| Ka Young Lee | 27 Articles |
Background
It is not clear which demographic factors would be considered for human papillomavirus (HPV) infection in Korean women and how women understand the HPV infection. This study was conducted to fi nd the factors related to HIV infection and the realities of follow-up tests and perception among women infected with HPV. Methods: The subjects were 2,113 women (median 41 years old) who received a Papanicolaou smear and a HPV DNA test at a health promotion center from March 2006 to October 2007. The follow-up rate and perception for HPV infection among women infected by HPV were surveyed using telephone. Results: Overall prevalence of HPV infection was 17.3% (N = 365). However, the prevalence of HPV infection among women younger than 30 years old reached 30.7% (17.6% for low-risk group of HPV, 13.1% for high-risk group of HPV). The odds for being infected with HPV was 3.2 (95% confi dence interval, 2.0 to 5.2) among unmarried women younger than 30 years old compared to those at the ages of 30 years or older. Married women younger than 30 years were also 2.1-4.3 times more likely to be infected with low-risk group of HPV compared to those aged 30 years or older. Among those infected with HPV and answered to the survey (N = 282), 51.4% took irregular gynecologic follow-up and 66.2% did not have information for the need or importance of follow-up examination. Conclusion: The risk of being infected with HPV seems to be higher for unmarried women younger than 30 years old. Additionally, a standardized guideline should be provided to improve follow-up examination and knowledge about HPV infection. Citations Citations to this article as recorded by
Background
After the referral system had been established, a tendency of patients who prefer to consult themselves to a specialist with 'self requested referral' is increasing in university hospital family medicine clinics. This study was conducted to know which factors of patients who for the fi rst time visited university hospital family medicine clinic to require medical request for 'self requested referral' to a specialist infl uence 'self requested referral' tendency. Methods: Among 905 patients, 647 agreed to the questionnaire were included in this study. We divided the patients in two, the 'self requested referral' group and the 'general patients' group that does not. Patients completed a four-item, selfadministered questionnaire. Results: 'Self requested referral' group tended to have no experience in family medicine and tended to be negative about the need for family medicine (P < 0.001) The factors that have effect on 'self requested referral' are age, occupation, education, experience of family medicine, and recognition degree of necessity of family medicine. Patients in 20-39 of age, who were white colored, higher education had higher tendency of 'self requested referral' and patients who had no experience in family medicine and lower degree of recognition about the necessity of family medicine had higher tendency of 'self-referral'. Conclusion: It is necessary to fi nd ways to increase satisfaction of patients who have factors that have effect on their 'self requested referral' tendency such as age, occupation, education, experience of family medicine, and degree of recognition about the necessity of family medicine.
Background
Premenstrual syndrome (PMS) is a common and disabling disorder among adolescents. But the research addressing premenstrual disorders in adolescents is sparse and such disorders may well be underrecognized. In this regard, the study aimed at identifying attributes to premenstrual symptoms by surveying one high school located in Busan, Korea. Methods: A total of 381 adolescent females who accepted the participation in this study were recruited from one academic high school in Busan, Korea. For the evaluation of risk factors on the PMS, we investigated menstrual patterns, severity of premenstrual symptoms, environment and life events, stress, and physical activity. Results: In bivariate analysis, earlier menarche (P = 0.007), higher BEPSI score (P < 0.001), higher physical activity score (P = 0.003), and drinking alcohol (P = 0.047) were related to PMS symptom severity. On multiple regression analysis, Brief Encounter Psychosocial Instrument Score (P < 0.001), age of menarche (P = 0.003) and physical activity (P = 0.004) were independent explanatory variables of PMS symptom severity. Conclusion: This study showed that the relationship between PMS symptom severity and age of menarche and stress was statistically signifi cant in high school girls. Citations Citations to this article as recorded by
Background
