Little Strokes Fell Big Oaks: How Repeated Recommendations for Suicide Reporting Drive the Quality of Suicide News in South Korea.

This study investigates how far repeated releases of recommendations for responsible reporting on suicide (RRS) are associated with changes in the quality of suicide reporting. A content analysis was conducted on suicide news articles (N = 606) by the Korean newspapers Hankyoreh Sinmun and Chosun Ilbo in four six-month periods from 2004 to 2019, which covered the periods before and after the releases of three versions of suicide reporting guidelines. Elements for RRS served as a proxy for the reporting quality, which includes both avoiding negative elements and providing positive ones. Not only the number of suicide news stories reduced by half in the last two observation periods, overall RRS scores and most individual RRS elements increased in the third period, compared to the first or second period. The avoidance RRS for headline, however, was not significantly improved. Korean news media also tended to be sensationalistic in using photos.

The effect of resource loss on depression and peritraumatic distress during the early period of the COVID-19: considering the pandemic-situational and social context.

BACKGROUND: The public experienced loss of resources, including their health and property during the COVID-19 pandemic. The Conservation of Resources (COR) theory is a useful tool to explain the effect of resource loss on mental health. This paper examines the effect of resource loss on depression and peritraumatic distress considering the situational and social context of the COVID-19 pandemic applying COR theory. METHODS: An online survey was conducted for Gyeonggi residents when the second wave of COVID-19 in South Korea declined (5 October to 13 October 2020); 2,548 subjects were included in the hierarchical linear regression analysis. RESULTS: COVID-19 infection-related experiences, resource losses (e.g., financial burden, deterioration of health, and decline of self-esteem), and fear of stigma were related to elevated levels of peritraumatic distress and depression. Risk perception was associated with peritraumatic distress. Reduced income or job loss were related to depression. Social support was a protective factor for mental health. CONCLUSIONS: This study suggests that we need to focus on COVID-19 infection-related experiences and loss of daily resources in order to understand mental health deterioration during the COVID-19 pandemic. Moreover, it is important to monitor the mental health of medically and socially vulnerable groups and those who have lost resources due to the pandemic and to provide them with social support services.

Comparing the Effect of Declarative vs. Procedural Knowledge on Health Behavior Moderated by Outrage Factors.

Knowledge's effect on behavioral responses in a health crisis has been a point of inquiry in many empirical studies that obtained significant findings. However, a variety of knowledge types has been considered in these studies rarely. This study compared the effect of declarative vs. procedural knowledge on behavioral responses to the COVID-19 pandemic. In addition, we examined whether outrage factors, which refer to perceived risk characteristics that are likely to elicit emotional responses, can moderate cognitive knowledge's effect. Data were collected with a survey conducted five months after the first COVID-19 case was confirmed in South Korea. A total of 1,000 respondents completed questions on the two types of knowledge, risk perception, and health behaviors in the pandemic crisis, and three different outrage factors. The results showed that procedural knowledge on how-to-do something was associated significantly with the health behaviors in the crisis, while the declarative knowledge that involves knowing that "something is the case" was not. Further, the outrage factors moderated knowledge's effect in such a way that procedural knowledge's influence on health behaviors diminished when the respondents perceived that the pandemic was uncontrollable. On the other hand, procedural knowledge's effect increased when the outrage factor of fairness was heightened. The implications are discussed in the context of studies of knowledge's effect and the outrage factors' moderation.

The Outrage Effect of Personal Stake, Effect on Children, Dread, and Controllability on COVID-19 Risk Perception Moderated by Media Use.

Public response to the COVID-19 pandemic provides a unique opportunity to study how lay people's risk perception involves their emotive responses. We investigated how outrage factors as emotional responses to risk influence levels of risk perception in the context of the pandemic disease. Furthermore, how media use influences the perception of outrage factors is also examined. A nationwide online survey (n = 1,000) was conducted in South Korea. The survey results indicated that pandemic risk perception was connected to the generic intensity of perceived outrage factors as measured by averaging the perception of multiple outrage factors. Individual outrage factors such as personal stake, effect on children, dread, and controllability directly influenced risk perception regarding COVID-19. When the intensity of media use was considered, individuals with heavy media use perceived outrage factors more intensely than those who used media less frequently. Media use also moderated the outrage effect of catastrophic potential and moral nature on the perception of risk associated with the pandemic disease. For heavy media users, the outrage effect of moral nature was increased, while that of catastrophic potential decreased. The implications of the outrage effect on the pandemic disease risk perception are addressed. Finally, we discuss the meaning of heavy media users' varying levels of vulnerability to outrage effect by moral nature and catastrophic potential.

