ABSTRACT
Objectives@#We aimed to investigate the recent changes in clinical practice in Korea after the introduction of the national health insurance coverage for polysomnography and positive airway pressure (PAP) treatment for obstructive sleep apnea syndrome (OSAS) in July 2018. @*Methods@#We assessed the amount, cost, and geographic distribution of healthcare utilization associated with the diagnostic codes of sleep apnea, polysomnography tests, and PAP treatment using the Korea National Health Insurance Database. Furthermore, the specialties of the prescribing physician and the type of health institute were investigated. @*Results@#The number of patients who used health resources under the diagnostic codes of sleep apnea has increased since 2018. In total, 81,016 polysomnography tests were performed from July 2018 to December 2019, and 58,213 patients underwent PAP treatment from July 2018 to March 2020. The total medical cost associated with sleep apnea was 56,517,061 thousand won in 2019. Auto-titrating PAP accounted for 85.1% of all PAP devices prescribed, and the overall adherence rate for PAP was 69.3%. PAP was prescribed most frequently in private clinics (49.9%) and mostly by physicians of ear-nose-throat (66.6%), neurology (18.7%), and psychiatry (10.3%) specializations. PAP was used more frequently by those living in urban areas than by those living in rural areas. @*Conclusions@#Recent changes in the national health insurance coverage have resulted in a surge in the healthcare utilization related to OSAS. There was a regional variation in OSAS treatment, suggesting an inequality in the availability of healthcare for OSAS and the need to improve the awareness regarding OSAS.
ABSTRACT
Objectives@#We aimed to investigate the recent changes in clinical practice in Korea after the introduction of the national health insurance coverage for polysomnography and positive airway pressure (PAP) treatment for obstructive sleep apnea syndrome (OSAS) in July 2018. @*Methods@#We assessed the amount, cost, and geographic distribution of healthcare utilization associated with the diagnostic codes of sleep apnea, polysomnography tests, and PAP treatment using the Korea National Health Insurance Database. Furthermore, the specialties of the prescribing physician and the type of health institute were investigated. @*Results@#The number of patients who used health resources under the diagnostic codes of sleep apnea has increased since 2018. In total, 81,016 polysomnography tests were performed from July 2018 to December 2019, and 58,213 patients underwent PAP treatment from July 2018 to March 2020. The total medical cost associated with sleep apnea was 56,517,061 thousand won in 2019. Auto-titrating PAP accounted for 85.1% of all PAP devices prescribed, and the overall adherence rate for PAP was 69.3%. PAP was prescribed most frequently in private clinics (49.9%) and mostly by physicians of ear-nose-throat (66.6%), neurology (18.7%), and psychiatry (10.3%) specializations. PAP was used more frequently by those living in urban areas than by those living in rural areas. @*Conclusions@#Recent changes in the national health insurance coverage have resulted in a surge in the healthcare utilization related to OSAS. There was a regional variation in OSAS treatment, suggesting an inequality in the availability of healthcare for OSAS and the need to improve the awareness regarding OSAS.
ABSTRACT
PURPOSE: To determine impacts of psychological distress, gender role attitude, and housekeeping sharing on quality of life of gynecologic cancer survivors. METHODS: Subjects completed questionnaires consisting of four measurements: FACT-G (ver. 4) for quality of life, anxiety and depression from SCL-90-R for psychological distress, gender role attitude, and housekeeping sharing. A total of 158 completed data sets were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 21.0 program. RESULTS: Quality of life was significantly and negatively correlated with psychological distress (r=−0.64, p < .001), but not with gender role attitude (r=−0.14, p=.820) or housekeeping sharing (r=0.08, p=.350). Psychological distress was significantly and positively correlated with gender role attitude (r=0.25, p < .010). Factors that significantly impacted quality of life were type of cancer (t=2.27, p=.025), number of treatment methods (t=2.58, p=.011), education level (t=3.33, p < .001), and psychological distress (t=−9.96, p < .001). CONCLUSION: Nursing interventions that can relieve psychological distress need to be developed for gynecologic cancer survivors. Nurses need to put priority on ovarian cancer survivors who have low education level with multiple treatment methods when performing nursing interventions to improve the quality of life of gynecologic cancer survivors.
Subject(s)
Humans , Anxiety , Dataset , Depression , Education , Gender Identity , Household Work , Nursing , Ovarian Neoplasms , Quality of Life , SurvivorsABSTRACT
PURPOSE: The study was to develop an instrument to measure grandmothering stress for Korean day-care grandmothers and to test the validity and reliability of the instrument. METHOD: The items of the instrument were based on a literature review and secondary data. After content validity tests and a pilot test, 20 items were developed. In order to test the reliability and validity of the scale, data were collected from 126 grandmothers. RESULT: After a factor analysis, five factors and 15 items were selected. These explained 67.2% of the total variance. The first domain was termed 'Health problems', and explained 18.1% of the total variance, and the second domain of 'Possibility of role substitution' explained 13.8%. The third and the fourth domains were 'Relations with adult children' and 'Grandchildren's characteristics' explaining 12.5% and 12.1%, respectively. The last domain explained 10.8% of the total variance with the theme 'Restriction of social life'. After accomplishing the reliability analysis, Cronbach's alpha coefficient was determined to be .75. CONCLUSIONS: This initial step in the development of a Grandmothering Stress Index is valuable to reflect the subject of Grandmothering stress in senior citizens in Korea. Future study should to refine the constitution of the instrument.
Subject(s)
Adult , Humans , Constitution and Bylaws , Korea , Parenting , Reproducibility of ResultsABSTRACT
PURPOSE: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. METHODS: This study was based on the phenomenological method described by Colaizzi (1978). RESULTS: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context." CONCLUSION: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.