Background
The prognosis of end-of-life patients is challenging, and clinicians have attempted to predict survival more accurately. High serum creatinine (sCr) levels are associated with lower survival rates in patients with various cancers; however, low sCr levels are commonly expected in patients with terminal cancer because of muscle wasting and malnutrition. Therefore, we investigated the prevalence of low and high sCr levels and their association with survival duration in patients with terminal cancer in a palliative care unit.
Methods
We analyzed the medical records of 280 patients admitted to a palliative care unit. Patients were divided into low (<0.5 mg/dL), normal (0.5–1.2 mg/dL), and high (>1.2 mg/dL) sCr groups. Kaplan-Meier survival curves using sCr levels were plotted and compared using the log-rank test. Using stepwise selection, a multivariable Cox proportional hazards model was used to identify the significant prognostic factors.
Results
The median survival durations in the high-, low-, and normal-sCr groups were 9.57 days, 22.26 days, and 27.51 days, respectively. Multivariable Cox proportional hazard model identified that males (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.16–2.85), poor performance status (HR, 3.43; 95% CI, 1.12–10.54), total parenteral nutrition use (HR, 1.84; 95% CI, 1.09–3.1), high sCr (HR, 2.74; 95% CI, 1.52–4.94), and low sCr (HR, 1.22; 95% CI, 1.07–1.43) were significantly associated with a shorter survival time.
Conclusion
Low and high serum creatinine levels were significantly associated with poor survival in patients with cancer at the end-of-life stage. Therefore, readily available and simple biomarkers may help plan advanced care in palliative care settings.

Background
A usual source of care (USC) is related to longitudinal and personalized services, which are attributes of primary care. Patient-centered communication, an important element of patient-centered care, helps physicians understand health problems from a patient’s point of view. We analyzed the association between USC and patient-centered communication.
Methods
Data from the Korea Health Panel 2018 were used in the analysis. Patient-centered communication scores were obtained by combining the four communication-related questionnaire items. Usual source of care types were categorized based on responses to two questionnaire items: no USC, a place without a regular doctor and with a regular doctor. Multiple logistic regression analysis was used to adjust for confounders.
Results
Good communication rate was higher for those with a regular doctor (71.8%) than for those with no USC (61.8%) or a place only (61.5%). Those with a regular doctor had better communication (odds ratio, 1.49 for individuals with poor/moderate health, and 2.08 for those with good health) than those without a USC after adjusting for confounders. In terms of communication, no difference was observed between individuals with no USC and those with a place only.
Conclusion
Having a regular doctor promotes communication between patients and doctors. Good communication may be a mediator between having a regular doctor and related beneficial outcomes. Better communication by having a regular doctor, along with several other benefits identified in previous studies suggests the need for a health policy that encourages individuals to have regular doctors.

Citations

• Types of Usual Source of Care and Medication Adherence in Patients with Diabetes Mellitus
  Yoon-Eui Choi, Nak-Jin Sung
  Korean Journal of Family Practice.2025; 15(1): 47.     CrossRef
• Patterns of health literacy and influencing factors differ by age: a cross-sectional study
  Da Hae Kwon, Young Dae Kwon
  BMC Public Health.2025;[Epub]     CrossRef
• Correlation between Usual Source of Care and Medication Adherence in Patients with Hypertension
  Han-Kil Kang, Nak-Jin Sung
  Korean Journal of Family Medicine.2024; 45(2): 82.     CrossRef
• Determinants of Patient-Centered Communication, Its Impact On Quality of Services, Overall Health Status And Trust In The Healthcare System In The United States
  Cuma Çakmak, İsmail Biçer
  Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi.2024; 11(4): 630.     CrossRef