It is important to evaluate the functional ability of the elderly for optimal care. This study was conducted to identify factors associated with dependence for activities of daily living (ADL) and instrumental activities of daily living (IADL) in elderly adults in Korea.Methods: A cross-sectional study of data from the third Korea National Health and Nutrition Examination Survey (KNHANES III) 2005 was undertaken. The sample consisted of 3,656 participants, 65 years of age or older. Multifactorial regression analysis was used to identify associations between ADL and IADL dependence and sociodemographics, lifestyle, and health history.Results: Among the 629 (17.2%) ADL-dependent and signifi cantly and independently associated factors were age, lower education level, health assistance or no-insurance, stroke, urinary incontinence, diabetes, arthritis, and lung cancer. Among the 1,674 (55.7%) IADL-dependent and significantly and independently associated factors were age, lower education level, single or widowed, male, stroke, arthritis, glaucoma and/or cataract. Conclusion: Functional dependence in older adults was directly related to aging and had multiple determinants. Awareness of these determinants should help design health programs that can identify individuals who are at high risk of losing their independence, and implement interventions for slowing or reversing the process. Citations Citations to this article as recorded by
Background
: The purpose of this study was to assess the lifestyle associated with weight gain and persistent overweight for 2 years. Methods : The subjects were 580 workers (109 men, 471 women) at one university affiliated hospital. Their height and weight were measured twice in 2000 and 2002. A questionnaire, about lifestyle was filled out in 2000. The questionnaire included the average amount of alcohol intake and the number of days per week in which alcohol was consumed, smoking status, and the number of days per week in which exercise was done. Their weight change in 2 years was calculated and their weight status was classified into two groups: persistent normal weight (BMI＜23 kg/m2) and persistent overweight (BMI≥23 kg/m2). Results : Among the total, 54.3% of men and 10.0% of women had persistent overweight over 2 years. Overall 93.4% of overweight men and 68.7% of overweight women remained overweight after 2 years. Compared with male non-smokers and male ex- smokers, current male smokers gained weight as much as 1.17 kg over 2 years after adjusting for age and initial BMI (P=0.033). Compared with females who exercised less than 3 per week, those who exercised 3 or more per week lost weight as much as 1.21 kg over 2 years after adjusting for age and initial BMI (P=0.005). Compared with males who consumed alcohol an average of ≤30 g per consumption, those who consumed an average of ＞30 g were 4.1 times (95% C.I. 1.04∼16.21) more likely to maintain persistent overweight over 2 years after adjustment for age and frequency of alcohol use. However no particular lifestyle was shown to predict the risk of persistent overweight for women. Conclusion : Regular exercise of moderate intensity and modest alcohol consumption seemed to prevent weight gain and persistent overweight. Such lifestyle may be encouraged to maintain healthy weight.
Background
: This study was performed to find out about the factors related to administration of hormone replacement therapy (HRT) in postmenopausal women. Methods : One thousand seventy three postmenopausal women living in Busan and Kimhae were surveyed from August, 2000 to February, 2001. The subjects were asked whether they were receiving the HRT or not and about several factors that have known to be related to receiving the HRT. Results : Among the total, 16.3% of women were current users, 12.4% were ex-users, and 71.2% were non-users. There were significant differences in age, marital status, number of children, education level, and income among the three groups. The proportions of hysterectomy and health-related behaviors were higher among current and ex-users than non-users. The current users were receiving the HRT by continuous combination method rather than cyclic therapy. Among them, 70% responded 'physician's recommendation' as the main reason for receiving the HRT. Among the current users 48% responded 'improved general condition' for receiving as the main reason the HRT currently. However, 29% of ex-users stopped therapy because of side effects. Among non-users 55% have not been provided with information about the HRT. Women having regular exercise at least once a week were 3.5 times more likely to be current users (95% C.I.: 1.3∼9.6). One year after menopause women were 1.2 times (95% C.I: 1.0∼1.4) more likely to be current users. Conclusion : Postmenopausal women who exercised regularly and experienced menopause at an older age seemed to be more likely current users. Therefore, women having such characteristics may need more adequate information about the HRT.
