Earticle

The purpose of this study was to investigate current status of 19 general hospitals which performed the hospital social responsibility (HSR) to global health issues. The survey focused on the global healthcare supporting system & activity (including the administration, information, materials, finance, and human resources, et al.), and the government's policy in Korea. Based on the analysis of survey data, the main global health issues of general hospitals were activities of overseas volunteers (56%) and aids of the developing countries (19%). Also, general hospitals have mainly supported into eastern Asia (49%). And then, the most important goal of general hospitals related these activities kept the founding principle of a hospital for global health issues (53%). The second ranking was the social responsibility (32%) and the interchange between Korean and foreign hospitals (32%). There were many differences between general hospitals about the global healthcare supporting system & activities for HSR to global health issues. In conclusion, we suggest that most of general hospitals in Korea would be gotten prior setting the global issues for unmet-need of the developing countries around the world in the near future. This study also served as the effective way by partnership on global health issues of general hospitals for recognizing the HSR as hospital governance.

본 연구는 지난 20여 년간 건강신념모형을 적용한 국내 건강관련행동 연구를 수집하여 연구 동향을 파악하고, 계량적 메타분석을 통하여 행동 개선을 위한 건강신념모형의 구성요소별 통합효과 크기를 산출하였다. 연구결과는 다음과 같다. 첫째, 국내에서 건강신념모형을 적용한 83편의 연구논문 중 계량적 메타분석에 포함된 연구는 64편으로 이 중 건강행동 연구가 16편, 환자역할행동 연구가 48편으로 주로 치료순응도 향상을 위한 접근이 이루어지고 있었다. 둘째, 건강행동의 경우 건강신념모형의 모든 구성요소의 통합효과크기가 유의하게 큰 것으로 나타났으며, 이중 가장 큰 효과를 미치는 구성요소는 행동 수행에 대한 장애요인(d=-0.5757)으로 장애요인을 낮게 인지할수록 건강행동이 향상되는 것으로 보인다. 셋째, 환자역할행동에 대한 분석결과에서는 행동 수행에 대한 환자 교육을 통한 행동계기 제공이 가장 큰 효과를 보였으며(d=2.0389), 행동 수행에 대한 편익의 인지 또한 치료순응도 향상에 효과가 있었던 반면(d=0.6540), 질병의 심각성과 질병에 이환될 가능성의 효과는 낮은 것으로 제시되고 있다. 이상의 결과는 건강행동 및 환자역할행동의 개선을 도모하기 위해서는 과거의 ‘겁주기’ 교육방법 보다는 행동 변화로 연계될 수 있는 순기능적 이익을 주지시키는 방법과 장애요인을 감소시키는 방법이 적극 모색될 필요가 있음을 제시하고 있다.

The purpose of this study is to summarize results from 64 domestic studies about health related behavior applied of health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. We collected the existing literatures by using web search of 'health belief model', ‘health behavior’, 'illness behavior', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Among 83 articles, 64 studies were selected for quantitative meta-analysis. All the components of health belief model produced significant effects on health behavior with the magnitude of effect size from 0.35 to 0.57. The largest effects were barrier on actions of health behavior. However, barrier, benefit and cue to action had effects for only sick role behavior. Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of individual health related behavior. Strategic intervention based on health related behavior model showed clear advantage in improvement of behavioral change.

본 연구는 미네랄방식으로 만들어진 수소가 풍부한 알칼리성 환원수의 생리통과 생리불편감에 대한 영향을 20명 의 생리통증이 심한 여성(시각적 상사 척도 5 이상)들을 대상으로 조사하였다. 생리통증의 경우 시각적 상사 척도에서 10을 최대값으로 0을 최소값으로 측정한 결과, 미네랄환원수 음용전의 생리통증의 평균은 7.6, 1개월째 음용에서는 평 균 6.4, 2개월째는 평균 4.8, 3개월째는 평균 4.1으로 미네랄환원수 음용에 따라 매우 유의성 있게 감소함을 알 수 있었 다. 생리불편감을 신체증상 16개 항목, 정신증상 9개 항목, 행동증상 5개 항목으로 나누어 4점 리커트 척도를 이용하여 항목별로 조사한 결과, 생리불편감 30개 항목의 전체 평균값의 변화는 미네랄환원수 음용전 2.1에서 음용후 1개월째 1.9, 음용 2개월째 1.7, 음용 3개월째 1.5로 미네랄환원수 음용기간에 따라 매우 유의성 있게 감소하였다. 전체 생리불편 감 평균 외에 신체증상의 불편감 16개 전체항목, 정신증상의 불편감 9개 전체항목, 행동증상의 불편감 5개 거의 대부분 의 항목에서도 미네랄환원수 음용에 따라 생리불편감이 시간에 따라 유의성 있게 감소하였다. 그 외에도 미네랄환원수 음용에 따라 생리혈 냄새가 줄어들거나 사라지고, 생리량이 줄어들고, 생리주기가 규칙적으로 변하는 것들이 관찰되었 다. 본 연구에서 제시되었듯이 미네랄환원수와 같이 부작용 없이 매일 마실 수 있는 물이 생리통증과 생리불편감 그리 고 다양한 생리지표에 대해서 개선효과를 나타낸다면 여성건강에 크게 이바지할 수 있을 것으로 기대된다.

