Effect of Chronic Kidney Disease on All-Cause Mortality After Hip Fracture Surgery: A Retrospective Cohort Study.

In this retrospective cohort study, we investigated: (1) The impact of comorbid chronic kidney disease (CKD) on postoperative mortality in patients with a hip fracture; (2) mortality variations by dialysis type, potentially indicating CKD stage; (3) the efficacy of different hip fracture surgical methods in reducing mortality for patients with CKD. This study included 25,760 patients from the Korean National Health Insurance Service-Senior cohort (2002-2019) who underwent hip fracture surgery. Participants were categorized as CKD and Non-CKD. Mortality rate was determined using a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) through a Cox proportional-hazard model. During follow-up, we ascertained that 978 patients (3.8%) had CKD preoperatively. Compared to the Non-CKD group, the mortality risk (HR) in the CKD group was 2.17 times higher (95% confidence interval [CI], 1.99-2.37). In sensitivity analysis, the mortality risk of in patients who received peritoneal dialysis and hemodialysis was 6.21 (95% CI, 3.90-9.87) and 3.62 times (95% CI, 3.11-4.20) higher than that of patients who received conservative care. Mortality risk varied by surgical method: hip hemiarthroplasty (HR, 2.11; 95% CI, 1.86-2.40), open reduction and internal fixation (HR, 2.21; 95% CI, 1.94-2.51), total hip replacement (HR, 2.27; 95% CI, 1.60-3.24), and closed reduction and percutaneous fixation (HR, 3.08; 95% CI, 1.88-5.06). Older patients with CKD undergoing hip fracture surgery had elevated mortality risk, necessitating comprehensive pre- and postoperative assessments and management.

Association between nurse staffing level in intensive care settings and hospital-acquired pneumonia among surgery patients: result from the Korea National Health Insurance cohort.

This study examined the association between the number of nursing staff in intensive care units (ICUs) and hospital-acquired pneumonia (HAP) among surgical patients in South Korea. Data were obtained between 2008 and 2019 from the Korean National Health Insurance Service Cohort Database; 37,706 surgical patients who received critical care services were included in the analysis. Patients with a history of pneumonia 1 year prior to surgery or those who had undergone lung-related surgery were excluded. The ICU nursing management fee is an admission fee that varies based on the grading determined by nurse-to-bed ratio. Using this grading system, we classified four groups from the highest to the lowest level based on the proportion of beds to nurses (high, high-mid, mid-low, and low group). HAP was defined by the International Classification of Disease, 10th revision (ICD-10) code. Multilevel logistic regression was used to investigate the relationship between the level of ICU nurse staffing and pneumonia, controlling for variables at the individual and hospital levels. Lower levels of nurse staffing were associated with a greater incidence of HAP than higher levels of nurse staffing (mid-high, OR: 1.33, 95% CI: 1.12-1.57; mid-low, OR: 1.61, 95% CI: 1.27-2.04; low, OR: 2.13, 95% CI: 1.67-2.71). The intraclass correlation coefficient value was 0.177, and 17.7% of the variability in HAP was accounted for by the hospital. Higher ICU nursing management fee grades (grade 5 and above) in general and hospital settings were significantly associated with an increased risk of HAP compared to grade 1 admissions. Similarly, in tertiary hospitals, grade 2 and higher ICU nursing management fees were significantly associated with an increased risk of HAP compared to grade 1 admissions. Especially, a lower level of nurse staffing was associated with bacterial pneumonia but not pneumonia due to aspiration. In conclusion, this study found an association between the level of ICU nurse staffing and HAP among surgical patients. A lower level of nurse staffing in the ICU was associated with increased rates of HAP among surgical patients. This indicates that having fewer beds assigned to nurses in the ICU setting is a significant factor in preventing HAP, regardless of the size of the hospital.

Association between watching eating broadcast "Mukbang and Cookbang" and body mass index status in South Korean adolescents stratified by gender.

