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Original Articles

Association between Undergraduate Education for Community-Based Medicine and General Practice Majors: A Longitudinal Study in Japan
Mariko Ishisaka, Akiko Hanamoto, Makoto Kaneko, Daisuke Kato, Kazuhisa Motomura, Yuki Kataoka
Korean J Fam Med 2023;44(4):215-223.   Published online June 23, 2023
DOI: https://doi.org/10.4082/kjfm.22.0189
Background
There is a shortage of general practitioners in Japan. With the revision of educational guidelines, general practice (GP) education has improved. However, the amount of education on GP in medical schools remains inconsistent. This study examined the relationship between medical students’ amount of GP-related education and their subsequent choice of GP majors.
Methods
A retrospective cohort study was conducted in a teaching hospital in Japan. Participants were residents in the hospital. The exposure comprised compulsory lectures and training time for community-based medicine in medical schools. The outcome included participants choosing GP majors after their initial 2-year junior residency.
Results
Fifty-one participants were included in the final analysis. Of these, 14 majored in GP and 37 in non-GP after their initial 2-year junior residency. Of the participants who took GP lectures for 18 hours or more, 11 chose GP majors, and 18 chose non-GP majors (risk ratio, 2.78; 95% confidence interval [CI], 0.88–8.79). Of the participants who underwent training for 12 days or more, 10 chose GP majors, and 16 chose non-GP majors (risk ratio, 2.40; 95% CI, 0.87–6.68).
Conclusion
The results do not support the association between the amount of compulsory undergraduate education for community-based medicine and the subsequent increase in the number of residents choosing GP majors in Japan. Educators would do well to explore different approaches, such as improving the quality of education to increase the number of GP residents. Further research is needed to reach more definitive conclusions.

Citations

Citations to this article as recorded by  
  • Rethinking community‐based clinical training in Japan: Toward a more effective model for increasing the number of general practice physicians
    Masanobu Okayama
    Journal of General and Family Medicine.2025;[Epub]     CrossRef
  • Distribution of internal medicine rotations among resident physicians in Japan: a nationwide, multicenter, cross-sectional study
    Kiyoshi Shikino, Miwa Sekine, Yuji Nishizaki, Yu Yamamoto, Taro Shimizu, Sho Fukui, Kazuya Nagasaki, Daiki Yokokawa, Takashi Watari, Hiroyuki Kobayashi, Yasuharu Tokuda
    BMC Medical Education.2024;[Epub]     CrossRef
  • Strengthening Primary Health Care through Medical Education
    Seung-Won Oh
    Korean Journal of Family Medicine.2023; 44(4): 181.     CrossRef
  • Factors associated with regional retention of physicians: a cross-sectional online survey of medical students and graduates in Japan
    Soichi Koike, Kentaro Okazaki, Akiko Tokinobu, Masatoshi Matsumoto, Kazuhiko Kotani, Hitomi Kataoka
    Human Resources for Health.2023;[Epub]     CrossRef
  • 5,188 View
  • 98 Download
  • 5 Web of Science
  • 4 Crossref
Knowledge and Risk Behaviors Regarding Human Immunodeficiency Virus Transmission among Portuguese Healthcare Students
Bárbara Joana Alvarenga Carvalho, António Miguel da Cruz-Ferreira
Korean J Fam Med 2023;44(1):35-43.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.22.0012
Background
Human immunodeficiency virus (HIV), the agent responsible for acquired immunodeficiency syndrome, remains a worldwide public health problem. Therefore, this study aimed to assess Portuguese healthcare students’ knowledge of HIV, identify risk behaviors for HIV transmission, and assess the frequency of HIV testing and its dissemination by general practitioners.
Methods
A cross-sectional observational study was conducted using an anonymous questionnaire published online. The questionnaire was administered to Portuguese healthcare students who voluntarily agreed to participate in the study after clarifying its objectives and procedures.
Results
Most students were aware of the three main HIV transmission routes; however, 66.3% were unaware of the level A recommendation for HIV screening in adolescents and adults. In addition, 59.6% of the students were never informed by their general practitioner about HIV screening tests or risk behaviors for HIV transmission. Of the sample, 78.9% had never been tested for HIV infection. Of the 74.6% of sexually active students, 82.0% had or had already had unprotected sex (without a condom). Men showed riskier sexual behaviors than women. None of the inquiries reported intravenous drug use, and most students (69.9%) never shared personal objects.
Conclusion
General practitioners and awareness campaigns need to alert and disseminate HIV screening tests. Sexual health and risk behaviors should be addressed more frequently in schools to educate this population because prevention is the best strategy against HIV transmission/contraction.
  • 2,628 View
  • 70 Download
  • 1 Web of Science

Review Articles

Recent Advance in Clinical Practice Guideline Development Methodology
Soo Young Kim
Korean J Fam Med 2022;43(6):347-352.   Published online November 20, 2022
DOI: https://doi.org/10.4082/kjfm.22.0178
Clinical practice guidelines (CPG) can be defined as systematically developed recommendations and related content obtained by reviewing scientific evidence, which help healthcare providers make decisions. CPG is one of the most powerful tools that helps clinicians make evidence-based decisions in practice. Methodologies in areas essential for CPG development, such as for systematic review, risk of bias (ROB) assessment, adaptation, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations, are rapidly developing. Therefore, they must be well-understood and applied to evidence-based CPG development. In this regard, it is necessary to learn about the updates and changed in the methodologies for CPG development. This manuscript covers the following CPG development methodologies: (1) main principles of CPG, (2) managing conflict of interest, (3) considering patient value and preference, (4) determination of key questions, (5) ROB assessment, (6) adaptation, (7) rapid guideline development, (8) living guideline development, and (9) GIN-McMaster Guideline Development Checklist.

Citations

Citations to this article as recorded by  
  • RoBANS 2: A Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions
    Hyun-Ju Seo, Soo Young Kim, Yoon Jae Lee, Ji-Eun Park
    Korean Journal of Family Medicine.2023; 44(5): 249.     CrossRef
  • Association between Conflicts of Interest Disclosure and Quality of Clinical Practice Guidelines in Japan: A Meta-Epidemiological Study
    Norio Yamamoto, Akihiko Ozaki, Shunsuke Taito, Takashi Ariie, Hidehiro Someko, Hiroaki Saito, Tetsuya Tanimoto, Yuki Kataoka
    Journal of Personalized Medicine.2023; 13(12): 1722.     CrossRef
  • 3,033 View
  • 69 Download
  • 2 Web of Science
  • 2 Crossref
Teaching Family Medicine and General Practice
Muhammad Jawad Hashim
Korean J Fam Med 2022;43(2):93-100.   Published online March 17, 2022
DOI: https://doi.org/10.4082/kjfm.20.0223
The teaching of family medicine and general practice should aim to develop an appreciation of the unique nature and role of the specialty. Teachers should relate patient cases to the principles of family medicine. These principles include (1) compassionate care; (2) a generalist/holistic approach focusing on the whole person, family, and community; (3) continuity of relationship, i.e., building a patient-physician bond of trust; (4) reflective mindfulness; and (5) lifelong learning. The curriculum, instructional strategy, and assessment should be carefully aligned. Core competencies include patient-centered communication, physical examination skills, clinical procedures, palliative care, humanities in medicine, holistic care, shared decision-making, family therapy, home and community visits, chronic disease care, problem-based documentation, team-based care, data-driven improvement, information mastery, ethics and professionalism, and work-life balance. Family medicine/general practice is defined as the medical specialty that manages common and long-term illnesses, focusing on overall health and well-being. Hence, clerkship schedules should maximize clinical exposure and opportunities for self-reflection. A learner-centered approach should begin with a self-identified inventory of learning needs based on the curriculum; next, these needs should be chosen as topics for student presentations. Teaching methods should include mini-workshops: a combination of didactic lectures and small-group exercises. Individual face-to-face formative feedback should occur at midcourse and culminate in a group reflection on the learning experience. Clinical supervision should gradually decrease as each resident demonstrates safe patient care. Procedure skills training should be closely supervised, formally documented, and constitute about one-fourth of learning sessions.