형태공명장은 입자로만 보이는 개체가 갖고 있는 파동성을 통해서 패턴이 형성되고, 그 패턴들의 중첩에 의해서 장이 형성되고 그 장이 다시 새롭게 전달되는 파동의 패턴을 통하여 다시 변화해 나간다고 설명하며,우주가 결국 하나의 장을 이룬다고 본다. 형태공명장을 현대과학의 수준에서 명확하게 설명할 수는 없지만, 형태공명장이 존재하는지의 여부는 실험적인 접근들을 통해서 판단할 수 있다. 본 연구에서는 형태공명장에 대해서 연세대 원주의대 및 연세대 원주캠퍼스의 학생들을 대상으로 실험적으로 접근해 보았다. 형태공명장의 존재는 진화나 발생 등을 비롯한 근본적인 의문들에 대한 대답을 제공할 수 있을 것으로 기대된다.

Morphic resonance explains that the pattern is formed through the wave property of the matter, and thefield is developed by overlapping each pattern. The field is again changing intro other new field, ultimately to formunified field of the universe. It is impossible to explain morphic resonance with current scientific knowledge. However,experimental approach is possible for the existence of morphic resonance. In the present investigation we test thepossibility of morphic resonance using students of Yonsei university at Wonju campus. The morphic resonance couldanswer basic questions regarding the development and the evolution.

형태공명장은 입자로만 보이는 개체가 갖고 있는 파동성을 통해서 패턴이 형성되고, 그 패턴들의 중첩에의해서 장이 형성되고 그 장이 다시 새롭게 전달되는 파동의 패턴을 통하여 다시 변화해 나간다고 설명하며,우주가 결국 하나의 장을 이룬다고 본다. 형태공명장을 현대과학의 수준에서 명확하게 설명할 수는 없지만,형태공명장이 존재하는지의 여부는 실험적인 접근들을 통해서 판단할 수 있다. 본 연구에서는 형태공명장에대해서 연세대 원주의대 및 연세대 원주캠퍼스의 학생들을 대상으로 실험적으로 접근해 보았다. 형태공명장의 존재는 진화나 발생 등을 비롯한 근본적인 의문들에 대한 대답을 제공할 수 있을 것으로 기대된다.

이 연구는 강원도 원주시와 춘천시에 거주하고 있는 만 19세 이상 성인 600명을 대상으로 두 지역 간 흡연 상태에 차이가 있는지를 탐색하고, 지역 내 금연프로그램 경험이 금연 시도에 영향을 미치는지를 평가하였다. 연구결과 원주시는 춘천시보다 현재흡연율이 더 높고, 흡연기간은 더 길었으며, 흡연 시작 연령은 춘천시보다 더 낮았다. 원주시의 현재흡연율이 춘천시보다 더 높았음에도 불구하고 관할지역 내 보건소 등에서 운영하는 금연 교육프로그램의 이수 경험률이 원주지역에서 더 낮았고(OR=0.52, 95% CI=0.33~0.81), 금연클리닉의 이용률도 더 낮았지만 유의하지는 않았다. 지역 내 금연프로그램 경험이 금연 시도에 미치는 영향을 분석한 결과, 원주시는 금연교육 이수자와 금연클리닉 이용자가 그렇지 않은 대상자에 비해 각각 OR=2.31, OR=2.29로서 금연 시도 경험이 더 높았고, 춘천시의 경우도 금연지원서비스를 인지하고 있는 대상자의 금연 시도 경험이 그렇지 않은 대상자에 비해 OR=2.26배 더 높았다. 하지만 두 지역 모두 적은 표본수로 인하여 통계적 유의수준에 도달하지는 못하였다. 이 연구결과를 바탕으로 해당보건의료기관은 지역주민의 금연지원서비스에 대한 인식 제고와 흡연자의 금연 시도를 높이기 위한 지역 내 보다 실용성 있는 금연 교육프로그램을 개발하고 지역-밀착형 홍보로 접근성을 제고하여 현재흡연율의 지역 격차를 해소할 수 있는 중재전략을 마련할 필요가 있다.