BACKGROUND: It has been suggested that Mukbang and Cookbang, a type of eating broadcast originating from Korea and gaining popularity, may contribute to obesity. However, despite suggestions that Mukbang might contribute to obesity, studies investigating the impact of watching Mukbang on obesity is lacking. The goal of this study is to analyze the relationship between watching Mukbang and Cookbang and body mass index (BMI) status in Korean adolescents. All analyses were stratified by gender. METHODS: This study utilized data from the 2022 Korea Youth Risk Behavior Web-based Surveys. The anonymous online survey was conducted with 56,213 students, and 51,850 students (92.2%) who participated in the survey were analyzed. Participants reported the frequency of watching Mukbang and Cookbang per week over the previous 12 months. BMI was categorized into four subgroups based on percentiles: underweight (< 5th percentile), normal (5th - 85th percentiles), overweight (85th - 95th percentiles), and obese (> 95th percentile). This study used multinomial logistic regression for analysis. RESULTS: The likelihood of being obese was significantly higher in Mukbang-watching boys compared to those who never watched Mukbang and Cookbang (adjusted odds ratio [aOR]: 1.22, 95% confidence interval [CI]: 1.12-1.32). A dose-dependent association was found between the frequency of Mukbang and Cookbang watching and the likelihood of obesity among boys (p-for-trend < 0.0001). Subgroups that currently smoke, currently drink alcohol, frequently consume fast food, or drink sweetened beverages showed significantly higher odds of being obese in the "Ever" group than those in the "Never" group. CONCLUSION: This study found a relationship between watching Mukbang and Cookbang and obesity in boys. Appropriate interventions should be considered for boys watching Mukbang and Cookbang.

Association between watching eating shows and unhealthy food consumption in Korean adolescents.

BACKGROUND: Eating habits formed during adolescence greatly influence the maintenance of health in adulthood. With the recent development of social media and easy access to the Internet, adolescents watch plenty of food videos, particularly Mukbang and Cookbnag(eating show)content. This media genre's impact on food choices has been covered in several studies; however, studies on unhealthy eating habits directly related to adolescents' exposure to eating shows are insufficient. METHODS: For this study, we used data from the 18th Korea Youth Risk Behavior Survey conducted in 2022 and finalized 50,451 participants. The extent of exposure to eating show media over the course of a week, as well as the consumption of fast food, sugar-sweetened beverages (SSBs), and high caffeinated beverages within that week were measured through self-reporting questionnaires. We classified the participants into two groups based on their frequency of watching eating shows. A multiple logistic regression analysis was performed to investigate the association between eating show and unhealthy food consumption. RESULTS: For both males and females, eating show exposure was strongly associated with the consumption of fast food (male: OR:1.37, 95% CI:1.26-1.49; female: OR:1.46, 95% CI:1.36-1.57), SSB (male: OR:1.42, 95% CI:1.26-1.60; female: OR:1.51, 95% CI:1.35-1.70), and high caffeinated beverage (male: OR:1.30, 95% CI:1.23-1.37; female: OR:1.24, 95% CI:1.18-1.31). It was observed that both sexes were more likely to frequently eat unhealthy food than students who did not watch eating shows. CONCLUSION: Among Korean adolescents, students exposed to eating shows, which primarily aim to entertain, were more likely to consume fast food, SSBs, and high caffeinated beverages. Therefore, this study's findings suggest that eating show could influence adolescents' food choices, highlighting the need for interest in emerging cultures and corresponding health policies.

Impact of parental leave system on the childbirth plan among working married women: a three-year follow-up study of the Korean longitudinal survey of women and families.

BACKGROUND: The Korean government seeks to balance work and family and alleviate low fertility by implementing a parental leave system. This study aimed to identify the impact of the parental leave system on childbirth among married working women in South Korea. METHODS: This study used three-year follow-up data from the Korean Longitudinal Survey of Women and Families (2016, 2018, and 2020). The number of participants was 324 at baseline. Logistic regressions using a generalized estimating equation model were performed to examine the impact of parental leave on childbirth. Sub-analyses of covariates, childbirth support, and parental leave systems were conducted. RESULTS: Of workers covered by the parental leave system, 31.7% considered childbirth. Women covered by parental leave were 3.63 times more likely to plan childbirth (95% confidence interval [CI], 1.32-9.99). The tendency to plan childbirth was pronounced among those in their early 30s (adjusted odds ratio [AOR], 7.20) and those who thought that having children was necessary (AOR, 4.30). Child planning was more influenced by leave support (AOR, 6.61) than subsidies. CONCLUSIONS: Parental leave systems can have a positive impact on working married women's childbirth plans. Although this system was effective in a group interested in childbirth, it did not create a fundamental child plan. Time support is more important than money concerning childbirth plans. The parental leave system had an impact on childbirth plan. Appropriate parenting policies can effectively increase the fertility rate.