Citations

Citations to this article as recorded by  
  • Use of audio-visual aids and case studies to enhance understanding of family medicine among medical students
    Stephen T. Engmann
    African Journal of Primary Health Care & Family Medicine.2024;[Epub]     CrossRef
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • Disease prevention measures applicable to primary healthcare clinics
    Jae-Heon Kang
    Journal of the Korean Medical Association.2024; 67(4): 226.     CrossRef
  • Perception of Family Medicine Residents on the Use of Small Group Discussion in Comparison to Standard Lectures
    Ahmed Mohammed Gharawi, Abdullah Mohammed Alateeq, Ghada Alarfaj, Ayman Afify, Saad Albatal, Alaa Alahmari, Mostafa Kofi
    European Journal of Contemporary Education and E-Learning.2024; 2(5): 3.     CrossRef
  • Strengthening Primary Health Care through Medical Education
    Seung-Won Oh
    Korean Journal of Family Medicine.2023; 44(4): 181.     CrossRef
  • 5,618 View
  • 145 Download
  • 4 Web of Science
  • 5 Crossref

Original Article

Effectiveness of a Pelvic Floor Muscle Exercise Intervention in Improving Knowledge, Attitude, Practice, and Self-Efficacy among Pregnant Women: A Randomized Controlled Trial
Parwathi Alagirisamy, Sherina Mohd Sidik, Lekhraj Rampal, Siti Irma Fadhilah Ismail
Korean J Fam Med 2022;43(1):42-55.   Published online January 20, 2022
DOI: https://doi.org/10.4082/kjfm.21.0011
Background
The awareness and practice of pelvic floor muscle exercise (PFME) in the prevention and reduction of the rate of urinary incontinence among pregnant women was considerably poor, despite the increased prevalence of urinary incontinence during pregnancy across Malaysia. There healthcare providers do not give adequate attention to the potential impact of PFME on urinary incontinence and there is limited local intervention addressed urinary incontinence during pregnancy. The objective of this study was to determine the effectiveness of a newly developed PFME intervention in terms of knowledge, attitude, practice, self-efficacy, and urinary symptoms.
Methods
A single-blinded, two-armed, randomized control trial was included pregnant women from 18 to 20 weeks of gestation and was conducted at the Maternity Hospital of Kuala Lumpur. The intervention group received PFME in addition to the usual perinatal care. The data were collected using validated questionnaires at 4 time points: baseline, post-intervention in the early third trimester, late third trimester, and early postnatal period. The intervention effects were analyzed using a generalized estimating equation.
Results
The primary analysis included pregnant women who had at least one follow-up; 122 women (71.8%) in the intervention group had significant improvement in knowledge, attitude, practice, and self-efficacy, as well as in the severity of urinary incontinence over time. However, improvement was not observed in self-reported urinary incontinence.
Conclusion
PFME can be considered an effective initial intervention to provide information about urinary incontinence prevention to pregnant women.

Citations

Citations to this article as recorded by  
  • Prenatal Exercise Decreases Urinary Incontinence in Late Pregnancy and 3 Months Postpartum: A Randomized Controlled Trial
    DINGFENG ZHANG, MIGUEL SÁNCHEZ-POLÁN, CRISTINA SILVA-JOSE, ÁNGELES DÍAZ-BLANCO, MAIA BRIK, ARANZAZU MARTÍN ARIAS, PALOMA HERNANDO, RUBÉN BARAKAT
    Medicine & Science in Sports & Exercise.2025; 57(3): 555.     CrossRef
  • Effect of lattice CO2 laser combined with Kegel exercise mild moderate stress urinary incontinence and postpartum depression anxiety
    Zhao-Xia Lou, Shu-Ying Huang, Ze-Qiu Wan, Yun Chen, Hua-Ying Shan, Ling-Yan Wang
    World Journal of Psychiatry.2025;[Epub]     CrossRef
  • Compliance and Adherence to Pelvic Floor Exercise Therapy in People with Pelvic Floor Disorders: A Systematic Review and Meta-Analysis
    Inmaculada Villa-Del-Pino, José-Jesús Jiménez-Rejano, Manuel Rebollo-Salas, Álvaro-José Rodríguez-Domínguez, Carmen-María Suárez-Serrano
    Life.2025; 15(4): 613.     CrossRef
  • Influence of pelvic floor muscle training alone or as part of a general physical activity program during pregnancy on urinary incontinence, episiotomy and third‐ or fourth‐degree perineal tear: Systematic review and meta‐analysis of randomized clinical tr
    Dingfeng Zhang, Kari Bo, Rocío Montejo, Miguel Sánchez‐Polán, Cristina Silva‐José, Montse Palacio, Rubén Barakat
    Acta Obstetricia et Gynecologica Scandinavica.2024; 103(6): 1015.     CrossRef
  • Knowledge, attitudes, and practices of pelvic floor muscle exercises among pregnant women visiting public hospitals
    Javeria Saeed, Laiba Abdullah
    Journal of Basic & Clinical Medical Sciences.2023; 1: 12.     CrossRef
  • Preliminary Findings on Urinary Incontinence Screening Among Childbearing Women Attending Maternal and Child Health Clinic in Kuantan
    Siti Mariam Muda, Umi Maisarah Sutaji, Muzaitul Akma Mustapa Kamal Basha, Haliza Hasan, Zalina Nusee
    Malaysian Journal of Medicine and Health Sciences.2022; 18(s19): 142.     CrossRef
  • Effects of exercises for strengthening pelvic floor muscles in pregnant women
    Ranka Ogurlić, Anka Vukićević, Ljiljana Stijepović
    Medicinski casopis.2022; 56(4): 107.     CrossRef
  • 5,704 View
  • 250 Download
  • 5 Web of Science
  • 7 Crossref

Clinical Practice Guideline

Clinical Practice Guidelines for Managing Frailty in Community-Dwelling Korean Elderly Adults in Primary Care Settings
Hyo-Sun You, Yu-Jin Kwon, Sunyoung Kim, Yang-Hyun Kim, Ye-seul Kim, Yonghwan Kim, Yong-kyun Roh, Byoungjin Park, Young Kyu Park, Chang-Hae Park, Joung Sik Son, Jinyoung Shin, Hyun-Young Shin, Bumjo Oh, Jae-woo Lee, Jae Yong Shim, Chang Won Won, Ji Won Yoo, Sang-Hyun Lee, Hee-Taik Kang, Duk Chul Lee
Korean J Fam Med 2021;42(6):413-424.   Published online November 20, 2021
DOI: https://doi.org/10.4082/kjfm.21.0162
Aging has become a global problem, and the interest in healthy aging is growing. Healthy aging involves a focus on the maintenance of the function and well-being of elderly adults, rather than a specific disease. Thus, the management of frailty, which is an accumulated decline in function, is important for healthy aging. The adaptation method was used to develop clinical practice guidelines on frailty management that are applicable in primary care settings. The guidelines were developed in three phases: preparation (organization of committees and establishment of the scope of development), literature screening and evaluation (selection of the clinical practice guidelines to be adapted and evaluation of the guidelines using the Korean Appraisal of Guidelines for Research and Evaluation II tool), and confirmation of recommendations (three rounds of Delphi consensus and internal and external reviews). A total of 16 recommendations (five recommendations for diagnosis and assessment, 11 recommendations for intervention of frailty) were made through the guideline development process. These clinical practice guidelines provide overall guidance on the identification, evaluation, intervention, and monitoring of frailty, making them applicable in primary care settings. As aging and “healthy aging” become more and more important, these guidelines are also expected to increase in clinical usefulness.