Objectives: This study aimed to explore whether there are differences in smoking status between two regions of Wonju-City and Chuncheon-City, Gangwon State, and to determine whether the experience of smoking cessation programs in the region affects quit attempts. Methods: The study design was a cross-sectional study in which adults aged 19 and older living in two cities were surveyed using a pre-developed mobile app to investigate social capital for smoking cessation, and a total of 600 citizens were participated, including 310 in Wonju-City and 290 in Chuncheon-City. The statistical analysis was conducted using chi-square test and logistic regression analysis. Results: Wonju-City had a higher prevalence of current smoking than Chuncheon-City. Among smoking cessation programs operated by local public health centers, Wonju-City had a lower odds ratio for experience with smoking cessation education than Chuncheon-City (OR=0.52, 95% CI=0.33 to 0.81). When examining the effect of smoking cessation program experience on quit attempts, in Wonju-City, citizens who had completed smoking cessation education and used a smoking cessation clinic were more likely to attempt to quit than those who had not (OR=2.31 and OR=2.29, respectively). In Chuncheon-City, citizens who were aware of smoking cessation support services were 2.26 times more likely to attempt to quit smoking than those who were not, but statistical significance was not reached due to the small sample size. Conclusion: Therefore, healthcare organizations in both regions should develop more practical intervention strategies to increase smokers' quit attempts, reduce smoking rates in the community, and address regional disparities.

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen's medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion: The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

By the end of 2017, in a world of 7.6 billion people, there were inequalities in healthcare indices both within and between nations, and this gap continues to increase. Therefore, this study aims to understand the current status of regional inequalities in healthcare indices and to find an action plan to tackle regional health inequality through a geo-economic review in Korea. Since 2008, there was great inequality in life expectancy and healthy life expectancy by region in not only metropolitan cities but also districts in Korea. While the community health statistics from 2008-2017 show a continuous increase of inequality during the last 10 years in most healthcare indices related to noncommunicable diseases (except for some, like smoking), the inequality has doubled in 254 districts. Furthermore, health inequality intensified as the gap between urban (metropolitan cities) and rural regions (counties) for rates of obesity (self-reported), sufficient walking practices, and healthy lifestyle practices increased from twofold to fivefold. However, regionalism and uneven development are natural consequences of the spatial perspective caused by state-lead developmentalism as Korea has fixed the accumulation strategy as its model for growth with the background of export-led industrialization in the 1960s and heavy and chemical industrialization in the 1970s, although the Constitution of the Republic of Korea recognizes the legal value of balanced development within the regions by specifying "the balanced development of the state" or "ensuring the balanced development of all regions." In addition, the danger of a 30% decline or extinction of local government nationwide is expected by 2040 as we face not only a decline in general and ageing populations but also the era of the demographic cliff. Thus, the government should continuously operate the "Special Committee on Regional Balanced Development" with a government-wide effort until 2030 to prevent disparities in the health conditions of local residents, which is the responsibility of the nation in terms of strengthening governance. To address the regional inequalities of rural and urban regions, it is necessary to re-adjust the basic subsidy and cost-sharing rates with local governments of current national subsidies based mainly on population scale, financial independence of local government, or distribution of healthcare resources and healthcare indices (showing high inequalities) overall.

Background: The purpose of this study is to investigate the trends on the induced abortion in Korea using social big-data and confirm whether there was time series trends and seasonal characteristics in induced abortion. Methods: From October 1, 2007 to October 24, 2016, we used Naver's data lab query, and the search word was 'induced abortion' in Korean. The average trend of each year was analyzed and the seasonality was analyzed using the cosinor model. Results: There was no significant changes in search volume of abortion during that period. Monthly search volume was the highest in May followed by the order of June and April. On the other hand, the lowest month was December followed by the order of January, and September. The cosinor analysis showed statistically significant seasonal variations (amplitude, 4.46; confidence interval, 1.46-7.47; p< 0.0036). The search volume for induced abortion gradually increased to the lowest point at the end of November and was the highest at the end of May and declined again from June. Conclusion: There has been no significant changes in induced abortion for the past nine years, and seasonal changes in induced abortion have been identified. Therefore, considering the seasonality of the intervention program for the prevention of induced abortion, it will be effective to concentrate on the induced abortion from March to May.

