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Effect of An Education Program on the Pregnant Women to Improve the Correct Recognition and Choice among the BCG Vaccination Methods.
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Seung Hee Lee, Chae Min Chun, Jin Ho Chun
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Korean J Epidemiol. 2008;30(2):263-271. Published online December 31, 2008
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DOI: https://doi.org/10.4178/kje.2008.30.2.263
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PURPOSE
The most effective and basic Tb preventive measure is BCG vaccination. Even though the Intradermal vaccination method in BCG vaccination is known to be the most accurate method in preventing the advanced Tb, nowdays most of the Korean civilian hospitals utilize multipuncture BCG vaccination method ,which is quite contrary to the national standard intradermal vaccination method. Therefore I decided to inform and educate the pregnant women who would be in a position to choose the BCG vaccination method. This will help them understand the BCG vaccination methods properly.
We should urge the intradermal method which is acknowledged as the national standard vaccination method.
METHODS The questionnaire was mailed twice to 214 pregnant women requring the antenatal care who visited any of the 9 health centers in Busan from the period of Aug to Oct. 2007.
The 1st questionnaire was done in 214 pregnant women prior to education concerning the BCG vaccination methods and Tb, and the 2nd questionnaire was done after education. Contents of the questionnaire were general knowledges for BCG vaccination method, intention of selection for BCG vaccination, knowledges for the adverse effect, etc. Data analysis was performed utilizing SPSS (ver12) and the pregnant women's change in concept was comparatively analyzed with percentage, chi-square -test .
RESULTS Considering the general characteristics of the pregnant women who participated in the study, the highest percentage was noticed in their 15-28 gestational weeks (60.8%), Age over 30 (70.1%), Education level-college graduate (76.6%). Recognition to the presence of two types BCG vaccination method was 27.6% before education and 95.3% after education which showed a marked improvement (p=0.0001). After education, 82.2% of pregnant women decided to choose intradermal BCG vaccination method at birth which was 23.4% before education (p=0.0003). Despite the fact that intradermal BCG method is the national standard vaccination method, some of them prefer multipuncture BCG vaccination method, because most of the scars (41.3%), the civilian hospitals do it (35.7%), because of the lack of the education and information from the health centers and public institutions (17.4%). The future selection of BCG vaccination methods as follows: before education, intradermal BCG vaccination 31.0%, multipuncture BCG vaccination 14.6%, uncertain 54.4%, and after education, intradermal BCG vaccination 72.4%, multipuncture BCG vaccination 2.8%, uncertain 24.8% (p<0.0001).
CONCLUSIONS The pregnant women were not fully aware of intradermal and multipuncture BCG vaccination methods.
Through education and information, it was possible for them to thoroughly recognize the BCG vaccination methods. In order to urge the intradermal BCG vaccination method, the health centers and public institutions need to educate and inform the pregnant women regarding the intradermal BCG vaccination method which is the standard vaccination method in Korea.
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Knowledges and Attitudes of College Student to Aquired Immune Deficiency Syndrome.
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Jin Ho Chun, Seong Hoon Lee, Hae Sook Sohn, Jong Tae Lee
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Korean J Epidemiol. 2002;24(1):37-53.
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OBJECTIVES
Though AIDS is one of the most serious and world-wide health problem, there have been developed no effective control measure but individually oriented prevention. This study was performed to help preparing the efficient control program for college student who are sexually active, considered as a risk group for HIV infection.METHODS Subjects were 852 college students of one university in Gyungsangnam-do. From September to October 2001, questionnaire survey on the students' knowledge and attitude, and status of health education about AIDS (HEAIDS) was done. Collected data was analyzed using SAS (ver 6.21) program.RESULTS The subjects were freshman (52.1%) and enrollment (47.9%), with department of medicine (19.1%), nursing (25.8%), health administration (9.1%), business (11.4%), chemical (16.2%), food (8.8%), gymnastics (9.5%). Though about 90% of them agreed with the necessity of HEAIDS, half of them (54.7%) had no experience of HEAIDS and most (88.1%) of them considered it had been insufficient. The informations about AIDS was acquired mainly from TV newspaper (73.0%), but partly from specified health education (16.1%). They have no experience of unsafe sexual contact (96.1%), however, they considered that they can have accidental sexual contact (22.7%) in the future. Response for intention to use of preventative condom use was certainly (66.7%) and questionable (33.3%). About the knowledges on HIV infection and transmission, most of them knew relatively well about no curative medicine (94.8%), infected by sexual contact (85.7%), common use of needle (96.4%), transfusion (95.2%), transplantation (89.8%), longitudinal infection (88.7%). However, the correct answer rate was relatively low in clinical spectrum; can maintain normal life with medical care (31.0%), and some transmission route; kiss (46.9%), cough sneezing (45.8%), common use of bowl towl (49.1%) and bath (43.4%), insect like mosquitos (49.1%), razor (35.4%). The mean level of the knowledges on HIV infection and transmission was 67.5 and 71.6 out of a possible 100, respectively. The knowledge level (p=0.003) and certainty to use of preventable condom use (p=0.001) was higher in HEAIDS experienced group. Experiences to HEAIDS was more in enrollment (50.5%) than freshman (40.5%) (p=0.004), medicine (51.4%) than health (32.1%) and general (41.9%) by department group (p=0.001). With regard to the attitudes on HIV infection, they didn't agreed with 'had intention to check themselves for HIV infection (94.2%)', 'case or suspected case can attend to same school with my children (71.8%)', 'had intention to join in clinical trial of new regimen for AIDS (74.4%)'.CONCLUSIONS This result showed that present status of HEAIDS for college students is still insufficient. Because the knowledges and attitudes about AIDS are influenced by HEAIDS, professional and efficient education program would be emphasized on the practical level for health protection, eg, preventative condom use. This study has also another meanings to reveal the positive effect and to recall the motive for individual-based prevention
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Actual Conditions and Pitfalls of Death Statistics Based on the Current Death Registration System in Korea.
