ABSTRACT
Objectives@#The purpose of this research was to examine differences between clinical variables among outpatients with schizophrenia in competitive and partial employed and unemployed groups. @*Methods@#The study subjects were 168 outpatients with schizophrenia, and these were divided into three groups, that is, competitive (n=20), partial (n=28), and unemployed (n=120) groups, based on employment status. Job and psychopathology data were collected by interview and using self-report questionnaires (self-stigma, will to recover, family attitude, perceived social support, insight into disease, self-esteem, hopelessness, and attitude to drugs). @*Results@#The proportion of male patients in the competitive employment group was greater than in the partial or unemployed groups. Education level was significantly higher, and the number of hospitalizations was significantly lower in the competitive group than in the unemployed group.Levels of self-stigma, will to recover, and perceived social support were significantly higher, and levels of self-esteem and hopelessness were significantly lower in the competitive and partial employment groups than in the unemployed group. Patients in these two groups also reported a more positive family attitude, more insight into the disease, and a more positive attitude toward drugs than patients in the unemployed group. @*Conclusion@#Most clinical variables were similar in the competitive and partial employment groups.The findings of this study suggest environmental and systematic factors are more important for the employment of outpatients with schizophrenia than disease-associated factors.
ABSTRACT
PURPOSE: The aim of this study was to compare the difference in acute stroke management between urban and rural areas, to investigate the factors affecting these differences, and to acquire basic information for establishing an efficient regional hub and spoke system for stroke patients. METHODS: This retrospective study was based on adult patients diagnosed with acute ischemic stroke from January 2012 to December 2012 at a regional cerebrovascular center. The term "acute" was defined as 24 hours from symptom recognized. The term "urban" was defined as the region within the boundary of a metropolitan area. The distance from the symptom onset location to the stroke center was calculated using a global positioning system. RESULTS: The rate of arriving at a stroke center within 3 hours after stroke recognition for acute ischemic stroke patients was much higher in urban areas compared to rural areas (27.5 vs. 19.2%, respectively; p-value=0.011). In stroke cases in rural areas, the distance from symptom onset location to a stroke center was determined as statistically significant through multivariate logistic regression analysis (Odds ratio (OR), 0.982; 95% Confidence interval (CI) 0.969-0.995). In contrast, the use of a public ambulance (OR, 4.258; 95% CI 2.233-8.118) and inter-hospital transfer (OR, 0.416; 95% CI 0.216-0.800) were the main prehospital delay factors in urban areas. CONCLUSION: For stroke cases in urban areas, it was important to directly visit a stroke center without transfer using a public ambulance. For rural areas, a new hub hospital and policies are necessary for reducing prehospital delay.