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1.
Asian Nurs Res (Korean Soc Nurs Sci) ; 13(2): 99-106, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30802669

RESUMEN

PURPOSE: The purpose of this study was to establish normative data for holistic health parameters in the general Korean population and to investigate the factor associated with ideal life expectancy (ILE) among these holistic health parameters and sociodemographic variables. METHODS: This study used a questionnaire to obtain self-reported physical, mental, social, spiritual, and general health status and then evaluated their association with ILE. A total of 1,241 individuals responded to the questionnaire, from which we established a multidimensional health status reference data set representing the Korean population. To explain factors associated with ILE, we stratified results by age and gender and performed multiple logistic regression of sociodemographic variables and multidimensional health status. RESULTS: Women reported poor health status more frequently for all five health categories. The average ILE was 87.46 years versus 84.42 years of life expectancy in the general Korean population. Single marital status, higher income, and better social health were significantly associated with higher ILE. CONCLUSION: ILE could be a good indicator reflecting social wellness in a certain society. Comprehensive social health promotion programs can improve individuals' attitudes toward life expectancy, especially for vulnerable groups.


Asunto(s)
Estado de Salud , Salud Holística/estadística & datos numéricos , Esperanza de Vida , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Autoinforme , Factores Sexuales , Encuestas y Cuestionarios , Adulto Joven
2.
BMC Palliat Care ; 17(1): 40, 2018 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-29506514

RESUMEN

BACKGROUND: In this study, we aimed to develop and validate an instrument that could be used by patients with cancer to evaluate their quality of palliative care. METHODS: Development of the questionnaire followed the four-phase process: item generation and reduction, construction, pilot testing, and field testing. Based on the literature, we constructed a list of items for the quality of palliative care from 104 quality care issues divided into 14 subscales. We constructed scales of 43 items that only the cancer patients were asked to answer. Using relevance and feasibility criteria and pilot testing, we developed a 44-item questionnaire. To assess the sensitivity and validity of the questionnaire, we recruited 220 patients over 18 years of age from three Korean hospitals. RESULTS: Factor analysis of the data and fit statistics process resulted in the 4-factor, 32-item Quality Care Questionnaire-Palliative Care (QCQ-PC), which covers appropriate communication with health care professionals (ten items), discussing value of life and goals of care (nine items), support and counseling for needs of holistic care (seven items), and accessibility and sustainability of care (six items). All subscales and total scores showed a high internal consistency (Cronbach alpha range, 0.89 to 0.97). Multi-trait scaling analysis showed good convergent (0.568-0.995) and discriminant (0.472-0.869) validity. The correlation between the total and subscale scores of QCQ-PC and those of EORTC QLQ-C15-PAL, MQOL, SAT-SF, and DCS was obtained. CONCLUSION: This study demonstrates that the QCQ-PC can be adopted to assess the quality of care in patients with cancer.


Asunto(s)
Neoplasias/terapia , Cuidados Paliativos/normas , Satisfacción del Paciente , Psicometría/normas , Calidad de la Atención de Salud/normas , Adulto , Anciano , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/psicología , Psicometría/instrumentación , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
3.
Asian Pac J Cancer Prev ; 13(4): 1419-24, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22799342

RESUMEN

OBJECTIVES: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. DESIGN AND LOCATION: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. RESULTS: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1% . The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. CONCLUSIONS: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.


Asunto(s)
Terapias Complementarias/estadística & datos numéricos , Neoplasias/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Terapias Complementarias/economía , Revelación , Femenino , Encuestas de Atención de la Salud , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Satisfacción del Paciente , Relaciones Médico-Paciente , República de Corea , Encuestas y Cuestionarios , Cuidado Terminal , Factores de Tiempo
4.
J Clin Oncol ; 30(12): 1296-303, 2012 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-22412149