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Jin Ho Chun, Kyung Sook Lee
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Korean J Epidemiol. 2000;22(2):124-135.
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BACKGROUND
Death statistics is the most basic one among health-related statistics. This study was conducted to propose actual data to improve the quality of death statistics through a review of the contents of total registered death reports which are primary sources of death statistics.METHODS The author reviewed the recent regulations about the death registration and analyzed contents of the total 1,383 death certificates written out from January, 1998 to December, 1999 in a county of Kyungsangnamdo, Korea.RESULTS The two laws - the Family Registration Act and the Medical Act that mainly control death registration, and the two legal forms - death certificates and death report form that actually used were not accorded. This is a reason why there occurred frequent mistakes in the current death registration. Also, there was no way to correct the incomplete contents of death certificate primarily written by doctors. Among 1,383 death report cases, 83.9% of death was due to illness. The causes of the death were generally incredible; diverse expression even on the same disease, incorrect and inadequate expression, not standardized by standard classification of disease, and unwritten or 'unknown' especially in case of the intermediate underlying and underlying cause. The major place of death was home(67.8%) and medical facilities(22.3%). And, it considered that the welfare facilities should be added as one of the place of death. The proportion of the doctors' diagnosis for death was as high as 96.6%, however, the death certificates issued by a clinic had many problems in aspect of accuracy and completeness. In the time spent for the death report, 98.0% reported within the legal term of one month.CONCLUSIONS The authors propose the followings to improve the quality of death statistics. First of all, contents of the two laws should be unified. Secondly, concerns and professionalism of the personnel who deal with death registration are should be strengthened. Thirdly, the regular and reinforcing training for the doctors and the officials who issue the death certificates should be emphasized with consistent upgrade of the standard guidelines. Fourthly, the death reporting system should be qualified through the validation of the contents of the death report forms, i.e., checked by medical doctor or medical professionals in the Community Health Center in the process of the receipt, informing, and report.
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Factors for Chronic Hepatitis Defined as Elevated Level of Aminotransferases among Koreans.
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Jin Ho Chun, Jong Tae Lee, Hae Sook Sohn
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Korean J Epidemiol. 1999;21(1):53-63.
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Sustained abnormal liver function is closely associated with chronic hepatitis in Korea with high prevalence of hepatitis B infection. Follow up about AST and ALT on 839 adults(male 727, female 112) was executed with interval of at least 6 months for 2 years to evaluate the factors contribute to the progression of chronic hepatitis. HBsAg, HBsAb, anti-HCV, body mass index(BMI), total cholesterol, fasting blood sugar(FBS), Clonorchis sinensis in stool(Cs), fatty liver on abdominal sonogram and alcohol habit were also checked. We defined abnormal liver function as both of AST 35 U/L and ALT 50 U/L.
As the result of first time liver function test(LFT), the frequency of abnormal liver function was 13.6%(114/839). The positive rate of HBsAg and HBsAb was 7.0% and 73.9%, respectively, and the positive rate of anti-HCV and Cs was 0.7% and 1.3%. As the result of the follow up, 6.2%(52/839) in total has a tendency of chronic hepatitis with sustained abnormal LFT. Among abnormal LFT, 45.6%(52/114) was sustained LFT abnormality, and 12.8%(93/725) was aggravated LFT abnormality from normal LFT at the first check.
