Tuberculosis Notification Completeness and Timeliness in the Republic of Korea During 2012-2014.

OBJECTIVES: Completeness and timeliness are key attributes of accurate disease surveillance. This study aimed to evaluate the completeness and timeliness of tuberculosis (TB) notification in the Republic of Korea, by comparing notification data from the Korean National Tuberculosis Surveillance System and reimbursement data from the National Health Insurance. METHODS: We evaluated reimbursement data from 103,075 cases (2012-2014) and surveillance data from 215,055 cases (2011-2015); cases were matched using Resident Registration Numbers. Completeness was evaluated using notifications that were reported within 365 days of the corresponding insurance claim. Timeliness was evaluated using the delay between starting TB treatment and the corresponding notification. Multivariate logistic regression analysis was used to analyze factors that affected completeness (e.g., sex, age, institution type, and nationality). RESULTS: The completeness values were 90.0% in 2012 (33,094/36,775), 93.0% in 2013 (31,445/33,803), and 94.0% in 2014 (30,537/32,497). The rates of notification within 7 days of the corresponding claim were 81.6% in 2012 (27,323/33,489), 79.8% in 2013 (25,469/31,905), and 80.4% in 2014 (24,891/30,978). Increases over time were observed in the sex-, age-, institution type-, and nationality-specific analyses. Multivariate analyses revealed that completeness was affected by institution type [hospitals: odds ratio (OR) = 1.82, p < 0.001; general hospitals: OR = 4.18, p < 0.001] and nationality (native Korean status: OR = 1.48, p < 0.001). CONCLUSION: Notification completeness exhibited a 4.0% increase during 2012-2014 in Korea, and institution type and nationality significantly affected the completeness of TB notifications.

[The effects of a group smoking cessation program among adult smokers in a rural community].

PURPOSE: The purpose of this study was to investigate the effects of a community-based group smoking cessation program among adult smokers in a rural community. METHOD: The study design was quasi-experimental with a pre and posttest. A total of 55 adult smokers participated in the study. They were evaluated 1, 3, and 6 months after the program to identify the long-term effectiveness of the program. The program consisted of a total of 5 sessions provided twice a week. To test the effectiveness of the program, urine creatinine, expired air carbon monoxide, nicotine dependence, and smoking-related knowledge were used as dependent variables. Data was analyzed with the SPSS 10.0 program with a t-test, paired t-test, and Scheffe test. RESULT: Urine creatinine, expired air carbon monoxide, and nicotine dependence were significantly decreased after the program. Also, the rates of continuous abstinence were 81.8% at posttest, 65.5% at 1 month, 54.5% at 3 months, and 54.5% at 6 months follow-up. CONCLUSION: This community-based group smoking cessation program implemented by a nurse and smoking cessation counselors was effective for quitting smoking and decreasing urine creatinine and nicotine dependence. Therefore, this smoking cessation program could be recommended to induce smoking cessation as health promotion management in the rural community.

[Nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adults smokers in a rural area].

PURPOSE: The purpose of this study was to identify nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adult smokers in a rural area. METHOD: The subjects were 276 current smokers (male=243, female=33). There were 3 stages of change for smoking cessation: pre-contemplation, contemplation, and preparation stage. Data was collected by an interview or self-reporting from February 12th to March 5th 2004, and analyzed with frequency, percentage, chi- square-test, Fisher's exact probability test, ANOVA, and Scheffe test using the SPSS-PC program. RESULT: According to the stages of change, 114(41.3%) current smokers were in pre-contemplation, 110(39.9%) in contemplation, and 52(18.8%) in the preparation stage. There was a higher percentage of males than females (chi- square=8.99, p=.011) in the preparation stage. The mean score of the smoking-related attitude (F=7.43, p=.001) and subjective norm(F=27.41, p=.001) were both lowest in the pre-contemplation stage and increased positively during the stages of change for smoking cessation. CONCLUSION: Based on these findings, the authors recommend that community-based smoking cessation programs should be developed by considering the intention or motives of current smokers and should be initiated in the preparation stage and primarily for male groups.

