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1.
Ann Lab Med ; 42(1): 24-35, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34374346

RESUMEN

Background: Laboratory parameter abnormalities are commonly observed in COVID-19 patients; however, their clinical significance remains controversial. We assessed the prevalence, characteristics, and clinical impact of laboratory parameters in COVID-19 patients hospitalized in Daegu, Korea. Methods: We investigated the clinical and laboratory parameters of 1,952 COVID-19 patients on admission in nine hospitals in Daegu, Korea. The average patient age was 58.1 years, and 700 (35.9%) patients were men. The patients were classified into mild (N=1,612), moderate (N=294), and severe (N=46) disease groups based on clinical severity scores. We used chi-square test, multiple comparison analysis, and multinomial logistic regression to evaluate the correlation between laboratory parameters and disease severity. Results: Laboratory parameters on admission in the three disease groups were significantly different in terms of hematologic (Hb, Hct, white blood cell count, lymphocyte%, and platelet count), coagulation (prothrombin time and activated partial thromboplastin time), biochemical (albumin, aspartate aminotransferase, alanine aminotransferase, lactate, blood urea nitrogen, creatinine, and electrolytes), inflammatory (C-reactive protein and procalcitonin), cardiac (creatinine kinase MB isoenzyme and troponin I), and molecular virologic (Ct value of SARS-CoV-2 RdRP gene) parameters. Relative lymphopenia, prothrombin time prolongation, and hypoalbuminemia were significant indicators of COVID-19 severity. Patients with both hypoalbuminemia and lymphopenia had a higher risk of severe COVID-19. Conclusions: Laboratory parameter abnormalities on admission are common, are significantly associated with clinical severity, and can serve as independent predictors of COVID-19 severity. Monitoring the laboratory parameters, including albumin and lymphocyte count, is crucial for timely treatment of COVID-19.


Asunto(s)
COVID-19 , Análisis de Datos , Humanos , Laboratorios , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Retrospectivos , SARS-CoV-2
3.
BMC Psychiatry ; 21(1): 445, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496823

RESUMEN

BACKGROUND: The risk of depression has risen in the general population during the COVID-19 epidemic. This study was conducted to explore risk and protective factors associated with depression among the general population uninfected by COVID-19. METHODS: A cross-sectional study was conducted with 1,500 representative South Korean citizens aged 19-65 years through an anonymous online survey. Depression was defined as a Patient Health Questionnaire-9 score of 10 or higher. Other questionnaires included one measuring psycho-behavioural and social changes, and stress, due to COVID-19, a six-item version of the Gratitude Questionnaire (GQ-6), and a three-item version of the UCLA loneliness scale. RESULTS: Of the 1492 participants not infected by COVID-19, 312 (20.9%) exhibited depression. Multiple logistic regression analysis revealed that depression was positively associated with COVID-19-related stress and psycho-behavioural variables such as disturbances in eating and sleeping, younger age, smoking, underlying mental illness, and loneliness scale scores. In contrast, exercise three or more times per week and GQ-6 scale scores were inversely associated with depression. CONCLUSION: During the COVID-19 pandemic, maintaining daily routines including eating, sleeping, and regular exercise and focusing on gratitude may be important for the prevention of depression. In addition, more attention should be paid to vulnerable populations, including young people, those with mental illnesses, and smokers, who might be more susceptible to depression.


Asunto(s)
COVID-19 , Pandemias , Adolescente , Ansiedad , Estudios Transversales , Depresión/epidemiología , Humanos , Salud Mental , Factores Protectores , República de Corea/epidemiología , SARS-CoV-2
4.
BMJ Open ; 11(9): e049358, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34475169

RESUMEN

OBJECTIVE: The present study aimed to determine whether the suicide risk increased after a cancer diagnosis. DESIGN: Population-based cohort study. SETTING AND PARTICIPANTS: This study incorporated the National Health Insurance Service-National Sample Cohort in South Korea. Of the 975 348 subjects, 39 027 with cancer and 936 321 who were cancer free participated between 2005 and 2013. PRIMARY OUTCOME MEASURE: Suicide. RESULTS: A total of 110 suicides (82 men, 28 women) were identified among these 39 027 subjects with cancer during a total of 127 184 person-years; among the 936 321 cancer-free subjects, 2163 suicides were reported during a total of 8 222 479 person-years. Cox proportional hazards models were used to compare all-cause and suicide mortalities after cancer diagnosis following adjustment for possible confounding covariates. After adjusting for factors related to suicide, we identified an elevated relative risk of suicide among patients with cancer (HR: 1.480, 95% CI: 1.209 to 1.812). Among men, the relative risk was substantially increased among patients with lip, oral cavity/pharyngeal, colon and rectal, pancreatic and lung cancers when compared with cancer-free subjects; whereas among women, the relative risk was substantially increased among patients with colon and rectal cancers. CONCLUSION: Our study observed an increased risk of suicide among patients with cancer that varied according to the anatomical cancer site, even after accounting for clinical comorbidities and psychiatric illness. Our findings indicate a need for social support and suicide prevention strategies for patients with cancer.


