- Current Status of Hospital-based Health Promotion Programs in Korea and the Factors Influencing Their Introduction.
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Sang Gyu Lee, Choon Seon Park, Myung Guen Kang, Myung Il Hahm, Soon Young Lee, Woo Hyun Cho
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Korean J Prev Med. 2001;34(4):399-407.
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Abstract
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- OBJECTIVES
To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. METHODS: We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. RESULTS: 106 of 125 hospitals responding (84.8%) had more than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. CONCLUSION: Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.
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Summary
- What Factors Affect Mortality over the Age of 40?.
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Jong Ku Park, Sang Baek Koh, Chun Bae Kim, Myung Guen Kang, Kee Ho Park, Seung Jun Wang, Sei Jin Chang, Soon Ae Sin
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Korean J Prev Med. 1999;32(3):383-394.
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Abstract
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- OBJECTIVES
This study was conducted to identify the factors influencing the mortality of Koreans over the age of 40 by a nested case-control study. METHODS: The cohort consisted of the beneficiaries of Korea Medical Insurance Corporation for Government Employees & Private School Teachers and Staff(KMIC) who received health examinations of KMIC in 1992 and 1993 retrospectively. At that time, they were more than 40 years old. The cases were 19,258 cohort members who had died until December 31, 1997. The controls were 19,258 cohort members who were alive until December 31, 1997. Controls were matched with age and sex distribution of the cases. The data used in this study were the funeral expenses requesting files, and the files of health examinations and health questionnaires gathered in 1992 and 1993. To assess the putative risk factors of death, student t-test, chi-square test, multiple logistic regression analysis were used. RESULTS: In multiple logistic regression analysis, independent risk factors of death were as follows; systolic blood pressure, diastolic blood pressure, blood glucose, AST, urine glucose, urine protein, alcohol drinking(frequency), cigarette smoking and perceived health status, intake of restoratives and blood transfusion showed positive associations with death; coffee consumption showed negative associations with death; and body mass index and serum total cholesterol showed J-shaped association with death. CONCLUSIONS: Regarding the direction of association, the result of analysis on the data restricted to '96-'97 was same as that of '93-'97. But in some variables such as obesity, serum cholesterol, the odds ratios of death in the data of '96-'97 were higer than those of '93-'94, which suggested that the data of '93-'94 was bearing effect-cause relationship. We concluded that it suggested further researches using long-term follow-up data to be needed in this area.
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Summary
- Effects of Cigarette Smoking on Psychosicial Distress and Occupational Risks.
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Bong Suk Cha, Sei Jin Chang, Jong Ku Park, Sang Baek Ko, Myung Guen Kang, Sang Yul Ko
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Korean J Prev Med. 1997;30(3):540-554.
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- The effects of cigarette smoking on the psychosocial distress, the absenteeism, the occupational injuries, and on the prevalence for the accidents were assessed in 795 male workers who had been employed since March 1994. The results show that the prevalence of current smokers were higher in young men, lower educational level, lower income, single men(unmarried or divorced), alcohol drinkers, and blue collar workers. In the bivariate analyses, the workers with the high job demand and low work control were more likely to smoke, although the relationship was not strong. Those who reported lower satisfaction on his job tended to smoke more. Mean scores of psychosocial well-being Index(PWI) were higher in current smokers than nonsmokers. For the hierarchical multiple regression analyses, interaction terms between cigarette smoking and job stressors(job demand and work control) were not significant. For smokers, the odds ratios for the occupational injuries, and the accidents were 1.40(95% confidence interval 0.77-2.57) and 1.96 (95% confidence interval 0.75-5.09), respectively. The mean absent day were 4.13 for smokers, 3.65 for nonsmokers, although the differences were not statistically significant. It seems that cigarette smoking had not caused any crucial effects on the psychosocial well-being status and the occupational risks. Some considerations for the further research on the relationship of cigarette smoking on the mental health status and the occupational risks were also discussed.
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Summary
- Reliability and Validity on Measurement Instrument for Health Status Assessment in Occupational Workers.
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Sang Baek Koh, Sei Jin Chang, Myung Guen Kang, Bong Suk Cha, Jong Ku Park
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Korean J Prev Med. 1997;30(2):251-266.
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- In order to test scaling assumption, and to assess the validity, reliability, and acceptability of the Short Form 36(SF-36) health survey questionnaire, we conducted a survey. Samples were 296 workers who had been employed in small sized companies. All scale passed for item internal consistency(100% sucess rate) and item discriminant validity(100% success rate). Reliability coefficients were ranged from a low of 0.51 to a high of 0.85. For 87.5% of the total workers, inconsistent responses were not observed. Only 3.0% of the total workers failed two or more checks. Factor analysis was performed using principal axis factor method and quartimax rotation. In this survey, the SF-36 retained available psychometric properties even when used in a generally healthy worker group. But further study with some consideration to develope health status measurement is expected ; first, the definition of health status should be rationalized. Second, the measurement of outcome is an important consideration in evaluations of quality of care. But ambiguities hinder understanding of this important topic. Third, internal consistency should be interpreted with caution as an indication reliability because it ignores potentially important sources of variation that can occur over time.
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