Dentists' attitudes toward patient-centered care and its predictors: a cross-sectional study in South Korea.

BACKGROUND: Patient-centered care (PCC) has been one of medical practice's most frequently discussed principles. However, attitudes toward PCC among dentists remain underexplored. This study focuses on examining dentists' patient-centered attitudes and investigating their predictors. METHODS: The Patient-Practitioner Orientation Scale which consists of Sharing and Caring subscales was used to assess patient-centered attitudes. The statistical analysis included 217 dentists from South Korea. Hierarchical linear regression analysis was performed to examine the predictors such as sociodemographic aspects, academic factors, work-related factors, and empathy. RESULTS: A patient-centered attitude of Caring subscale (M = 4.29, SD = 0.56) emerged, but the provider-centered attitude was higher in Sharing subscale (M = 3.40, SD = 0.48). Work year, academic track, and empathy were associated significantly with an overall caring aspect of patient-centered attitude, while the gender effect remained insignificant. Empathy had a critical and significant impact on the patient-centered attitude. CONCLUSIONS: Efforts to enhance patient-centeredness in Sharing are needed; post-graduate education and transition to a more patient-centered health system are recommended. Moreover, empathy still matters as it was found to be a significant predictor of patient-centered attitudes. The findings of this study support the need for efforts to enhance patient-centered attitudes among dentists, which will help generate discussion on improving the curriculum of post-graduate education and health system reform.

Perceived sources of occupational burn-out and embitterment among front-line health workers for COVID-19 control in Gyeonggi province, South Korea: a qualitative study.

OBJECTIVES: Front-line health workers (FHWs) for COVID-19 control in South Korea have implemented a labour-intensive contact tracing programme, which places them at high risk for mental health problems. However, a few studies have examined mental health conditions in this population. We employed a qualitative approach to understand the factors perceived as causes of burn-out and embitterment among temporary FHWs to provide recommendations for supporting the workforce. METHODS: We recruited 20 FHWs to participate in semistructured focus group interviews through purposive sampling. The sample size was determined on the basis of data saturation. We collected data from October to November 2020, audiorecording and transcribing the interviews. Data analysis was conducted manually, applying the principles of grounded theory. RESULTS: Five levels of perceived sources of occupational burn-out and embitterment emerged. FHWs showed considerable mistrust of patients and faced ethical dilemmas in accessing and disclosing personal information. Poor collaboration with community health centre workers and interested parties as well as inadequate organisational support aggravated their conditions. Lack of social recognition and employment instability also presented challenges for FHWs' mental health. CONCLUSIONS: The current pandemic response system imposes great moral and emotional burdens on the workforce, prompting the need for initiatives to safeguard the values and needs of those who represent the backbone of the system. This study suggests that multilevel strategies, including providing organisational support and establishing contingency plans for workforce management and resource distribution, may improve FHWs' mental health outcomes as well as the health system for emergency preparedness.

The Correlation Function of Communication in an Emotional Domain Observed in the Effect of Media on Embitterment.

The media correlation function has mainly been evaluated in cognitive domains from theoretical perspectives, such as agenda-setting, framing, or priming. Here we examined the correlation function in an emotional domain by investigating the association between media use and the degree of embitterment, which is a psychological symptom that originates from the accumulation of negative life experiences. A survey of 1,720 South Koreans revealed that those who had higher frequencies of media use felt a greater degree of embitterment. When different media types were examined, frequent use of print newspapers was associated with a level of embitterment from personal experiences, whereas heavy consumption of the internet and TV news was associated with embitterment from mediated reality. The implications of these findings are addressed in the context of both communication function and social epidemiology.

Direct and Indirect Associations of Media Use With COVID-19 Vaccine Hesitancy in South Korea: Cross-sectional Web-Based Survey.