[Effects of an obesity control program based on behavior modification and self-efficacy in obese elementary school children].

PURPOSE: The purpose of this study was to identify the effects of a school-based obesity control program based on behavior modification and self-efficacy for obese elementary school children. The program was composed of strategies to modify diet and exercise habits and to increase self-efficacy. METHOD: The subjects were 57 obese children (experimental group = 28, control group = 29) whose Röhler index was 150 and over. The program was implemented once a week for 12 weeks from September 16 to December 12, 2003. The data was analyzed by Fisher's exact probability, chi (2)-test, t-test, and Wilcoxon Rank Sum test. RESULT: The Röhler index, fat mass and lean body mass of the experimental group positively changed after the intervention more than those of the control group, but there was a significant difference in the Röhler index only (t=2.06, p=.045). In addition, obesity stress significantly decreased (z=-2.86, p=.047) and dietary self-efficacy significantly increased (t=2.35, p=.023) in the experimental group than those of the control group. CONCLUSION: This study supports that a school-based obesity control program based on behavior modification and self-efficacy can be effective in decreasing obesity stress and increasing dietary self-efficacy. Parents, school nurses and the other support groups should be encouraged to participate from the planning stage of the program to be effective in weight control of obese elementary school children. Also school-based program should be implemented as an essential course in the curriculum, not as an elective.

[Health pattern of elderly according to age group who living alone in an urban area].

PURPOSE: This study was conducted to identify the differences of health patterns; health-related characteristics, health behaviors, health problems, and self-care levels of elderly, living alone in an urban area according to age group. METHOD: The study design was a descriptive survey and the subjects were 1,800 elderly consisting of 937 young old, 704 middle old, and 159 old old. Data was collected from May to July 2003 using the structured questionnaire and analyzed by descriptive statistics, chi(2)-test, Fisher's exact probability test, ANOVA and Scheffe test using SPSS/PC. RESULT: The health related characteristics which involved body mass index, mental status, use of assistant devices, perceived health, concern of health, and social support were different among the groups and more aggravated by aging. Health behaviors and health problems were also significantly aggravated in the old old group. The self-care levels measured by ADL, physical activity, and self-care ability scores were also significantly decreased in the old old group. CONCLUSION: For the level of health status, health behaviors and self-care ability were significantly decreased by aging, health care services for the elderly should be planned considering the difference in the health pattern by age group.

[Nurses' image perceived by academic and vocational high school teachers in Korea].

PURPOSE: The purpose of this study was to identify nurses' image and its related factors to make nurses' image among academic and vocational high school teachers in Korea. METHOD: Study samples were composed of 470 teachers who were from 12 high schools in G and J city located in southwestern part of Korea. Data were collected from August 26 to October 4, 2002. The internal consistency of the total scale was Cronbach's a =.940. RESULT: In order to make nurses' image, 76.4% of respondents were influenced by the experience of their hospitalization in visiting hospitals. The mean score of nurses' image in general was 3.19+/-0.55; in four subcategories, 3.46+/-0.60 for professional image, 3.28+/-0.69 for traditional image, 2.93+/-0.70 for social image, and 2.91+/-0.64 for vision of nursing career. The mean score of nurses' image in general was more positive significantly in the 50's age group (F=6.43, p=.002) and in male groups (t=2.92, p=.002). CONCLUSION: On the basis of these findings, nursing professionals need to improve their working conditions, aspiration in job, and autonomy of nurses in their practice fields, monitor the mass media and other publishing materials continuously, and share the appropriate information on nursing profession to the school teachers and the public.

[Comparison of nursing activities reflected in nursing notes and in-depth interviews of nurses in an acute hospital].

PURPOSE: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. METHOD: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. RESULT: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. CONCLUSION: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.