Associations of anxiety and fatigue with hazardous occupational conditions of Korean nurses in early pregnancy: A cross-sectional study.

AIM: To identify occupational conditions associated with anxiety and fatigue among Korean nurses in early pregnancy. BACKGROUND: Pregnant nurses, like non-pregnant hospital nurses, are exposed to dangerous and stressful work environments, which can affect fatigue and anxiety. DESIGN AND METHODS: This cross-sectional study enrolled 1490 nurses who participated in the early pregnancy module in the Korea Nurses' Health Study between 2014 and 2020. Hierarchical linear regression analyses were employed to identify the factors associated with anxiety and fatigue among nurses in early pregnancy. RESULTS: One-fifth of participants were working night shifts, and more than two-thirds were working overtime. When using antineoplastic drugs and disinfectants, the rate of use of protective equipment varied depending on the size of the hospital. Working overtime and lifting heavy objects were associated with increased anxiety and fatigue among nurses. CONCLUSION: Overtime work was associated with both anxiety and fatigue among pregnant nurses. Pregnant hospital nurses were exposed to both night shift and overtime work. Therefore, hospital managers should improve hazardous working environments to protect the health of nurses in early pregnancy and their fetuses.

Self-Management Support with Yoga on Psychological Health and Quality of Life for Breast Cancer Survivors.

The purpose of this study was to identify whether the improvement of self-management support (SMS) combined with yoga can improve anxiety, depression, stress, and quality of life in female breast cancer survivors. The SMS combined with yoga group and control group (yoga only) were comprised of 21 and 20 participants, respectively. The SMS with yoga and yoga programs were provided to each group for 8 weeks. Data obtained from self-report questionnaires included details of anxiety, depression, stress, and quality of life. The levels of anxiety, depression, and stress significantly decreased in both the SMS with yoga and control groups (p < 0.05). Moreover, the quality of life improved significantly in the SMS with yoga group (p < 0.001). Among the five quality-of-life domains (physical, social/family, emotional and functional well-being, and breast cancer subscale), social/family well-being in the SMS with yoga group was significantly higher than that in the yoga-only group (p = 0.011). Conclusions: The results show that yoga is a beneficial activity for the psychological health of breast cancer survivors. Our findings suggest that SMS strategies can improve quality of life.

Cervical Cancer Prevention Education Program for Rural Korean Immigrant Women.

The study aimed to evaluate the effectiveness of a cervical cancer prevention education program for rural Korean immigrant women. A total of 46 Korean immigrant women who had not been screened in the past three years participated. The experimental group participated in the intervention program once a week for four weeks and completed a post-program survey in week 12. Compared to the control group, significant increases were detected in level of knowledge of cervical cancer prevention (p = .001), behavioral attitude toward cervical cancer prevention (p = .029) and behavioral intention regarding cervical cancer prevention (p = .005) in the experimental group. Pap screening rate of the experimental group was significantly increased (p = .029), but the rate of change in the selection of primary care providers was not significant. The results suggest the need for a multilevel approach to address cultural and systemic barriers to Korean immigrant women in promotion of cervical cancer prevention behavior.

Body mass index, menstruation, acne, and hirsutism of polycystic ovary syndrome in women: A cross-sectional study.

We examined to compare menstruation and body mass index (BMI) in women with and without polycystic ovary syndrome (PCOS) and to explore the effects of BMI on menstruation, facial acne, and hirsutism in women with PCOS of child-bearing age. Data from the Korea Nurses' Health Study were analyzed. The effect of BMI on irregularity of menstruation, acne, and hirsutism in the PCOS group was analyzed by logistic regression. The prevalence of PCOS was 7.1% among 11,866 participants. We found that BMI affects menstrual irregularity, facial acne, and hirsutism in PCOS women. Healthcare providers should consider weight control to improve irregularity of menstruation and hirsutism in PCOS women.

Korean nurses' adherence to safety guidelines for chemotherapy administration.

PURPOSE: Nurses are at risk from handling chemotherapeutic agents. This study aimed to determine adherence to safety guidelines for chemotherapy administration by Korean nurses and to examine the relationship between the hospital safety climate and nurses' adherence to safety guidelines. METHOD: A descriptive, correlational design with a cross-sectional survey using data from the Korea Nurses' Health Study. For this study, participants included 872 female nurses who had administered chemotherapeutic agents to patients in the last 30 days. RESULTS: Only a quarter of the participants had high adherence to the safety guidelines, while the majority had moderate to low adherence. The absence of job hindrances and feedback/training - two sub-factors of the hospital safety climate - enhanced the likeliness for nurses to comply with the safety guidelines by almost 1.3 and 1.7 times, respectively. CONCLUSION: The results imply that the hospital safety climate, particularly feedback/training, and the absence of job hindrances are significantly correlated with adherence to the safety guidelines for chemotherapy administration. Therefore, organisational and policy support is needed to improve the hospital safety climate.