RESUMEN

PURPOSE: To determine whether an Internet-based tailored education program is effective for disease-free cancer survivors with cancer-related fatigue (CRF). PATIENTS AND METHODS: We randomly assigned patients who had completed primary cancer treatment within the past 24 months in any of four Korean hospitals and had reported moderate to severe fatigue for at least 1 week to participate in a 12-week, Internet-based, individually tailored CRF education program or to receive routine care. We based the program on the CRF guidelines of the National Comprehensive Cancer Network (NCCN) and incorporated the transtheoretic model (TTM). At baseline and 12 weeks, we used the Brief Fatigue Inventory (BFI) and Fatigue Severity Scale (FSS) as primary outcomes and the Hospital Anxiety and Depression Scale (HADS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) for secondary outcomes. RESULTS: We recruited 273 participants and randomly assigned 136 to the intervention group. Compared with the control group, the intervention group had an improvement in fatigue as shown by a significantly greater decrease in BFI global score (-0.66 points; 95% CI -1.04 to -0.27) and FSS total score (-0.49; 95% CI, -0.78 to -0.21). In secondary outcomes, the intervention group experienced a significantly greater decrease in HADS anxiety score (-0.90; 95% CI, -1.51 to -0.29) as well as global quality of life (5.22; 95% CI, 0.93 to 9.50) and several functioning scores of the EORTC QLQ-C30. CONCLUSION: An Internet-based education program based on NCCN guidelines and TTM may help patients manage CRF.


Asunto(s)
Fatiga/terapia , Internet , Neoplasias/complicaciones , Educación del Paciente como Asunto/métodos , Calidad de Vida , Factores de Edad , Anciano , Anciano de 80 o más Años , Intervalos de Confianza , Supervivencia sin Enfermedad , Fatiga/etiología , Fatiga/fisiopatología , Femenino , Estudios de Seguimiento , Humanos , Corea (Geográfico) , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/patología , Neoplasias/terapia , Valor Predictivo de las Pruebas , Valores de Referencia , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Sobrevivientes , Resultado del Tratamiento
5.
World J Gastroenterol ; 15(25): 3153-60, 2009 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-19575496

RESUMEN

AIM: To identify a cost-effective strategy of second primary colorectal cancer (CRC) screening for cancer survivors in Korea using a decision-analytic model. METHODS: A Markov model estimated the clinical and economic consequences of a simulated 50-year-old male cancer survivors' cohort, and we compared the results of eight screening strategies: no screening, fecal occult blood test (FOBT) annually, FOBT every 2 years, sigmoidoscopy every 5 years, double contrast barium enema every 5 years, and colonoscopy every 10 years (COL10), every 5 years (COL5), and every 3 years (COL3). We included only direct medical costs, and our main outcome measures were discounted lifetime costs, life expectancy, and incremental cost-effectiveness ratio (ICER). RESULTS: In the base-case analysis, the non-dominated strategies in cancer survivors were COL5, and COL3. The ICER for COL3 in cancer survivors was $5593/life-year saved (LYS), and did not exceed $10,000/LYS in one-way sensitivity analyses. If the risk of CRC in cancer survivors is at least two times higher than that in the general population, COL5 had an ICER of less than $10,500/LYS among both good and poor prognosis of index cancer. If the age of cancer survivors starting CRC screening was decreased to 40 years, the ICER of COL5 was less than $7400/LYS regardless of screening compliance. CONCLUSION: Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors.


Asunto(s)
Colonoscopía/economía , Neoplasias Colorrectales/economía , Neoplasias Colorrectales/epidemiología , Tamizaje Masivo , Neoplasias Primarias Secundarias/economía , Neoplasias Primarias Secundarias/epidemiología , Sobrevivientes , Anciano , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/patología , Simulación por Computador , Análisis Costo-Beneficio/economía , Detección Precoz del Cáncer , Humanos , Corea (Geográfico)/epidemiología , Masculino , Cadenas de Markov , Persona de Mediana Edad , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Primarias Secundarias/patología , Sensibilidad y Especificidad
6.
J Clin Oncol ; 25(30): 4835-43, 2007 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-17947733

