Prevalence and risk factors of maternal depression among women who participated in a home visitation program in South Korea.

PURPOSE: The psychosocial health of mother is crucial for healthy prenatal period and early childhood. We investigated the prevalence and risk factors of maternal depression during pregnancy and postpartum among women who participated in a home visitation program in Seoul, South Korea (Seoul Healthy First Step Project, SHFSP). METHODS: We analyzed 80,116 women who participated in the SHFSP, which was launched by Seoul metropolitan government in 2013, and defined peripartum depression as a score ≥ 10 on the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Sociodemographic factors and psychosocial health status were evaluated through a standardized questionnaire completed by participants upon program registration. We calculated the prevalence of women at risk for peripartum depression and evaluated associated factors by multivariable logistic regression analysis. RESULTS: Prevalence of women at risk for peripartum depression was 17.7% (prepartum depression: 14.2%, postpartum depression: 24.3%). Younger maternal age, low income (OR 2.40, 95% CI 2.03-2.84), disability (2.61, 1.96-3.47), single parenthood (3.27, 2.69-3.99), and smoking (2.02, 1.44-2.83) increased the peripartum depression risk. Furthermore, experience of stress, change, or loss over the past 12 months (3.36, 3.22-3.50), history of treatment for emotional issues (2.47, 2.27-2.70), experience of child abuse (1.91, 1.74-2.11), and domestic violence (2.25, 1.81-2.80) increased the risk for peripartum depression, whereas having helpers for the baby (0.62, 0.58-0.67), having someone to talk with (0.31, 0.27-0.35), and considering oneself confident (0.30, 0.29-0.31) decreased the risk. CONCLUSIONS: Policies to reduce and manage peripartum depression should be strengthened, with a focus on high-risk pregnant and puerperal women.

Prevalence and risk factors of clonorchiasis among residents of riverside areas in Muju-gun, Jeollabuk-do, Korea.

We evaluated the status of Clonorchis sinensis infection and potential risk factors among residents of riverside areas (Geumgang) in Muju-gun, Jeollabuk-do (Province), Korea. From January to February 2010, a total of 349 (171 males, 178 females) stool samples were collected and examined by the formalin-ether concentration technique. Also, village residents were interviewed using questionnaires to obtain information about C. sinensis infection-related risk factors. Overall egg-positive rate of C. sinensis was 13.2%. Egg-positive rates were significantly higher in males, farmers, and residents who had lived there more than 20 years, and in residents who had eaten raw freshwater fish than in opposite groups, respectively. However, there was no significant difference between age groups, education levels, cigarette smoking, alcohol drinking, health status, past history of infection, and experience of clonorchiasis medication and examination. Logistic regression analysis was performed to determine risk factors for clonorchiasis. On univariate analysis, the odds ratios for males, farmers, those who had lived there more than 20 years, and who had eaten raw freshwater fish were 2.41, 4.44, 3.16, and 4.88 times higher than those of the opposites, respectively. On multivariate analysis, the odds ratio of residents who had eaten raw freshwater fish was 3.2-fold higher than that of those who had not. These results indicate that residents living in Muju-gun, along the Geum River, Korea, have relatively high C. sinensis egg-positive rates, and the habit of eating raw freshwater fish was the major factor for the maintenance of clonorchiasis.

Impact of the Korea Early Childhood Home-visiting Intervention (KECHI) on child health and development and maternal health: a randomised controlled trial protocol.

