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Purpose@#This study aimed to investigate the influence of body image, self-esteem, and depression on sexual function in young breast cancer survivors. @*Methods@#Data were collected through an online questionnaire from 171 patients under 50 years of age between February and April 2023. The statistical analysis, performed using SPSS/WIN 26.0, included descriptive statistics, independent t-tests, one-way analysis of variance, Pearson’s correlation, and multiple linear regression. The bias-corrected bootstrap method was employed for testing mediation using JASP 0.17.2. @*Results@#Sexual function correlated with body image (r=-.54, p<.001), selfesteem (r=.50, p<.001), and depression (r=-.60, p<.001). Regression analysis revealed depression, age, and cancer stage influenced sexual function. Body image and self-esteem indirectly influenced sexual function through depression. @*Conclusion@#A tailored sexual function improvement program for young breast cancer survivors should consider addressing issues related to body image, selfesteem and depression.
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Purpose@#The aim of this study was to predict the subgroups vulnerable to poorer health-related quality of life (HRQoL) according to gender in older adults. @*Methods@#Data from 5,553 Koreans aged 65 or older were extracted from the Korea National Health and Nutrition Examination Survey. HRQoL was assessed using the EQ-5D tool. Complex sample analysis and decision-tree analysis were conducted using SPSS for Windows version 27.0. @*Results@#The mean scores of the EQ-5D index were 0.93 ± 0.00 in men and 0.88 ± 0.00 in women. In men, poorer HRQoL groups were identified with seven different pathways, which were categorized based on participants’ characteristics, such as restriction of activity, perceived health status, muscle exercise, age, relative hand grip strength, suicidal ideation, the number of chronic diseases, body mass index, and income status. Restriction of activity was the most significant predictor of poorer HRQoL in elderly men. In women, the poorer HRQoL groups were identified with nine different pathways, which were categorized based on participants’ characteristics, such as perceived health status, restriction of activity, age, education, unmet medical service needs, anemia, body mass index, relative hand grip, and aerobic exercise. Perceived health status was the most significant predictor of poorer HRQoL in elderly women. @*Conclusion@#This study presents a predictive model of HRQoL in older adults according to gender and can be used to detect individuals at risk of poorer HRQoL.
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Background@#Korea’s aging population has raised several challenges, especially concerning healthcare costs. Consequently, this study evaluated the association of frailty transitions with healthcare utilization and costs for older adults aged 70 to 84. @*Methods@#This study linked the frailty status data of the Korean Frailty and Aging Cohort Study to the National Health Insurance Database. We included 2,291 participants who had frailty measured by Fried Frailty phenotype at baseline in 2016–2017 and follow-up in 2018– 2019. We conducted a multivariate regression analysis to determine the association between their healthcare utilization and costs by frailty transition groups. @*Results@#After 2 years, changes from “pre-frail” to “frail” (Group 6) and “frail” to “pre-frail” (Group 8) were significantly associated with increased inpatient days (P < 0.001), inpatient frequency (P < 0.001), inpatient cost (P < 0.001 and P < 0.01, respectively), and total healthcare cost (P < 0.001) than “robust” to “robust” (Group 1) older adults. A transition to frailty from “pre-frail” to “frail” (Group 6) resulted in a $2,339 total healthcare cost increase, and from “frail” to “pre-frail” (Group 8), a $1,605, compared to “robust” to “robust” older adults. @*Conclusion@#Frailty among community-dwelling older adults is economically relevant.Therefore, it is crucial to study the burden of medical expenses and countermeasures for older adults to not only provide appropriate medical services but also to prevent the decline in their living standards due to medical expenses.
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Background@#The treatment outcomes of patients with multidrug/rifampin-resistant (MDR/RR) tuberculosis (TB) are important indicators that reflect the current status of TB management and identify the key challenges encountered by TB control programs in a country. @*Methods@#We retrospectively evaluated the treatment outcomes as well as predictors of unfavorable outcomes in patients with MDR/RR-TB notified from 2011 to 2017, using an integrated TB database. @*Results@#A total of 7,226 patients with MDR/RR-TB were included. The treatment success rate had significantly increased from 63.9% in 2011 to 75.1% in 2017 (P < 0.001). Among unfavorable outcomes, the proportion of patients who failed, were lost to follow up, and were not evaluated had gradually decreased (P< 0.001). In contrast, TB-related death rate was not significantly changed (P= 0.513), while the non-TB related death rate had increased from 3.2% in 2011 to 11.1% in 2017 (P < 0.001). Older age, male sex, immigrants, low household income, previous history of TB treatment, and comorbidities were independent predictors of unfavorable outcomes. Of the 5,308 patients who were successfully treated, recurrence occurred in 241 patients (4.5%) at a median 18.4 months (interquartile range, 9.2–32.4) after completion treatment. @*Conclusion@#The treatment outcomes of patients with MDR/RR-TB has gradually improved but increasing deaths during treatment is an emerging challenge for MDR-TB control in Korea. Targeted and comprehensive care is needed for vulnerable patients such as the elderly, patients with comorbidities, and those with low household incomes.