Objectives: The purpose of this study was to investigate the changes in factors on unmet dental scaling rate before and after the national health insurance. Methods: This study used the $2^{nd}$ data from the Community Health Survey. The study participants numbered 209,341 in 2011 and 219,517 in 2013.The average age was $51{\pm}17$ in 2011 and $52{\pm}17$ in 2013. Data were analyzed by descriptive statistics, chi -squared test and logistic regression using SPSS 23.0. Results: The scaling experienced rate of Korean adults has fallen by 3.5% from 66% to 69.5%. Logistic regression analysis showed that 2.7 times more 'people who were educated at elementary school level or lower' did not use dental scaling compared to higher educated children. Agriculture, forestry and fisheries workers did not use scaling at 2.0 times. Local residents with an income of less than one million won did not use 1.7times scaling. Local residents of 'no private insurance' did not use scaling at 1.5 times. In the case of the predisposing factors, the 20s had less than 1.8 times scaling compared to 50s. In the case of needs factor, local residents who experienced 'bad oral health status' and 'dental calculus' were treated scaling 1.3 times less compared to people with good oral health status and normal periodontal symptoms. Conclusions: In Korea, local residents are less frequently treated scaling due to enabling factors such as accessibility. In addition, predisposing factors such as age and sex, and oral health status and periodontal symptoms were related to not using the dental scaling. Therefore, the universality of health care services should be considered so that people who need periodontal care can use scaling.

Background: The purpose of this study is to investigate current status and investigation of government agencies, communities, corporates, hospitals, non-governmental organization, non-profit organization, and so on which performed Corporate Social Responsibility to global health issues. Methods: This paper focuses on analyzing definition and principle of public-private partnership (PPP), types of PPP, challenge of PPP through delphi survey and interview which need to be discussed by professional groups such as private groups, universities and researches, government decision makers, corporates, and hospitals for successful PPP. Results: Based on this analysis on global health issues of 237 groups, the results were shown that main global health issues of many hospitals were aids of the developing countries (48%). Main program was activities of overseas volunteers (30%) and most 152 groups (42%) supported Asia. Also, this paper gives a definition of PPP that is the growth together in PPPs as a way of fulfilling public tasks in partnership between the state administration and private enterprises to apply both strengths behind transparency, accountability. Conclusion: In conclusion, from the results of analysis, we suggest as prior setting of global issues for both demand and supply side and are served as the effective way by PPP on global health issues. Moreover, this study will be expanded on the sections of findings, multiple researches, discussion, and policy recommendations.

Purpose: The aim of this study was to assess health-related behavior of pregnant women and breastfeeding mothers by investigating relevant risk factors. Methods: Data of 10,396 women (age 19 to 49 years) from the Korea National Health and Nutrition Examination Survey report from 2007 to 2012 was used to analyze factors associated with health-related behavior. The subjects were divided into pregnant women; breastfeeding mothers; and non-pregnant women. Bottle feeding mothers were excluded. Results: Current smoking rate including self-reported smoker and/or positive cotinine urine test were lower for pregnant or breast-feeding group than non-pregnant group. Heavy-drinking was not different among groups while monthly drinking rate was higher in non-pregnant group. Rate of stress recognition was lower in pregnant and breast-feeding group than non-pregnant group. Rate of experience for depressive symptoms and rate of suicidal ideation were not different among groups. Conclusion: Pregnant women and breast-feeding mothers maintain a good pattern of health- related behavior compared to non-pregnant women. However, substantial proportion of pregnant women and breast-feeding mothers continue to drink and smoke. This shows the need for a plan that will modify health-related behavior.