Background
: The purpose of this study was to find changes in percentage obesity and the factors associated with the changes after its treatment in obese children and adolescents. Methods : A total of 42 obese children from 3- to 17- year-olds (males 60%) were enrolled in an obesity treatment program at least 3 times. They were provided with an individual weight control program that included dietary, activity, and behavioral change information. The paired t-test, Kruskal-Wallis test, Mann-Whitney test, and linear regression were used for analyses. Results : The means of BMI, percent body fat, and percent obesity were 27.4 kg/m2, 39.4%, and 52.3%, respectively. Among them, 85.3% of obese children had one or more abnormalities on biochemical tests and 32.4% of them had 3 or more abnormalities. There was a significant reduction in weight (1.4 kg), BMI (1.1 kg/m2), percent body fat (1.8%) and percent obesity (7.1%), whereas height increased significantly by 1.3 cm after the treatment. The decrease in percent obesity was associated significantly with the number of follow-up, the number of accompanied biochemical abnormality, and the duration of treatment. The decrease in percent obesity was 12.9% among obese children who were followed-up 6 times or more, by 12.2% among those who did not accompany biochemical abnormality and by 13.3% among those who were retained in the program for 76 days or over. However, the change in % obesity was not associated with sex, age groups (＜12, ≥12-year-old), severity of obesity and parental obesity. The percent obesity decreased by 5.2% as the number of follow-up (n=3/4, 5/6∼17) increased after adjusting for sex, age groups and the number of biochemical abnormalities. The number of follow-up also explained 38% for the variance of change in percent obesity in that model. Conclusion : Continuous program retention was an effective factor to reduce percent obesity. Therefore, further investigation is needed to develop methods to enforce program retention.
Background
: The risk of hypertension increases as body weight is gained. In most studies, smoking has been considered as a confounder in association, but such association had not been analyzed between weight and the risk of hypertension varied according to smoking status. Methods : The subject were 1,813 male worker who had routine bealth examination from April to June in 1998. They were divided into current smokers and non smokers according to smoking status and categorized into three different weight group; normal weight (BMI<23kg/m²), overweight(23≤BMI≤25 kg/m²) and obesity(BM≥25 kg/m²). Hypertension was defined if systolic blood pressure was ≥ 140 mmHg, or diastolic blood pressure was ≥ 90 mmHg. The interaction between smoking status and BMI for prevalence of hypertension, and the prevalence odds rations for hypertension among six groups categorized according to weight and smoking status, were analyzed by multiple logistic regression. Results : The interaction between smoking status and BMI was significant (B=-0.058, SE=0.025, P=0.021). The risk of hypertension was 1.55 times (95% C.I 0.76~3.15) higher among the non-smokers with overweight and 2.90 times (95%) C.I. 1.01~4.32) higher among the non-smokers with obesity compared to the non-smokers with normal weight after controlling for age, serum glucose, and total cholesterol. In contrast, weight was not associated with the risk of hypertension among smokers. Conclusion : The risk of hypertension rose as the weight of non-smokers increased. However, there was no association between the weight and the risk of hypertension among current smokers.
Background
: It has been found that parental role is essential for obesity management in childhood. However, there are few studies concerning parental on childhood obesity in Korea. Parental perception on childhood obesity according to weight status in elementary school children was examined. Methods : The subjects were 3,996 elementary school children and their parents in Busan. The surveys which included socioeconomic characteristics, children's eating habits and activities, parental weight and height, parental perception on childhood obesity, were filled out by parents. Children's body mass index(BMI) were calculated using the height and weight measured in school. Children were classified into the obese group (BMI≥95 percentile), the high risk group (85 percentile≤BMI<95 percentile) and the normal weight group (<85 percentile) according to BMI gender and age. The analyses were done using x²-test and ANOVA. Results : Parental BMI in the obese group was higher than the normal weight group in boys and girls (P<0.001). Participation in regular exercise was higher among the obese group compared to the normal weight group regardless of sex, but daily exercise time was lesser among the obese group only in boys (P<0.001). Daily TV watching time was not different according to weight status in both sex. The parents with obese children perceived their children's weight as an appearance problem or a health problem about 7-18 times more likely than the parents of children with normal weight. 70% of obese children have tried weight control. The proportion of parental understanding on childhood obesity as a disease was not different among boys, but different among girls (P<0.001). Eighty five percents of the parents perceived childhood obesity as a disease or a risk factor. But, their perception for the association of hypertension, fatty liver, sleep apnea syndrome with obesity was relatively low. Conclusion : Most parents with obese children perceived childhood obesity as an appearance problem, a health problem and as a disease or a risk factor.