Citations

Citations to this article as recorded by  
  • Summary of best evidence for prevention and management of frailty
    Yinning Guo, Xueyi Miao, Jieman Hu, Li Chen, Yimeng Chen, Kang Zhao, Ting Xu, Xiaoman Jiang, Hanfei Zhu, Xinyi Xu, Qin Xu
    Age and Ageing.2024;[Epub]     CrossRef
  • Frailty: Assessment and Intervention
    Hana Moon, Geon Ho Lee, DaeHyun Kim
    Keimyung Medical Journal.2024; 43(2): 100.     CrossRef
  • Clinical practice guidelines for frailty vary in quality but guide primary health care: a systematic review
    Huaxin Si, Jiaqi Yu, Qinqin Liu, Yanyan Li, Yaru Jin, Yanhui Bian, Xiaoxia Qiao, Wenyu Wang, Lili Ji, Yan Wang, Jian Du, Cuili Wang
    Journal of Clinical Epidemiology.2023; 161: 28.     CrossRef
  • Yaşlılarda Kırılganlığın Önlenmesi ve Yönetiminde Kanıta Dayalı Yaklaşımlar
    Ayşe Buket DOĞAN, Özlem CANBOLAT
    Sağlık Bilimlerinde Değer.2023; 13(3): 501.     CrossRef
  • Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
    Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
    Epidemiology and Health.2023; 46: e2024008.     CrossRef
  • Up-to-date knowledge of frailty
    Chang Won Won
    Journal of the Korean Medical Association.2022; 65(2): 108.     CrossRef
  • Current status of nutrient intake in Korea: focused on macronutrients
    Seung-Won Oh
    Journal of the Korean Medical Association.2022; 65(12): 801.     CrossRef
  • 7,122 View
  • 180 Download
  • 5 Web of Science
  • 7 Crossref

Original Articles

Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial
Ghada M. Khafagy, Mervat M. Mahmoud, Saeed S. A. Soliman
Korean J Fam Med 2021;42(5):369-375.   Published online September 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0212
Background
Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation.
Methods
This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period.
Results
The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups.
Conclusion
Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Citations

Citations to this article as recorded by  
  • Behavioral health care provider’s beliefs, confidence, and knowledge in treating cigarette smoking in relation to their use of the 5A’s intervention
    Midhat Z. Jafry, Jayda Martinez, Tzuan A. Chen, Maggie Britton, Isabel Martinez Leal, Anastasia Rogova, Bryce Kyburz, Teresa Williams, Mayuri Patel, Brian J. Carter, Lorraine R. Reitzel
    Addictive Behaviors Reports.2023; 17: 100493.     CrossRef
  • Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts
    Kyung Hyun Suh
    STRESS.2023; 31(4): 189.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Public Health Intervention for Smoking Cessation
    Soo Young Kim
    Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef
  • 4,476 View
  • 79 Download
  • 3 Web of Science
  • 4 Crossref
Developing National Functional Accreditation Model for Primary Healthcares with Emphasis on Family Practice in Iran
Jafar Sadegh Tabrizi, Farid Gharibi
Korean J Fam Med 2021;42(3):232-239.   Published online March 30, 2021
DOI: https://doi.org/10.4082/kjfm.20.0011
Background
Accreditation is an approach toward quality improvement which has been increasingly implemented in healthcare. This study aimed at developing a national functional accreditation model for primary healthcare with emphasis on family practice in Iran.
Methods
This mixed-method study utilizes a set of research methods purposefully. Initially, the reference models were used for benchmarking accreditation standards through a systematic review. Then, the primary accreditation standards were developed and then they were assessed and approved by the experts of the field via Delphi technique. In the following and after developing essential parts of the standards, the necessary changes in developed model were done according to the pilot test results.
Results
The results of systematic review suggested the superiority of accreditation models of the United States, Australia, Canada, and the United Kingdom globally; and the models of Jordan, Saudi Arabia, Lebanon, and Egypt in Eastern-Mediterranean region. Then, the primary standards including 39 functional standards with 231 measures were developed according to the benchmarked models, and were approved by the experts in Delphi-based study. In pilot test step, the compliance rate of developed standards by primary healthcare centers was calculated 61.61% and 26.37% for self-evaluation and external evaluation phases, respectively.
Conclusion
Regarding the comprehensiveness of developed accreditation model due to its focus on all functional dimensions and the consensus over the developed standards by the experts, it can be an underlying ground for the establishment and evaluation of functional improvement programs in Iranian primary healthcare system.

Citations

Citations to this article as recorded by  
  • Accreditation of primary health care services: A systematic review
    Babak Rastegarimehr, Ahmad Ahmadi Teymourlouy, Hasan Abolghasem Gorji
    Journal of Education and Health Promotion.2025;[Epub]     CrossRef
  • Challenges and Weaknesses of Leadership and Governance-related Health Policies in Iran: A Systematic Review
    Rahim Khodayari-Zarnaq, Khorshid Mobasseri, Shabnam Ghasemyani, Fatemeh Sadeghi-Ghyassi, Maryam Naghshi, Neda Kabiri
    Archives of Iranian Medicine.2024; 27(9): 508.     CrossRef
  • ssessing the performance of comprehensive health care centers in Aradan district based on the national accreditation model
    Farid Gharibi, Jafar Jandaghi, Esmaeil Moshiri
    Koomesh journal.2021; 23(5): 617.     CrossRef
  • 4,051 View
  • 78 Download
  • 4 Web of Science
  • 3 Crossref
“GENOGRAM Physician Involvement Model” New Approach for Indonesian Physician Involvement with Family
Ta Larasati, Nur Indrawaty Lipoeto, Mudjiran , Masrul , Hardisman , Adi Heru Sutomo
Korean J Fam Med 2020;41(5):325-331.   Published online July 9, 2020
DOI: https://doi.org/10.4082/kjfm.19.0017
Background
The family, as the smallest social institution, has responsibilities across many functions, including maintaining family health. Increases in chronic diseases and life expectancy require more family support to prevent disease and implement treatment for family members with chronic diseases. Therefore, physician involvement in not only the treatment of diseases but also their prevention and rehabilitation is required In Indonesia. Hence, a new approach for physician involvement with families is required, especially with regard to comprehensiveness. This study aimed to develop a physician involvement program with the family model for primary healthcare in Indonesia.
Methods
A two-round Delphi method with family medicine experts from 17 of the highest accredited medical faculties in Indonesia as participants was conducted, and factor analysis performed thereafter. The items were considered relevant at ≤0.8 validity content ratio. The second step of this research is survey using e-questionnaire involving 101 primary care physician from all over Indonesia. They live scattered in several provinces in the main islands of Indonesia such Sumatra, Java, Kalimantan, Sulawesi dan Bali.
Results
Results showed an adequately measured sample and correlation for all items (Kaiser-Meyer-Olkin of sampling=0.821; Bartlett’s test <0.001). Seven dimensions were derived from results with eigenvalue of >1, and 25 items were filtered after determining the loading factor of >0.5. The Cronbach’s α for each factor varied from 0.602 to 0.829, and that for the total 25 items was 0.913, with a total variation documented as high as 66%.
Conclusion
A new physician involvement model with the family approach model, known as the “GENOGRAM model,” was developed, which consisted of seven dimensions and 25 items.

