similar to those who visit family medicine clinics in general. Family physicians should take more interest in providing a more effective and better care to migrant workers.
Background
: Women smoker faces increased risk for heart disease, stroke, cancers, and respiratory diseases as well as a number of gender specific risks. Maternal smoking has been linked to harmful effects on their offspring such as increased incidence of premature, stillbirth and sudden infant death syndrome, etc. Recently, the rate of female adolescent smoking in Korea is increasing, and the rate of adult woman has expected to increase. This study is aimed at obtaining basic information about smoking patterns and factors associated with smoking in Korean adult women. Methods : From May 1995 to April 1999, a self-administered questionnaire was distributed to the female visitors of Health Promotion Center in Seoul National university hospital. The number of smokes was 492. The control group(984 nonsmokers) was selected by 1:2 age group matched random sampling. Smokers and control group were divided into three age group-young age(20-39 years), middle age(40-59 years), old age(60 years and over) - and analyzed the results using SPSS and EpiInfo software. Results : The most frequent amount of cigarette smoking was below 10 cigarettes in all age groups. The duration of smoking was below 10 years in most young and middle age groups. In the old age group the duration of smoking was longer than others. Variables positively associated with smoking included alcohol drinking, being engaged in trade service, being unmarried or divorced or separated or parted for ever, high stress status, dissatisfation of life in young age group. The variable of no exercise was added to them in middle age group. In old age group alcohol drinking, no exercise, no school education were the positive meaningful factors associated with smoking in multivariant logistic regression analysis. Conclusion : The modifiable variables associated with smoking in Korean adult women include alcohol drinking, high stress status, dissatisfaction of life and no exercise.
Background
: Recently, many large epidemiological studies revealed that total cholesterol (TC) / high density lipoprotein-cholesterol (HDL-C) ratio is a better predictor of risk for coronary heart disease than total cholesterol, high density lipoprotein-cholesterol, or low density lipopoteim-cholesterol as a single factor. Our study is designed to examine the factors associated with TC/HDL-C ratio in healthy Korean adults. Methods : The study involved 6,584 adults who visited the SNUH Health Promotion Center from March 1997 to February 1998. We examined their demographic data, medical history, smoking habits, alcohol intake and exercise through a questionnaire. Serum lipid levels were checked after 14 hours of fasting. We analyzed the data by covariance and multiple regression analysis. Results : 3,774 healthy adults (men 1,976, women 1,798) were statistically analyzed. The average TC/HDL-C ratio was 4.2±1.2 in men, 3.6±1.0 in women. TC/HDL-C ratio was highest in over age 70(4.4±1.3), and was increased as BMI, the amount of smoking increased, and was decreased as alcohol intake increased in men. In women, TC/HDL-C ratio was increased as BMI increased, and was lower in exercise groups(3.5±1.0) than inactive group(3.7±1.0), but there was no difference according to the smoking amount. Regression analyses revealed a positive correlation between TC/HDL-C ratio and BMI, smoking (P<0.05, respectively), and a negative correlation between TC/HDL-C ratio and alcohol intake(P<0.05) in women, there was a positive correlation between TC/HDL-C ratio and BMI, age(P<0.05, respectively), and a negative correlation between TC/HDL-C rato and exercise amount and alcohol intake(P<0.05, respectively). In both men and women, BMI showed the highest correlation with TC/HDL-C ratio. Conclusion : BMI, smoking, exercise as well as sex and age are related to TC/HDL-C ratio. Thus, primary physicians should consider correction of these factors.
Background
: Since the winter of 1997, Korea has been in an economic crisis. During this period family the most important and basic social unit faced many problems. The purpose of this survey was to assess Korean family's functional status and emphasize family as a social support unit. Methods : During April-May 1998 Nationwide Telephone survey was done. Sampling was done by Multi State Random Sampling technique. We questioned subjects on 5 categories of present family problems and used Modified Faces-III Questionnaire for evaluation of family function. Results : By 5 point scale, the impact of present economic problems to the family showed the highest score(3.7). Other causes had a score range of 1.7-2.1. Economic impact was greater in 4th and 5th life cycle step, those with low income, and those in bereavement. Family type was divided in to 3 groups; extreme type 20%, mid range 50%, and balanced 30%. Among extreme groups chaotic adoption and enmeshed cohesion type were the most common(10.8%). Conclusion : In the korean family 1998, economic problem seems to be the most important impact factor and the proportion of extreme type family is high.