INTRODUCTION: Randomised controlled trials (RCTs) of early childhood home-visiting interventions led by nurses have been conducted mainly in Western countries, whereas such trials have been limited in non-Western cultures, including Asia. In South Korea, a national nurse home visit programme (Korea Early Childhood Home-visiting Intervention (KECHI)) was developed in 2020 and launched throughout the country. We designed a pragmatic RCT to evaluate the effectiveness of KECHI on child health and development and maternal health. METHODS AND ANALYSIS: Eligible participants will be pregnant women at <37 weeks of gestation with risk factor scores of 2 or over, who are sufficiently fluent in Korean to read and answer the questionnaire written in Korean and live in districts where the KECHI services are available. Eight hundred participants will be recruited from the general community and through the District Public Health Centres. The participants will be randomised 1:1 to KECHI plus usual care or usual care. KECHI encompasses 25-29 home visits, group activities and community service linkage. Participants will complete assessments at baseline (<37 weeks gestation), 6 weeks, 6 months, 12 months, 18 months and 24 months post partum. The six primary outcomes will be (1) home environment (assessed by Infant/Toddler Home Observation for Measurement of the Environment), (2) emergency department visits due to injuries, (3) child development (assessed using Korean Bayley Scales of Infant and Toddler Development-III), (4) breastfeeding duration, (5) maternal self-rated health and (6) community service linkage. ETHICS AND DISSEMINATION: This trial has received full ethical approval from the Institutional Review Board of the Seoul National University Hospital. Written consent will be obtained from the participants. The results will be reported at conferences, disseminated through peer-reviewed publications and used by the Korean government to expand the KECHI services. TRIAL REGISTRATION NUMBER: NCT04749888.

Prevalence of intimate partner violence victimization among Korean perinatal women and associated factors.

OBJECTIVE: To determine the prevalence of intimate partner violence (IPV) victimization and the factors associated with IPV during pregnancy and the early postnatal period in Korean community samples. METHODS: We enrolled 5953 pregnant mothers and mothers with young children registered in the Early Life Health Management Program provided by 30 public health centers in Korea between 2020 and 2021. We used the Korean Hurt, Insult, Threaten, and Scream (K-HITS) questionnaire to measure IPV. Sociodemographic, social support, and psychosocial variables were collected using self-administered questionnaires. χ2 tests and multiple logistic regression analyses were conducted using SAS. RESULTS: Using a cut-off score of 6 with K-HITS, the prevalence of IPV was 7.6%. According to multivariable logistic analyses, "have seen domestic violence during childhood or adolescence" (odds ratio [OR] 2.61, 95% confidence interval [CI] 1.95-3.50), unplanned pregnancy (OR 2.18, 95% CI 1.73-2.75), depression during pregnancy (OR 2.17, 95% CI 1.69-2.79), history of receiving treatment for emotional problems (OR 1.53, 95% CI 1.07-2.20), and living in a rural area (OR 1.52, 95% CI 1.01-2.29) increased the odds of IPV. "Having someone who talk to" was protective of IPV (for" "Not having someone to talk to": OR 2.24, 95% CI 1.49-3.35). CONCLUSIONS: Policies to prevent and address IPV during the perinatal period are urgently needed in Korea.

The association of women's experience of abuse in childhood with depression during pregnancy and the role of emotional support as a moderator.

BACKGROUND: This study aimed to examine the prevalence of antenatal depression and experience of abuse during childhood, to analyze the association between having experienced childhood abuse and depression during pregnancy, and to explore the role of emotional support as a moderator of that association. METHODS: In total, 44,770 pregnant women were analyzed from the self-administered registry for risk assessment at community public health centers in Seoul, Republic of Korea, for home visiting service provision between 2015 and 2019. The Edinburgh Postnatal Depression Scale (EPDS) was applied for the assessment of depression. The adjusted effects of childhood abuse experience on antepartum depression according to emotional support as an effect moderator were estimated. RESULTS: Depression was present in 2,451 pregnant women (5.5%), and 1,506 (3.4%) reported having experienced physical, emotional, or sexual abuse in childhood. After adjustment of covariates, pregnant women who had experienced abuse during childhood had EPDS scores 2.79 points higher than pregnant women without such experiences, and those who lacked emotional support during adulthood had 4.96 points higher than their counterparts. The difference in EPDS scores based on childhood abuse experience among women who reported emotional support (2.86) was larger than the difference in EPDS scores among those with no emotional support (1.91) (P for interaction = 0.0106). CONCLUSIONS: The experience of abuse in early life and emotional support in later life are both independently important for understanding antenatal depression in Korean women. More comprehensive emotional support is needed for pregnant women who experienced abuse in childhood.

Is a universal nurse home visiting program possible? A cross-sectional survey of nurse home visitation service needs among pregnant women and mothers with young children.