Citations

Citations to this article as recorded by  
  • Comprehensiveness in Primary Care: A Scoping Review
    AGNES GRUDNIEWICZ, ELLEN RANDALL, LORI JONES, AIDAN BODNER, M. RUTH LAVERGNE
    The Milbank Quarterly.2025; 103(1): 153.     CrossRef
  • 4,279 View
  • 102 Download
  • 1 Web of Science
  • 1 Crossref
Knowledge, Current Status, and Barriers toward Healthcare Worker Vaccination among Family Medicine Resident Participants in a Web-Based Survey in Korea
Kyungjin Ko, Sungjong Kim, Sang-Hyun Kim, Ki Young Son, Jungun Lee, Dong Ryul Lee
Korean J Fam Med 2017;38(1):21-27.   Published online January 18, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.1.21
Background

We investigated the knowledge, status, and barriers toward healthcare workers receiving vaccinations among Korean family medicine residents. To date, a systematic study has not been conducted among medical practitioners examining these variables.

Methods

A web-based, anonymous, self-administered questionnaire was distributed to all 942 family medicine residents working in 123 training hospitals in Korea. A multiple logistic regression analysis was performed to investigate factors affecting vaccination completion.

Results

Korean family medicine residents (N=242, 25.7%) from 54 training hospitals (43.9%) participated in the survey. Only 24 respondents (9.9%) had correct knowledge on all the recommended vaccinations by the Korean Society of Infectious Diseases. The complete vaccination rates against hepatitis B virus and influenza were relatively high (69.4% and 83.0%, respectively), whereas they were relatively low against other infections (e.g., 16.5%– 53.1%). The most common reason for not receiving a vaccination was the belief that there was little possibility of infection from the vaccine-preventable diseases.

Conclusion

Knowledge and vaccination coverage were poor among family medicine residents in Korea. Medical schools should provide vaccination information to healthcare workers as part of their mandatory curriculum. Further research should confirm these findings among primary care physicians and other healthcare workers.

Citations

Citations to this article as recorded by  
  • Hepatitis B in Healthcare Personnel: An Update on the Global Landscape
    Georgia B. Nikolopoulou, Ioannis Tzoutzas, Athanasios Tsakris, Helena C. Maltezou
    Viruses.2023; 15(12): 2454.     CrossRef
  • COVID-19 vaccine hesitancy in Sana'a, Yemen
    Redhwan Ahmed Al-Naggar, Hisham Alshaikhli, Reyadh R. Al-Rashidi, Sharon Murtagh
    International Journal of One Health.2022; : 58.     CrossRef
  • Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis
    Francesco Paolo Bianchi, Pasquale Stefanizzi, Giusy Diella, Andrea Martinelli, Antonio Di Lorenzo, Maria Serena Gallone, Silvio Tafuri
    Vaccine: X.2022; 12: 100195.     CrossRef
  • Prevention of Hepatitis B among Homeless People: Challenges for Vaccination in Brazil
    Thaynara Lorrane Silva Martins, Marcos André de Matos, Sheila Araujo Teles, Raquel Silva Pinheiro, Paulie Marcelly Ribeiro Carvalho, Márcia Maria de Souza, Camila Canhete Ferreira, Regina Maria Bringel Martins, Karlla Antonieta Amorim Caetano
    Journal of Poverty.2021; 25(4): 347.     CrossRef
  • Promotion of healthcare personnel vaccinations among newly employed doctors and nurses: Evidence-guided strategy
    Hyo-Ju Son, Eunjung Lee, Se Yoon Park, Seungjae Lee, Hyohyun Hong, Eun Ju Choo, Tark Kim, Min Hyok Jeon, Shinae Yu, Jung Wan Park, Tae Hyong Kim
    Vaccine.2021; 39(26): 3480.     CrossRef
  • Knowledge, Vaccination Status, and Reasons for Avoiding Vaccinations against Hepatitis B in Developing Countries: A Systematic Review
    Putri Bungsu Machmud, Saskia Glasauer, Cornelia Gottschick, Rafael Mikolajczyk
    Vaccines.2021; 9(6): 625.     CrossRef
  • A Nationwide Survey on the Hospital Vaccination Policies in Korea
    Sun Hee Park, Mi Suk Lee, Sung Ran Kim, Yee Gyung Kwak
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • PERCEPÇÕES ACERCA DA IMPORTÂNCIA DAS VACINAS E DA RECUSA VACINAL NUMA ESCOLA DE MEDICINA
    Amanda Hayashida Mizuta, Guilherme de Menezes Succi, Victor Angelo Martins Montalli, Regina Célia de Menezes Succi
    Revista Paulista de Pediatria.2019; 37(1): 34.     CrossRef
  • Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States
    Lauren L. Dybsand, Kylie J. Hall, Paul J. Carson
    BMC Medical Education.2019;[Epub]     CrossRef
  • Vaccine refusal – what we need to know
    Regina Célia de Menezes Succi
    Jornal de Pediatria.2018; 94(6): 574.     CrossRef
  • Measles vaccination status of nurses and associated factors during community measles outbreaks
    Kyung Mi Kim, Jeong Sil Choi
    Japan Journal of Nursing Science.2018; 15(3): 249.     CrossRef
  • Comparison of three immunoassays for determination of immunity to rubella virus in healthcare workers
    Su-Yeon Jo, Kyung-Hwa Shin, Sun Min Lee, Eun-Young Jeong, Hyun-Ji Lee, Chulhun L. Chang
    Journal of Immunological Methods.2018; 463: 84.     CrossRef
  • Vaccine refusal – what we need to know
    Regina Célia de Menezes Succi
    Jornal de Pediatria (Versão em Português).2018; 94(6): 574.     CrossRef
  • Seroprevalence of hepatitis B virus infection and associated factors among healthcare workers in northern Tanzania
    Elichilia R. Shao, Innocent B. Mboya, Daniel W. Gunda, Flora G. Ruhangisa, Elizabeth M. Temu, Mercy L. Nkwama, Jeremia J. Pyuza, Kajiru G. Kilonzo, Furaha S. Lyamuya, Venance P. Maro
    BMC Infectious Diseases.2018;[Epub]     CrossRef
  • 5,355 View
  • 53 Download
  • 12 Web of Science
  • 14 Crossref

Brief Communication

Patients' Perceived Quality of Family Physicians' Primary Care with or without 'Family Medicine' in the Clinic Name
Ka Young Kim, Kangjin Lim, Eal Whan Park, Eun Young Choi, Yoo Seock Cheong
Korean J Fam Med 2016;37(5):303-307.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.303
Background

Patients' perspectives of family medicine according to the physician's identity and role as a primary-care specialist need to be investigated. This study was conducted to investigate the perceived quality of the primary care of family medicine clinics as assessed by patients in a community setting.

Methods

Patients (or their guardians) visiting nine community family medicine clinics were surveyed using the Korean Primary Care Assessment Tool from April 2014 to June 2014. The scores of the Korean Primary Care Assessment Tool domains were compared according to the clinics' designation (or not) as 'family medicine' and the patients' recognition (or not) of the physicians as board-certified family medicine specialists.

Results

A total of 196 subjects responded to the questionnaire. They assessed the community clinics' quality of primary care as moderate to high. Of the clinics, those that were not designated as family medicine scored higher than those that were designated as family medicine (P<0.05). The group of patients that recognized a clinic as that of a board-certified family medicine specialist awarded higher scores than the non-recognition group in the domains of coordination function and personalized care (P<0.05).

Conclusion

The moderate to high scores for the community family medicine clinics' quality of primary care are encouraging. It seems that patients' recognition of the family physician's role and of the physician-patient relationship has a significant influence on their assessment of the quality of primary care.