Background
Systemic Clinic Outcome and Routine Evaluation (SCORE-15) is a compact scale that contains the most critical family function assessment tools including assessments of the strengths, adaptability, and communication among family members. It has been translated into other languages in the United States and Europe. This study aimed to verify the reliability and validity of SCORE-15 with a small research population and justify its applicability in Korea.
Methods
SCORE-15 is a self-reporting family function measurement tool for each family member over the age of 11 years. This study used the Family Communication Scale (FCS) included in the Family Adaptability and Cohesion Evaluation Scales (FACES) IV package and FACES in FACES-III to verify the validity of the Korean-translated SCORE-15. Cronbach’s α value was calculated to check the reliability of SCORE-15. Data were analyzed using STATA ver. 15.0 (Stata Corp., College Station, TX, USA).
Results
The study analyzed the correlation between FACES-III and SCORE-15 and FCS and SCORE-15 so that there was a significant static correlation in both comparisons (r=0.72 and r=0.81, respectively). Also, the research compared each subscale to analyze the correlation and the range was 0.47 to 0.95. The total SCORE-15 Cronbach’s α value was 0.92 and those values of the subscales for family strengths, family communication, and family difficulty were 0.89, 0.73, and 0.87, respectively (P<0.001).
Conclusion
Our study was the first to validate the Korean SCORE-15, which can be used as an appropriate shortform indicator for evaluating family function and changes in detecting therapeutic improvements in Korea.

Citations

• Empowerment among treatment-engaged individuals living with schizophrenia in Tanzania
  Madeline Jin Van Husen, Sylvia Kaaya, Praxeda Swai, Paul Sarea Lawala, Beatrice Thadei, Anna Minja, Jennifer Headley, Joseph R. Egger, Joy Noel Baumgartner
  BMC Psychiatry.2025;[Epub]     CrossRef
• Validade Discriminante da Versão Brasileira do SCORE-15: Um Estudo com Amostra Comunitária e Clínica
  Marisa Machado Alves dos Santos Santos, Juliana Maciel de Queiroz, Edna Lúcia Tinoco Ponciano, Margarida Vilaça, Ana Paula Relvas, Luciana Sotero
  Saúde Coletiva (Barueri).2025; 15(95): 15768.     CrossRef
• The development of a reliable change index and cutoff score for the SCORE‐15
  Richard B. Miller, Cara A. Nebeker‐Adams, Shayne R. Anderson, Angela B. Bradford, Lee N. Johnson
  Journal of Marital and Family Therapy.2023; 49(1): 36.     CrossRef
• Effect of Method Bias on the Internal Structure of the Systemic Clinical Outcomes in Routine Evaluation Measure of Family Functioning
  Christina Hamme Peterson, N. Andrew Peterson, Corinne Casey
  The Family Journal.2023; 31(3): 498.     CrossRef
• Children's version of the systemic clinical outcome and routine evaluation (C‐SCORE): Exploring the psychometric qualities in the Portuguese context
  Margarida Vilaça, Bruna Veloso, Peter Stratton, Ana Paula Relvas
  Journal of Family Therapy.2022; 44(4): 550.     CrossRef

Citations

• Analysis of Factors Influencing the Willingness of Chinese Older Adults to Use mHealth Devices: Nationwide Cross-Sectional Survey Study
  Mengyao Yan, Wendi Sun, Cheng Tan, Yibo Wu, Yuanli Liu
  Journal of Medical Internet Research.2025; 27: e66804.     CrossRef
• How men with alcohol use disorder perceive communication, couple satisfaction, relational boredom, and quality of life compared to wives: Findings from a hospital-based study
  Pradeep Kumar P.C., Princy P.J., Shivanand Manohar, Kishor M., Manoj K. Pandey
  Journal of Ethnicity in Substance Abuse.2023; : 1.     CrossRef
• The Association Between Family Violence, Depression and Anxiety Among Women Whose Partners Have Been Treated for Alcohol Dependence
  Natasa Dostanic, Bosiljka Djikanovic, Mirjana Jovanovic, Zeljka Stamenkovic, Aleksandra Đeric
  Journal of Family Violence.2022; 37(2): 313.     CrossRef
• Family Functioning and Communication in Spouses of Patients with Parkinsonism
  Seo Young Kang, Myung Hwa Yang, Jung Ah Lee, Wooyoung Jang, Chong Sik Lee, Young Sik Kim
  Korean Journal of Family Medicine.2017; 38(1): 14.     CrossRef