Background
: This is a cross-sectional study to assess the effect of BMI (body mass index) on blood pressure and to get the appropriate BMI range for the prevention and control of hypertension in old men and women. Methods : From 1996 to 1998 we obtained data for anthropometrics, blood pressure, serum blood profiles and health behaviors about 418 out of 668 old people having visited a charge-free clinic in rural areas. First we tried to figure out the relationship between BMI and systolic or diastolic blood pressure in old men and women separately. After adjusting age, smoking , alcohol, blood glucose, total cholesterol, we checked the linear relationship between each quintile BMI group and prevalence of hypertension in old men and women and obtained prevalence odds ratio (POR) for hypertension in each the 2nd to the 5th quintile BMI group compared to the baseline hypertension- prevalence of the1st quintile BMI group. Results : Regardless of sex, there was significant correlations between BMI and systolic blood pressure (in men r=0.257, p=0.002;in women r=0.182 p=0.005) or diastolic blood pressure (in men r=0.204, p=0.014;in women r=0.256 p<0.001). The prevalence of hypertension in men and women increased 1.37 and 1.41 times respectively by each quintile BMI increase. According to each BMI group in men (median BMI value of each quintile group:18.2, 20.4, 21.8, 23.3, 26.6 kg/㎡), PORs for hypertension were 1.0, 3.7(95% C.I;1.05-12.68), 3.6(95% C.I;1.03-12.59), 6.5(95% C.I;1.89-22.29), 4.0 (95% C.I;1.11-14.36). In women, (median BMI value of each quintile group;18.6, 21.3, 22.9, 25.1, 28.3 kg/㎡), PORs for hypertension were 1.0, 1.6(95% C.I;0.62-3.82), 2.9(95% C.I;1.22-6.99), 2.9(95% C.I;1.28-6.68), 4.2(95% C.I;1.73-9.98). Conclusion : Regardless of sex, there was a significant positive association between BMI and prevalence of hypertension in the old and the risk of hypertension increased even in normal weight group compared to the underweight group. Further studies on the appropriate to prevent and control hypertension in old people will be needed.
Background
: There are different opinions on whether the percentage of dietary fat is associated with the development of obesity and on it's treatment. In this country, dietary fat intake has been smaller compared to the Western countries. The purpose of this study was to find whether intake of dietary fat is related to percentage body fat in obese adults cross-sectionally. Methods : Nutrient intake form 24-hour dietary recall and percent body fat from bioelectrical impedance method were measured in 51 obese adults. Total energy intake was associated with intake of dietary fat and body size. Thus, the association of intake of dietary fat and three types of fat with percentage body fat were examined after adjustment for total energy intake by using 4 statistical models (standard multivariate model, and nutrient residual model, energy-partition model, and multivariate nutrient density model). Results : In all of these models, the results for types of fat and total fat showed similar results. Higher intake of total fat, saturated and polyunsaturated fat was associated with increased percentage body fat, while higher intake of monounsaturated fat was associated with decreased percentage body fat. Conclusion : We found positive association between dietary intake of fat and percentage body fat in obese adults. Our results suggest that reducing fat intake would be a helpful way to prevent and treat obesity in adults.
Background
: The purpose of this study was to compare the long-term effect of the cholestreol-lowering diet education provided by physicians with the education provided by dieticians on serum lipid profiles of hypercholestreolemic patients. Methods : Among 248 ambulatory patients who had mean baseline serum total cholesterol (TC) level >200mg/dL and received cholesterol-lowering diet education from physicians or dieticians, 41 patients who checked serum lipid profiles three times during the mean of 403 days after education were included as subjects. The differences in means of all serum lipid profiles associated with education methods after controlling for follow-up duration, differences in means of all serum lipid profiles associated with follow-up duration after controlling for education methods, any interaction between education methods and follow-up duration on serum lipid profiles were analyzed by using repeated measures of analysis of variance. The difference between the baseline lipid levels and the third lipid levels after education were analyzed by using Wilcoxon signed ranks tests in each group. Correlations between baseline serum lipid profiles and the last changes in serum lipid profiles were analyzed. Results : There were no significant differences in means of all serum lipid profiles associated with education methods of follow-up duration except LDL-cholesterol (LDL-C). The first LDL-C level after education was significantly lower in the group educated by physicians compared with the baseline LDL-C, but there was no such change in the group educated by dieticians. There were no interactions between education methods and follow-up duration on all serum lipid profiles. The last change of total cholesterol in both groups and LDL-C only in the group educated by dieticians were significant. Correlation coefficients between baseline triglyceride (TG) and change in TG, baseline LDL-C and change in LDL-C, baceline total cholesterol (TC) and change in TC in patients with TC 240mg/dL were -0.500 (P=0.002), -0.597 (P<0.001), and -0.578 (P=0.001), respectively. Conclusion : The changes of serum lipid profile during more than 1 year after education were not significantly different according to diet education methods, but total cholesterol level was significantly degreased in both groups.
