The residential, area-specific prevalence and associated factors of suicidal ideation among South Korean adolescents.

Objectives: This study investigated the residential, area-specific prevalence and associated factors of suicidal ideation among adolescents in South Korea, based on nationally representative data. Methods: A secondary analysis was performed using the database of the 17th Korean Youth Health Behavior Survey, which contained data from 54,848 adolescents. Results: Female adolescents (more influential in counties), low economic status (more influential in metropolitan cities), perceived stress (more influential in metropolitan cities), depression (more influential in counties), loneliness (more influential in counties), and anxiety (more influential in counties) were influencing factors in all areas, and the factors associated with suicidal ideation differed by residential area. The factors related to suicidal ideation were similar by residential area, but the degree of relevance differed from area to area; in particular, the prevalence of variables related to mental health (depression, loneliness, and anxiety) was high in counties. Alcohol drinking was significant only in small- and medium-sized cities in terms of suicidal ideation. Conclusion: Suicide prevention programs for adolescents should be implemented given the higher incidence of suicidal ideation among female adolescents, the greater influence of mental health-related variables in counties, and the influence of smoking in cities. There were differences in the prevalence and risk factors of suicidal ideation by residential areas.

Effective service coverage of long-term care among older persons in South Korea.

BACKGROUND: Global population aging, and the accelerated increase in the number of oldest-old adults, over 80 years, has implied a heightened need for long-term care (LTC). We aimed to provide a theoretical care cascade of LTC services to assess publicly funded LTC (Analysis 1) and to investigate the association between the use of LTC insurance (LTCI) and unmet care needs among older people (Analysis 2) in South Korea. METHODS: Analysis 1 used data from the eighth wave (2020) of the Korean Longitudinal Study of Aging (KLoSA), the 2020 National Health Insurance Service LTCI Statistical YearBook and the 2020 National Awareness Survey of LTCI. The care cascade consisted of the target population, service contacts, coverage and outcomes. Analysis 2 used the fifth to eighth waves of KLoSA, and LTCI analysis was based on three groups: not aware, aware but do not use and aware and use. Unmet care needs were defined as the absence of help among older people with care needs. RESULTS: Among 8,489,208 people aged 65 or older in 2020, 1,368,148 (16.1%) were estimated to want care. Of these, 62.7% (N = 857,984) had LTCI service contact and 807,067 (94.1%) of those had used LTCI services in the past year (Analysis 1). Older people who were aware and used LTCI were less likely to report unmet activities of daily living (ADL) (prevalence ratio (PR): 0.34, 95% confidence interval (CI): 0.18-0.66) or unmet instrumental ADL (IADL) needs (PR: 0.27, 95% CI: 0.17-0.43) than those who were not aware (Analysis 2). CONCLUSIONS: This article provides a theoretical cascade to assess LTC provision in South Korea and a preliminary model for other countries. Korea's LTCI is associated with reduced unmet ADL and IADL needs.

Trends in Obesity and Obesity-Related Risk Factors among Adolescents in Korea from 2009 to 2019.

This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13-18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents' sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies.

Improving the quality of long-term care services in workforce dimension: expert views from Australia and South Korea.

BACKGROUND: The long-term care workforce is an essential factor in the provision of qualified long-term care services. Identifying workforce issues can help developing countries in East Asia and the Pacific prepare for the increase in the older population. Their experiences can be used as lessons for other countries. This study aimed to identify the workforce issues that should be addressed in order to provide high-quality long-term care services for older adults. METHODS: In-depth interviews and content analysis were conducted with a purposive sample of long-term care experts. There were eight participants from Australia and 14 from South Korea. The participants were questioned on important workforce issues to improve the quality of long-term care services. These were open-ended questions that comprised ideas derived from the literature. Major themes were systematically and comprehensively classified and coded to examine recurring comments and themes. RESULTS: The issues in the two countries were very similar: labor shortages, inadequate working conditions, insufficient career and staff training, and the need of counselors or consultants for finding proper services. There were also differences in terms of competency of the service operators and their corresponding multicultural competency. CONCLUSIONS: Providing high-quality long-term care service requires multipronged approaches to workforce capacity and work environment. An adequate and competent workforce should be established to match the service needs of the older population. To improve quality, better working conditions and improved motivation to work in care for older people should be considered. Concurrently, each country would need a workforce strategy tailored to different conditions and environments. This should include policies to induce an influx into the workforce.