Objectives: This study aimed to share with experiences of a demonstration program based on a community for prevention and management of hypertension and diabetes mellitus, and to supply the evidence of accessible strategies within the community through the public-private partnershipin the near future. Methods: This study case was "the program of registration and management of hypertension and diabetes mellitus patients" which was conducted in Hogncheon-gun in Gangwon-province, 2012. Results: The infrastructure of this center was constructed with the public-private sector partnership according to the basic model of demonstration program since November, 2012. So, the total registered rate of hypertension and diabetes mellitus patients were 26.6% in comparison with suspected patients (to the result of 2011 Korea National Health and Nutrition Examination Survey), 37.8% in comparison with the real number of outpatient (to the claims data of 2011 Branch Honcheon-gun, National Health Insurance Corporation), and 107.8% in comparison with the project goal, sequentially. To the patients who were not treated for 30 and 60 days among the registered patients, a recall service was conducted. Through this intervention, it was monitored that this program has enhanced the consecutive treatment rate of the registered patients. Conclusions: To improve the continuous management of hypertension and diabetes mellitus patients, we are gotten to know that the community need the joint participation and mutual cooperation with public-private sector partnership.

이 연구목적은 일부 지역 재가 노인을 대상으로 보완대체요법 이용행태와 그 영향요인을 구명하는데 있다. 2단계 집락추출로 선정된 대구광역시와 경상남도의 2개 시 군의 노인복지시설(9개)을 이용한 60세 이상 노인 233명을 대상으로 보완대체요법 이용현황, 보완대체요법 인지 여부, 만성질환유형에 따른 이용실태 등을 파악하기 위해 교차분석 및 로지스틱 회귀분석을 실시하였다. 그 결과 조사대상 노인의 70.4%(164명)가 지난 1년간 보완대체요법 이용 경험이 있었다. CAM 종류별로 48.8%(64명)~60.7%(88명)의 노인들이 보건의료 전문가와의 상담 없이 이용하고 있었다. 보완대체요법을 인지하고 있는 경우의 이용 경험은 2 이상 높았으며, 이환된 만성질환 수가 많은 경우의 이용경험은 수기요법 5.85(95% CI 1.97-17.34), 영양요법 2.92(95% CI 1.07-7.97), 약물요법 2.92(95% CI 1.04-8.17)로 높았으며, 만성질환 중 당뇨병을 진단받은 경우의 영양요법 이용 경험은 3.76(95% CI 1.49-9.47) 높았다. 노인 만성질환관리를 위해서는 보완대체요법에 대한 명확하고 체계적인 분류, 효과 및 안전성에 대한 객관적 검증과 함께 노인들의 건강상태를 고려한 전문가 및 의료인의 보완대체요법 이용 중재가 필요하다.

Objectives: The aim of this study is to analyze the utilization behaviour and influencing factors of complementary and alternative medicine (CAM) therapies among elderly people with chronic diseases. Methods: The study population was selected among 9 welfare facilities for the aged in 2 cities among Daegu Metropolitan City & Gyeongsangnam Province by two-stage cluster sampling. 250 senior citizens participated in a face-to-face interview using a structured questionnaire. Logistic regression analysis was performed to examine the association between the utilization of CAM therapies and various characteristics of the elderly. All statistics were analyzed using the PASW (ver 18.0). Results: Among 233 elderly peoples, 70.4% (164 persons) had used various kinds of CAM therapies (including nutritional methods, pharmacologic and biologic treatments, etc.) more than once during the last year. 48.8% (64 persons) ~ 60.7% (88 persons) of the elderly used CAM therapies without health and medical experts' counsel. The elderly with perceptions of CAM therapy used it 2 times more than those without knowledge of CAM therapies. The number of chronic diseases was more likely to increase the usage of nutritional methods (OR=2.92, 95% CI: 1.07-7.97), manipulative and body-based practices (OR=5.85, 95% CI: 1.97-17.34), pharmacologic and biologic treatments (OR=2.92, 95% CI: 1.49-8.17). Elderly with diabetes used nutritional methods 3.76 (95% CI: 1.49-9.47) more than elderly without diabetes. Conclusions: CAM therapies use in the aged with chronic diseases appears common. The findings suggest that the clinical efficacy and safety of CAM therapies on medical management of chronic disease may be investigated and that patient-physician communication need to be strengthened.