BACKGROUND: The battle against the 2019 novel coronavirus (COVID-19) has not concluded. Despite the availability of vaccines, the high prevalence of vaccine hesitancy represents a significant challenge to public health, and raising vaccine acceptance among the public is critical. Although media has become an increasingly popular source of COVID-19 vaccine-related information, the question of whether and how media use is related to the public's vaccine hesitancy warrants exploration. OBJECTIVE: This study aimed to (1) examine the level of COVID-19 vaccine hesitancy, (2) identify factors associated with COVID-19 vaccine hesitancy, and (3) explore the direct and indirect relationship between media use and vaccine hesitancy through psychological factors. METHODS: A month before COVID-19 vaccination was initiated in South Korea, we conducted a cross-sectional web-based survey over 6 days (January 20-25, 2021). This study included 1016 participants, and a logit model for regression analyzed associations between sociodemographic factors, health-related factors, psychological factors, and media use toward one's COVID-19 vaccine hesitancy. Additionally, we conducted a path analysis to examine the indirect effects of media use on vaccine hesitancy by using psychological factors (ie, perceived risk of COVID-19 infection, perceived benefits, and perceived barriers of COVID-19 vaccination). RESULTS: Among the participants (N=1016), 53.3% (541/1016) hesitated to take the COVID-19 vaccine, while 46.7% (475/1016) agreed to accept the vaccine. Of the sociodemographic factors, female gender (odds ratio [OR] 1.967, 95% CI 1.36-2.86; P<.001), age in 50s (OR 0.47, 95% CI 0.23-0.96; P=.004), and age over 60s (OR 0.49, 95% CI 0.24-0.99; P=.04) were significant individual predictors of COVID-19 vaccine hesitancy. Perceived susceptibility of infection (OR 0.69, 95% CI 0.52-0.91; P=.01) and perceived benefits of vaccination (OR 0.69, 95% CI 0.52-0.91; P=.01) were associated with lower vaccine hesitancy. Perceived barriers of vaccination (OR 1.63, 95% CI 1.29-2.07; P<.001) and lower trust in government (OR 0.72, 95% CI 0.53-0.98; P=.04) were related to vaccine hesitancy. The use of offline and online media as sources for the perceived benefits of vaccination was associated with vaccine hesitancy, resulting in lower vaccine hesitancy. Moreover, perceived susceptibility of the disease and perceived barriers of vaccination mediated the association between social media use and vaccine hesitancy. CONCLUSIONS: Our findings revealed a considerable level of COVID-19 vaccine hesitancy in South Korea. Gender-based and generation-based public health policies and communication are recommended. Efforts to lower the perceived risk of vaccine side effects and heighten perceived benefits of the vaccine are required. Although the use of media has a positive and negative effect on the population's vaccine hesitancy, efforts should be made to disseminate reliable and timely information on media while confronting misinformation or disinformation for successive implementation of vaccine programs during pandemics.

It's Politics, Isn't It? Investigating Direct and Indirect Influences of Political Orientation on Risk Perception of COVID-19.

Public response to the COVID-19 pandemic provides a unique opportunity to study risk perception in relation to political orientation. We tested a risk perception model of how political orientation influences risk perception of an emerging infectious disease and how it moderates other influences. Two nationwide online surveys in South Korea (N = 2,000) revealed that conservatives showed a higher risk perception regarding an emerging infectious disease, and political orientation can even moderate the influence of perceived risk characteristics on risk perception such as how a liberal orientation exhibited a greater outrage effect of perceived unfairness on COVID-19 risk perception. Also, the frequency of media use is positively related to higher risk perception. The implications of the direct and moderating effects of political orientation are discussed in the context of the studies of political orientation as well as risk perception.

Knowledge, attitudes, and practices (KAP) toward COVID-19: a cross-sectional study in South Korea.