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Purpose@#The aim of this study was to identify the factors explaining protective behaviors against radiation exposure in perioperative nurses based on the theory of planned behavior. @*Methods@#This was a cross-sectional study. A total of 229 perioperative nurses participated between October 3 and October 20, 2021. Data were analyzed using SPSS/WIN 23.0 and AMOS 23.0 software. The three exogenous variables (attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control) and two endogenous variables (radiation protective intention and radiation protective behaviors) were surveyed. @*Results@#The hypothetical model fit the data (χ2/df = 1.18, SRMR = .02, TLI = .98, CFI = .99, RMSEA = .03). Radiation protective intention (β = .24, p = .001) and attitude toward radiation protective behaviors (β = .32, p = .002) had direct effects on radiation protective behaviors. Subjective norm (β = .43, p = .002) and perceived behavior control (β = .24, p = .003) had direct effects on radiation protective intention, which explained 38.0% of the variance. Subjective norm (β = .10, p = .001) and perceived behavior control (β = .06, p = .002) had indirect effects via radiation protective intention on radiation protective behaviors. Attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control were the significant factors explaining 49.0% of the variance in radiation protective behaviors. @*Conclusion@#This study shows that the theory of planned behavior can be used to effectively predict radiation protective behaviors in perioperative nurses. Radiation safety guidelines or education programs to enhance perioperative nurses’ protective behaviors should focus on radiation protective intention, attitude toward radiation protective behaviors, subjective norm, and perceived behavioral control.
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Background@#Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. @*Methods@#The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. @*Results@#The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). @*Conclusion@#A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.
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This study investigated the effects of job embeddedness and resilience on the relationship between job rotation stress and nursing work performance among clinical nurses. Methods: We conducted a nationwide online survey with 205 nurses employed at advanced general or general hospitals. Data were collected from August 17 to October 5, 2021. We analyzed the data using various descriptive statistics, independent t-tests, one-way analysis of variance, Scheffé test, Welch test, Games-Howell test, Pearson's correlation coefficients, multiple regression, and the PROCESS macro with a 95% bias-corrected bootstrap confidence interval. These analyses were conducted using SPSS Windows Software version 23.0 and SPSS PROCESS macro version 3.5.2. Results: Nurses' job embeddedness mediated the relationship between job rotation stress and nursing work performance (B=-0.02, p<.05). Furthermore, their resilience moderated this mediated relationship, also known as moderated mediation, with job embeddedness as the mediating factor (B=-0.02, p<.05). Conclusion: These findings imply that, when devising a strategy to improve the nursing work performance of nurses undergoing job rotation, their resilience levels should be considered. Reducing job rotation stress while concurrently enhancing job embeddedness is essential for enhancing the nursing work performance of nurses with high levels of resilience.
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Purpose@#This study aimed to identify the main keyword, network structure, and main topics of the national petition related to “nursing” in South Korea. @*Methods@#Data were gathered from petitions related to the national petition in Korea Blue House related to the topic “nursing” or “nurse” from August 17, 2017, to May 9, 2022. A total of 5,154 petitions were searched, and 995 were selected for the final analysis. Text network analysis and topic modeling were analyzed using the Netminer 4.5.0 program. @*Results@#Regarding network characteristics, a density of 0.03, an average degree of 144.483, and an average distance of 1.943 were found. Compared to results of degree centrality and betweenness centrality, keywords such as “work environment,” “nursing university,” “license,” and “education” appeared typically in the eigenvector centrality analysis. Topic modeling derived four topics: (1) “Improving the working environment and dealing with nursing professionals,” (2) “requesting investigation and punishment related to medical accidents,” (3) “requiring clear role regulation and legislation of medical and nonmedical professions,” and (4) “demanding improvement of healthcare-related systems and services.” @*Conclusion@#This is the first study to analyze Korea's national petitions in the field of nursing. This study's results confirmed both the internal needs and external demands for nurses in South Korea. Policies and laws that reflect these results should be developed.
