Group Intervention by Primary Care Physicians on Heavy Drinkers: A 1-Year Follow-up Study / 가정의학회지

BACKGROUND: This study was performed to evaluate the effect of group intervention by primary care physicians on the changes of drinking behaviors in Korean heavy drinkers. METHODS: A total of 32 male heavy drinkers participated in group intervention by family physicians of Chungnam National University Hospital. Initially, they were assessed for general characteristics, family function and drinking characteristics prior to the intervention conducted 4 times (about 40 minutes/each session). Reassessment on their drinking frequencies (times/week), drinking amounts (drinks/drinking day) and Alcohol Use Disorders Identification Test (AUDIT) score was achieved at directly, at 12 weeks and at 1 year after intervention. RESULTS: The mean drinking frequency was significantly (P < 0.01) decreased from 5.2 +/- 1.7 before to 3.5 +/- 2.4 at directly, 3.9 +/- 2.3 at 12 weeks and 4.0 +/- 2.3 at 1 year after intervention. The mean drinking amounts were significantly (P < 0.01) decreased from 17.0 +/- 16.5 before to 11.0 +/- 16.9 at directly, 14.2 +/- 17.8 at 12 weeks and 13.9 +/- 17.8 at 1 year after intervention. The mean AUDIT score was significantly (P < 0.01) decreased from 29.4 +/- 5.8 before to 19.1 +/- 11.0 at directly, 21.8 +/- 9.1 at 12 weeks and 23.0 +/- 9.4 at 1 year after intervention. The number of heavy drinkers and binge drinkers were significantly (P < 0.05) decreased from 32 (100%) and 32 (100%) before to 20 (62.5%) and 22 (68.8%) at directly, 23 (71.9%) and 24 (75.0%) at 12 weeks, and 22 (68.8%) and 19 (59.4%) at 1 year after intervention. CONCLUSION: It is suggested that group intervention by family physicians may be effective on the improvement of drinking behavior at 12 weeks and 1 year after the intervention in heavy drinkers.

Relationship Between Status of Physical and Mental Function and Quality of Life Among the Elderly People Admitted from Long-Term Care Insurance / 예방의학회지

OBJECTIVES: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). METHODS: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The mean scores of QOL among all the subjects was 55.4 +/- 15.62 (Grade I: 49.7 +/- 14.17, Grade II: 56.8 +/- 14.62, Grade III: 59.4+/-16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). CONCLUSIONS: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

Prevalence of Urinary Incontinence and Its Related Factors among the Rural Residing Elderlies / 農村醫學 地域保健

OBJECTIVES: This study was conducted to find out the frequency of urinary incontinence among the rural elderly people and its related factors. METHODS: Informations have been obtained through interviews from the 464 rural residents of advanced age over 65 years on September 1st through November 30th, 2007, in Chungnam Province. RESULTS: As for the rate of experiencing urinary incontinence, the group with the experience rate of 'every day' were 9.5% and 'occasionally' 35.5%, with the total of 45.0%. The higher rates of urinary incontinence were in the elderly women(58.5%) than in the elderly men (29.8%), in the more advanced in age, in the higher educated, and in the groups with higher monthly income. Based on life styles, the rate of experiencing urinary incontinence was significantly higher in smoking groups and non-drinking groups. Based on subjective senses of health, it was more highly associated with the groups who reported that they were not healthy, that they concerned themselves about health, that they had physical disability, that they had forgetfulness, and they needed assistance in terms of activity of daily living(ADL) and instrumental activity of daily living(IADL) than their respective counterparts. By the result of multiple logistic regression, sex, age, smoking status, anxiety, physical disability, amnesia, and IADL was indicated the affecting factors to the prevalence of urinary incontinence. CONCLUSIONS: The above results reveal that the rate of urinary incontinence was higher in the elderly women than the elderly men, and in more advanced age. Moreover, its rate increases in the groups with undesirable life styles or lower senses of subjective and physical health conditions. It is highly suggested that efforts to manage urinary incontinence of the elderly need to be narrowed to the more advanced, especially those with lower standards of health conditions.

Effects of Group Education by Primary Care Physicians on the Readiness to Change in Heavy Drinkers / 가정의학회지

BACKGROUND: Patient education can play an important role in motivating patients to change their problematic behavior. This study purposed to evaluate the effects of brief group education, which was performed by primary care physicians, on the improvement of the readiness to change in problem drinkers after a year from the education. METHODS: A total of 34 male were followed up as the subjects who had been problem drinkers and at the stage of precontemplation or contemplation before group education. The readiness to change in the subjects was re-evaluated again 12 weeks and a year after the brief group education. RESULTS: Before the education, 11 patients among the subjects were at the stage of precontemplation and 23 at the contemplation. The distribution was significantly changed into 2 at the stage of precontemplation, 14 at the contemplation and 18 at the action 12 weeks after the group education (P < 0.001), and into 2 at the precontemplation, 16 at the contemplation, and 16 at the action a year after the group education (P < 0.001). The most influential factor associated with the improvement of the status of readiness to change was the family function score (after 12 weeks odds ratio 1.99, 95% CI 1.10-3.62; after a year odds ratio 2.31, 95% CI 1.10-4.85). CONCLUSION: Problem drinkers who had participated in the brief group education by primary care physicians showed continuous improvement in the readiness to change even after a year from the education.