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    Ning Zhao, Mei Gu, Jin Li, Haiyan Zhang, Jia Yang
    BMC Health Services Research.2024;[Epub]     CrossRef
  • Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia
    Bashair M Alshammrani, Renad O Aljuhani, Khadijah M Basaqr, Eman A Bin Mahfouz, Ebtisam M Alhawsawi, Reem Alqahtani
    Cureus.2022;[Epub]     CrossRef
  • Aile Hekimliği Uygulamasını Daha Az Tercih Eden Kişilerin Uygulama Hakkındaki Bilgilerinin Değerlendirilmesi: Kesitsel Bir Çalışma
    Fatma Nur ÖZDEMİR, Can ÖNER, Huseyin CETİN, Engin Ersin ŞİMŞEK
    Turkish Journal of Family Medicine and Primary Care.2022; 16(4): 823.     CrossRef
  • In the Name of Family Medicine: A Nationwide Survey of Registered Names of Family Medicine Clinics in Taiwan
    Ya-An Liu, Sally Cheng, Ya-Chuan Hsu, Po-Chin Yang, Hsiao-Ting Chang, Ming-Hwai Lin, Tzeng-Ji Chen, Li-Fang Chou, Shinn-Jang Hwang
    International Journal of Environmental Research and Public Health.2020; 17(11): 4062.     CrossRef
  • Public's perception and satisfaction on the role and services provided by family physicians in Saudi Arabia: A cross-sectional study
    AmnahAli Abdulqader Elagi, BasemAmer Jaber, AlmontherHussain Ahmed Wassly, RubaMohammed Sallam Ahmed, FatimahAli Ahmed Bosily
    Journal of Family Medicine and Primary Care.2019; 8(10): 3282.     CrossRef
  • 4,706 View
  • 41 Download
  • 5 Web of Science
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Original Articles
Comparison of Research Trends in Korean and International Family Medicine in Journals of Family Medicine
Jin-Kyung Jeon, Jungun Lee, Dong Ryul Lee
Korean J Fam Med 2014;35(6):265-275.   Published online November 21, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.6.265
Background

Research is important for the development of family medicine as a professional field in primary care. The aim of this study was to suggest directions for the development of family medicine research by analyzing research trends in original papers published in the Korean Journal of Family Medicine (KJFM) and international journals.

Methods

We investigated original research papers published in KJFM and 4 international journals from August 2009 to July 2010. Analysis was conducted according to research topics, authors, methods, participants, and data sources.

Results

'Clinical research' was the most common research topic in both the KJFM (88.3%) and international journals (57.3%); however, international journals had more studies in other domains ('education and research,' 'health service,' and 'family medicine'). More authors other than family physicians participated in international journals than in the KJFM (58% and 3.3%, respectively). Most studies were 'cross-sectional' in KJFM (77.0%) and international journals (51.5%): however, the latter had more 'qualitative' studies, 'cohort' studies, and 'systematic reviews' than the former. The largest study population was 'visitors of health promotion center' in the KJFM and 'outpatients' in international journals. Most of the study sources were 'survey' and 'medical records' in both.

Conclusion

There were limitations of diversity in the papers of the KJFM. Future investigation on papers of other than family medicine journals should be planned to assess research trends of family physicians.

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  • Analysis of evidence appraisals for interventional studies in family medicine using an informatics approach
    Alain Nathan Sahin, Andrew Goldstein, Chunhua Weng
    Primary Health Care Research & Development.2019;[Epub]     CrossRef
  • Current status of health services research in primary care in Korea
    Hee-Young Lee, Jong-Heon Park, Yong-Jun Choi
    Journal of the Korean Medical Association.2016; 59(11): 888.     CrossRef
  • 4,116 View
  • 28 Download
  • 2 Web of Science
  • 2 Crossref
Residents' Expectation of Family Medicine-Specific Training Program and Its Current State
Yong Jun Kim, Eal Whan Park, Yoo Seock Cheong, Eun Young Choi, Kuk Hyun Baek, Hwa Yoen Sung, Hong-Yeon Lee, Ji Hyun Kim
Korean J Fam Med 2011;32(7):390-398.   Published online November 30, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.7.390
Background

The family medicine residency program consists mainly of clinical rotations in other specialties and the family medicine-specific training. We conducted this study to investigate how family medicine residents evaluated their training program that include family-oriented medicine, clinical preventive medicine, behavioral science and research in primary care.

Methods

In 2009, third-year residents of 129 training hospitals in Korea were surveyed to investigate the current state and their expectation of the residency program. The contents of questionnaires included training periods, conferences, procedures, interview techniques, outpatient and inpatient consultations, and written thesis.

Results

Total 133 out of 142 residents (93.7%) responded that 3 years of training is ideal or pertinent. Residents responded that the types of conference that they need most are journal review (81%), staff lecture (73.2%), and clinical topic review (73.2%), in that order. Procedures and interview techniques that the residents want to learn most were gastroscopy (72.5%), abdominal ultrasonography (65.2%), and pain management (46.4%). Hospitals where family medicine residents do not see hospitalized patients or patients in the outpatient clinic were 7.9% and 6.5%, respectively, whereas hospitals that maintain continuous family medicine outpatient clinics were only 40.8%. Education in outpatient clinic and articlewriting seminars was done less frequently in the secondary hospitals than in the tertiary hospitals.

Conclusion

Evaluation and quality improvement of family medicine training program as well as specialty rotations should be considered in order to foster better family physicians. The efforts have to be made to minimize the difference in quality of each family medicine residency program.

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  • A New Role of Case Reports in Family Medicine and Primary Care
    Ki Dong Ko
    Korean Journal of Family Medicine.2021; 42(2): 181.     CrossRef
  • Adecuación y calidad de las ecografías abdominales solicitadas por los profesionales de medicina
    Llorenç Caballería, Guillem Pera, Lluís Rodríguez, José Darío Casas, Dolores Miranda, M. Antònia Auladell, Isabel Buezo, Carmen Expósito, Ingrid Arteaga, Pere Torán
    Gastroenterología y Hepatología.2016; 39(8): 516.     CrossRef
  • Acceptability and quality of abdominal ultrasound studies requested by medical professionals
    Llorenç Caballería, Guillem Pera, Lluís Rodríguez, José Darío Casas, Dolores Miranda, M. Antònia Auladell, Isabel Buezo, Carmen Expósito, Ingrid Arteaga, Pere Torán
    Gastroenterología y Hepatología (English Edition).2016; 39(8): 516.     CrossRef
  • Epiglottic Cyst Incidentally Discovered During Screening Endoscopy: A Case Report and Review of Literature
    Seung-Hwa Lee, Duck-Joo Lee, Kwang-Min Kim, Kyu-Nam Kim, Sang-Wook Seo, Young-Kyu Park, Sung-Min Cho, Young-Ah Choi, Jung-Un Lee, Dong-Ryul Lee
    Korean Journal of Family Medicine.2014; 35(3): 160.     CrossRef
  • 3,504 View
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  • 4 Crossref
Predictive Value of the Korean Academy of Family Medicine In-Training Examination for Certifying Examination
Jung-Jin Cho, Ji-Yong Kim
Korean J Fam Med 2011;32(6):352-357.   Published online September 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.6.352
Background

In-training examination (ITE) is a cognitive examination similar to the written test, but it is different from the Clinical Practice Examination of the Korean Academy of Family Medicine (KAFM) Certification Examination (CE). The objective of this is to estimate the positive predictive value of the KAFM-ITE for identifying residents at risk for poor performance on the three types of KAFM-CE.