BACKGROUND
Much time and cost have been consumed for just a treatment of a simple disease and inappropriate management has taken place because of misjudgement by laymen. To establish a desirable health care system, need for the usual-medical-provider system (U.MP. system) has been suggested. This study was performed to find some data that would be helpful to establish the U.MP. system by surveying some factors influencing on choosing care providers of children. METHODS 440 questionnaires were gathered from surveys administered to the parents of the students in a primary school. The period for study was 1 week of September in 1999 and the response rate was 88.0%. The questionnaire was composed of sociodemographic variables, a question for having U.MP. and some factors related with choosing U.MP. RESULTS The fourth and fifth decade of age showed higher proportion for having U.MP. than sixth decade. The proportion of having U.MP. was also higher in respondents with higher educational attainment and higher income. The proportion of visiting local clinics or hospitals was about 65.7% in groups having U.MP., whereas the proportion was about 41.5% in group not having U.MP., The frequency of visiting local clinics or hospitals for a year was higher for groups having U.MP., compared with groups not having U.MP.. The factors related with choosing U.MP. were `doctors who explain the disease in detail and easily', `doctors who provide care meticulously', and `effective treatment'. CONCLUSION To establish the U.MP. system, a kinder attitude and care would be necessary for doctors who will provide care to the patients and their family.
BACKGROUND
The purpose of this study was to evaluate the association between social support and health status for the elderly in a rural area where social network has been decreased. METHODS One hundred and 58 elderly patients who visited free medical services participated in the survey that contained items about social support, heath status, socioeconomic status, health behaviors, and depression. Subjects were divided into three groups according to their social support index scores and two groups according to their health status. The health behaviors, socioeconomic status, and depression were considered as confounders. The associations between social support and confounders were analyzed by oneway analysis of variance, Cochran Mantel-Haenszel test, x2-test, and t-test. Then, multiple logistic regression analyses were done to find the adjusted association between social support and health status. RESULTS Social support was related to education (P=0.012), economic level (P=0.007), smoking status (P=0.028), depression score (P<0.001), and health status (P<0.001). Health status was related to age (P=0.02), economic level (P<0.001), and depression score (P<0.001). The unadjusted prevalence odds ratios (POR) for poor health status were 7.3 (95% CI: 2.8-19.2) in the poorly supported group and 1.3 (95% CI: 0.5-3.5) in moderately supported group compared with the highly supported group. The corresponding adjusted POR increased to 14.3 (95% CI: 2.8-73.3) in poorly supported group and 6.2 (95% CI: 1.2-31.9) in moderately supported group. CONCLUSION The poor social support was associated with poor health status and the relationship increased more with adjustment of confounders. Several methods to improve social support is necessary to maintain and enhance health status in the rural elderly.
Background
: The purpose of this study was to identify health practices that would be helpful in order to reduce the prevalence of correctable cardiovascular risk factors (CVR), i.e. hypertension, hypercholesterolemia, and hyperglycemia in male workers by examining the association between health practices and the prevalence of the three risk factors. Methods : For 1,815 male workers at a car manufacturer who participated in the basic health examination, survey on socioeconomic status and seven healthy practices such as not currenly smoking, moderate alcohol drinking, proper weight control, regular exercise, 7-8 hour sleep, eating breakfast regularly, and not eating between meals was done and the prevalence of hypertension, hypercholesterolemia, and hyperglycemia as obtained. χ²test, Fisher's exact test, and multiple logistic regression analyses were done for workers under 40 years old and workers 40 and over in two, separate groups by adjusting socioeconomic variables. Results : The prevalence of hypertension and hypercholesterolemia was 1.84 times and 5.22 times, respectively, showing, higher in overweight younger workers than in those of normal weight. The prevalence of hypercholesterolemia was 2.02 times higher in younger smoking than in younger non-smokers. In contrast, the prevalence of hyperglycemia was 4.99 times higher in older smokers than in older non-smokers. The prevalence of hyperglycemia was 16.5 times higher in older workers with regular snacking habit than in those without such a habit. The prevalence of hypercholesterolemia was 7.47 times higher only in younger workers practicing healthy behaviors below 3 than in those practicing at least 6 healthy behaviors. Conclusion : Our study suggests that overweight and smoking habit among younger workers, and smoking habit among older workers sould be controlled in order to decrease the prevalence of hypertension, hypercholesterolemia, and hyperglycemia.