Gastroesophageal reflux disease and its related factors among women of reproductive age: Korea Nurses' Health Study.

BACKGROUND: Recently, the number of patients diagnosed with gastroesophageal reflux disease (GERD) has increased in Korea. Risk factors of GERD include age, sex, medication use, lack of physical exercise, increased psychological stress, low or high body mass index (BMI), unhealthy eating habits, increased alcohol consumption, and cigarette smoking. However, few studies examined the major factors affecting GERD in women of childbearing age. Therefore, this study assessed the risk factors of GERD among 20,613 female nurses of reproductive age using data from the Korea Nurses' Health Study. METHODS: Participants were recruited from July 2013 to November 2014. They provided their history of GERD 1 year prior to data collection, along with information on their demographic characteristics, health-related behaviors, diet, medical history, and physical and psychological factors. Of the total sample, 1184 individuals with GERD diagnosed in the year prior to the study were identified. Propensity score matching was used for analysis. RESULTS: Cigarette smoking, increased alcohol consumption, low or high BMI, depression, and increased psychosocial stress were associated with the prevalence of GERD among Korean young women. Multivariate ordinal logistic regression analysis revealed significant positive relationships between GERD and being a former smoker; having a low (< 18.5 kg/m2) or high BMI (> 23 kg/m2); and having mild, moderate, moderately severe, and severe depression. CONCLUSIONS: Smoking, BMI, and depression were associated with GERD. To reduce this risk among female nurses, intervention strategies are required to help nurses maintain a normal weight and manage their depression.

Weight change and risk of uterine leiomyomas: Korea Nurses' Health Study.

OBJECTIVE: This study examined the associations between anthropometric measures and uterine leiomyomas. METHODS: This study included a total of 5,062 women (median age of 35.5 years) who had experienced pregnancy and, of these women, 210 reported a diagnosis of uterine leiomyomas within the past 2 years prior to baseline in the Korea Nurses' Health Study. Participants were asked about their anthropometric factors. The odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression models. RESULTS: Mean body mass index (BMI) was 21.8 kg/m2 among non-cases. An increase in weight from the age of 18 years to the present was associated with increased risk of uterine leiomyomas (p for trend = .002); compared to women whose weight remained stable, the multivariate ORs (95% CIs) were 1.84 (1.22-2.76) for weight gain of 5-10 kg and 2.00 (1.25-3.20) for weight gain of more than 10 kg since age 18. A similar pattern was observed when the analysis was limited to women with a BMI of 18.5-25 kg/m2. Current weight was associated with higher odds of uterine leiomyomas. No associations were found for body size in childhood or in adolescence, weight at age 18, current BMI, or current body size. CONCLUSIONS: Weight gain in adulthood was associated with increased risk of uterine leiomyomas in Korean women, even in those with normal weight.

Radiation safety education and compliance with safety procedures-The Korea Nurses' Health Study.

AIMS AND OBJECTIVES: To examine the current state of radiation safety education and its influence on nurses' compliance with safety procedures. BACKGROUND: Use of radiation in therapy and diagnosis has prolonged and improved millions of lives, but it presents potential hazards for healthcare professionals. DESIGN: A cross-sectional design. METHODS: Participants included 1,672 female nurses of childbearing age who had recently been exposed to radiation-emitting generators or radiation. Quantitative data were taken from the Korea Nurses' Health Study, the Korean version of the Nurses' Health Study conducted in the USA. Confounding variables included sociodemographic factors, duration of employment in a department where work involved radiation, hospital's geographical location, bed size and hospital safety climate. Statistical analyses included descriptive statistics, Spearman's correlation coefficients and multivariable ordinal logistic regression. RESULTS: Half (50.3%) of nurses received no safety training, whereas the other half received some safety training as follows: only once (14.4%), irregularly (10.2%) and regularly (25.1%). Of the six radioactive safety compliance questionnaires, 29.4%, 20.2%, 30.7% and 19.7% complied to none, one, two and more than three, respectively. After controlling for confounding variables, relative to that observed with no safety education, irregular education that occurred more than twice (OR = 1.597, CI = 1.177-2.164) and regular education (OR = 2.223, CI = 1.770-2.792) increased the likelihood that nurses would comply with safety procedures. CONCLUSIONS: Low levels of safety education and adherence raise critical concerns regarding nurses' well-being. As routine safety education increases safety adherence, healthcare managers and policymakers should emphasise regular safety education. RELEVANCE TO CLINICAL PRACTICE: Radiation safety education for nurses and their compliance with safety procedures have seldom been discussed in South Korea. However, as nurses' safety is directly related to the quality of patient care, additional safety education should be provided for hospital nurses to minimise their occupational exposure to harmful radioactive substances in clinical settings.