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Purpose@#The aim of this study was to assess lipid levels and to identify groups with poor lipid control group among patients with dyslipidemia. @*Methods@#Data from 1,399 Korean patients with dyslipidemia older than 20 years were extracted from the Korea National Health and Nutrition Examination Survey. Complex sample analysis and decision-tree analysis were conducted with using SPSS for Windows version 27.0. @*Results@#The mean levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein cholesterol were 211.38±1.15 mg/dL, 306.61±1.15 mg/dL, 118.48±1.08 mg/dL, and 42.39±1.15 mg/dL, respectively. About 61% of participants showed abnormal lipid control. Poor glycemic control groups (TC ≥ 200 mg/dL or TG ≥ 150 mg/dL or LDL-C ≥ 130 mg/dL) were identified through seven different pathways via decision-tree analysis. Poor lipid control groups were categorized based on patients’ characteristics such as gender, age, education, dyslipidemia medication adherence, perception of dyslipidemia, diagnosis of myocardial infarction or angina, diabetes mellitus, perceived health status, relative hand grip strength, hemoglobin A1c, aerobic exercise per week, and walking days per week. Dyslipidemia medication adherence was the most significant predictor of poor lipid control. @*Conclusion@#The findings demonstrated characteristics that are predictive of poor lipid control and can be used to detect poor lipid control in patients with dyslipidemia.
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Purpose@#The aims of study were to identify the main keywords, the network structure, and the main topics of press articles related to nurses that have appeared in media reports. @*Methods@#Data were media articles related to the topic “nurse” reported in 16 central media within a one-year period spanning July 1, 2019 to June 30, 2020. Data were collected from the Big Kinds database. A total of 7,800 articles were searched, and 1,038 were used for the final analysis. Text network analysis and topic modeling were performed using NetMiner 4.4. @*Results@#The number of media reports related to nurses increased by 3.86 times after the novel coronavirus (COVID-19) outbreak compared to prior. Pre- and post-COVID-19 network characteristics were density 0.002, 0.001; average degree 4.63, 4.92; and average distance 4.25, 4.01, respectively. Four topics were derived before and after the COVID-19 outbreak, respectively. Pre-COVID-19 example topics are “a nurse who committed suicide because she could not withstand the Taewoom at work” andf “a nurse as a perpetrator of a newborn abuse case,” while post-COVID-19 examples are “a nurse as a victim of COVID-19,” “a nurse working with the support of the people,” and “a nurse as a top contributor and a warrior to protect from COVID-19.” @*Conclusion@#Topic modeling shows that topics become more positive after the COVID-19 outbreak. Individual nurses and nursing organizations should continuously monitor and conduct further research on nurses’ image.
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Background@#It was reported that South Korea showed the greatest decline in the fertility rate among the entire OECD countries over the last 30 years with the total fertility rate (TFR) of 0.84 persons in 2020. Despite the efforts of the Korean government, the TFR has decreased constantly. This study intended to analyze the perception of Koreans toward pregnancy and childbirth regarding the low fertility rate in South Korea for understanding the causes of constantly decreased low fertility. @*Methods@#This study carried out an online survey based on 1,002 men and women aged 19 to 59 years old for six days from October 21 to October 26 in 2021 in cooperation with Gallup Korea. This study analyzed the perception of people toward low fertility, the severity of low fertility, and level of interest in low fertility to inspect awareness of the severity of low fertility in South Korea through a survey. @*Results@#It was found that 62%, 52%, and 72% of entire participants, women, and men agreed on a question “It is better to get married”. As for women’s age, a positive response for this question was derived from 34.2% (20s), 43.1% (30s), 53.4% (40s), and 71.4% (50s), respectively (P < 0.001). In a question “the necessity of children”, a positive response for this question was derived from 34.7% (20s), 58.3% (30s), 75.9% (40s), and 83.5% (50s) of female respondents, respectively (P < 0.001). Positive responses were shown 39.2%, 60.0%, 79.7%, and 81.5% of female participants in their 20s, 30s, 40s, and 50s agreed on the question “My children make me happy in my life”, respectively (P < 0.001). @*Conclusion@#This study found that a decrease in the TFR was affected mainly by the negative perception of women in their 20s and 30s toward marriage, childbirth, and the necessity of children. Therefore, further research should be conducted to develop policies that focus on these significant variables to overcome the worsening low fertility problem.
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We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.
