Factors Associated with Willingness to Visit Psychiatric Clinic among General Adult Population in Bucheon City / 신경정신의학

OBJECTIVES: The aim of this study was to investigate various factors associated with the willingness to visit psychiatric clinics among the general adult population in Bucheon city, South Korea. METHODS: One thousand seventy-five adults completed a self-questionnaire assessing their willingness to visit psychiatric clinics, family history of mental illnesses, frequency of contact with the mentally ill, stigma and discrimination toward the mentally ill, and the Community Attitude toward the Mentally Ill (CAMI). Logistic regression analyses were performed to identify variables associated with the willingness to visit psychiatric clinics. RESULTS: Study results showed that being single was associated with reduced willingness to visit psychiatric clinics. Subjects who had more frequent contact with mentally ill patients were more willing to visit psychiatric clinics. Concerning the CAMI scale, higher scores in authoritarianism and lower scores in benevolence subscales were associated with greater willingness to visit psychiatric clinic. Subjects who strongly admitted the existence of the stigma, and discrimination, toward mentally ill patients were more willing to visit psychiatric clinics. CONCLUSION: Enhanced understanding of the factors associated with the willingness to visit psychiatric clinics would be helpful in reducing barriers to mental health services utilization in the community.

Early Intervention for Low-Temperature Burns: Comparison between Early and Late Hospital Visit Patients

BACKGROUND: Various focal heating devices are popular in Korea under the cultural influence of the traditional ondol under-floor method of home heating. These devices can cause severe burn-like injuries resulting from device malfunction or extended with low heat contact. In addition to injuries under these high heat contact, burns can be occurred by low heat exposure with prolonged periods despite the devices are properly functioning. In order to develop strategies to reduce the duration of periods of illness due to low-temperature burns, we analyzed and compared treatment methods and therapeutic periods for this type of injury. METHODS: This retrospective study included 43 patients burned under low heat conditions. Patients were divided into an operative group and a conservative group. The patients in the operative group underwent at least one surgical excision, and were further subdivided into early and late visit groups. The conservative group was treated only with dressings. We compared the treatment periods between the operative group and the conservative group, and also compared the preparation periods and treatment periods between the two operative groups. RESULTS: The average treatment period was significantly shorter in the operative group (P=0.02). In the early visit operative group, both wound preparation and treatment were briefer than in the late visit group. CONCLUSIONS: We recommend that early proper burn care and early surgical intervention, including appropriate excision, are feasible ways to reduce the treatment period of low-temperature burn patients.

The one-stop clinic as the standard of out-patient care in a hospital urology department

PURPOSE: To evaluate the performance of a 'one-stop' clinic in terms of proportion of discharges or inclusion in surgical waiting lists. MATERIALS AND METHODS: All patients were referred from primary care facilities (population 220.646) and from different departments in the hospital. Eight senior urologists, two registered nurses and two nurse attendants participated in the experience. Prior to the start of the project, referral protocols had been agreed with the primary care physicians involved. Compliance with the protocols was periodically tested. Eventually 5537 first visits (January-December 2009) where evaluable. RESULTS: Overall, the 'one-stop' format proved feasible in 74.2 percent of the patients (4108/5537). Patients, who successfully used the 'one-stop' format, were significantly younger than those who required additional consultations (43 vs 50 years old, respectively, Student's t test < 0.001). For obvious reasons the 'one-stop' format was universally possible in male sterilization and penile phimosis patients. Similarly, the 'one-stop' policy was applied in most consultations due to male sexual dysfunction (75 percent) and urinary tract infection (73 percent). Other health problems, such as haematuria (62 percent) and renal colic (46 percent), required more than one visit so that care of the patient reverted to the traditional, outpatient care model. CONCLUSION: A 'one-stop' philosophy is feasible for a number of procedures in a urological outpatient clinic. The costs to implement such an approach would be limited to managerial expenditure.

Five-Year Follow-Up Evaluation of the Program of Clinic Visits for Humanity Education / 医学教育

A program of clinic visits for humanity education has been conducted for 4th-year medical students who have not experienced clinical practices in wards. The major aim is for students to observe the doctor-patient relationship and to establish a close relationship with the tutor doctor. We evaluated the 5-year follow-up data. The most important part of the program was the orientation, which included the aim of the program for students and teachers and contributed to promoting educational effects. A student cannot become a good physician by staying only in the university hospital. An experienced physician who feels a duty to help educate younger doctors may have beneficial effects. In the program, close contact between the students and the tutor had a great effect upon the student which cannot be obtained in the university hospital.