Differences in end-of-life care patterns between types of hospice used for cancer patients: a retrospective cohort study.

BACKGROUND: In response to the rapid aging population and increasing number of cancer patients, discussions on dignified end-of-life (EoL) decisions are active around the world. Therefore, this study aimed to identify the differences in EoL care patterns between types of hospice used for cancer patients. METHODS: In this population-based cohort study, the Korean National Health Insurance Service cohort data containing all registered cancer patients who died between 2017 and 2021 were used. A total of 408,964 individuals were eligible for analysis. The variable of interest, the type of hospice used in the 6 months before death, was classified as follows: (1) Non-hospice users; (2) Hospital-based hospice single users; (3) Home-based hospice single users; (4) Combined hospice users. The outcomes were set as patterns of care, including intense care and supportive care. To identify differences in care patterns between hospice types, a generalized linear model with zero-inflated negative binomial distribution was applied. RESULTS: Hospice enrollment was associated with less intense care and more supportive care near death. Notably, those who used combined hospice care had the lowest probability and frequency of receiving intense care (aOR: 0.18, 95% CI: 0.17-0.19, aRR: 0.47, 95% CI: 0.44-0.49), while home-based hospice single users had the highest probability and frequency of receiving supportive care (Prescription for narcotic analgesics, aOR: 2.95, 95% CI: 2.69-3.23, aRR: 1.45, 95% CI: 1.41-1.49; Mental health care, aOR: 3.40, 95% CI: 3.13-3.69, aRR: 1.35, 95% CI: 1.31-1.39). CONCLUSION: Our findings suggest that although intense care for life-sustaining decreases with hospice enrollment, QoL at the EoL actually improves with appropriate supportive care. This study is meaningful in that it not only offers valuable insight into hospice care for terminally ill patients, but also provides policy implications for the introduction of patient-centered community-based hospice services.

Association Between Economic Activity and Depressive Symptoms Among Women With Parenting Children.

BACKGROUND: Balancing parenting and work life poses challenges for women with children, potentially making them vulnerable to depression owing to their dual responsibilities. Investigating working mothers' mental health status is important on both the individual and societal levels. This study aimed to explore the relationship between economic activity participation and depressive symptoms among working mothers. METHODS: This study was a cross-sectional study and used data from the Korea National Health and Nutrition Examination Survey collected in 2014, 2016, 2018, and 2020. The participants in the study were women aged 19 to 50 who were residing with their children. In the total, 3,151 participants were used in the analysis. The independent variable was economic activity, categorized into two groups: 1) economically active and 2) economically inactive. The dependent variable was the depressive symptoms, categorized as present for a Patient Health Questionnaire-9 score of ≥ 10 and absent for a score < 10. Multiple logistic regression analysis was performed to assess the association between economic activity and depressive symptoms, and sensitivity analyses were performed based on the severity of depressive symptoms. RESULTS: Among women with children, economically active women had reduced odds ratio of depressive symptoms compared with economically inactive women (odds ratio [OR], 0.54; 95% confidence interval [CI], 0.36-0.80). In additional analysis, women working as wage earners had the lowest odds of depressive symptoms (OR, 0.43; 95% CI, 0.28-0.66). Women working an average of 40 hours or less per week were least likely to have depressive symptoms (OR, 0.42; 95% CI, 0.25-0.69). CONCLUSION: Economic activity is significantly associated with depressive symptoms among women with children. Environmental support and policy approaches are needed to ensure that women remain economically active after childbirth.

Risk of Pancreatic Cancer After Acute Pancreatitis: A Retrospective Analysis of the Korean National Sample Cohort.