이 연구는 2007년부터 2010년까지 4년간의 국민건강영양조사에 참여한 대상자 중 인플루엔자 백신 예방접종에 응답한 19세 이상 65세 미만 성인 남녀 18,289명을 대상으로 인구사회학적 특성 및 건강행태에 따른 인플루엔자 예방접종률과 접종에 미치는 영향요인을 분석하였다. 국민건강영양조사 데이터를 분석한 결과, 인플루엔자 예방 백신 접종률은 21.7%이었으며, 예방접종에 영향을 주는 요소는 연령의 증가, 농촌지역 거주, 높은 개인 소득수준, 낮은 교육수준, 직업이 없는 여성, 의료기관 이용 경험이 있는 경우 및 만성질환에 유병 되어 있는 경우이었다. 결론적으로 우리나라의 인플루엔자 예방접종률은 낮고, 다양한 인구사회학적 특성 및 건강행태에 영향을 받는다. 인플루엔자 예방접종률을 높이기 위하여 인플루엔자 예방접종에 영향을 주는 요인들을 고려하여 예방접종률의 극대화를 위한 방안을 모색하여야 할 것이다.

The aim of this study was to investigate the factors influencing on influenza vaccination among socio-demographic characteristics and health behaviors. Data of 18,299 adults of age between 19 and 65 years who answered to the survey on National Health and Nutrition and influenza vaccination from 2007 to 2010 was used and analyzed. Overall influenza vaccination rate was 21.7%. Logistic regression analysis revealed that factors influencing on influenza vaccination were an increasing age, a residence in rural area, a high personal income, a low educational level, jobless women, experience of hospital visits, and morbidity of chronic illnesses. In conclusion, influenza vaccination rate in Korea is low and influenced by multiple socio-demographic factors and health behaviors. It is needed to seek a strategy to develop a vaccination program in consideration of factors associated with influenza vaccination.

Objective: This study was conducted to investigate the relationship between the degree of stress and social support among residents in a rural area. Methods: We used the baseline data of the Korean Genomic Rural Cohort (KGRC), a sub-cohort of the Korean Genome Epidemiology Study (KOGES) that collected data about relationships among environmental, genetic risk factors, and chronic illness in Korean adults since November 2005. The cases chosen for the study included 1737 men and women, aged 40 to 70, living in a rural area of Wonju-city, South Korea. A questionnaire interviewing method was addressed in 2006. The final participants consisted of 1349 participants, of which 589 were male (43.7%) and 760 were female (56.3%). We applied the hierarchical multiple regression analysis with three stages. The first and second stages include socio-demographic and health-related behaviour factors and the third stage includes more social support factors. Results: The main findings revealed that the amount of social support and health-related behaviour significantly influenced the level of stress the subjects reported. The degree of stress was shown to be significantly higher for the following individuals: females, those who were divorced, the bereaved, participants who suffer from chronic disease, and non-exercisers. Low social support was shown to be negatively associated with stress. Conclusion: Social support factors along with socio-demographic and health-related behavior had an influence on stress levels in Korean rural adults. It is necessary to relieve residents from stress through diverse social support programs and healthy living initiatives.

Objective: This study was conducted to investigate the relationship between the degree of stress and social support among residents in a rural area. Methods: We used the baseline data of the Korean Genomic Rural Cohort (KGRC), a sub-cohort of the Korean Genome Epidemiology Study (KOGES) that collected data about relationships among environmental, genetic risk factors, and chronic illness in Korean adults since November 2005. The cases chosen for the study included 1737 men and women, aged 40 to 70, living in a rural area of Wonju-city, South Korea. A questionnaire interviewing method was addressed in 2006. The final participants consisted of 1349 participants, of which 589 were male (43.7%) and 760 were female (56.3%). We applied the hierarchical multiple regression analysis with three stages. The first and second stages include socio-demographic and health-related behaviour factors and the third stage includes more social support factors. Results: The main findings revealed that the amount of social support and health-related behaviour significantly influenced the level of stress the subjects reported. The degree of stress was shown to be significantly higher for the following individuals: females, those who were divorced, the bereaved, participants who suffer from chronic disease, and non-exercisers. Low social support was shown to be negatively associated with stress. Conclusion: Social support factors along with socio-demographic and health-related behavior had an influence on stress levels in Korean rural adults. It is necessary to relieve residents from stress through diverse social support programs and healthy living initiatives.

Melasma is a common disorder that causes dark colored patches. It generally causes brown spots on the face, especially on the forehead, cheeks, and upper lips. The pattern of patches has bilateral symmetry in yellowish-brown to gray-brown colors. It is much more common in women than in men. Melasma is considered to be caused by environmental and physical constitutional factors and often occurs when a woman's hormone changes by pregnancy or the use of oral contraceptive pills. It is important to combine oriental medicine and Sasang constitutional medicine for treatment of Melasma. Normal treatment of Melasma includes warming oneself, removal of the emotional stress factors, and good nutrition.