Methods

372 residents who completed the KAFM-CE in 2011 were included. We compared the mean KAFM-CE scores with ITE experience. We evaluated the correlation and the positive predictive value (PPV) of ITE for the multiple choice question (MCQ) scores of 1st written test & 2nd slide examination, the total clinical practice examination scores, and the total sum of 2nd test.

Results

275 out of 372 residents completed ITE. Those who completed ITE had significantly higher MCQ scores of 1st written test than those who did not. The correlation of ITE scores with 1st written MCQ (0.627) was found to be the highest among the other kinds of CE. The PPV of the ITE score for 1st written MCQ scores was 0.672. The PPV of the ITE score ranged from 0.376 to 0.502.

Conclusion

The score of the KAFM ITE has acceptable positive predictive value that could be used as a part of comprehensive evaluation system for residents in cognitive field.

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  • The Predictive Validity of the National Board of Osteopathic Medical Examiners’ COMLEX-USA Examinations With Regard to Outcomes on American Board of Family Medicine Examinations
    Thomas R. O’Neill, Michael R. Peabody, Hao Song
    Academic Medicine.2016; 91(11): 1568.     CrossRef
  • 3,571 View
  • 15 Download
  • 1 Crossref
Attitude of Korean Primary Care Family Physicians Towards Telehealth
Ji-Eun Kim, Yun-Mi Song, Joo-Hyun Park, Jae-Ri Lee
Korean J Fam Med 2011;32(6):341-351.   Published online September 28, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.6.341
Background

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

Methods

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

Results

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

Conclusion

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

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    Bioengineering.2024; 11(3): 216.     CrossRef
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    Graziano Lepri, Francesco Oddi, Rosario Alfio Gulino, Daniele Giansanti
    Healthcare.2024; 12(7): 732.     CrossRef
  • On the use of telemedicine in the context of COVID-19: legal aspects and a systematic review of technology
    Adriano de Oliveira Andrade, Adeilson Barbosa Soares, Angélica de Andrade Palis, Ariana Moura Cabral, Cassiana Gabriela Lima Barreto, Daniel Baldoino de Souza, Fernanda de Paula Silva, Fernando Pasquini Santos, Gabriella Lelis Silva, José Flávio Viana Gui
    Research on Biomedical Engineering.2022; 38(1): 209.     CrossRef
  • Understanding Clinicians’ Adoption of Mobile Health Tools: A Qualitative Review of the Most Used Frameworks
    Christine Jacob, Antonio Sanchez-Vazquez, Chris Ivory
    JMIR mHealth and uHealth.2020; 8(7): e18072.     CrossRef
  • Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram
    Hyejung Chang
    Healthcare Informatics Research.2015; 21(4): 230.     CrossRef
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Prevalence of Sleep Disorder and Associated Factors in Family Practice.
Sam Lee, Yoo Seock Cheong, Eal Whan Park, Eun Young Choi, Ho Kuan Yoo, Ki Hyoung Kang, Won Soon Kang, Ki Sung Kim, Hye Kyung Kim, Kyung Sup Park, Yun Jong Park, Moon Sung Suh, Sug Kyu Sim, Hung Tag Yeoum, Ran Lee, Seung Hwa Lee, Ki Bo Lim, Eun Joo Jeong, Hyun Kyung Park, Bum Lee, Hang Lee
Korean J Fam Med 2010;31(11):837-844.   Published online November 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.11.837
Background
Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice.Methods: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression.Results: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression.Conclusion: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.

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    Ji-Eun Park, Sujeong Mun, Siwoo Lee
    Journal of Physiology & Pathology in Korean Medicine.2020; 34(1): 37.     CrossRef
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    Ji Kyeung Ha, Seonglim Lee
    Family and Environment Research.2017; 55(2): 141.     CrossRef
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    Dong Hyun Ahn
    Hanyang Medical Reviews.2013; 33(4): 203.     CrossRef
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    Ki-Youn Kim, Man-Su Cho, Won-Mo Gal
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    Jin‐Hee Park, Moon‐Sook Yoo, Sun Hyoung Bae
    International Journal of Nursing Practice.2013; 19(2): 116.     CrossRef
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  • 43 Download
  • 5 Crossref
Qualitative Research on Experience of Primary Physicians Operating Their Primary Health Care Centers.
Daegeun Lee, Myung Sun Yi, Eun Young Park, Sung Hee Jo, Sang Min Park
Korean J Fam Med 2010;31(4):275-283.   Published online April 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.4.275
Background
The purpose of the study was to understand how family physicians managed their primary health care centers and to identify the factors for successful management of their privative clinics. Methods: The data was collected through individual interviews from five family physicians who operated their private clinics. All interviews were tape-recorded and transcribed into verbatim data. The data was analyzed using qualitative content analysis. Results: Three major categories were identified: 1) types of physician based on major value as a doctor; 2) difficulties in operation and management; 3) desirable operating strategies for success. The first category described what kinds of value the physicians pursued as they operated their private clinics. Two different types were identified. One was intrinsic value oriented and the other was extrinsic value oriented. The second category illustrated many difficulties that family physicians faced in operating and managing their private clinics. Lack of private time, social isolation, and gap between mission and reality of practice were identified as major difficulties. Desirable strategies for the successful management were four subcategories: location; self-oriented developmental plan; specialization of the services; and activating network with larger hospitals. Conclusion: The results of the study would be helpful in setting up and operating private clinics through understanding the difficulties and strategies of primary physicians and recognizing mission and major value of them.
  • 1,917 View
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The Perception and Opinions for the 'Compulsory Clinical Training Program' of Postgraduate Medical Trainee.
Junghyoun Cho, Jaeho Lee, Seolly Jeong
Korean J Fam Med 2009;30(11):864-871.   Published online November 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.11.864
Background
Nowadays 2-year 'Compulsory Clinical Training Program' is on issue. The perception and opinions for the new training system of residents and interns may be essential to establish ideal postgraduate medical education. Methods: A questionnaire survey of postgraduate trainee from March to April 2008 was performed by person to person method. Gender, age, specialty, the location and the facility of the hospital, and 7 questions reflecting individual perception and opinions for the 'Compulsory Clinical Training Program' were reviewed. Results: Among in 1,314, 1,284 subjects completed the survey fully. We divided 1,284 sujects into 4 groups; Intern; Resident of Family Medicine; Resident of Internal Medicine or Pediatrics; Resident of other than Family Medicine, Internal Medicine and Pediatrics. About the vision for independent clinical skills through the 'Compulsory Clinical Training Program', most were negative. They were afraid of 'prolongation of current Internship' or 'unclear quality of the training course'. In case of setting the 'Compulsory Clinical Training Program', most chose additional resident courses for specialty. The main opinion about the ideal model of a primary physician was medical doctors who obtained primary care specialty. Conclusion: Most of the residents and interns think that the specialists of family medicine, internal medicine or pediatrics are suitable for primary care. And on wishing the additional residency course even after 'Compulsory Clinical Training Program', they doubt about the effi cacy of the new training system.
  • 1,859 View
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Motivation and Time to Apply for Family Medicine Resident.
Se Jun Bak, Eun Jung Jo, Jae Eun Lee, Jun Seok Lee, Mee Young Kim, Jong Lull Yoon
J Korean Acad Fam Med 2007;28(12):931-936.   Published online December 10, 2007
Background
As of 2006, the residents of family medicine occupies about 9 percent among the total. However, expansion of more general practice doctors is in demand to conduct desirable general practice. Accordingly, this study was conducted to survey the motivation to apply for family medicine residency and the actual situation. Methods: A questionnaire survey of 862 residents of nationwide family medicine from June 2006 to July 2006 was performed via e-mails. Hospital, size, years, gender, age, university, career, time and motivation to apply, and existence and nonexistence of lecture in medical school or clinical practice of family medicine for students were reviewed. Results: Among the total, 415 (48.14%) residents from 72 training hospitals answered. For the motivation, 'the necessity to diagnose and treat various patients' was 53.49%, 'advantageous to start practice' was 21.93%, and 'relatively short training period' was 11.33%. For the time, during 'intern' was 49.40%, 'on getting a job' 16.63%, and as a 'student' 15.42%. When they had lectures of family medicine in medical school, decision made as a student was 19.93%, and during clinical practice was 21.61%. Conclusion: Among the reasons that motivated to apply for family medicine, 'the necessity to diagnose and treat various patients' was the biggest, which conforms to the training goal of Academy of Family Physicians. Since there is a tendency to select family medicine residency earlier when they are exposed to lectures of family medicine or clinical practices in medical school, the effort to expand substantial lectures and clinical practices is needed. (J Korean Acad Fam Med 2007;28:931-936)
  • 1,275 View
  • 9 Download
The Current Educational Measurement of Family Practice Residents.
Min Jeong Kim, Ho Cheol Shin, Cheol Hawn Kim, Youn Seon Choi, Hang Lee, Ae Kyung Choi, Yu Jin Paek, Eon Sook Lee, Jin Ho Park, Yoon Jung Chang
J Korean Acad Fam Med 2007;28(8):616-625.   Published online August 10, 2007
Background
The educational assessment of residents is very important in order to check their knowledge and to improve their ability. In case of family practice, the residents spend most of their training time in outside rotations with other specialities. Therefore, they are requested to be evaluated by each specialist after each rotation. To give more accurate assessment, we surveyed directly our family practice residents and family practice faculties. Methods: A questionnaire was sent to family practice residents and family practice faculties in 116 hospitals from May to June 2006. The response rate was 29% and 78%, respectively. Results: Among the total, 70.2% of family practice residents thought an assessment is necessary, but only 51.7% were evaluated. Overall, 90.4% of family practice faculties knew about the assessment of residents made by other specialists, and only 56.7% of faculties requested other specialists to assess their family practice residents. Conclusion: Most of the family practice residents and their faculties knew the need for assessment, but they complained there were no objectivity and the assessment tool was lacking. In order to solve this problem, it is urgent to develop a unified form and guidelines of assesment. (J Korean Acad Fam Med 2007;28:616-625)
  • 1,351 View
  • 14 Download
Referral Pattern of Family Practitioners : Cheonan Practice-Based Research Network Study.
Ran Lee, Yoo Seock Cheong, Eal Whan Park, Eun Young Choi, Ki Sung Kim, Sug Kyu Sim, Yun Jong Park, Hung Tag Yeoum, Eun Joo Jeong, Sun Yeol Kim, Sung Suhmoon, So Jeong Lee, Jong Taik Kim, Ki Hyoung Kang
J Korean Acad Fam Med 2007;28(4):286-291.   Published online April 10, 2007
Background
Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). Methods: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. Results: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. Conclusion: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty. (J Korean Acad Fam Med 2007;28:286-291)
  • 1,498 View
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Analysis of Family Practice Academic Dissertations.
Ki Hoon Ha, Chul Won Jang, Jae Wook Jeong, Dong Uk Lee, Ki Heum Park, Nak Jin Sung
J Korean Acad Fam Med 2006;27(11):883-888.   Published online November 10, 2006
Background
: Family practice academic dissertations are the product of family practice research in the school of medicine. This paper was intended to evaluate the status of family practice academic dissertations, analyze the basic data and suggest directions for family practice research in the school of medicine.