BACKGROUND: Acute pancreatitis may increase the risk of pancreatic cancer, although this association remains unclear. Therefore, we aimed to investigate this association. METHODS: We retrospectively analyzed the 2002-2019 Korean National Health Insurance Service-National Sample Cohort using 1:3 propensity score matching for sex and age (acute pancreatitis, n = 4,494; matched controls, n = 13,482). We calculated the hazard ratio (HR) for pancreatic cancer risk in patients with acute pancreatitis using Cox proportional hazards regression. RESULTS: Acute pancreatitis was significantly associated with an increased risk of pancreatic cancer throughout the study period (adjusted HR, 7.56 [95% confidence interval, 5.00-11.41]), which persisted for 2, 2-5, and > 5 years post-diagnosis (19.11 [9.60-38.05], 3.46 [1.35-8.33], and 2.73 [1.21-6.15], respectively). This pancreatitis-related pancreatic cancer risk became insignificant beyond 10 years of follow-up (1.24 [0.24-6.49]). Furthermore, this risk notably increased as the number of recurrent acute pancreatitis episodes increased (1 episode: 5.25 [3.31-8.33], 2 episodes: 11.35 [6.38-20.19], ≥ 3 episodes: 24.58 [13.66-44.26]). CONCLUSION: Following an acute pancreatitis diagnosis, the risk of pancreatic cancer increases significantly in the initial years, with a rapid increase further accentuated with recurrent acute pancreatitis episodes. Additional study is needed to evaluate whether this increased risk of carcinogenesis is attributed to accumulated inflammation.

New-onset dyslipidemia in adult cancer survivors from medically underserved areas: a 10-year retrospective cohort study.

BACKGROUND: Cancer survival rates are increasing; however, studies on dyslipidemia as a comorbidity of cancer are limited. For efficient management of the disease burden, this study aimed to understand new-onset dyslipidemia in medically underserved areas (MUA) among cancer survivors > 19 years. METHODS: This study used 11-year (2009-2019) data from the Korean National Health Insurance Service sample cohort. Cancer survivors for five years or more (diagnosed with ICD-10 codes 'C00-C97') > 19 years were matched for sex, age, cancer type, and survival years using a 1:1 ratio with propensity scores. New-onset dyslipidemia outpatients based on MUA were analyzed using the Cox proportional hazards model. RESULTS: Of the 5,736 cancer survivors included in the study, the number of new-onset dyslipidemia patients was 855 in MUA and 781 in non-MUA. Cancer survivors for five years or more from MUA had a 1.22-fold higher risk of onset of dyslipidemia (95% CI = 1.10-1.34) than patients from non-MUA. The prominent factors for the risk of dyslipidemia in MUA include women, age ≥ 80 years, high income, disability, complications, and fifth-year cancer survivors. CONCLUSIONS: Cancer survivors for five years or more from MUA had a higher risk of new-onset dyslipidemia than those from non-MUA. Thus, cancer survivors for five years or more living in MUA require healthcare to prevent and alleviate dyslipidemia.

Association between alcohol use disorder and risk of obstructive sleep apnea.

Obstructive sleep apnea (OSA) is a common sleep disorder characterised by recurrent upper airway collapse during sleep. Alcohol consumption has been linked to an increased risk of OSA due to its effects on the upper airway and body mass index (BMI). We aimed to investigate the correlation between alcohol use disorders and OSA. We used 11,859 participants data from Korean National Health and Nutrition Examination Surveys. The variable of interest was alcohol use disorder, measured using the Alcohol Use Disorders Identification Test, and the dependent variable was the risk of OSA, measured using the Snoring, Tiredness, Observed apnea, high blood Pressure, BMI, age, neck circumference, and male gender questionnaires. Multiple logistic regression was used to assess the association between alcohol use disorder and OSA risk after adjusted analysis. A significant association was found between alcohol use disorder and OSA (adjusted odds ratio [aOR] 2.14, 95% confidence interval [CI] 1.93-2.37). In the unemployed group, those with alcohol use disorder had the highest odds of being at risk of OSA compared with those who did not have this disorder (aOR 2.45, 95% CI 2.04-2.95). The OSA risk increased as the snoring frequency, amount of alcohol consumed, and frequency of binge drinking increased. This study suggests an association between alcohol use disorders and the risk of OSA. The frequency of alcohol consumption, quantity of alcohol consumed, and snoring frequency were associated with the risk of OSA. Therefore, ceasing alcohol consumption is recommended as an effective approach to enhancing sleep quality.