Objectives: The purpose of this study was to define the association between the medical utilization of osteoarthritis patient and its related factors. Methods: We used the 2005 Korean National Health and Nutrition Survey data and we enrolled 2833 participants who were forty or older and who were diagnosed as having osteoarthritis by a doctor within 1 year and who had suffered from osteoarthritis for more than 3 months. The Andersen behavioral model was used as the analytic framework, and the variables were categorized into predisposing, enabling, and need factors. To determine the influence of each variable on the medical utilization of osteoarthritis patient, we applied hierarchical logistic regression analysis with two stages: the first stage included the predisposing and enabling factors and the second stage included the need factors. Results: On the hierarchical logistic analysis, the variables of personal income, the type of medical security, the duration of arthritis related symptoms within 1 month, the subjective health status and the duration of osteoarthritis showed a statistically significant association with medical utilization in men. And the variables of age, limitation activity due to osteoarthritis, arthritis related symptoms within 1 month, and the subjective health status had a statistically significant association with medical utilization in women. Conclusions: The patients who tend to receive less care are those who suffer less from symptoms of osteoarthritis, those who are within the initial phase, or those with a low-level severity of osteoarthritis. It is necessary to encourage patients to receive the treatment in the initial phase.

다양한 보건사업 수행과 서비스 질 보장을 위해서는 공공보건부문 지식을 비롯하여 행정력과 리더십을 갖춘 의사인력의 확대를 통한 인프라 구축이 중요하다. 본 연구는 공공의료계의 우수한 의사인력의 진출을 활성화하는 방안의 일환으로써 현재 보건소에서 근무하고 있는 의사들을 대상으로 공공보건부문 의사인력 양성과 개발에 대한 인식정도를 파악함으로써 향후 공공보건부문에 종사하는 의사인력의 확대 방안을 모색하기 위한 기초자료를 제공하기 위해 시행되었다. 본 설문조사는 126명이 응답 하였으며, 수집된 자료는 SPSS ver. 17.0K를 이용하여 빈도분석을 통해 분석하였다. 분석 결과 ‘의사조직 내에서의 공공의료부문 의사의 위상확보와 지원 필요성’에 대한 조사결과, 거의 모든 항목에 대해 응답자들이 필요성을 높게 인식하고 있었다. 특히, ‘의사들의 공공보건부문 진출의 장애요인’에 대해서는 ‘낮은 급여문제’와 ‘승진기회의 부족’ 등을 중요하게 꼽고 있었다. ‘의사들의 보건소 근무를 위하여 가장 필요한 교육 프로그램’으로는 ‘보건기획과 보건사업 수행 관련 프로그램’을 꼽고 있었는데, 사전 교육 및 보수 교육을 통해 공공보건부문 의사들의 역량을 강화해 나가는 것이 필요할 것이다. 공공의료계 의사인력의 원활한 확보와 역량강화를 위해서는 의사를 많이 충원하는 것도 중요 하겠지만 공공의료계에 의사들의 진입을 위한 방안과 함께 현재 근무 중인 의사인력에 대한 역량강화 방안도 중요하다. 후속연구를 통해 공공보건부문 인력양성과 개발에 기여할 수 있는 새로운 방안들을 마련하고 제도화 하여 공공보건부문 확충을 통한 국민보건향상에 기여할 수 있기를 기대한다.

Objectives: This study, as for activating measures for capable medical physicians to penetrate into the public health sector, is to provide a basic informations which are used for the enlargement of human resources of physicians in the public health sector, by investigating the perception of physicians, who are now working in the public health center, on the training and development of physicians in the public health sector. Methods: The subjects of this study were 126 individuals. The data was analyzed by frequency analysis using SPSS ver. 17.0K. Results: According to the investigation of 'how to support physicians in public health sector', the necessity of almost questions is considered to be important. Especially, regarding to investigation on 'obstacles of physicians' entrance to public health sector', 'relatively low salary' and 'lack of promotion chances' were thought to be considerable. The most significant education programs to work for public health sector is to improve the ability of health administration planning and service performance. Conclusions: The important methods to reinforce and easily obtain the human resources of physicians in public health sector are not only to improve the penetration of physicians to public health sector, but also to enhance the ability of present physicians, even though sufficient recruitment of physicians is essential.