In 2019, the South Korean government established a plan to develop home visitation services for pregnant women and women with children below the age of 24 months and expand the services nationwide. Therefore, a national survey was needed to provide relevant information for the policy decision of whether to implement universal home visitation services by nurses for families with young children. To determine home visitation service needs in South Korea, 804 women who were pregnant or had children below the age of 24 months were selected as survey participants through stratified random sampling by region reflecting geographical distribution in numbers of births. Of them, 614 responded to survey questionnaires delivered via email. After excluding surveys with too short of a response time, extreme values, and incomplete answers, 500 participants' responses were analyzed. Participants indicated whether they supported the provision of home visitation services and whether they were willing to utilize home visitation services. The survey also elicited responses regarding the level of needs for individual service items that could be delivered by nurses during home visits. The fieldwork was conducted by a consulting and research firm. The differences in whether respondents supported nurse home visitation services and intended to use nurse home visitation services according to mothers' characteristics were examined using the chi-square test. In total, 88.0% of survey participants supported nurse home visitation services, and 81.2% indicated that they intended to receive the services. Most pregnant women and women with children below the age of 24 months responded positively to the various prenatal or postpartum services that nurses could provide during home visits. The percentages of support for the services and intention to use services were generally high among subgroups according to mothers' characteristics. Therefore, universal home visitation services by nurses during pregnancy and in the postnatal period would be received well by Korean women.

Differences in intensive care unit work environments among and within hospitals using subscales and a composite measure of the Revised Nursing Work Index.

AIM: To examine variations in nurses' perceptions of their work environments among hospitals and intensive care units, and to compare analytic findings from using subscales and a composite measure of the Revised Nursing Work Index at the hospital and intensive care unit levels. BACKGROUND: A positive relationship has been found between the nurse work environment and outcomes for patients and nurses. Nurses' perceptions of their work environments have been analysed using different analytic approaches. METHODS: A survey was conducted in August-October 2007 that included 817 staff nurses in 39 adult intensive care units of 15 hospitals in South Korea. Seven subscales of the Revised Nursing Work Index were identified from an exploratory factor analysis. The subscales and composite (mean of the seven subscales) for each hospital and intensive care unit were analysed using multilevel regression analyses and classified as good, moderate or poor environments. RESULTS: Considerable variations in the subscales were found among both hospitals and intensive care units. On the composite measure, 2 hospitals were rated as good, 10 moderate and 3 poor; 9 intensive care units were ranked as good, 24 moderate and 6 poor. Even intensive care units within hospitals exhibited variations in the subscales and composite. Most hospitals and intensive care units had mixed (i.e., good, moderate, poor) environments across the seven subscales and thus, subscales were not always congruent with the composite. CONCLUSION: Heterogeneity of the subscales and the composite measure, and the differences among intensive care units within hospitals imply that use of different analytic approaches may reveal different findings and perspectives of nurse work environments.

Low back pain and work-related factors among nurses in intensive care units.

AIM: To examine the relationship of low back pain prevalence and treatment to personal and work-related characteristics among intensive care unit nurses. BACKGROUND: Back pain is the most common work-related health problem among nurses. DESIGN: A cross-sectional study including a survey conducted in 2007. METHODS: The study sample included 1345 nurses in 65 intensive care units in 22 South Korean hospitals. Back pain prevalence was measured by the frequency of back pain (always, once a week, once a month or once in two or more months) during the past year. Multilevel logistic regression analyses were conducted to examine the relationship between back pain and personal and work-related characteristics. RESULTS: The mean age of nurses was 27.2 years. Overall, 90.3% of nurses had back pain at least once a month (21.9% always, 40.7% once a week and 27.7% once a month). Only 18.3% had received medical treatment for their back pain. Compared with neonatal intensive care unit nurses, who had the lowest prevalence, nurses in other specialties, excluding paediatric intensive care units, had a greater likelihood of back pain. Specialty medical (e.g. cardiology, neurology) intensive care unit nurses had the greatest probability of back pain and treatment. Perceiving staffing as inadequate and working 6 or more night shifts per month were related to a 64% increase (OR = 1.64; 95% CI =1.16-2.33) and 48% increase (OR =1.48; 95% CI = 1.10-1.99) in back pain, respectively. Nurses with 2-4 years of working experience in intensive care units had the greatest probability of back pain and treatment. CONCLUSIONS: A high prevalence of back pain was found in intensive care unit nurses, even though they comprise a very young workforce in Korea. RELEVANCE TO CLINICAL PRACTICE: Improving nurse staffing, reducing the frequency of night shifts and assessing risk factors in specific intensive care unit specialties are suggested to decrease back pain prevalence.

Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units.

AIM: To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. BACKGROUND: Nurse staffing has been reported to influence patient and nurse outcomes. DESIGN: A cross-sectional study with a survey conducted August-October 2007. METHODS: The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. RESULTS: The average patient-to-nurse ratio was 2.8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3.26; 95% confidence interval, 1.14-9.31) or 2.0-2.5 patients (odds ratio, 2.44; 95% confidence interval, 1.32-4.52), compared with having more than three patients. Perceived adequate staffing was related to a threefold increase (odds ratio, 2.97; 95% confidence interval, 2.22-3.97) in the odds of nurses' rating high quality and decreases in the odds of dissatisfaction (odds ratio, 0.30; 95% confidence interval, 0.23-0.40), burnout (odds ratio, 0.50; 95% confidence interval, 0.34-0.73) and plan to leave (odds ratio, 0.40; 95% confidence interval, 0.28-0.56). CONCLUSIONS: Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units. RELEVANCE TO CLINICAL PRACTICE: Adequate staffing must be assured to achieve better quality of care and job outcomes.

Predictive validity of automated oscillometric blood pressure monitors for screening atrial fibrillation: a systematic review and meta-analysis.

Background: This study was conducted to verify if automated oscillometric blood pressure monitors (AOBPMs) have sufficiently high predictive validity to screen patients with atrial fibrillation (AF). Methods: Electronic searches were performed to identify all studies published between 1946 and 14 July 2018, from indexed in Ovid-Medline, Embase, the Cochrane Library, and CINAHL by using the following keywords: 'atrial fibrillation,' 'atrial flutter,' 'blood pressure monitor,' and 'sphygmomanometer.' Results: Thirteen diagnostic accuracy studies, including a total of 9,380 elderly, were included in our meta-analysis. The meta-analysis showed that the pooled sensitivity was 0.91 (95% CI, 0.89 to 0.93), and the heterogeneity between studies was as high as 88.4% (X2 = 120.55, p < 0.001). The pooled specificity was 0.96 (95% CI, 0.96 to 0.97), and the heterogeneity between studies was 95.3% (X2 = 299.26, p < .001). The area under the curve (AUC) of the summary receiver operating characteristic (sROC) curve was 0.98 (SE = 0.005), and the Q-value was 0.94 (SE = 0.010). Conclusion: The AOBPM is an appropriate screening tool that may be applied to elderly to verify the presence of AF conveniently. The AOBPM has high applicability in practice, since it may prevent potentially fatal complications such as stroke.

[A study of factors that influence Internet addiction, smoking, and drinking in high school students].

PURPOSE: This study aimed at exploring relationships among Internet addiction, smoking, and drinking and examining the effect factors on Internet addiction, smoking and drinking. METHODS: By using stratified sampling, 1,529 participants representing high school students in the Kangwon province were selected. Data was analyzed by SPSS 12.0. using chi2, Pearson correlation coefficient and multiple regression. RESULTS: One-fifth of the total participants were at the mild or moderate stage of Internet addiction. Regarding smoking, 22.7% of male subjects and 4.5% of female subjects were current smokers. Regarding drinking, the percentages of subjects who drank alcohol once or twice per month were 53.5% of male students and 40.7% of female students. Internet addiction positively correlated with depression, novelty seeking, harm avoidance and reward dependence, Internet addiction negatively correlated with persistence, self-directness, cooperativeness, and self-transcendence. Significant factors affecting Internet addiction were depression, gender, novelty seeking, and self-transcendence. Important factors influencing smoking were drinking, gender, school type, satisfaction with school, novelty seeking, and reward dependence. Significant factors affecting drinking were smoking, novelty seeking, school type and ages. CONCLUSION: This study shows the necessity of developing and implementing effective intervention programs in order to prevent adolescents from experiencing Internet addiction and health risk behaviors.