What long-term care interventions have been published between 2010 and 2020? Results of a WHO scoping review identifying long-term care interventions for older people around the world.

OBJECTIVE: The global population is rapidly ageing. To tackle the increasing prevalence of older adults' chronic conditions, loss of intrinsic capacity and functional ability, long-term care interventions are required. The study aim was to identify long-term care interventions reported in scientific literature from 2010 to 2020 and categorise them in relation to WHO's public health framework of healthy ageing. DESIGN: Scoping review conducted on PubMed, CINHAL, Cochrane and Google Advanced targeting studies reporting on long-term care interventions for older and frail adults. An internal validated Excel matrix was used for charting.Setting nursing homes, assisted care homes, long-term care facilities, home, residential houses for the elderly and at the community. INCLUSION CRITERIA: Studies published in peer-reviewed journals between 1 January 2010 to 1 February 2020 on implemented interventions with outcome measures provided in the settings mentioned above for subjects older than 60 years old in English, Spanish, German, Portuguese or French. RESULTS: 305 studies were included. Fifty clustered interventions were identified and organised into four WHO Healthy Ageing domains and 20 subdomains. All interventions delved from high-income settings; no interventions from low-resource settings were identified. The most frequently reported interventions were multimodal exercise (n=68 reports, person-centred assessment and care plan development (n=22), case management for continuum care (n=16), multicomponent interventions (n=15), psychoeducational interventions for caregivers (n=13) and interventions mitigating cognitive decline (n=13). CONCLUSION: The identified interventions are diverse overarching multiple settings and areas seeking to prevent, treat and improve loss of functional ability and intrinsic capacity. Interventions from low-resource settings were not identified.

Socioeconomic Vulnerability Index and Obesity among Korean Adults.

Examining the socioeconomic vulnerability-obesity relationship is a different approach than comparing obesity rates according to the socioeconomic level. This study explored the socioeconomic vulnerability-obesity relationship among Korean adults. This secondary analysis used data from the Korea National Health and Nutrition Examination Survey, which were collected nationwide from participants aged 30-64 years. Seven socioeconomic indicators (education level, residential area, personal income level, household income level, food insecurity, house ownership, and national basic livelihood security beneficiary status) were used to create the socioeconomic vulnerability index. The prevalence of obesity was higher in the lowest socioeconomic vulnerability index quartile than in the highest socioeconomic vulnerability index quartile (odds ratio = 1.31; 95% confidence interval = 1.13-1.52) after adjusting for gender. When developing future interventions for the prevention and management of obesity, health care providers and researchers need to consider the differences in socioeconomic vulnerability index in adults.

Gender Differences in Harmful Use of Alcohol Among Korean Adults.

OBJECTIVES: Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults. METHODS: We analyzed the data from the 2012-2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20-64 years (N = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chi-squared tests and multiple logistic regression analyses were conducted. RESULTS: The prevalence of harmful alcohol use (Alcohol Use Disorders Identification Test score ≥ 16) was 10.7% in the total sample; 18.4% in men and 3.4% in women, which constituted a significant difference. Education, marital status, smoking, perceived stress, and depressive feeling were associated with harmful drinking in both genders. However, household income, occupation, and perceived health status were associated with harmful drinking only in men. CONCLUSION: Since there are gender differences in harmful drinking and alcohol dependence, gender tailored prevention and intervention strategies for alcohol dependence are necessary including consideration of smoking, stress, and depressive feeling.

[Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph].

PURPOSE: This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community. METHODS: Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion. RESULTS: School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity. CONCLUSION: To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.

The Cognitive Impact of Chronic Diseases on Functional Capacity in Community-Dwelling Adults.