[The lifestyle modification coaching program for secondary stroke prevention].

PURPOSE: The purpose of this study was to investigate the effects of the lifestyle modification coaching program on self efficacy, lifestyle and physiologic indexes related to the recurrence of stroke in patients with stroke. METHODS: Sixty-one patients with stroke registered with a stroke center participated in this study. Of the participants, 32 were assigned to the experimental group and 29 to the control group. Self efficacy, alcohol drinking, smoking, physical activity, BMI (body mass index), WHR (waist-hip ratio), blood lipid level, and blood pressure were measured both for the baseline, as well as after intervention. The lifestyle modification coaching program consisted of an 8-week telecoaching session following face-to-face education. The control group received only the face-to-face education. RESULTS: There were significant differences in physical activities, WHR, blood pressure within and between groups after intervention. The lifestyle modification coaching program had significant influences on blood pressure even after gender, age, and physical activity had been adjusted. CONCLUSION: The results of the study indicate that lifestyle modification coaching program is effective for physical activity, abdominal obesity and blood pressure. Therefore it can be used by nurses in hospitals and communities as one of the secondary stroke prevention programs for patients with stroke.

Association of asthma symptoms with cigarette smoking and alcohol consumption in Korean adolescents.

The association of asthma symptoms with cigarette smoking and alcohol consumption in Korean adolescents was investigated in this study using the data of Korean Youth Risk Behavior Survey. Associated risk factors for experiencing asthma symptoms were explored in 3432 adolescents. In the symptomatic group, 21.7% were current smokers, compared to 10.9% in the asymptomatic group. Current smokers in the symptomatic group also smoked more cigarettes than those in the asymptomatic group. In the symptomatic group, 27.4% were current drinkers, compared to 17.9% in the asymptomatic group. Current drinkers in the symptomatic group were more likely to drink alcohol and to have experienced severe intoxication than those in the asymptomatic group. Participants who had been diagnosed within one year (odds ratio = 5.19, 95% confidence interval = 4.17-6.44) and those who had smoked over 20 days during the past 30 days (odds ratio = 1.77, 95% confidence interval = 1.26-2.49) were more likely to experience asthma symptoms. Healthcare providers should identify the risk behaviors of adolescents with asthma and counsel them and their parents simultaneously.

Risk factors related to hazardous alcohol consumption among Korean men with hypertension.

The present study examines the alcohol consumption behaviors and risk factors related to hazardous alcohol consumption in men with hypertension in South Korea. The participants were 490 Korean hypertensive men > 20 years of age. The Alcohol Use Disorders Identification Test was used to detect hazardous alcohol consumption. The majority of the participants were current drinkers, and 37.4% were hazardous drinkers. However, very few participants had received consultation about alcohol consumption. Of the participants, 37.7% were current smokers, and almost half of them smoked more than one pack of cigarettes daily. The hazardous drinkers smoked much more than the normal drinkers, and their stress levels were higher than that of normal drinkers. Participants aged 40-49 and 50-59 years (odds ratio = 7.91, 95% confidence interval = 1.50-41.70; odds ratio = 7.57, 95% confidence interval = 1.31-43.70), those without stroke (odds ratio = 4.86, 95% confidence interval = 1.33-17.77), and current smokers (odds ratio = 4.24, 95% confidence interval = 2.00-8.98) were more likely to be involved in hazardous alcohol consumption. Successful blood pressure management will necessitate the education of such hypertensive men with consideration of their risk factors.

Activation of the GDNF-inducible transcription factor (GIF) gene promoter by glucocorticoid and progesterone.