Socioeconomic disparities in household secondhand smoke exposure among non-smoking adolescents in the Republic of Korea.

This nationally representative study examined (a) gender and age differences in household secondhand smoke exposure (HSHSE) and (b) associations between socioeconomic status (SES) and HSHSE among non-smoking Korean adolescents. Two subsamples were analysed: males (n = 25,648) and females (n = 30,240). The HSHSE measures were incidence of HSHSE (yes/no) and number of days of HSHSE (1-7 days); the SES measures were parental education, perceived economic status, and family wealth. For the first aim, chi-square test, t-test, and bivariate negative binomial regression analysis were performed; For the second aim, multivariate logistic regression and negative binomial regression analyses were performed. The incidence and number of days of HSHSE were significantly higher among females (32.35% and 3.48 days) than males (26.83% and 3.08 days). The HSHSE incidence was significantly higher among younger adolescents (23.32% to 31.08% of males and 26.58% to 37.03% of females). Lower SES was associated with (a) greater odds of HSHSE (odds ratio: 1.12-1.58 among males and 1.19-1.85 among females) and (b) greater incidence rates of HSHSE (incidence rate ratio: 1.05-1.17 among males and 1.10-1.14 among females). Efforts should be made to decrease HSHSE among adolescents, particularly low-SES youth.

Time dependent factors affecting the duration of work disability after compensated low-back pain in South Korea.

The purpose of this study was to investigate the time dependent effects among factors affecting duration of work disability after compensated low-back pain. A postal survey involving 238 compensated workers at 39 companies was performed between January 5, 2004, and March 23, 2004. Cox proportional hazard regression analysis was used to model the effect of demographic, work-related, and injury factors affecting the duration of work disability. The variables that significantly affected the duration of work disability were age, company size, compensation benefit, pain radiation, and diagnosis. In addition, company size and pain radiation showed statistically significant time dependent effect. Consequently, this study found that there were time dependent factors affecting the duration of work disability. A phase-specific analysis would be useful to make policy for the prevention of long-term disability after back injury.

The importance of smoking definitions for the study of adolescent smoking behavior.

PURPOSE: Smoking is the leading cause of death and smoking initiation rarely occurs after adolescence. Thus research on adolescent smoking is crucial. A consistent definition of smoking is important because inconsistent definitions make comparisons across studies an arduous task. Thus, the aim of the study was to suggest future research directions for smoking definitions after examining pitfalls in the literature. METHODS: In this study the literature on adolescent smoking in the U.S. and South Korea was examined, and three types of smoking definitions were identified. Limitations in the studies are identified and future research directions are suggested. RESULTS: In the U.S. literature, smoking definitions can be categorized into three groups: definitions based on stage models, smoking trajectories, and definitions derived from specific data. In the South Korean literature, various levels of smoking have not been differentiated. CONCLUSIONS: While the literature does not provide a definitive answer regarding the definition of smoking, it suggests three issues to consider for future research. First, multiple measures of smoking are more desirable than a one-time measure. Second, theory- or trajectory-based smoking definitions are more desirable than definitions derived from available data. Finally, regularity and amount of cigarette use should be incorporated in defining smoking behavior.

Factors related to nurse staffing levels in tertiary and general hospitals.

BACKGROUND: Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. PURPOSE: To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. METHODS: A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. RESULTS: None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. CONCLUSIONS: The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

Effects of a health-promotion program on cardiovascular risk factors, health behaviors, and life satisfaction in institutionalized elderly women.

This study applied a 3-month health-promotion program to institutionalized elderly people to examine changes in cardiovascular risk factors, health behaviors, and life satisfaction. Twenty-one elderly women with an average age of 77 years participated in the program consisting of cardiovascular risk assessments, Korean traditional dance movements (KTDMs), and health education/counseling. Paired t-tests revealed that the participants exhibited significant reductions in total risk score, improvements in health behaviors and life satisfaction at the end of the program. However, the positive effects tend to decrease at 3 months after the program ended. In conclusion, the health-promotion program using KTDM exercises was safely applicable and beneficial to institutionalized elderly women.