Background
: This study was performed to document the reliability and validity of the Korean version of the Women’s Health Questionnaire (WHQ), and evaluate the quality of life experienced during menopause. Methods : The subjects of this study were 161 women (premenopause 61, peri/postmenopause 100) between the aged of 40 and 65 years who visited the office of Family Medicine department in Pusan Paik Hospital. The instruments consisted of the WHQ, the Nottingham Health Profile(NHP), the Self-rating Anxiety Scale(SAS), and the Self-rating Depression Scale (SDS). We evaluated the internal consistency of the instruments and the correlations between the WHQ and other scales. Then, we compared the scales between the premenopausal women and the peri/postmenopausal women. Finally, we found predictable variables explaining the quality of life. Results : The Cronbach’s α value showed 0.8060 for the WHQ. The correlation coefficient of the WHQ was 0.724 with the NHP, 0.760 with the SAS, and 0.704 with the SDS. The peri/postmenopausal women perceived more severely than the premenopausal women in the WHQ areas of sexual functioning (P=0.003), vasomotor symptoms (P=0.004), and sleep(P=0.0222) as well as in the NHP areas of physical mobility(P=0.005), sleep(P=0.001), and total score(P=0.002). However stress level was more important predictor of scores of questionnaires than peri/postmenopausal status in stepwise multiple regression analysis. Conclusion : This data suggest that we should pay attention to stress level, sociodemographic status when we consider the quality of life in the menopausal women.
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
: This study was performed to assess the effect of hormone replacement therapy(HRT) on the menopausal symptoms of Korean women by comparing the postmenopausal symptoms before and after HRT in women who continued therapy and those who stopped. Methods : The subjects were 40 menopausal women(24 women on continuous medication, 16 women who discontinued medication) who received HRT and were aiding follow-up of at least 2 months later in the Department of Family Practice. The menopausal symptoms were evaluated by two doctors according to the modified Kupperman Index. Results : The basic values of Kupperman Index were not significantly different between women who had received the HRT continuously and those who discontinued HRT. In women with continued HRT improved symptoms after HRT were hot flushes, sweating, fatigue, headache, tachycardia and total score of Kupperman Index. However, only vertigo and headache were improved in women who discontinued HRT. Treatment period was the single most predictor of total score of Kupperman Index after therapy. And it could explain the 44.1% of variance of total score in the direction of improvement proportional to the treatment period. Conclusion : The HRT is helpful to relieve the menopausal symptoms. And the treatment period is more important than the severity of basic symptoms to improve menopausal symptoms after therapy.
Background
: This study was performed to investigate the relationship of health behaviors and physical health status in the elderly. Therefore, we evaluated the significance of health behaviors and acquire useful data for health promotion in the elderly. Methods : The elderly 65-years old or over were recruited and enrolled at a medical service practiced in 8 different rural areas in 1997. A total of 217 completed questionnaires were obtained. The questionnaire consisted of the variables of sociodemography, health behavior, physical health status, health concern, and depression. The data were analysed by Mantel-Haenszel test for linear association, t-test, ANOVA, and multiple regression analysis. Results : Among the health behaviors eating breakfast and physical activity were related to physical health status. Factor of the level of practicing health behavior was related to physical health status, especially to the admission history, and disability in work because of illness. The predictors of health status score were health concern and total health behaviors. Only physical activity among the health behaviors was the significant predictor of physical health status. Conclusion : The result that health behaviors are related to health status in the middle-aged is applicable to the elderly. And physical activity is the predictor of physical health status in the elderly. These results suggest health behaviors will be helpful to the elderly's health.(J Koean Acad Fam Med 1998;19:538~548)
Background
: Korea is one of the endemic areas of viral hepatitis B, and 6-8% of general population are hepatitis B virus carriers. Although there have been little reduction in morbidity and infectivity of viral hepatitis B owing to newer vaccines and the effects of immunizations, there are some differences among physicians in managing hepatitis B virus infection, and guidelines have not been established. Therefore in this study, we investigated general practitioners' concept and the practical management of viral hepatitis B in comparison with the hepatologists'. Methods : Information was obtained through questionnaires sent to 67 hepatologists and 400 general practitioners(general internists, general surgeons, family physicians, general physicians, and public health center managers) in Pusan during the 5 months from April to August, 1997. Overall respondents were 142(116 General practitioners, 26 Hepatologists), and the response rate was 32.9%. Results : In general practitioners, the most commonly used serologic test for viral hepatitis was HBsAg/HBsAb(71.0%). 51.9% of subjects underwent anti-HBs test 3-5 months later after vaccination. The most common revaccination method for healthy non-responders of initial vaccination was 3 series of immunizations with the same vaccine of equal dosage(36.9%). 65.7% of subjects were tested for LFT every 6 months for chronic carriers, and 41.5% of them were advised α-interferon treatment for chronic active hepatitis patients only if the patients requested it. In comparison with general practitioners, hepatologists had a tendency to add anti-HCV test for the serologic evaluation of hepatitis(56.6% vs 26.2%), to limit age for vaccination(82.6% vs 54.1%), and to delay prescribing hepatotonics until the AST and ALT levels increased up to 2 folds normal(53.8% vs 39.1%). 38.5% of hepatologists did not recommend giving booster injection of hepatitis. Conclusion : Practical guideline is necessary to manage viral hepatitis B patients.