From these results, male and hepatitis B infection were evaluated as important factors for the progression of chronic hepatitis. HBsAb considered that has a protective effect to the progression of chronic hepatitis. Therefore, even though no symptoms or sign, periodic examination for hepatitis B marker and LFT is important to control the chronic hepatitis, especially for male. Furthermore, because only 25%(13/52) of sustained abnormal LFT was HBsAg positive, it suggests that further study for evaluating the factors except hepatitis B infection would be needed for the control of chronic hepatitis.
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Knowledges and Attitudes of Overseas Seamen on HIV Infection.
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Jin Ho Chun, Bok Soon Oh
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Korean J Epidemiol. 1999;21(1):8-19.
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BACKGROUND
Though AIDS is one of the most serious health problem in worldwide, there have been developed no effective control measure yet. Therefore, individual-based prevention is the only way to control AIDS. Because overseas seamen would be considered as a high risk group for HIV infection due to their life style, this study was conducted in order to provide some informations for preparing the control program fit for them.METHODS The knowledges and attitudes on HIV infection among 201 Korean male overseas seamen - who were belonged to the one shipping company - were surveyed through questionnaire The survey was conducted for 2 months from October 1, 1997 and the results were analyzed by PC SAS (ver 6.12).RESULTS The mean age of the subjects was 36.4 years old, and the average tenure was 10.6years. 69.2% of them were married. The information about AIDS was acquired mostly from television(40.3%) and newspapers or magazines(32.8%). 30.8% of them have not received any AIDS-related education, and 66.7% were not satisfied with the fidelity of education.
About the knowledges on HIV infection, most of them knew relatively well about cause(84.1%), diagnosis(97.0%), epidemiology (94.5%) etc, however, they did not know about clinical spectrum and treatability well. With regard to the transmission of AIDS, most of them knew relatively well about needle(93.0%), longitudinal infection(92.5%), transfusion(91.0%), homosexuality(88.0%), trans plantation(81.6%), sexual contact (80.1%). However, they showed different responses about kiss, cough sneezing, mosquitos, and razor. With regard to the attitudes on HIV infection, they weighted 'isolation', for example, 'patients isolation'(65.7%), 'school-life isolation'(54.2%), 'divorce with his wife'(41.8%). There showed rather accurate knowledges and resonable attitudes in the educated group, and the response of 'will divorce with his wife' was higher in older group. With regard to the characteristics on sexual life, the possibility of future sexual contact was higher in the uneducated group, and intention to use of preventative condoms was higher in the seamanship group than the sailer group, but no difference by marrital status.CONCLUSIONS It should be emphasized to get the accurate knowledge about HIV infection through health education, especially focused on the practical levels, eg, preventative use of condoms during sexual contacts. This study has also another meanings to reveal the positive effect and to recall the motive for individual-based prevention.
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Risk Factors of Hypertension and The Effect of These Factors on Blood Pressure.
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Hae Sook Sohn, Chae Un Lee, Jin Ho Chun, Jung Hak Kang, Hwi Dong Kim, Kui Oak Jung, Kyu Il Cho
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Korean J Epidemiol. 1995;17(2):201-213.
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This study was conducted to find out the risk factors of hypertension and the effect of thesefactors on blood pressure. The eighteen factors were collected on the subjects of 932 from November 1994 to January 1995 through questionnaire and laboratory test - those were age, sex, education level, body mass index(BMI), family history of hypertension (FHH), triglyceride (TG), blood sugar and lactate dehydrogenase(LDH), etc. The status of blood pressure was classified by the classification of hypertension proposed by Joint National Committee of hypertension, USA. The prevalence of diastolic hypertension was 17.7% and the prevalence of systolic hypertension was 11.6 %. In the frequency analysis on the status of blood pressure, by age, education level, smoking habit, RM, BMI, FBS, LDH, TG, the prevalences were significantly different for both diastolic and systolic hypertension(p(0. 05). By stepwise logistic regression with dichotemization of blood pressure, the following odds ratios were significantly high (p, 0.05) - for diastolic hypertension, age 1.973, BMI 2.
106, FHH 2, 102, LDH 2. 773, TG 1.715, and for systolic hypertension, age 4.414, BMI 1.563, FHH 2.125, RM 0.487, LDH 3.814, TG 2. 707. By multiple regression analysis with blood pressure as dependent variable and these factors as independent variables, the regression equationswere diastolic hypertension =51.07+0.20.age+0.07 BMI+0.02.TG+0.02.LDH+3.22.FHH, and systolic hypertension = 88. 59+0.23.age+0.06.BMI+5.46.FHH-2.62.RM+0.03.LDH+0,03.TG By this study, the significant risk factors of hypertension were age, BMI, TG, family history of hypertension, LDH, and efficient control of hypertension would be expected through control of these factors.
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