BACKGROUND: People with chronic diseases may experience poor cognitive functioning associated with advanced age, progression of disease, or other comorbid chronic conditions. Empirical evidence of this phenomenon is limited despite the clinical relevance of cognitive decline and associated adverse outcomes such as poor physical functioning. PURPOSE: The purpose of this study was to examine cognitive functioning in the domains of memory, attention, and executive function and its association with functional capacity in a sample of community-dwelling adults with a spectrum of chronic diseases. METHODS: An exploratory cross-sectional study was conducted in a sample of community-dwelling adults with chronic diseases, including hypertension (58.9%), diabetes mellitus (DM; 20.0%), and dyslipidemia (14.4%). Participants' mean age was 64.1 ± 11.2 years, and 48.9% were male. Ninety persons completed the face-to-face interviews, which evaluated cognitive functioning in the domains of memory, attention, and executive function using neuropsychological tests and the physical well-being test, which measured functional capacity using the Duke Activity Status Index. RESULTS: Compared with those with other chronic diseases, our sample with hypertension and DM had significantly more memory loss and poorer executive function. These significant differences were nullified when adjusting for age, gender, and education. Approximately one third had functional limitations (n = 29, 32.2%), using a cutoff point of 35 or less (Duke Activity Status Index). Memory loss (delayed recall, b = 1.5, p = .016) and poor executive function (Trail Making Test Part A, b = -0.2, p < .001) were predicting factors of functional decline, independent of age, gender, education, and comorbidity. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Cognitive function, particularly memory and executive function, was poorer among chronically ill Korean adults in the community with hypertension or DM than their counterparts. Functional decline was worse in the presence of memory loss and poor executive function. Studies examining the mechanism by which overall functioning is impacted by cognitive decline and its relevance to functional declines in a larger representative sample are warranted.

Association between sleep quality and nurse productivity among Korean clinical nurses.

AIMS: To determine the association between sleep quality and nurse productivity. BACKGROUND: Although poor sleep quality may decrease nurses' productivity, the association between the two has not yet been evaluated in the literature. METHODS: A cross-sectional survey was completed in May 2014 by 188 nurses working in acute hospitals in South Korea using the Pittsburgh Sleep Quality Index. Descriptive statistics, t tests, ANOVA, Pearson's correlation, and stepwise multiple regression were conducted for data analysis. RESULTS: The prevalence of poor sleep quality was high (79.8%). Among the components of sleep quality, sleep disturbances (ß = -0.19) and subjective sleep quality (ß = -0.16) were determined to be statistically significant predictive factors of nurse productivity, in addition to shift work (ß = -0.20) and age (ß = 0.32). CONCLUSION: Poor sleep quality may lead to lower nurse productivity. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders and executives should consider measures to improve nurses' sleep quality and enhance nurse productivity. Steps that need to be considered include longer intervals between shift-work cycles, clockwise scheduling order, a longer break time after night shift work, allowing nurses to nap before / during a night shift, and providing a worksite healthy sleep programme.

Memory loss and decreased executive function are associated with limited functional capacity in patients with heart failure compared to patients with other medical conditions.

BACKGROUND: There is limited evidence on the degree of cognitive impairment and its association with physical functional capacity among patients with heart failure (HF) in Korea. OBJECTIVES: In this study, we compared cognitive impairment between patients with HF and community-dwelling participants with non-HF medical conditions (medical participants) and its association with physical functional capacity. METHODS: We conducted a cross-sectional comparative study and assessed the neuropsychological cognitive status (Seoul Neuropsychological Screening Battery) and physical functional capacity (Duke Activity Status Index) of patients with HF and medical participants using face-to-face interviews. RESULTS: One hundred and eighteen patients with HF (age, 65.45 ± 9.38 years; men, 57.6%; left ventricular ejection fraction, 34.93 ± 8.72%) and 83 medical participants (age, 66.02 ± 8.28 years; men, 47.0%) were included. Using seventh-percentile medical participant Z-scores as cutoffs, memory and executive function were worse in patients with HF than in medical participants: immediate (35.0% vs. 6.0%) and delayed recall memory (34.5% vs. 8.4%), and executive function (28.6% vs. 6.0%). Independent of age, sex, education, comorbidity, and HF status, executive function was a significant predictor of physical functional capacity (b = 1.82, p = .021). CONCLUSIONS: More patients with HF had impaired memory and executive function, which were associated with their physical functional capacities.

Factors Influencing Patient-Perceived Satisfaction With Community-Based Case Management Services.

This study aimed to identify factors that significantly affect patient-perceived satisfaction with community-based case management services and provide practical strategies for improving patient-perceived quality of care. Secondary data analyses were performed in 2010, 2013, 2015, and 2016, which included Pearson's and Spearman's correlation, Mann-Whitney U and Kruskal-Wallis tests, and stepwise multiple regression. The response variable was measured by the Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM; a 10-level Likert-type scale), whereas explanatory variables were derived from prior studies. Significant predictors of patient-perceived satisfaction with community-based case management services included "capacity to change," "patient-perceived time spent with a case manager," "support/advocacy," "working period," and "emotional connectedness."