Factors Related to Depressive Symptoms Among the Elderly in Urban and Rural Areas / 農村醫學 地域保健

OBJECTIVES: This study was performed to determine the levels of depression symptoms among the community elderlies and to reveal its related factors, specifically aimed at revealing psycho-social factors such as social support net-work, sense of self-esteem, state anxiety, interpersonal behavior trait and locus of control. METHODS: The interviews were performed during the period from April 1st to June 30th, 2007 to the 790 elderlies in urban and rural areas. RESULTS: The mean scores of depression (CES-D) among all subjects were 16.65+/-10.97(urban: 18.81+/-10.31, rural: 14.49+/-11.20) and they were higher in urban than rural. The level of depression symptoms was influenced by the variables of educational level, with or without spouse, bear for living expenses, sense of satisfaction in daily life. As for health related behaviors, they were influenced by the variables of with or without regular exercise. As for health status, they were influenced by the subjective health status, with or without disability of body, visual acuity, hearing ability, ability of food mastication, urinary incontinence, with or without help in activity of daily living (ADL) and instrumental activity of daily living (IADL). As for social support net-work and social activities, they were influenced by number of offspring, frequency of offspring contents, frequency of going out and activity of hobbies. As for psycho-social factors, they were influenced by sense of self-esteem, state anxiety and social support, especially, the level of depression symptoms was higher influenced by the variables of psycho-social factors than other variables. CONCLUSIONS: Lower of the level of depression symptoms among the community elderlies would require development and application of programs to keep under management psycho-social factors as well as looking for ways to promoting the present health status.

Factors Related to Psychosocial Distress and Fatigue Symptoms among Clerical Public Officers / 農村醫學 地域保健

OBJECTIVES: We evaluated the level of psychosocial stresses and fatigue symptoms among clerical public officers and its related factors. METHODS: The self-administered questionnaires were performed, during the period between Dec. 5th, 2005 and Jan. 31st, 2006, to 1,005 individuals in the service of general administration located in Daejeon Metropolitan City. The survey items included subjects' socio-demographic and job-related characteristics, health-related behavior, degree of job demand, job autonomy, social support in work, type A behavior pattern, locus of control, sense of self-esteem, psychosocial distress and degree of fatigue. RESULTS: The study results indicated that the level of stress or fatigue is so complicatedly influenced by variable factors as well as job-related characteristics such as socio-demographic characteristics, rank in work, or job career, to a greater extent, by job specifications and personality traits(type A) like whether performing health-related behavior or not, job demand, job autonomy, social support in work, or sense of self-esteem. CONCLUSIONS: Thus the effective strategy for psychosocial distress and fatigue symptoms reduction among governmental employees requires additional programs focusing on innovated job specifications and managed personality trait.

Improvement of Readiness to Change in Heavy Drinkers by Group Drinking Education

BACKGROUND: This study was designed to evaluate the effectiveness of brief group education on improvement of readiness to change in heavy drinkers. METHODS: We selected 37 heavy drinkers categoriged in the state of precontemplation and contemplation stage according to readiness to change questionnaire (RTCQ). The readiness to change was re-evaluated after 4 sessions of drinking education. RESULTS: The mean (+/-SD) frequency of participation in group education was 3.5 (+/-0.6). According to the stage of readiness to change, the subjects were distributed into 11 (29.7%) in the stage of precontemplation and 26 (70.3%) in contemplation before participation in the program. After completion of educational program, the readiness to change in the subjects was significantly (P<0.001) changed into 1 drinker (2.7%) in the stage of precontemplation, 16 (43.2%) in contemplation and 20 (54.1%) in action. The influential factors associated with the improvement of the status of readiness to change was family APGAR score (odd ratio 1.75, 95% CI 1.02-3.03). CONCLUSION: Above results suggested that the readiness to change in heavy drinkers can be improved by brief group education program.

The Effects of Group Education for Heavy Drinkers on the Improvement of Drinking Behavior

BACKGROUND: The present study purposed to execute group temperance education for heavy drinkers, and to examine how much the participants' drinking behavior is improved. METHODS: We ran a drinking class composed of 4 sessions of group temperance education with 40 male heavy drinkers selected through the case management program of the National Health Insurance Corporation, and compared their drinking behavior before, right after, and 12 weeks after the class. RESULTS: The mean (SD) drinks per week was 4.8 (1.8) before the drinking class, 3.3 (2.3) (P<0.001) right after the completion of the class, and 3.6 (2.2) (P<0.001) 12 weeks after the class, showing a significant decrease. The mean (SD) alcohol intake per drink also decreased significantly from 14.4 (15.6) drinks before the drinking class to 9.3 (15.5) (P<0.001) right after the completion of the class and to 12.0 (16.6) (P<0.001) 12 weeks after the class. The mean (SD) alcohol use disorder identification test score improved significantly from 27.7 (6.3) before the drinking class to 17.8 (11.1) (P<0.001) right after the completion of the class and 20.5 (8.8) (P<0.001) 12 weeks after the class. The number of heavy drinkers decreased significantly from 40 (100.0%) before the drinking class to 26 (65.0%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001), and the number of binge drinkers also decreased significantly from 40 (100.0%) before the drinking class to 27 (67.5%) right after the completion of the class and 28 (70.0%) 12 weeks after the class (P<0.001). CONCLUSION: The results of this study showed that group temperance education by primary care physicians improved heavy drinkers' drinking behavior.