Steroid hormones, especially glucocorticoids, exert physiologic effects on dopaminergic neurotransmission and have been implicated in several dopamine-mediated neuropsychiatric conditions. D(2) dopamine receptor gene expression is regulated by the zinc finger-type nuclear protein GDNF-inducible transcription factor (GIF). In this study, we sought to investigate if steroids could regulate transcription of the GIF gene itself. Transient co-transfection of the D(2) expressing neuroblastoma cell line NB41A3 with GIF promoter-luciferase constructs along with expression vectors for steroid hormone receptors showed that activation of glucocorticoid receptors but not estrogen receptors up-regulates transcription from the GIF promoter 5.0-fold. Progesterone receptors, which share the same consensus DNA recognition sequence as glucocorticoid receptors, also activated the GIF promoter. Serial 5'-deletion mutants of the GIF gene upstream region localized the glucocorticoid-responsive segment between nucleotides -128 and -66 relative to the transcription start site. This region contains a putative glucocorticoid-responsive element/progesterone-responsive element (GRE/PRE). Additionally, this fragment of the GIF gene 5'-upstream region activated the heterologous herpes simplex virus thymidine kinase (TK) promoter, which is known to be glucocorticoid and progesterone responsive. Furthermore, glucocorticoid receptor activation up-regulated endogenous GIF gene mRNA expression in NB41A3 cells. These observations demonstrate a molecular basis for glucocorticoid and progesterone-induced up-regulation of GIF gene transcription and provide a mechanism for the modulation of dopamine-mediated behaviors by these hormones.

Predictors of perceived barriers to mammography in korean women.

PURPOSE: The purpose of the study was to investigate the effects of cancer fatalism, breast cancer fear, and health motivation on perceived barriers to mammography in Korean women living in the community. METHODS: The sample for this study was a convenience sample of 138 Korean women. Data were collected through a questionnaire that included Cancer Fatalism, the Breast Cancer Fear Scale, Health Motivation, and the Revised Barriers Scale for Mammography. The data were analyzed by multiple regression using SPSS version 11.0. RESULTS: The level of cancer fatalism was low with a mean of 1.07. The levels of fear of breast cancer, health motivation and barriers to mammography were moderate with means of 27.10, 26.44 and 25.80, respectively. Age (F = 3.22, p = .02) was significantly related to mammography barriers but breast-related characteristics were not significantly associated with any mammography barriers. Health motivation (b =-.34, p = .00) and breast cancer fear (b = .22, p = .00) were predictive variables of perceived barriers to mammography. The model explained 19% of the variance in mammography barriers scores (F = 9.98, p = .00). CONCLUSION: Nurses who work with Korean women for breast cancer screening need to assess these predictive factors, including health motivation and breast cancer fear. Further extensive research will be needed to demonstrate the relationship between breast cancer fatalism and perceived barriers to mammography.

Stress and cigarette smoking in Korean men with diabetes.

The purpose of the study was to investigate the level of stress and cigarette smoking behaviors in Korean men with diabetes and to exam the relationships among them. Data were collected using the questionnaire including background characteristics, modified Brief Encounter Psychosocial Instrument (BEPSI) and the Fagerstrom Tolerance Questionnaire (FTQ). 37% of the participants were current smokers with a mean of 4.22 FTQ score. 22% among the current smokers had a nicotine dependency. 43.1% indicated they were considering quitting smoking within 6 months. The level of stress was not associated with the amount of smoking. However, the level of stress was associated with nicotine dependency. There were no significant differences between the smoking cessation stage and stress. In conclusion, the prevalence of smoking among Korean men with diabetes is high. The large proportion of smokers in the contemplation and preparation stages should be supported by the need for stage-matched interventions targeting this special group of smokers.

Alcohol consumption, cigarette smoking, and subjective health in Korean elderly men.

The purpose of the study was to investigate the level of alcohol drinking, cigarette smoking, and subjective health in elderly Korean men and to examine the relationships among those variables. The data were collected through the questionnaire that includes general characteristics, the quantity-frequency (Q-F) method, and the Fagerstrom Tolerance Questionnaire (FTQ) scale. The prevalence of alcohol consumption was 65.2%, and 28.7% represented heavier drinkers. The prevalence of smoking was 47.0%. Among the smokers, 17.1% elderly men reported nicotine dependence in the medium range. Forty-six percent of subjects reported their health as poor or fair. In conclusion, alcohol drinking and smoking were prevalent among Korean elderly men. These findings show the need to improve strategies for educating elderly men and motivating them to incorporate healthy behaviors.

The relationship of depression to health risk behaviors and health perceptions in Korean college students.

The purpose of this study was to investigate the relationship of depression to health risk behaviors and health perceptions in Korean college students. The sample consisted of 434 students, ranging in age from 18 to 28 years, who were attending four universities in Korea. Data were collected using the Beck Depression Inventory, the Symptom Pattern Scale, and the Short Form Health Survey. Results indicate that the students were mildly depressed. The prevalence of alcohol consumption during the previous month was 84.6% and for smoking it was 33.6%. The majority of the students reported a low occurrence of symptoms of psychological distress and evaluated their health as either very good or good. The level of depression predicted alcohol consumption, symptom pattern, and physical health. Students who were more depressed reported more symptoms and perceived their health as worse compared with those who were less depressed. The students who were less depressed drank more alcohol. Depression did not predict smoking.