BACKGROUND: The public must routinely practice precautionary behaviors to control the spread of COVID-19, as no vaccines and antiviral treatments are currently available. This paper examines the public's knowledge, attitudes, and practices (KAP) related to COVID-19 and their relationships and identified the pandemic's vulnerable populations to provide recommendations for behavioral interventions and policies. METHODS: Data collection took place over 3 days (June 26-29) via an online survey 5 months after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first COVID case in South Korea; 970 subjects were included in the statistical data analysis. RESULTS: Knowledge directly affected both attitudes (e.g., perceived risk and efficacy belief) and practices (e.g., personal hygiene practices and social distancing). Among the influencing factors of COVID-19 preventive behaviors, efficacy belief was the most influential and significant practice factor. It mediated the relationship between knowledge and all three preventive behaviors (wearing facial masks, practicing hand hygiene, and avoiding crowded places). The level of knowledge varied by sociodemographic characteristics. Females (ß = 0.06, p <  0.05) and individuals with higher levels of education (ß = 0.06, p <  0.05) demonstrated higher levels of knowledge. CONCLUSION: To increase precautionary behaviors among the public, health officials and policymakers must promote knowledge and efficacy belief. Future interventions and policies should also be developed in a 'person-centered' approach, targeting vulnerable subgroups, embracing them, and closing the gap of KAP toward COVID-19.

Burnout and peritraumatic distress of healthcare workers in the COVID-19 pandemic.

BACKGROUND: To evaluate the current status of emotional exhaustion and peritraumatic distress of healthcare workers (HCWs) in the COVID-19 pandemic, and identify factors associated with their mental health status. METHODS: An online survey involving 1068 of consented HCWs that included nurses, physicians, and public health officers was conducted in May 2020. Descriptive statistics and multivariate regression analyses were performed on the collected data. RESULTS: Although no significant difference in peritraumatic distress was observed among the surveyed HCWs, the workers' experience of emotional exhaustion varied according to work characteristics. Respondents who were female, older, living with a spouse, and/or full-time workers reported higher levels of emotional exhaustion. Public health officers and other medical personnel who did not have direct contact with confirmed patients and full-time workers had a higher level of peritraumatic distress. Forced involvement in work related to COVID-19, worry about stigma, worry about becoming infected, and perceived sufficiency of organizational support negatively predict emotional exhaustion and peritraumatic distress. CONCLUSIONS: Job-related and emotional stress of HCWs should not be neglected. Evidence-based interventions and supports are required to protect HCWs from mental illness and to promote mental health of those involved in the response to the COVID-19 pandemic.

Exploring News Media Epidemiology of "Embitterment": A Content Analysis of Korean News Coverage between 1990 and 2018.

Embitterment is a newly emerging mental problem that requires a social epidemiological approach. As this emotional state is varied in its manifestation and is pervasive in South Korea, we examined the embittered, those embittering, and causes of embitterment covered in news media in the nation. All news stories appearing between January 1, 1990 and August 31, 2018 in seven major daily newspapers in South Korea were searched for headlines containing "embitterment". A total of 321 news stories were identified for content analysis, which was conducted by two trained coders who examined each article to determine the identity of the embittered and embitters and the causes of and reponses from the embitterment. An inductive method was used to establish major levels for each variable. As a result, victims of disaster and accidents (and their families) were the most frequently embittered group, followed by politicians, laborers, persons of interest and the general public without specification. The three major causes of embitterment were: deprivation of basic life needs and rights, defamation/insult and abuse of power. Liberal newspapers published more "embitterment" stories, especially during conservative regimes. Since the periods of conservative regimes were longer than liberal regimes during the time under investigation, liberal newspapers published more "embitterment" stories than conservative newspapers. The patterns of coverage for the embittered, those embittering, and causes of embitterment also differed according to the political orientation of the newspaper. The implications of the findings from a social epidemiological approach and points requiring further study are discussed.

The Outrage Effect of Personal Stake, Dread, and Moral Nature on Fine Dust Risk Perception Moderated by Media Use.

Outrage factors are perceived characteristics of risk that provoke emotional responses and influence risk perception by individuals. We investigated outrage factors that are associated with risk perception regarding fine dust. A nationwide online survey (N = 1,000) measured the magnitude of 14 perceived outrage factors and media use in a South Korean population. As a result, the hypothetical three outrage factors of personal stake, dread, and moral nature were found to be influential. The risk perception increased when people perceived that the environmental hazard has personal implications or is associated with fearful images and irresponsible government/corporate actions. The risk perception was also heightened when fine dust was thought to cause large-scale damage to many people simultaneously. Those using news media frequently showed higher risk perception than those using it less frequently. However, heavy media users were affected to a lesser degree by the outrage effects voluntariness and effects on children. The implications of the direct and indirect outrage effect are discussed in light of risk perception studies.