RESUMEN

PURPOSE: Smoking, obesity, and insulin resistance are well-known risk factors for cancer, yet few epidemiology studies evaluate their role as risk factors for a second primary cancer (SPC). PATIENTS AND METHODS: We identified 14,181 men with a first cancer from the National Health Insurance Corporation Study cohort. We obtained data on fasting glucose level, body mass index (BMI), and smoking history from an enrollment interview (1996). We obtained SPC incidence data for 1996 through 2002 from the Korean Central Cancer Registry. We used the standard Poisson regression model to estimate the age- and multivariate-adjusted relative risk (RR) for SPCs in relation to smoking history, BMI, and insulin resistance before diagnosis. RESULTS: We observed 204 patients with SPC. The overall age-standardized incidence rate of SPC was 603.2 occurrences per 100,000 person-years, which was about 2.3 times higher than that of first cancer in the general male population. Multivariate regression revealed that lung (RR, 3.69; 95% CI, 1.35 to 10.09) and smoking-related (RR, 2.02; 95% CI, 1.02 to 4.03) SPCs were significantly associated with smoking. Obese patients (BMI > or = 25 kg/m2) had significantly elevated RRs for colorectal (RR, 3.45; 95% CI, 1.50 to 7.93) and genitourinary (RR, 3.61; 95% CI, 1.36 to 9.54) SPCs. Patients with a fasting serum glucose concentration > or = 126 mg/dL had a higher RR for hepatopancreatobiliary (RR, 3.33; 95% CI, 1.33 to 8.37) and smoking-related (1.93; 95% CI, 1.01 to 3.68) SPCs. CONCLUSION: Prediagnosis smoking history, obesity, and insulin resistance were risk factors for several SPCs. These findings suggest that more thorough surveillance and screening for SPCs is needed for the cancer survivors with these risk factors.


Asunto(s)
Resistencia a la Insulina , Neoplasias Primarias Secundarias/epidemiología , Obesidad , Fumar/efectos adversos , Sobrevivientes , Consumo de Bebidas Alcohólicas/efectos adversos , Glucemia/metabolismo , Índice de Masa Corporal , Humanos , Seguro de Salud , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Neoplasias Primarias Secundarias/etiología , Factores de Riesgo , Tasa de Supervivencia
7.
World J Gastroenterol ; 11(11): 1587-93, 2005 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-15786532

RESUMEN

AIM: While colorectal cancer (CRC) is an ideal target for population screening, physician and patient attitudes contribute to low levels of screening uptake. This study was carried out to find feasible economic strategies to improve the CRC screening compliance in Korea. METHODS: The natural history of a simulated cohort of 50-year-old Korean in the general population was modeled with CRC screening until the age of 80 years. Cases of positive results were worked up with colonoscopy. After polypectomy, colonoscopy was repeated every 3 years. Baseline screening compliance without insurance coverage by the national health insurance (NHI) was assumed to be 30%. If NHI covered the CRC screening or the reimbursement of screening to physicians increased, the compliance was assumed to increase. We evaluated 16 different CRC screening strategies based on Markov model. RESULTS: When the NHI did not cover the screening and compliance was 30%, non-dominated strategies were colonoscopy every 5 years (COL5) and colonoscopy every 3 years (COL3). In all scenarios of various compliance rates with raised coverage of the NHI and increased reimbursement of colonoscopy, COL10, COL5 and COL3 were non-dominated strategies, and COL10 had lower or minimal incremental medical cost and financial burden on the NHI than the strategy of no screening. These results were stable with sensitivity analyses. CONCLUSION: Economic strategies for promoting screening compliance can be accompanied by expanding insurance coverage by the NHI and by increasing reimbursement for CRC screening to providers. COL10 was a cost-effective and cost saving screening strategy for CRC in Korea.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/economía , Tamizaje Masivo/economía , Cooperación del Paciente , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Estudios de Factibilidad , Humanos , Corea (Geográfico) , Persona de Mediana Edad , Programas Nacionales de Salud , Mecanismo de Reembolso
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