Background
: Alcohol use is a major source of health problem. The social and economic costs related to alcohol use are enormous. Thus, alcohol use is a public health issue. Previous studies on alcohol use were based on hospitalized patients(especially alcoholics) or community subjects, but national survey is lacking. In this study, we describe alcohol use among the Koreans. Methods : Household telephone survey was carried out using multistage stratified random sampling methods from April to May, 1997. Fifteen to sixty-nine year old subjects were randomly selected from household and asked to report type, quantity and frequency of alcoholic beverage consumption. Results : The prevalences of alcohol drinking during the last month were 64.0% for men, 37.8% for women, and 64.7% for those in their twenties, and it decreased with increasing age. In multivariate logistic regression model, men, the unmarried, those in their twenties, administrative and professional personnel were associated with higher prevalence of alcohol drinking. Proportions of nearly daily drinker were 16.5% for men, 2.2% for women, and more than 20% for those in their forties and over and increased with increasing age. Mean alcohol consumption was 56 grams for men, 12 grams for women. Heavy drinkers, defined as average intake of 30 grams or more per day, were found in 23.4% of men and 2.4% of women. The most widely consumed beverages were soju, beer and makuli. In multivariate logistic regression model, men, the unmarried, those in their twenties, and administrative and professional personnel were highly associated with heavy drinking. Conclusion : The prevalences of alcohol drinking during the last month was 49.0%. The proportion of heavy drinker was 11.4%. Men, the unmarried, those in their twenties, and administrative and professional personnel were highly associated with heavy drinking. Therefore, efforts should be made to reduce heavy alcohol drinking among the risk groups.
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.
Background
: Ministry of Health and Welfare offered 'Home Doctor Registration Program' to reinforce primary care and to increase the efficiency of national health delivery system. But, it failed because it was not supported by doctors and nations. We designed this study to develope and evaluate a practical version of 'Home Doctor Registration Program'. Methods : We invited primary care doctors who were concerned with 'Home Doctor Registration Program' via PC-communication and developed a practical version of this program. After 6 months of this program, surveys on participated doctors and patients were done. Results : 8 primary care doctors and 285 patients have participated in this study. All the 8 doctors have offered the 4 obligatory services and 3 doctors have offered telephone counselling and no doctor has offered visiting examination. After 6 months of this program, CCPQ score was increased significantly and all the health risk factors of participated patients were decreased. Doctors have thought that Family Chart Service, Health Risk Appraisal, Vaccination and Screening Test are more necessary in this program. But, patients have thought that Telephone Counselling and Visiting Examination are more important in this program. Conclusion : Almost of participated doctors and patients have been satisfied with this practical version of 'Home Doctor Registration Program'. But, subjective feeling about which service was more necessary in this program was different between doctors and patients.
Background
: A survey is the only direct way of determining the distribution of behav-ioral risk factors among a population. The department of Family Medicine in Seoul national university hospital adopted telephone interviewing for collecting information about behavior-al risk factors of Koreans. Because methodological aspect of telephone survey is different according to the telephone and communication environment of the area in which the sur-vey would be held, we tried to figure out adequate methodological aspects of a telephone survey on the behavioral risk factor in Korea. Methods : We sampled telephone numbers from the telephone number database which is supported by Infornet Ltd. with stratified cluster random sampling method and selected re-spondent by using algorithm of Kish. 13 part-time job interviewers were trained for 6 hours and then interviews were made in a fixed area for the time assigned. Results : 13 interviewers tried to do 1,826 interviews for 4 weeks. Sociodemographic characteristics of respondents were compared with the census estimates and another face-to-face interview and there were no significant differences. A response rate of 79.8%, re-fusal rate of 12.9% and interview efficiency of 58.1% were obtained, yielding 1060 comple-ted interview. A total of 28,830 person minutes of interview time were spent on the survey with an average of 27.2 minutes per completed interview. Conclusion : Sampling method using the telephone number database could be used keeping the representativeness of the samples and telephone survey was considered to be reliable and affordable method for determining the prevalence of behavioral risk factors in Korea.
Background
: Nowadays, since Aquired immunodeficiency syndrome(AIDS) prevailing all of the world has no exact cure yet, the only countermeasure is to guide the masses' steps in the path of awareness through publicity & education. In the first stage, only the high risk group and countries hea the opportunity of infection. But, at the present the way of infection has changed to 'within the general publics' and multiplied among Koreans. Since, it has become important to educate the low risk groups(general publics). We research the general public's knowledge of AIDS. Methods : A questionnaire was given to two groups; one was composed of the people who visited a hospital for periodic health examinations during one month(April 1993). The other group was composed of people who worked in a government office. Results : A total of 289 people answered the questionnaire. The rate of response was 90.1%. And the percentage of males was 53.3%, Concerning the question of the latent period, 49.5% had a correct understanding of the fact that AIDS development took more than several years after HIV infection. 52.2% of the subjects of investigation didn't want to visit hospital even though they felt they might have the infection. Among them, 83% said that the reason was the contempt and isolation from society, when they are regarded as AIDS patient. Once guaranted of security, most of them(78.9%) wanted a consultant, especially by phone(36%). Concerning the risk routes of infection, most of them(from 83.1% to 99.0% each items) looked at in the right light. However, concerning the possibility of the infection in daily life, they have some misconception, c.g. mosquitoes(88%), donation of blood(48%0, swimming(36.1%) etc. Only 56% know that condoms can protect from AIDS. Conclusion : Nearly half of the respondents would not visit a hopital, even though they have recognized their infection with AIDS. Almost all of them duly recognized the importance of sex and blood in AIDS transmission. But, many of them considered AIDS as an acute disease and had misconceptions that it was carried by the donation of blood, mosquitoes. We also find that half of the subjects of investigation didn't acknowledge that condoms could prevent AIDS.
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