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Pregnancy is a period of various hormonal changes; furthermore, since pregnancy and childbirth itself are major stressors, pregnant women are inevitably vulnerable to psychiatric disorders. The emotional changes during postpartum blues, the anxiety experienced by about half of all mothers in the first week after childbirth, are usually temporary; they peak 4–5 days after delivery and then normalize after 10 days. Postpartum depression, however, is a disease that occurs frequently in mothers, and its incidence has been increasing due to sociocultural changes. In Korea, interest in postpartum depression is growing due to the government's efforts to promote maternal health. The national policy provides support to overcome the low fertility rate and to change social perceptions, but there is still insufficient medical intervention for mothers at high risk of postpartum depression. Considering the negative effects of mental health disorders on mothers and childrearing, we propose plans for more active, early intervention and the prevention of prenatal and postpartum depression.
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Implant placement may be restricted by anatomical and/or financial limitations in restoring a completely edentulous arch, or the patients’ unwillingness to have extensive surgical procedures. Implant assisted removable partial dentures (IARPD) in combination with anterior fixed implant prostheses can be proposed as an alternative treatment option for the restoration of a completely edentulous arch. In this case, a 56-year-old female patient who has a fully edentulous maxilla opposed by partially edentulous mandible was treated. The treatment option for the maxilla consisted of an implant-assisted removable partial denture supported by four anterior fixed implant prostheses. The mandible was restored with 8 anterior fixed partial dentures and posterior fixed implant-supported prostheses.Long-term follow-up and supportive periodontal treatment were performed for 9years, and the patient was satisfied with the overall appearance as well as masticatory function.
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Purpose@#This study was performed to assess the level of blood glucose and to identify poor glycemic control groups among patients with type 2 diabetes mellitus (DM). @*Methods@#Data of 1,022 Korean type 2 DM patients aged 30-64 years were extracted from the Korea National Health and Nutrition Examination Survey VII. Complex samples analysis and a decision-tree analysis were performed using the SPSS WIN 26.0 program. @*Results@#The mean level of hemoglobin A1c (HbA1c) was 7.22± 0.25%, and 69.0% of the participants showed abnormal glycemic control (HbA1c≥ 6.5%). The characteristics of participants associated with poor glycemic control groups were presented with six different pathways by the decision-tree analysis. Poor glycemic control groups were classified according to the patients’ characteristics such as period after DM diagnosis, awareness of DM, sleep duration, gender, alcohol drinking, occupation, income status, low density lipoprotein-cholesterol, abdominal obesity, and number of walking days per week. Period of DM diagnosis with a cut-off point of 6 years was the most significant predictor of the poor glycemic control group. @*Conclusion@#The findings showed the predictable characteristics of the poor glycemic control groups, and they can be used to screen the poor glycemic control groups among adults with type 2 DM.
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Purpose@#The aims of this study were to assess the status of physical activity (PA) and to identify the association with physiological indicators, hand grip strength, stress, and health-related quality of life (HRQoL) among cancer survivors. @*Methods@#Data of 999 Korean cancer survivors aged 19 and older were extracted from the Korea National Health and Nutrition Examination Survey (VII, 2016-2018; VIII-1, 2019). Complex samples analysis was performed using the SPSS/WIN 26.0 program. @*Results@#The percentage of recommended levels of aerobic PA, walking, and muscle strength training was 43.8%, 19.3%, and 21.6%, respectively. Compared to the PA group, the non-aerobic PA group had a higher ratio in abnormal systolic blood pressure and triglyceride level; the non-walking group had a higher ratio in abnormal diastolic blood pressure, and normal total cholesterol and abnormal high sensitive C-reactive protein (hs-CRP) levels; and the non-muscle strength training group had a higher hs-CRP level. The non-aerobic PA or non-muscle strength training group had low hand grip strength. The non-walking group perceived high stress, and all non-PA subgroups showed low HRQoL. @*Conclusion@#This study provides useful results for predicting PA types that can be utilized to improve physiological function, stress, and HRQoL for cancer survivors, thus providing empirical evidence for developing PA intervention.
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As the perception on abortion changes into a social problem, it is high time to also change the notion of criminalizing abortion. This necessitates the creation of societal structures that will respond to it. This study aimed to review the abortion counseling system that responds to the pregnancy and childbirth crisis. We conducted a review of the literatures and documentations made available through search engines, including cases overseas. In addition, we analyzed the currently operating pregnancy and childbirth-related service systems and reviewed the issues being discussed in Korea regarding artificial abortion. Based on these analyses, we suggest steps that can be taken for the revision of the law as Constitutional Discordance determining on abortion clause of criminal law. In addition, we propose a plan to establish an appropriate abortion counseling system that will respond to the domestic pregnancy and childbirth crisis.