Correction: Effects of COVID-19 Emergency Alert Text Messages on Practicing Preventive Behaviors: Cross-sectional Web-Based Survey in South Korea.

[This corrects the article DOI: 10.2196/24165.].

Effects of COVID-19 Emergency Alert Text Messages on Practicing Preventive Behaviors: Cross-sectional Web-Based Survey in South Korea.

BACKGROUND: Sending emergency messages via mobile phone text messaging can be a promising communication tool to rapidly disseminate information and promote preventive behavior among the public during epidemic outbreaks. The battle to overcome COVID-19 is not yet over; thus, it is essential that the public practices preventive measures to prevent the spread of COVID-19. OBJECTIVE: This study aimed to investigate the effectiveness of reading and obtaining information via emergency alert SMS text messages and their effects on the individual's practice of preventive behaviors during the early stages of the COVID-19 outbreak in South Korea. METHODS: A cross-sectional web-based survey comprising 990 participants was conducted over 3 days (March 25-27, 2020). A multivariable logistic regression analysis revealed the sociodemographic factors that might influence the behavior of reading emergency alert text messages. A hierarchical linear regression model estimated the associations between reading emergency alert text messages for each precautionary behavior practiced against COVID-19. Additionally, the indirect effects of reading the text messages on each precautionary behavior via psychological factors (ie, perceived risk and response efficacy) were calculated. All data were weighted according to the 2019 Korea census data. RESULTS: Overall, 49.2% (487/990) of the participants reported that they always read emergency alert text messages and visited the linked website to obtain more information. Factors such as female sex (odds ratio [OR] 1.68, 95% CI 1.28-2.21) and older age (30-39 years: OR 2.02, 95% CI 1.25-3.28; 40-49 years: OR 2.84, 95% CI 1.80-4.47; 50-59 years: OR 3.19, 95% CI 2.01-5.06; 60 years and above: OR 3.12, 95% CI 2.00-4.86 versus 18-29 years) were identified to be associated with a higher frequency of reading the text messages. Participants who always read the text messages practiced wearing facial masks (ß=.074, P=.01) more frequently than those who did not. In terms of social distancing, participants who reported they always read the text messages avoided crowded places (ß=.078, P=.01) and canceled or postponed social gatherings (ß=.103, P<.001) more frequently than those who did not read the text messages. Furthermore, reading text messages directly and indirectly affected practicing precautionary behaviors, as the mediation effect of response efficacy between reading text messages and practicing preventive behaviors was significant. CONCLUSIONS: Our findings suggest that emergency alert text messages sent to individuals' mobile phones are timely and effective strategies for encouraging preventive behavior in public. Sending emergency alert text messages to provide the public with accurate and reliable information could be positively considered by the health authorities, which might reduce the negative impact of infodemics.

A cross-sectional survey of knowledge, attitude, and willingness to engage in spontaneous reporting of adverse drug reactions by Korean consumers.

BACKGROUND: Spontaneous reporting (SR) of adverse drug reactions (ADRs) from patients can be considered as a valuable activity providing both objective and subjective data. However, improving the rate of under-reporting has been a major challenge to ensure successful operation of the SR system. This study aimed to assess knowledge, attitude, and intent to report ADRs and explore the factors contributing to consumers' reporting intent in South Korea. METHODS: Self-administered questionnaire was collected from a sex-, age-, and regionally stratified nationwide convenience sample of consumers using a commercial panel in December 2018. Univariate and multivariate logistic regression analyses were used to explore the factors contributing to the intent to report ADRs by consumers. RESULTS: A total of 1000 respondents were enrolled in the survey; 50.9% were males and the mean age was 44.4 (standard deviation, 13.3) years. While less than 15% of the respondents were aware of the SR system and even fewer (3.4%) had actual experience of SR, however, 59.2% expressed their intent to report ADRs. The positive attitude (adjusted odds ratio [aOR] 3.972, p < 0.001), awareness of the SR system (aOR 2.102, p < 0.01), self-efficacy for SR (aOR 1.956, p < 0.001), and experiences related to ADR counselling with healthcare professionals (OR 2.318, p < 0.001) are the significant factors contributing to reporting intent. CONCLUSIONS: Findings of this study highlight the need for increasing the awareness of the SR system among consumers and empowering them to report ADRs by themselves, which would ultimately improve the drug-safety environment.