Methods : The total number of masters' and doctoral dissertations from 1992 to February, 2005 was 124. of those, 120 were collected. They were analyzed in terms of research area, subjects, collected data, methodology, and statistical methods.

Results : In terms of research area, health promotion/ disease prevention was the most common (42.5%). For study subjects, out-patients and in-hospital patients were the most prevalent (38.0%), followed by health promotion center visitors and community residents (28.7%). When it came to research methodology, analytic study was the most common by a wide margin (70.8%). Among analytic studies, cross-sectional studies were the most frequent, followed by case-control studies and cohort studies. The most commonly-used data were medical records and questionnaires.

Conclusion : Many advances have been made in research methodology and academic dissertation numbers since 1992. Many research topics, however, were not relevant to primary care. Much research was done in general hospital instead of primary-care facilities. These results must improve in the future.
  • 1,275 View
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Evaluation of Consistency, Generalizability, Applicability of Recommendations about Pharmacological Treatment of Osterarthritis using RAND Method.
Soo Young Kim, Nam Soon Kim, Hee Young Lee, Sang Cheol Bae, Chul Hwan Kim, Jin Goo Kim, Wan Sik Uhm, Jong Dae Ji, Chan Hee Lee
J Korean Acad Fam Med 2006;27(11):873-882.   Published online November 10, 2006
Background
: When research based evidence is not sufficient, clinical practice guidelines can be based on opinions. In such situations, formal consensus development methods, often based on the modified nominal group techniques are widely used. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.

Methods : To develop evidence based guidelines for osterarthritis pharmacotherapy, a consensus expert panel consisting of internists, family physicians, methodologists, and orthopedic surgeons were convened. After an extensive structured literature searching and evaluation, evidence statements for key question were developed. Rating methods for consistency, generalizability, applicability of statement were adopted from those jointly developed by Rand and the University of California, Los Angeles.

Results : We developed 27 evidence statements in 17 question domains. Among 72 rating items, 62 items reached agreement. Among 15 recommendations, 10 recommendation grading were A, 2 were B, and 3 were C.

Conclusion : When research based evidence is not sufficient, clinical practice guidelines can be based on formal consensus of experts, especially modified nominal group techniques. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.
  • 1,205 View
  • 15 Download
Pattern of Hypertensive Management and Usefulness of Treatment Guideline in Primary Care.
Gil Sub Park, Hyun Jin Ra, Hee Gyung Joe, Hyuk Jung Kweon, Dong Young Cho, Deuk Young Nah, Hyun Sul Lim
J Korean Acad Fam Med 2006;27(10):789-797.   Published online October 10, 2006
Background
: This study aimed at finding out how much the rate of the JNC-7 guideline was carried out, and assessed the degree of evidence based clinical practice patterns and the validity of the new guideline by comparatively analyzing primary care practice patterns in hypertensive patients.

Methods : A questionnaire regarding the management of hypertension was conducted by mail between May 15 and July 15, 2005, to 1,008 of the Korean Association of Family Medicine listed in the address book. There were 195 respondents with a response rate of 19.4%.

Results : Among the total respondents, 91.1% were aware of the new guideline and had received information mainly through training lectures and seminars. They said that the biggest difference between the new guideline from the previous one was the inclusion of prehypertension (62.3%), and 61.1% were using the new term prehypertension in their practice. The most frequency advice given to patients related to lifestyle modification were in the order of smoking cessation (44.8%), exercise (41.7%) and weight reduction (38.0%). Calcium channel blocker was the most commonly used (60.9%) as the first-line agent. When physicians failed to control blood pressure with the first medication in cases of stage 1 hypertension, 67.7% added other agents. In treating stage 2 hypertension, 59.9% started with a single agent and gradually added other agents.