Citations

• Video feedback combined with peer role-playing: a method to improve the teaching effect of medical undergraduates
  Jiwu Wang, Birong Wang, Dan Liu, Yiqun Zhou, Xin Xing, Xianggui Wang, Wei Gao
  BMC Medical Education.2024;[Epub]     CrossRef
• Communication skills utilized by physicians in the pediatric outpatient setting
  T. Lee, E. C. Lin, H. C. Lin
  BMC Health Services Research.2022;[Epub]     CrossRef
• Assessing effective physician-patient communication skills: “Are you listening to me, doc?”
  Anthony C. Berman, Darryl S. Chutka
  Korean Journal of Medical Education.2016; 28(2): 243.     CrossRef
• Assessors for communication skills: SPs or healthcare professionals?
  Siaw-Cheok Liew, Susmita Dutta, Jagmohni Kaur Sidhu, Ranjit De-Alwis, Nicole Chen, Chew-Fei Sow, Ankur Barua
  Medical Teacher.2014; 36(7): 626.     CrossRef
• Educational Interventions Need to Be Defined Precisely
  Kieran Walsh
  Korean Journal of Family Medicine.2013; 34(3): 226.     CrossRef

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.

Citations

• Experiences and Perceptions of Gender Discrimination and Equality among Korean Surgeons: Results of a Survey of the Korean Surgical Society
  Jihyeon Choi, Jeong-Eun Lee, Bora Choi, Jungook Kim, Seung Eun Lee
  Journal of Korean Medical Science.2021;[Epub]     CrossRef
• Perspectives of Cancer Patients on Korean Medicine Treatments: A Cross-sectional Survey
  Han-sung Ryu, Sung-soo Yoon, Jee-young Lee, Seong-woo Yoon
  The Journal of Internal Korean Medicine.2017; 38(3): 319.     CrossRef
• Nurses' Knowledge, Perceived Barriers, and Practices Regarding Complementary and Alternative Medicine in South Korea
  Sanghee Kim, Myung-Nam Lee, Senah Lee
  Holistic Nursing Practice.2016; 30(6): 338.     CrossRef

Breaking bad news to patients with an advanced cancer is a difficult task for physicians. Some strategies can be used when breaking bad news to patients with advanced cancer. However, many doctors were not trained sufficiently. 43-year old male complaining of general weakness and melena was diagnosed as an advanced gastric cancer with hepatic metastasis. We could deliver this bad news to the patient and his family step by step. Honest discussion allowed patient to be reassured about many points of concern and helped them to be calmer and to plan and readjust hopes and aims. Bad news cannot be broken gently, but it can be given in a sensitive manner and at the individual's pace. Sometimes doctor's own anxiety can be barrier to tell the truth. When we give the information, we always keep in mind about the respect for truth, the patient's rights, the duty to inform, maintaining hope, and the sanctity of the individual contract between patient and doctor.

Background
: Nowadays the addictive use of internet is becoming a serious social and health problem. The authors performed a study in PC bang users to evaluate the prevalence of addictive internet use and the association between addictive internet use and behavioral and psychological factors.

Methods : A face-to-face interview survey of 900 Korean internet users at six PC-bangs was performed between 11th and 19th of December, 2002, using standardized questionnaires composed of Young's internet addiction scale, scale of unwillingness to communicate, patient problem questionnaire for screening depression and anxiety, and questions asking internet using patterns and socio- demographic factors.

Results : Of the final 888 participants, 3.4% were identified as addictive users and 41.3% as over-users of internet service. The subjects who were male, unemployed, less educated, using internet mainly at PC bang, using internet more frequently, starting or finishing off internet use usually in the morning, using internet service usually for doing games tended to be more addictive users of internet (P＜0.05). In proportional odds model analysis, increasing duration of internet use (OR=1.22; 95% CI, 1.16∼1.30), daily use of internet (OR=2.06; 95% CI, 1.21∼3.51), finishing off internet use between midnight and 6 a.m. (OR=2.00; 95% CI, 1.30∼3.07), anxiety (OR=5.38; 95% CI, 2.86∼10.1), and increasing approach avoidance (OR=1.05; 95% CI, 1.03∼1.08) were significantly associated with a higher degree of internet addiction.

Conclusion : Addictive use of internet should be suspected in a person who uses internet for long time, daily, and over midnight. An active evaluation and management for anxiety are needed among addictive internet users.

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.

Background
: The purpose of this survey was to assess knowledge of the public on family medicine through the analysis of medical counseling by PC communication and compare them with that of internal medicine.