Comparing Outrage Effect on the Risk Perception of Climate Change versus Fine Dust.

Public evaluation of risk is influenced by the emotive response to perceived risk characteristics, namely outrage factors. We evaluated which outrage factors contribute to the public perception of two different environmental risks, climate change and fine dust. In particular, the outrage factors of controllability, familiarity, and delayed effect were assessed to determine if they are more salient and influential for climate change than fine dust. A nationwide online survey (N = 1,000) was conducted to measure nine outrage factors and risk perception for both risks in a South Korean population. Although both environmental risks were associated with a similar level of risk perception, catastrophic potential and personal stake were the highest scoring outrage factors for climate change and fine dust, respectively, and were also the strongest influence for the level of each risk perception. Familiarity was more salient for climate change than fine dust, and was influential only for climate change. Delayed effect was more salient for climate change, but was not influential for the perception of both risks. Controllability was more salient for fine dust but had no significant influence on both risk perceptions. Catastrophic potential, dread, personal stake, and trust were common influential outrage factors for both risks. We discuss the significance of an individualistic approach to evaluating outrage effects. In addition, the practical implications of comparing salient and influential outrage factors for both risks were addressed in terms of risk communication.

The Effects of Social Determinants on Public Health Emergency Preparedness Mediated by Health Communication: The 2015 MERS Outbreak in South Korea.

The influence of social determinants and health communication on Public health emergency preparedness (PHEP) as well as the mediating effect of health communication were investigated with respect to the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea. Data were collected through a survey six months after the de facto end of the outbreak and a total of 855 subjects completed the surveys and were included in the analysis. The results suggested that the public's preventive (hand hygiene) and avoidance (avoiding hospitals even when sick) behaviors that were frequently practiced during the pandemic were influenced by their social determinants both direct and indirect pathways. Health communication such as information seeking and processing mediated the effect of social determinants on the behaviors and information seeking was found to have the most significant mediating effect on the relationship between the practice of both preventive and avoidance behaviors and social determinants such as education and age. The results of the present study will deepen our understanding of PHEP by identifying key factors that influence the public's behavioral responses as well as providing information to public health emergency management and health risk communication officials to implement strategies necessary in improving PHEP.

A Comprehensive Examination of the Determinants for Food Risk Perception: Focusing on Psychometric Factors, Perceivers' Characteristics, and Media Use.

Risk characteristics within a psychometric paradigm have been of major concern in studies of food risk perception. This study compared the influence of psychometric factors, perceivers' characteristics (i.e., risk attitude, trust, and favorability of the country of origin), and that of the news media on the levels of food risk perception. The interaction of news media with the other two factors was also examined. A nationwide survey (n = 1,500) was conducted. The foods under investigation were Chinese processed foods and Japanese seafood imported to South Korea. In both cases, hierarchical multiple regression analyses revealed that psychometric factors had the greatest influence on food risk perception, followed by perceivers' characteristics and media use. In addition, our results showed that the effect of perceived benefit and dread in Chinese food were salient only for those with little media use. The implication of the interaction effect on food risk perception is discussed in terms of accessibility and limited capacity of information processing.

Outrage Factors in Government Press Releases of Food Risk and Their Influence on News Media Coverage.

An appropriate level of risk perception should be a critical issue in modern "risk society." There have been many studies on the influences on risk perception. This study investigates whether risk communication scholar Dr. Peter Sandman's outrage factors intensify journalistic attention to health risks from food consumption. A content analysis of a health institution's press releases was conducted to examine 15 outrage factors of food risks conveyed in the governmental risk communication. In addition, the news stories covering the food risks informed by the press releases were calculated to evaluate the relation between outrage factors of a risk and the number of news stories covering the risk. Results showed that controllability was the most salient outrage factor, followed by trust, voluntariness, familiarity, and human origin; the greater the outrage score of a risk, the more news stories of the risk. For individual outrage factors, a risk with an implication of catastrophic potential was associated with an increase of news stories. Food providers' distrustful behaviors also influenced journalistic attention to the food risks. The implication of the findings to health message designers is discussed.