Background
: It is known that obesity is related to hypertension, hyperlipidemia and diabetes mellitus. The results of study done in Korea are widely spread. In this study, we evaluated the prevalence of obesity by four obesity measure methods and the risk of obesity for obesity related diseases. Methods : This study was done for the period from May 1 to August 31, 1995 in three health care centers run by middle sized hospitals in Pusan. The total number of sampled population was 654(men227, women 427) Results : We compared obesity by sex and age according to four obesity measure methods. The results were as following : Obesity was more prevailed in women than in men for all measure methods. In women, there was significant difference according to age by Broca's Index(P=0.006), Kassura's modified formula(P=0.018) and Suh's formula(P=0.009) but in men there was no significant difference. We compared the laboratory test results of men and women. The test results elevated significantly in men were diastolic blood pressure(P=0.001), hemoglobin(P<0.001), aspartate aminotransferase(AST) (P=0.034), alanine aminotransferase(ALT) (P=0.011), gamma-glutamyltranspeptidase(γ-GT) (P<0.001). Total cholesterol was elevated significantly in women. We evaluated the correlation of age and obesity with the tests. For the age, systolic blood pressure(P<0.001), diastolic blood pressure(P=0.001), total cholesterol(P<0.001), glucose(P=0.045), ALT(P=0.003) were correlated positively. The odds ratio of obesity for elevated blood pressure was 1.03(P=0.005), for hypercholesterolemia 1.03(P=0.001), for elevated ALT 1.03(P=0.005) for hyperglycemia 1.01(P=0.083). Conclusion : In this study, we found that the prevalence of obesity is higher in women than in men at 40 years old and beyond. We found that obesity is independent risk factor of elevated blood pressure, hypercholesterolemia and elevated ALT. We suggest that the clinicians be concerned in dealing with obesity.
Background
: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. Methods : We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as parameter of self esteem and Hopkins symptomcheck list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. Results : We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.0009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sec, age, marriage, type of family, income showed no significant relationship with self esteem. Conclusion : The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
The purpose of this study is to find out the better Body Mass Index for Korean children.
We surveyed 737 students in a primary school in Seoul. Among them, 373 were boys. Using the records of the physical examination done for the children every last 5 years, the data of the children's weights and heights for last 5 years were obtained. From these data, we calculated 6 Body Mass Indices(Quetelet Index, Modified Quetelet Index, Rohrer Index, Ponderal Index, Weight for lenght Index, and Body Surface Area Index). We analysed the trends of indices by age and by sex. The results were as follows ; 1. In boys, Quetelet, Modified Quetelet, and Body Surface Area Indices increased as the age. The Ponderal Index increased till the second year and then remained unchanged. The change of the Weight for Lenght Index were unnoticeable for the the firs year, but the Index increased for next two years, and then there was no change. The Rohrer Index changed insignificantly all the years. 2. The trends of girls' indices were very similar to those of boys except the Weight for Length Index, which decreased slightly for the second year and increased till the fourth year for girls while never decreased for boys. 3. The Quetelet Index were significantly larger for boys than for girls in the first and second year(p<0.05). The Weight for Lenght Index was significantly larger for girls in the first and the second year, while it was opposite in the third and fourth year(p<0.05). The Body Surface Area Index was significantly larger for girls all the years but the fifth year(p<0.05).
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