Role of breast cancer screening in the overdiagnosis of thyroid cancer: results from a cross-sectional nationwide survey.

BACKGROUND: South Korea has the highest incidence of thyroid cancer worldwide, raising questions regarding the possibility of overdiagnosis. Examining the factors affecting thyroid cancer screening is crucial in elucidating the reasons for this unusually high incidence of thyroid cancer. Therefore, in the present study, we investigated the association between breast cancer screening and thyroid cancer screening to determine the potential role of breast cancer screening in the overdiagnosis of thyroid cancer in South Korea. METHODS: We analyzed the data of women aged > 30 years who were enrolled in the 2014 Korean National Cancer Screening Survey. Self-reported breast cancer screening behavior was categorized as follows: no screening, mammography only, ultrasonography only, and both ultrasonography and mammography. Thyroid cancer screening behavior was categorized as follows: those who had or had not undergone ultrasonography screening. Logistic regression analysis was used to examine the associations between breast and thyroid cancer screening behaviors. RESULTS: Of the 2270 participants, a total of 569 (25.1%) were screened for thyroid cancer. Those who underwent only mammography, only ultrasonography, or both mammography and ultrasonography were more likely to be screened for thyroid cancer than those who did not undergo breast cancer screening (odds ratio [OR]: 1.47, 95% confidence interval [CI] 1.06-2.04; OR 2.71, 95% CI 1.83-4.02; OR 2.75, 95% CI 1.99-3.80, respectively). CONCLUSIONS: Our findings indicate that thyroid cancer screening in Korea is likely to be performed on an opportunistic basis. Therefore, a nationwide public health and medical initiative is needed to curb the unnecessary use of thyroid screening in the asymptomatic general population.

Associations of stroke with all-cause and cause-specific mortality: A population-based matched cohort study.

BACKGROUND: This study aimed to assess the specific associations between stroke and all-cause and cause-specific mortality among Korean adults. METHODS: We used data extracted from the Korean National Health Insurance claims database from 2002 to 2013, including information on individuals with or without stroke aged 20 years and older. Patients with intracerebral hemorrhage, ischemic stroke or unspecified stroke were classified as stroke patients, while a reference population matched in terms of sex and age were also selected. The outcomes were all-cause mortality, natural causes of death (i.e. all natural causes, death by stroke and death by other diseases) and suicide. Survival analysis was performed using the Cox proportional hazards model. RESULTS: Of the 73 150 eligible participants-including 14 630 stroke patients and 58 520 age- and sex-matched controls-11 121 (15.2%) died during the study period. Of them, 10 513 participants (94.5%) died of natural causes, including 1653 (14.5%) who died due to stroke and 8860 (79.7%) who died due to other diseases. Two hundred and fifty patients (2.2%) died by suicide. Stroke patients showed higher adjusted hazard ratios (HR) for all-cause (HR = 6.48, 95% CI, 3.87-10.86), all-natural-cause (HR = 2.68, 95% CI, 2.53-2.84), stroke (HR = 21.16, 95% CI, 17.49-25.61), other disease (HR = 1.69, 95% CI, 1.58-1.81) and suicide mortality (HR = 3.34, 95% CI, 2.24-4.98) than those without stroke. The effect size of stroke for suicide mortality was greater than that for other causes of mortality (except stroke mortality). CONCLUSIONS: Stroke was associated with a higher risk of all-cause, natural cause and suicide mortality; stroke was more strongly associated with risk of suicide mortality than with any mortality for any other causes. From a policy standpoint, these results suggest the need for greater supportive care to prevent unnatural deaths among stroke patients.

Associations of social interactions during the COVID-19 pandemic with cognitive function among the South Korean older adults.

