Pneumococcal Vaccination Rate and Related Factors in Older Adults in Republic of Korea / 農村醫學 地域保健

Objectives@#This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. @*Methods@#The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. @*Results@#The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. @*Conclusions@#In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.

Rotavirus Vaccine Coverage and Related Factors

PURPOSE: The vaccination level of rotavirus vaccine not supported by the government is not known. As vaccines not included in the national immunization schedule are not registered in the computerized national immunization registry system, their vaccination rate cannot be calculated according to the same method used in government-supported vaccines. Therefore, this study aimed to measure the status of the vaccination rate of rotavirus not included in the national immunization schedule. METHODS: The target population is the 0-year-old cohort. The survey population was composed of registered children born in 2017 enrolled in the Immunization Registry Information System. The survey was conducted through a computerized telephone survey method. The survey variables were as follows: vaccination order and date, provider, and data source. Factors related to complete vaccination were the child's sex, residence, birth order, and parents' age, educational level, and job status. RESULTS: Children's vaccination rates for the rotavirus vaccine by 2017 were 88.0%, 86.9%, and 96.6% for the first, second, and third doses, respectively. The rate of complete vaccination was 85.6%. The factors related to rotavirus complete vaccination were the child's sex and birth order, area of residence, parents' age and job status, and father's education level. CONCLUSION: In the future, it is necessary to conduct regular investigations on the rate of rotavirus vaccination as a tool for the development of the rotavirus infectious diseases control policy or as an evaluation tool for vaccine programs.

Factors Affecting Self-efficacy of Cardiopulmonary Resuscitation(CPR) in Adults / 農村醫學 地域保健

OBJECTIVES: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. METHODS: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. RESULTS: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. CONCLUSIONS: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.

Factors Associated with the 2017–2018 Seasonal Influenza Vaccination Coverage among Elementary, Middle, and High School Students

PURPOSE@#During the 2017–2018 season, influenza vaccination among elementary, middle, and high school students was not supported by the government. As vaccines that are not included in the national immunization schedule are not registered in the computerized national immunization registry, vaccination rates in these groups during this season remain unknown. Thus, the aim of this study was to estimate the vaccination rate among elementary, middle, and high school students during the 2017–2018 influenza season.@*METHODS@#A total of 1,910 student's parents (690 elementary school students; 611 middle school students; 609 high school students) participated in this survey. The survey involved a computer-assisted telephone interview (CATI). The following information related to participants' 2017–2018 seasonal influenza vaccination status were collected: date, type, provider, and data source. Other data collected included student's sex, grade, area of residence, and birth order, and parent's age, educational level, and job status.@*RESULTS@#The influenza vaccination rate for the 2017–2018 season was 70.1%, 48.9%, and 35.9% for elementary, middle, and high school students, respectively. Factors that were significantly related to the influenza vaccination rate in the 2017–2018 season were student's sex, grade, area of residence and birth order, and parent's age, educational level, and job status.@*CONCLUSION@#In the future, it will be necessary to conduct regular assessments of the rate of seasonal influenza vaccination to inform national policy development regarding seasonal influenza infectious diseases control or as an evaluation tool for vaccine programs.

Investigation of Children with No Vaccinations Recorded on the National Immunization Registry Information System

PURPOSE: To improve the quality of the vaccination program, analyze the cause and identify the influencing factors for not being registered in the National Immunization Registry Information System even once. METHODS: We conducted one-on-one household visit interview surveys after, using a list supplemented with addresses from the Ministry of the Interior. We identified the basic respondent information, information on relevant children (those born in 2012), the reasons for omission from computerized vaccination registration, and the actual residence of the registered children. RESULTS: The total number of unvaccinated children born in 2012 was 1,870. The final contact result of the household surveys was 1,254 successful contacts, 51 refused to be interviewed, and 565 were not found. The reason for missed vaccination registration was 928 cases of long-term stay overseas, 241 cases of missing registration owing to intentional refusal of vaccination, and 57 cases of illness. A comparison of complete vaccination rates between non-registrants and those of computerized registrants revealed rates of 17.9% and 96.3% for the 3 doses hepatitis B vaccine, 14.9% and 95.6% for the 4doses DTaP vaccine, 16.1% and 97.4% for the 3 doses polio vaccine, and 3.9% and 92.5% for the 3 (or 2) doses Japanese encephalitis vaccine, respectively. CONCLUSION: Vaccination is the most effective national health policy and one of the most remarkable accomplishments in medical history. Through great effort, Korea has started to transcribe vaccination records since 2000, and the records are now reaching a considerable level. However, there is an unregistered population of around 0.3%. Several measures can be taken to improve the registration rate in the vaccination records, such as managing non-registrants through education and interviews, and sharing vaccination data with foreign countries. The non-registrant management plan should include periodically compiling a list of children who are not registered in the National Immunization Registry Information System, conducting of household visits using survey forms, and data analysis to establish appropriate measures.

Health Impact Assessment of Free Immunization Program in Jinju City, Korea / 예방의학회지

OBJECTIVES: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. METHODS: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. RESULTS: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. CONCLUSIONS: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

The Knowledge, Attitude and Practice of Blood Pressure Management from the Patient's Viewpoint: A Qualitative Study / 예방의학회지

OBJECTIVES: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. METHODS: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. RESULTS: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. CONCLUSIONS: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.

Difference of Perception around Emergency Circumstances between 119 Rescuer and Utilizer

This study was performed to investigate satisfaction of 119 rescue users and to know how much different in perception around emergency circumstance between 119 rescuers and users. We reviewed emergency care records of users who were transported by 119 rescue of six agencies in Chungnam province from July 13, 1998 to August 8, 1998, and in order to find real utilization pictures and users' satisfaction, we analysed 113 mail questionnaires with perfect address and answers at January, 1999. The difference about perception around emergency circumstances between users and rescuers were as follows, degree of coincidence about mental state was 28.6% in alert, 61.9% in stupor, 28.6% in coma. Also, the degree of coincidence about patient 's severity was 50.0% in emergent, 64.1% in urgent, 19.4% in nonurgent. Difference between rescuers and users about duration from 119 call receipt to scene arrival The reason of satisfaction about 119 rescue service was 94.7% in kindness, 79.6% in equipment and facilities. Factors about dissatisfaction were delayed time(25.0%), insufficient equipment(19.2%), etc.