Occupational health nursing practice, education, and research in Korea. An international update.

1. In Korea, occupational health nurses have been working as health managers at the workplace and as part of a hospital based group occupational health service since 1991. The role of occupational health manager, required by law, includes providing preventive and primary care, safety management, and inspection of the work environment. 2. Recently, occupational health nursing practice-based lecture has increased, and more emphasis has been placed on the process of occupational health nursing in both undergraduate and graduate programs. 3. The Korean Association of Occupational Health Nurses and the Korean Academic Society of Occupational Health Nursing have been working to develop professional competence for occupational health nurses since 1991. 4. Until the mid 1990s, occupational health nursing research focused primarily on role and job satisfaction of occupational health nurses. However, the number of research studies has dramatically increased and, gradually, survey studies have been replaced by studies with experimental design.

Prevalence and Risk Factors of Clonorchiasis among the Populations Served by Primary Healthcare Posts along Five Major Rivers in South Korea.

OBJECTIVES: Clonorchiasis is an infectious disease caused by the Chinese liver fluke Clonorchis sinensis. In this study, we investigated the prevalence and risk factors of clonorchiasis among the populations served by primary healthcare posts along five major rivers in South Korea. METHODS: Forty primary healthcare posts that are located less than 5 km from one of the five rivers were selected from 26 counties. For the purpose of the survey, community health practitioners selected the nearest villages from the riversides in their own catchment area. From January to May 2009, a total of 2788 stool samples were collected and examined using the formalin-ether sedimentation technique. Village inhabitants were also interviewed by means of questionnaires in order to obtain information on potential risk factors. RESULTS: THE PREVALENCE RATES OF CLONORCHIASIS AT VARIOUS RIVER BASINS WERE AS FOLLOWS: Seomjin River, 21.3%; Nakdong River, 13.5%; Geum River, 9.2%; Han River, 7.6%; and Yeongsan River, 4.9%. The total number of people infected with C. sinensis was 329 (11.3%). By gender, 14.3% of males and 7.6% of females were infected. In case of both males and females, the prevalence rate was highest in those in their 40s. Consumption of raw freshwater fish was confirmed as a risk factor based on a logistic regression analysis. CONCLUSION: The present findings suggest that clonorchiasis is still highly prevalent among the inhabitants of riverside areas in southern Korea, and, accordingly, it is necessary to implement a systematic control program in the endemic areas.

Working hours and depressive symptomatology among full-time employees: Results from the fourth Korean National Health and Nutrition Examination Survey (2007-2009).

OBJECTIVE: This study aimed to examine the distribution of working hours and the association between working hours and depressive symptomatology using representative data from a national, population-based survey. METHOD: Data came from the fourth Korean National Health and Nutrition Examination Survey (2007-2009), which employed a systematic, stratified cluster-sampling method. We used logistic regression procedures to estimate the importance of weekly working hours as a predictor of depressive symptomatology. RESULTS: The prevalence of depressive symptomatology was 10.2%. The work week, which averaged 48.3 hours for the sample as a whole, was longer for men (49.8 hours) than women (45.3 hours), and 12.1% of respondents were engaged in shift work. In logistic regression analyses, compared to those working < 52 hours per week, the odds ratios (OR) of working hours as a predictor of depressive symptomatology were 1.19 [95% confidence interval (95% CI) 0.77-1.85] for those working 52-59 hours per week and 1.62 (95% CI 1.20-2.18) for those working ≥ 60 hours per week, after adjustment for demographic characteristics, health behaviors, socioeconomic status, employment status, and work schedules. It showed a positive dose-response relationship between working hours and depressive symptomatology (P = 0.0059). CONCLUSIONS: Working hours in Korea are long. There is an association between working hours and depressive symptomatology, and there seems be a trend in working hours and depressive symptomatology.

[Effects of hospital nurse staffing on in-hospital mortality, pneumonia, sepsis, and urinary tract infection in surgical patients].

PURPOSE: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. METHODS: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. RESULTS: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. CONCLUSION: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.