Comparisons of Cardiometabolic Biomarkers, Lifestyle Behaviors, and Dietary Sodium and Potassium Intake in a Representative Sample of Korean Adults with and without Cardio-cerebrovascular Diseases.

PURPOSE: To compare the cardiometabolic condition of obesity, blood pressure (BP), cholesterol, dietary sodium and potassium intake, and lifestyle behaviors of persons with cardio-cerebrovascular diseases, with those who are disease-free in Korea. METHODS: A secondary data analysis was conducted using a representative sample of Korean adults. RESULTS: Of 10,906 Korean adults (mean age 43.12 ± 0.24 years, women 50.4%), 9,074 were disease-free and 1,520 had hypertension, 137 stroke, and 175 ischemic heart disease. Compared with the disease-free group, obesity, BP, and total cholesterol were higher for the hypertensives. 25.5% of ischemic heart disease group were still smoking; 14.9% of hypertensives were heavy alcohol drinkers. Physical activity was lower in cardio-cerebrovascular diseases than disease-free group. No significant association was found between Na/K ratio adequacy and types of cardio-cerebrovascular diseases. CONCLUSION: The cardiometabolic condition varied, with hypertensives having a higher prevalence for obesity, high BP, and cholesterol; poorer adherence to the behavioral recommendations was also noted in cardio-cerebrovascular diseases. Such variations in cardiovascular risks would provide implications for addressing vulnerability across groups.

Evolutionary History of Chemosensory-Related Gene Families across the Arthropoda.

Chemosensory-related gene (CRG) families have been studied extensively in insects, but their evolutionary history across the Arthropoda had remained relatively unexplored. Here, we address current hypotheses and prior conclusions on CRG family evolution using a more comprehensive data set. In particular, odorant receptors were hypothesized to have proliferated during terrestrial colonization by insects (hexapods), but their association with other pancrustacean clades and with independent terrestrial colonizations in other arthropod subphyla have been unclear. We also examine hypotheses on which arthropod CRG family is most ancient. Thus, we reconstructed phylogenies of CRGs, including those from new arthropod genomes and transcriptomes, and mapped CRG gains and losses across arthropod lineages. Our analysis was strengthened by including crustaceans, especially copepods, which reside outside the hexapod/branchiopod clade within the subphylum Pancrustacea. We generated the first high-resolution genome sequence of the copepod Eurytemora affinis and annotated its CRGs. We found odorant receptors and odorant binding proteins present only in hexapods (insects) and absent from all other arthropod lineages, indicating that they are not universal adaptations to land. Gustatory receptors likely represent the oldest chemosensory receptors among CRGs, dating back to the Placozoa. We also clarified and confirmed the evolutionary history of antennal ionotropic receptors across the Arthropoda. All antennal ionotropic receptors in E. affinis were expressed more highly in males than in females, suggestive of an association with male mate-recognition behavior. This study is the most comprehensive comparative analysis to date of CRG family evolution across the largest and most speciose metazoan phylum Arthropoda.

Korean Patient-Perceived Satisfaction Scale of Community-Based Case Management Services (Korean-PSCCM): Development and Psychometric Evaluation.

This study aimed to develop and psychometrically test an instrument for measuring patient-perceived satisfaction with community-based case management services in Korea. The study was conducted in 4 phases: Phase I, development of the instrument; Phase II, pilot testing of the instrument; Phase III, a large-scale study to test reliability and validity; and Phase IV, conversion of the new instrument from Korean to English. The new instrument was determined to have six factors-advocacy of case manager, outcome of care, communication skills, practice of a healthy lifestyle, referral, and recognition of risk factors-and also shown to be reliable.

[Development and Evaluation of Allergic Rhinitis-Specific Quality of Life (ARSQOL) Scale for Adults].