BACKGROUND: We aimed to demonstrate the associations between social interactions within social distancing norms during the coronavirus disease 2019 (COVID-19) pandemic and cognitive function among South Korean older adults. METHODS: Data from the 2017 and 2020 Survey of Living Conditions and Welfare Needs of Korean Older Persons were used. There were 18,813 participants (7,539 males; 11,274 females). T-test and multiple logistic regression analyses verified whether the mean difference in older adults' cognitive function before and during the COVID-19 pandemic was statistically significant. We also examined the associations between social interactions and cognitive function. The key results were presented as odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: All participants were more likely to experience cognitive impairment during the COVID-19 pandemic than before (males: OR 1.56, 95% CI 1.3-1.78; females: OR 1.26, 95% CI: 1.14-1.40). Cognitive impairment increased linearly with the decreased frequency of face-to-face contact with non-cohabiting children. Possible cognitive impairment was greater for females who had not visited senior welfare centers for the past year (OR 1.43, 95% CI 1.21-1.69). CONCLUSION: Korean older adults' cognitive function declined during the COVID-19 pandemic and was associated with reduced social interactions because of social distancing measures. Alternative interventions should be promoted for safely restoring social networks, considering the adverse effects of long-term social distancing on older adults' mental health and cognitive function.

Frailty transition and depression among community-dwelling older adults: the Korean Longitudinal Study of Aging (2006-2020).

BACKGROUND: Frailty is recognized as a geriatric syndrome associated with depression. The consequences and mechanism of frailty transitions are still understudied. This study assessed the influence of frailty transitions on new-onset depressive symptomology using longitudinal, nationwide data of Korean community-dwelling older adults. METHODS: Longitudinal population-based study conducted in every even-numbered year starting from 2006 to 2020 (eight waves) with a sample of older adults aged ≥ 60 years old. After the application of exclusion criteria, a total of 2,256 participants were included in the 2008 baseline year. Frailty transition was determined through the biennial assessment of change in frailty status using the frailty instrument (FI); depression was measured using the Center for Epidemiological Studies Depression 10 Scale. We employed the lagged general estimating equations to assess the temporal effect of frailty transition on obtaining depressive symptoms. RESULTS: Compared to non-frail individuals, the risk of depression was higher in transitioned into frailty and constantly frail participants over a 2-year interval: men (odds ratio (OR) 1.26, 95% confidence interval (CI) 1.21-1.32; OR 1.29, 95% CI 1.21-1.38), women (OR 1.34, 95% CI 1.28-1.40; OR 1.51, 95% CI 1.41-1.62), respectively. CONCLUSIONS: Frailty transition is found to be associated with new-onset depressive symptoms. Frail individuals and those who transitioned into frailty were associated with a higher risk of depression. Particular attention should be paid to these frailty transitioned groups. Early intervention and implementation of prevention strategies at physical, nutritional, and social levels are warranted to ameliorate frailty and depression in late life.

The impact of assisted reproductive technology treatment coverage on marriage, pregnancy, and childbirth in women of childbearing age: an interrupted time-series analysis.

BACKGROUND: Korea is encountering major challenges related to its declining birth rate and aging population. Various policies have been introduced to prevent further population decrease and boost the birth rate, but their effectiveness has not been verified. Therefore, this study examined the effects of assisted reproductive technology (ART) insurance coverage on marriage, pregnancy, and childbirth in women of childbearing age. METHODS: All information on marriage, pregnancy, childbirth of women of childbearing age was obtained from Statistics Korea and Korean National Health Insurance Service database. During a total follow-up period of 54 months (July 2015 to December 2019), an average of 12,524,214 women of childbearing age per month, and 29,701 live births per month were included in the analysis. An interrupted time series with segmented regression was performed to analyze the time trend and changes in outcomes. RESULTS: The implementation of ART coverage policies had no significant impact on marriage or pregnancy rates. However, it did affect multiple pregnancy and multiple birth rates, which increased by 1.0% (Exp(ß3) = 1.010, P-value = 0.0001) and 1.4% (Exp(ß3) = 1.014, P-value = < 0.0001), respectively, compared to the pre-intervention period. Although the effect of covering ART treatment on total birth rates were not confirmed, a slightly slower decline was observed after the intervention (Exp(ß1) = 0.993, P-value = < 0.0001, Exp(ß1 + ß3) = 0.996 P-value = 0.012). CONCLUSION: This study identified the effects of ART health insurance coverage policy on the rates of multiple pregnancies and births. After the policy implementation, the downward trend in the total birth rate reduced slightly. Our findings suggest that interventions to support infertile couples should be expanded to solve the problem of low fertility rates. To address the intricate problems related to low birth rates, the Korean government introduced a policy that provides financial support and health insurance coverage for assisted reproductive technology (ART) treatment for infertile couples. As a result of evaluating the effectiveness of the ART coverage policy, it led to higher rates of pregnancies and births. In addition, although the total birth rate has been continuously decreasing over time, the decline may have been slowed down slightly by this policy.