Methods : This survey analyzed the content of medical counseling by PC communication according to ICPC from Oct. 1996 to Jun. 1998. The survey was done by means of E-mail in Nownuri eyes and the selected medical departments were those of family medicine and internal medicine in Pusan National University Hospital.

Results : The total number of questions was 342, including 181 in the department of family medicine and 161 in internal medicine. In the analysis of medical counseling according to ICPC, there was a significant difference between family medicine and internal medicine in the reasons for questions by components(P<0.001). In family medicine, the reasons were symptoms, complaints(66.9%), diagnoses, diseases(18.8%), treatment, procedure, medication(17.2%), and diagnostic, screening, prevention(5.5%). In internal medicine, the reasons for questions were symptoms, complaints(64.6%), diagnoses, diseases(21.1%), treatment, procedure, medication(9.3%), and test results(4.3%).
There was a significant difference between family medicine and internal medicine in the questions by chapters(P<0.05). In family medicine, the questions about digestive system were 28 cases(15.5%), neurological system were 26 cases(14.4%), musculoskeletal system were 25 cases(13.8%), and unspecified were 25 cases(13.8%). In internal medicine, the questions about digestive system were 76 cases(47.2%), circulatory system were 21 cases(13.0%), and respiratory system were 15 cases(9.3%). The most common symptom was headache in family medicine and generalized abdominal pain in internal medicine.

Conclusion : There were significant differences in the age distribution, the reasons for questions, and the contents of questions between family medicine and internal medicine.

Background
: A good doctor-patient relationship should be based on mutual understanding and reliance. Proper conversation and same understanding of the use of this terminology is needed. This study was designed to make a cornerstone to establish appropriate medical terminology by means of investigation of the meaning of 'neurotic' among family' physicians.
Method : A questionnaire was sent to 971 family doctors registered as regular member in the Korean Academy of Family Medicine. We analyzed 184 returned questionnaires. We calculated the percent for each item. Chi-square test used to analyze demographic characteristics and compare whether the word 'neurotic' has been used or not, and whether it was a proper medical terminology or not.
Result:82.6% of responders(152/184) were used to 'neurotic' as a medical terminology. Doctors in their thirties were the least using group(78.7%) and doctors working in university hospitals rarely used them being statistically significant(p<0.000). 82.5% of the doctors in using 'neurotic' responded it is not an appropriate terminology. The most frequent situation in using it was 'patient appealed organic disorders such as functional dyspepsia(64.1%), tension headache(58.5), psychosomatic or somatoform disorder(54.9%). 59% of the patients diagnosed as 'neurotic' gave unsatisfying responses. Family doctors recommended substituting to terminology such as 'functional'(33%), 'psychogenic'(31.8%), and 'stress-induced'(25.0%).

Conclusion : Most family doctors were used to the word 'neurotic' but they did not think it was an appropriate terminology. There fore, other substitute words should be taken into consideration.

Background
: A good deal of medical information is in circulation with the great advances in communication technology. This study sought to collect and classify a wide variety of data in circulation, to determine the effects of this medical information via PC on people, to see whether people feel that it is useful, and how it can be applied clinically.

Methods : Contents of medical information in circulation were classified and analyzed from domestic PC network including Chollian, Hitel, and Unitel. The survey was conducted with 700 subjects who were given medical counsel through above communication networks between August 1 and September 30, 1997. They were given questionnaires for usefulness of medical information via e-mail and among these, cross-sectional study was made with 336 respondents who were feasible for statistical analysis.

Results : Users of medical information currently in circulation can be roughly classified into general and professional ones. Information for general user can by grouped by its content into one for medical common sense, medical consultation, First Aid, self-diagnosis, medical insurance, drug therapy, medical test interpretation, guide information for hospital and clinic visitors. The survey showed the following responses : PC communication was useful(70.8%), its education efficacy was higher than other measures(62.3%), it helped for the prevention of diseases(59.8%), it was useful in the reduction of medical fee(71.4%), I'll get the web information even if charged(63.1%), it helped for the correction of mistaken medical common sense(58.8%), it helped for the understanding of medical service in a hospital(63.5%).

Conclusion : Practically, PC communication can provide general users medical information in a convenient and useful way. In addition, this information can be helpful in the reduction of medical fee and prevention of diseases, and more effective in patient education than other measures.