PURPOSE: The purpose of this study was to develop an Allergic Rhinitis-Specific Quality of Life (ARSQOL) scale and verify its validity and reliability. METHODS: ARSQOL was developed in 5 steps. Items for the preliminary instrument of ARSQOL were developed through a literature review and deep interviews with allergic rhinitis patients. Face validity with Content Validity Index (CVI), construct validity using factor analysis, and known group comparison, criterion validity test using correlation between ARSQOL and total nasal symptoms score (TNSS) were conducted to evaluate the validity of ARSQOL. Cronbach's α was used to evaluate the reliability of ARSQOL. RESULTS: CVI for the items in the final ARSQOL were .92. Five factors including discomfort associated with nasal symptoms (4 items), physical function (7 items), mental function (5 items), sleep disorder and social function (4 items), and problems of daily life (6 items) were identified through factor analysis and these five factors explained 66.6% of the total variance. The correlation coefficient between TNSS and the total score of life quality was -.69. In the group comparison, the persistent allergic rhinitis group showed lower ARSQOL scores than the intermittent patient group, and moderate to the severe allergic rhinitis patient group presented poorer ARSQOL than the mild symptom patient group. The Cronbach's α reliability coefficient was .95. CONCLUSION: Results show that the ARSQOL has good reliability and validity and thus ARSQOL is a useful scale for clinical practices and research as a measure of quality of life in adults with allergicr hinitis.

[Frailty and its related Factors in Vulnerable Elderly Population by Age Groups].

PURPOSE: This study aimed to investigate factors affecting frailty by age groups among vulnerable elders in Korea. METHODS: In this secondary analysis, data were collected from records for 22,868 eldesr registered in the Visiting Health Management program of Publci Health Centers in 2012. Health behaviors, clinically diagnosed disease, frailty, depression and cognitive condition were assessed. Data were analyzed using stepwise regression to determine the associated factors of frailty by age group. RESULTS: Alcohol consumption, physical activity, number of diseases, DM, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors significantly associated with frailty among the elders aged 65~74 (F=135.66, p<.001). Alcohol consumption, physical activity, CVA, arthritis, urinary incontinence, depression and cognitive condition were found to be factors associated with frailty in the elders aged 75~84 (F=245.40, p<.001). Physical activity, CVA, arthritis, depression and cognitive condition were factors associated with frailty in the elders over 85 years of age (F=96.48, p<.001). CONCLUSION: The findings show that frailty of elders and associated factors were different by age group, and common factors affecting frailty were physical activity, CVA, arthritis, depression and cognitive condition. Thus, these factors should be considered in the development of intervention program for care and prevention of frailty and program should be modified according to age group.

The Impact of a Nurse-Led Home Visitation Program on Hypertension Self-Management among Older Community-Dwelling Koreans.

OBJECTIVES: To examine the impact of a nurse-led home visitation program for hypertension self-management among older community-dwelling Koreans. DESIGN AND SAMPLE: As part of a larger community-based home visitation project aimed at behavioral change in this vulnerable population, a single group pre- and posttest design was used. MEASURES: Visiting nurses affiliated to public health center assisted vulnerable elders with hypertension self-management tailored according to their health problems through home visits for a period of 2-4 months. RESULTS: A total of 13,452 hypertensive persons over the age of 65 completed the intervention. All outcomes were significantly improved and included hypertension knowledge, blood pressure monitoring, dietary management, medication adherence, and self-confidence in hypertension self-management (p < .001). Changes in hypertension knowledge, medication adherence, and self-confidence varied by gender with women showing greater knowledge improvement than men but less improvement in medication adherence and confidence in hypertension self-management. There was a marginal interaction effect for gender and age on dietary management (F = 3.55, p = .063), with men (≥75 years) showing greater improvement than their female counterparts after the intervention. CONCLUSIONS: This nurse-led home visitation intervention can be helpful in self-management skill building among hypertensive Korean elders. The program may improve medication adherence and health-promoting behavioral changes.

Factors Influencing Suicidal Ideation Among Korean Adults by Age: Results of the 2010-2011 Korean Health and Nutrition Examination Survey.

Suicidal ideation increases the risk of suicide. This study investigated the age-specific contributions of sociodemographic factors, health status, and health behaviors to suicidal ideation using nationally representative data. The factors associated with suicidal ideation differ by age. Perceived bad health, stress, and depression had a significant influence on suicidal ideation in all age groups, but their specific effects differed in different age groups. The influence of perceived bad health increased with age, and the effect of stress was strongest among those aged 45-64 years. Moreover, the effect of being depressed decreased by age and was strongest among those 20-44 years of age. Disease and marital status did not have a significant effect on suicidal ideation among those 45-64 years old, and education had no effect among those 65 years or older.