Conclusion : Family physicians in primary care clinics had a good understanding of the JNC-7 guideline. However, the rate at which they applied it in treatment was low. To effectively apply the guideline in actual treatments, aggressive education of practitioners and improvement on medical system and treatment guidelines are needed.
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Prevalence of Mental Disorders in Family Practice Centers in Korea and the Utility of a Diagnostic Tool.
Young Sik Kim, Yeong Sook Yoon, Jeong Yeol Oh, Hee Tak Ryu, Dae Hyun Kim, Young Sung Suh, Byung Sung Kim, Yun Jin Kim, Sang Wook Song, Jungkwon Lee
J Korean Acad Fam Med 2005;26(11):699-705.   Published online November 10, 2005
Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P<0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.
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Managing Outpatients with Dyslipidemia in a University Hospital.
Ha Jung Choi, Kayoung Lee, Bit Na Kim, Tae Jin Park, Jeong Nyeo Lee
J Korean Acad Fam Med 2005;26(7):384-390.   Published online July 10, 2005
Background
: We evaluated physician's management of hypercholesterolemia on the basis of the third Adult Treatment Panel (ATP III) report of the National Cholesterol Education Program.

Methods : The subjects were 85 adult patients. The inclusion criteria were as follows: outpatients with an initial total cholesterol level of ≥200 mg/dL or HDL-cholesterol <40 mg/dL from October to November in 2002, and those visiting the clinic at least three times for the 12 weeks after the baseline test. We reviewed the patients' cardiovascular risk factors (age, low and high HDL, hypertension, history of coronary heart disease (CHD), and diabetes) and the use of LDL-lowering drugs using hospital records. Smoking status and family history of premature CHD were obtained from 19 patients out of 36 patients without CHD or diabetes by telephone. On the whole, cardiovascular risk in 68 patients was identified. Among the total, 52 patients responded to telephone interview concerning education of therapeutic lifestyle change (TLC) provided by a physician.

Results : Forty nine (72.1%) of 68 patients were diagnosed as CHD or diabetes. Fifty three (77.9%) showed undesirable LDL that was categorized by the number of cardiovascular risk factors (≥160 mg/dL for patients with risk factor<2; ≥130 mg/dL for patients with risk factors ≥2; ≥100 mg/dL for patients with CHD or diabetes). In 59.5% of patients with undesirable LDL reported that they did not provide education about TLC and in 40.0% of patients with desirable LDL were provided prescription of LDL-lowering drugs from physicians. Physicians were more likely to prescribe if the patients had more risk factors (P=0.001) and educated patients when they prescribed them (P=0.049). However, physicians did not educate on TLC and did not recheck lipid profile prior to first prescription.

Conclusion : The physicians did not follow the ATP III guideline for management of hypercholesterolemia. Barriers to comply with these guidelines and ways to eliminate barriers should be found.
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Research and Scholarly Activity of Residency Programs of Family Medicine in Korea.
Sung Hee Lee, Yu Jin Paek, Soo Young Kim, Sang Woo Oh, Jae Yong Shim, Jung Kwon Lee
J Korean Acad Fam Med 2004;25(11):826-834.   Published online November 10, 2004
Background
: This study was conducted to survey current status of research and scholarly activity of residency programs and to evaluate quality of education.

Methods : Questionnaire on research and scholarly activity were sent to all residency training programs by regular mail on May 2003. The questionnaire included detailed characteristics of residency programs, current status of conferences, educations for research activities, degree of faculty involvement, and numbers of published papers and presentations for past year.

Results : A total of 103 residency programs answered the questionnaire. Most of the programs held journal review, book review, and clinical review in regular bases as scholarly activities. Smaller than 50% of the programs held case review, chart review, and psycho- social conference in regular bases. As research activity, 40 programs offered educations on epidemiology and statistics, and 55 programs held critical review of the literatures. Faculties involve actively in residents' research project in the process of designing research questions and selecting the subjects, but less actively in the process of gathering informations, completing manuscripts, and preparing presentations. Degrees of faculty involvement were smaller in the programs which are connected with medical school, had only 1 faculty, and educational experiences of the faculty were insufficient.

Conclusion : Current scholarly activities were active in various aspects, but psychosocial conference and chart audit should be encouraged. Special efforts are required in the research activities, especially in programs which were not connected with medical school and had only one faculty.
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A Selection and Translation of Evidence Based Clinical Practice Guidelines for Primary Care Physician in Respiratory Disease Field.
Soo Young Kim, Inhong Hwang, Jong Lull Yoon, Jung Jin Cho, Young Ho Choi, Yong Gyun Rho, Yoo Sun Moon, Mee Young Kim, Yu Jin Paek, Hong Ji Song, Kyung Hee Park
J Korean Acad Fam Med 2004;25(3):205-215.   Published online March 10, 2004
Background
: One method for achieving medical practice to be more evident, especially in the field of primary care, is to encourage the use of clinical guidelines. If development of guidelines is difficult because of time and cost, an evidence based foreign guidelines can be selected and translated into Korean for application.

Methods : A team was formed, consisting of 11 family physician experts on evidence based medicine and clinical practice guidelines. We selected six respiratory diseases requiring clinical guidelines because of variability in practice. We searched several clinical practice guideline databases and selected one guideline according to currency, scope of guideline, whether it was evidence based, and its feasibility in the field of primay care. We translated selected guideline's full-texts or summaries which were done by authorized organization into Korean.

Results : The selected respiratory diseases were chronic obstructive pulmonary disease, asthma, pneumonia, sinusitis, rhinitis, and influenza. According to criterion, we selected GOLD (Global Initiative for Chronic Obstructive Lung Disease) for chronic obstructive lung disease, GINA (Global initiative for asthma) for asthma, CDC (Center for disease control) guideline for influenza, IDSA (Infectious Diseases Society of America) guideline for pneumonia, AAP (American Academy of Pediatrics) guideline for sinusitis, and JCAAI (Joint Council of Allergy, Asthma and Immunology) for rhinitis.

Conclusion : We selected six common respiratory diseases and the most appropriate evidence based guidelines for those particular diseases.
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The Effect of Family Medicine Clerkship on the Preference for Family Medicine as a Career Choice in Third-year Medical Students.
Hoonki Park
J Korean Acad Fam Med 2003;24(5):444-450.   Published online May 10, 2003
Background
: Family medicine clerkship gives undergraduate medical students the opportunity to integrate knowledge and skills taught in class. Impression from clerkship experience and preceptor's role model allow medical students to consider family medicine as a career choice. This study investigated the effect of family medicine clerkship on the preference for family medicine as a career choice in third-year medical students.

Methods : From July through December of 1995, one hundred third-year medical students attended family medicine clerkship at Hanyang University Medical School (HUMS). They were divided into 20 groups of 4∼6 students. Seven half-days of clerkship teaching were provided in a private family medicine clinic and 2 half-days, in an university hospital family medicine clinic. The score of preference for family medicine was measured using the 10 cm visual analogue scale.

Results : The subjects' mean age was 24.1 years. Eighty eighty percent of students were males. The mean score of preference for family medicine as a career choice were 3.2 for pre-clerkship, 6.9 for post-clerkship, and 7.0 at the end of third-year semester exam, respectively. The group preference score was different among groups. Sex, age, hometown, parents' occupation, inhabitation type, religion, and lecture exam score were not related to the preference score. Eleven percent of students hoped to specialize in family medicine in the future. The students' main conception of family medicine were 'primary care', and 'comprehensive care', in descending order.

Conclusion : Third-year family medicine clinical clerkship improved the students' preference for family medicine as a career choice. A continuous program needs to be developed to render positive effect into the final stage of resident selection.
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A Survey on the Knowledge, Attitude, and Practice of Separation of Prescribing and Dispensing Medicine: Among Patients of Family Medicine Clinic in an University Hospital.
Hyuk Jung Kweon, Kyung Wan Rho, Hyeong Su Kim, Dong Young Cho, Myong Sei Sohn, Bang Bu Yoon
J Korean Acad Fam Med 2002;23(10):1188-1201.   Published online October 10, 2002
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