Association between work-related physical activity and depressive symptoms in Korean workers: data from the Korea national health and nutrition examination survey 2014, 2016, 2018, and 2020.

BACKGROUND: The workplace experiences of employees can impact their mental health. Depressive symptoms, which are experienced by workers, are a mental health issue that deserves attention. Several studies have evaluated physical activity to prevent possible depression in workers in a work environment, however, research on physical activity and depression symptoms directly related to work is still insufficient. Therefore, we aimed to identify the relationship between work-related physical activity and depression among South Korean workers. METHODS: We used data from the Korean National Health and Nutrition Examination Survey conducted in 2014, 2016, 2018, and 2020, which included 31,051 participants. We excluded, participants aged < 15 years (n = 4,663), unemployed and economically inactive persons (n = 9,793), those who did not engage in work-related physical activities (n = 1,513) and leisure physical activities (n = 1,558), or those with missing data (n = 450). Therefore, the study included 13,074 participants. Work-related activity was measured by self-reporting, while depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was performed to investigate the association between work-related physical symptoms and depressive symptoms among workers. RESULTS: Individuals who engaged in work-related physical activity had higher PHQ-9 scores than those who did not (male: odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.16-2.52; female: OR: 2.33, 95% CI: 1.66-3.29). High-intensity work-related physical activity significantly increased depressive symptoms (male: OR: 2.15, 95% CI: 1.04-4.43; female: OR: 2.90, 95% CI: 1.46-5.96). When classified according to the severity of depressive symptom, the OR of depressive symptoms of workers engaged in both leisure and work-related physical activities tended to be lower than that of those engaged only in work-related physical activities. CONCLUSION: Korean workers who engaged in work-related physical activities exhibited more depressive symptoms. Therefore, our findings suggest that balancing work-related and leisure physical activities can help Korean workers prevent development of depressive symptoms.

Association between sedentary behavior and chronic kidney disease in Korean adults.

BACKGROUND: Chronic kidney disease (CKD) is a significant health care burden, with a worldwide prevalence of approximately 11%. The general population spends over 50% of the awake time sedentary activities. However, to the best of our knowledge, no study has evaluated the association between sedentary time and CKD, with a focus on both kidney damage and kidney function, in the South Korean population. Accordingly, the present study aimed to address this gap in the knowledge. METHOD: We used data from the 8th Korea National Health and Nutrition Examination Survey. The analysis included 9,534 participants, especially excluded those who had been diagnosed with kidney disease or who were currently undergoing treatment. Sedentary behavior was self-reported by the participants. An estimated glomerular filtration rate (eGFR) and/or albuminuria were used as measures for detection of CKD according to the guidelines of the Kidney Disease Improving Global Outcomes. We analyzed the data using multiple logistic regression. RESULTS: Among the women, the risk of CKD was significantly greater among those who sat for ≥ 12 h/d relative to those who sat for < 6 h/d, after adjusting for physical activity and other covariates (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.01-2.06). Similarly, among those who sat over 12 h/d, those who engaged in low levels of physical activity had a higher risk of CKD than those who engaged in high levels of activity (OR: 1.65, 95% CI: 1.04-2.61). No statistically significant results were found for men. CONCLUSION: Excessive sedentary behavior was associated with an increased risk of CKD, especially albuminuria, regardless of the level of physical activity, only in women. These findings emphasize the importance of avoiding excessive sitting for a long time and increasing overall physical activity levels.

Association between having a meal together with family and smoking: a cross-sectional nationwide survey.