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Purpose@#To investigate potential differences in the frequency of preterm births (PTB) between pregnancies with or without prophylactic cerclage in women with a history of conization. @*Materials and Methods@#We identified women who had their first singleton delivery after conization between 2013 and 2018 using records in the National Health Insurance Service of Korea claims database. We only included women who had undergone a health examination and interview within 2 years before delivery. We used timing of maternal serum alpha-fetoprotein (MSAFP) tests to differentiate early (before) from late (after the MSAFP test) cerclage. The frequency of adverse pregnancy outcomes, including PTB, preterm labor and premature rupture of membranes, antibiotics and tocolytics use, cesarean delivery, and number of admissions before delivery, were compared. @*Results@#A total of 8322 women was included. Compared to the no cerclage group (n=7147), the risks of adverse pregnancy outcomes were higher in the cerclage group (n=1175). After categorizing patients with cerclage into two groups, the risk of PTB was still higher in the early cerclage group than in the no cerclage group after adjusting for baseline factors (4.48%, 30/669 vs. 2.77%, 159/5749, odds ratio 2.42, 95% confidence interval 1.49, 3.92). Other adverse pregnancy outcomes were also more frequent in the early cerclage group than the no cerclage group. @*Conclusion@#Early cerclage performed before MSAFP testing does not prevent PTB in pregnancy with a history of conization, but increases the risk of adverse pregnancy outcomes, including PTB.
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Purpose@#This study explored the level of Rehabilitation Adherence (RA) in patients with stroke receiving rehabilitation treatment and identified the impact of health literacy and illness perception on RA. @*Methods@#A total of 163 patients with stroke were recruited during hospitalization for rehabilitation treatment in a descriptive cross-sectional study. Data were collected from August 25, 2018 to October 30, 2018 using self-report structured questionnaires and analyzed using descriptive statistics and hierarchical regression analysis with SPSS/WIN 26.0 program. @*Results@#The mean score for RA in participants was 3.02±0.49 (range 1~4). Men (t=2.12, p=.035), family caregiver (F=6.59, p=.002), hemorrhagic stroke (t=-2.78, p=.006), shorter period in disease diagnosis (≤12 month) (F=7.49, p=.001) and need of someone’s help for activities of daily living (F=5.20, p=.006) were associated with higher RA. Hierarchical regression analysis showed that health literacy and emotional illness perception explained RA by additional 26%p and 3%p, respectively. Higher health literacy, higher perception about concern and emotional response about disease were effective factors of higher RA in stroke patients. Health literacy was the strongest variable to explain RA among patients with stroke. @*Conclusion@#The study provides insight into how health literacy and emotional illness perception promote RA in stroke patients. It suggests that health literacy and illness perception need to be considered in developing a nursing intervention to increase RA for patients with stroke receiving rehabilitation treatment.
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Purpose@#This descriptive study aimed to explore the performance, nurses' perception, and influencing contexts of intentional rounding (IR), and to identify the factors influencing the performance of IR. @*Methods@#498 questionnaire responses were collected from clinical nurses with more than six months of work experiences in general wards performing IR in a general hospital. @*Results@#The mean scores of the performance, nurses' perception, and influencing contexts of IR were 3.81(±0.68), 3.46(±0.42), and 3.79(±0.51) out of 5.00, respectively. There were significant differences in performance (F=20.51, p<.001) and nurses' perception (F=4.96, p=.001) based on the work department. There were significant differences in the influencing contexts based on age (F=6.02, p=.003) and the length of clinical experience in the ward (F=3.36, p=.010). Performance and nurses’ perception(r=.42, p<.001), performance and influencing contexts (r=.46, p<.001), and nurses' perception and influencing contexts (r=.58, p<.001) showed a statistically positive correlation. Work unit (F=10.45, p<.001), nurses' perception of the benefits to patients (F=-2.46, p=.014) and to nurses (F=4.34, p<.001), and influencing contexts at the individual (F=7.77, p<.001) and department levels (F=2.99, p=.003) were found to be significant factors on the performance of IR. @*Conclusion@#It is necessary to support the education programs and active participation of nurses in their role as leaders to raise their awareness regarding the benefits of IR. Furthermore, there is a need to adapt the IR protocol according to the unique characteristics of each unit and evaluate the effectiveness.