BACKGROUND: Smoking is a major risk factor that significantly affects public health. Although the South Korean government spends significant money on smoking cessation services, the smoking rate remains stagnant. Families influence health-conscious decisions, and family meals can positively affect smoking suppression and health behaviors. Therefore, this study investigated whether family meals are correlated with adults' smoking behaviors. METHODS: This study used data from the 2019-2021 Korean National Health and Nutrition Examination Survey. Having a meal together with family was defined as "yes" for those who have at least one meal with their family each day and "no" for those who do not. Current smoking status was classified as having smoked at least 5 packs of cigarettes (100 cigarettes) in one's lifetime and having used either conventional cigarettes or e-cigarettes in the last 30 days. Multiple logistic regression analyses were used to examine the association between eating together, smoking, and weight application. RESULTS: When comparing the group that ate with their family compared to the group that did not, the odds ratio for current smoking status was 1.27 (95% confidence interval [CI]: 1.05-1.54) for male participants and 1.90 (95% CI: 1.33-2.71) for female participants. This showed a dose-dependent effect according to the frequency of family meals. Those who smoked conventional cigarettes had a strong association (men: OR 1.28, 95% CI 1.00-1.67; women: OR 2.22, 95% CI 1.42-3.46). However, those who only vaped e-cigarettes or used both conventional cigarettes and e-cigarettes had no statistically significant correlations. CONCLUSION: This study provides evidence suggesting that eating meals as a family is related to smoking behavior and can positively affect smoking cessation intentions in adults. Consequently, a smoking cessation program can be developed that uses social support, such as encouraging family meals.

Association between caregiver type and catastrophic health expenditure among households using inpatient medical services: using Korean health panel.

BACKGROUND: Caregiving services often place a financial burden on individuals and households that use inpatient medical services. Consequently, this study aimed to examine the association between the type of caregiver and catastrophic health expenditure among households utilizing inpatient medical services. METHODS: Data were extracted from the Korea Health Panel Survey conducted in 2019. This study included 1126 households that used inpatient medical and caregiver services. These households were classified into three groups: formal caregivers, comprehensive nursing services, and informal caregivers. Multiple logistic regression was used to analyze the association between caregiver type and catastrophic health expenditure (CHE). RESULTS: Households receiving formal caregiving had an increased likelihood of CHE at threshold levels of 40% compared to those who received care from family (formal caregiver: OR 3.11; CI 1.63-5.92). Compared to those who received formal caregiving, households using comprehensive nursing services (CNS) had a decreased likelihood of CHE (CNS: OR, 0.35; CI 0.15-0.82). In addition, considering the economic value associated with informal care, there was no significant relationship between households received formal caregiving and informal caregiving. CONCLUSION: This study found that the association with CHE differed based on the type of caregiving used by each household. Households using formal care had a risk of developing CHE. Households using CNSs were likely to have a decreased association with CHE, compared to households using informal and formal caregivers. These findings highlight the need to expand policies to mitigate the burden on caregivers for households forced to use formal caregivers.

Effects of life-sustaining treatment plans on healthcare expenditure and healthcare utilization.

PURPOSE: To develop an ethical and cultural infrastructure for Life-Sustaining Treatment (LST) plan, it is crucial to carefully analyze its impact and ensure that healthcare utilization is maintained at an appropriate level, avoiding excessive medical interventions. This study aims to investigate the effects of LST decisions on both healthcare expenditure and utilization. METHODS: This cohort study utilized claims data from the National Health Insurance Service, encompassing all medical claims in South Korea. We included individuals who had planned to withdraw or withhold their LST between January and December 2018, identified by claim code IA71, IA72, IA73. We followed a total of 28,295 participants with documented LST plan who were deceased by June 2020. Participants were categorized into LST withdrawal / withholding and LST continuation groups. The dependent variables were healthcare expenditure and utilization. We construct a generalized linear model to analyze the association between these variables. RESULTS: Out of the 28,295 participants, 24,436 (86.4%) chose to withdraw or withhold LST, while the rest opted for its continuation. Compared to the LST continuation group, those who chose to withdraw or withhold LST had 0.91 times lower odds for total cost. Additionally, they experienced 0.91 times fewer hospitalization days and 0.92 times fewer outpatient visits than those in the LST continuation group. CONCLUSION: Healthcare expenditure and utilization deceased among those choosing to withdraw or withhold LST compared to those continuing it. These findings underscore the significance of patients actively participating in decision regarding their treatment to ensure appropriate levels of medical intervention for LST. Furthermore, they emphasize the critical role of proper education and the establishment of a cultural framework for LST plans.