Asunto(s)
Neoplasias , Suicidio , Estudios de Cohortes , Femenino , Humanos , Masculino , Neoplasias/epidemiología , Modelos de Riesgos Proporcionales , República de Corea/epidemiología , Factores de Riesgo
5.
BMJ Open ; 11(9): e050037, 2021 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-34479937

RESUMEN

OBJECTIVES: This study aimed to determine the cross-sectional association between long working hours and gastritis diagnosed by endoscopy. DESIGN: Cross-sectional study. SETTING: Large university hospitals in Seoul and Suwon, South Korea. PARTICIPANTS: Workers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 168 391 full-time day workers met the inclusion criteria and were included in the analysis. PRIMARY OUTCOME MEASURE: Endoscopic gastritis. RESULTS: The participants were predominantly college graduates or above (88.9%), male (71.2%) and in their 30s (51.1%), and the median age was 36 (IQR 31-42). Approximately 93.2% of participants had positive endoscopic gastritis, and there was a significant association between working hours and positive findings of endoscopic gastritis. The multivariate fully adjusted prevalence ratio (PR) of endoscopic gastritis for participants working >55 hours per week compared with 35-40 hours per week was 1.011 (95% CI 1.007 to 1.015). Furthermore, endoscopic findings were classified into nine subtypes of gastritis, including superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis increased with longer working hours (p for trends <0.05). Their PRs for participants working >55 hours per week compared with 35-40 hours per week were 1.019 (95% CI 1.012 to 1.026), 1.025 (95% CI 1.011 to 1.040), 1.017 (95% CI 1.008 to 1.027), 1.066 (95% CI 1.028 to 1.105) and 1.177 (95% CI 1.007 to 1.375), respectively. CONCLUSIONS: Working over 55 hours per week was cross-sectionally associated with positive findings of endoscopic gastritis. The study findings indicated potentially increased risks of superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis among workers with long working hours (>55 hours per week), supporting the need for further exploration via longitudinal studies.


Asunto(s)
Gastritis Atrófica , Gastritis , Adulto , Estudios Transversales , Endoscopía , Gastritis/epidemiología , Humanos , Masculino , República de Corea/epidemiología
6.
BMJ Open ; 11(9): e049063, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34489281

RESUMEN

OBJECTIVES: This study aimed to examine the association between metabolically healthy obesity and all-cause and cardiovascular disease (CVD) mortality in a Korean population. DESIGN: A prospective study. SETTING: This study used data from the Korean Genome and Epidemiology Study. PARTICIPANTS: A total of 140 137 participants were followed up over a median period of 9.2 years. Participants were categorised into four groups according to obesity (obese: body mass index ≥25 kg/m2 or non-obese) and metabolic health (metabolically unhealthy: two or more metabolic abnormalities or metabolically healthy). PRIMARY AND SECONDARY OUTCOME MEASURES: All-cause and CVD mortality of the participants until 31 December 2018 were ascertained by the National Health Insurance Service of beneficiary status of Korea. RESULTS: Metabolically unhealthy non-obese participants were at elevated risk of all-cause mortality (HR, 1.12; 95% CI, 1.04 to 1.21; p=0.0019) and CVD mortality (HR, 1.39; 95% CI, 1.17 to 1.65; p=0.0002), particularly mortality from ischaemic heart disease (IHD) (HR, 1.54; 95% CI, 1.10 to 2.14; p=0.0116) compared with metabolically healthy non-obese participants. Surprisingly, metabolically healthy obese participants were at reduced risk of all-cause mortality (HR, 0.89; 95% CI, 0.81 to 0.98; p=0.0197). Metabolically unhealthy obese participants were at elevated risk of CVD mortality (HR, 1.51; 95% CI, 1.26 to 1.81; p<0.0001) and IHD mortality (HR, 1.88; 95% CI, 1.35 to 2.63; p=0.0002) compared with metabolically healthy non-obese participants. CONCLUSIONS: In a Korean population, metabolically healthy obese participants had reduced risk of all-cause mortality compared with their non-obese counterparts, whereas metabolically unhealthy participants had elevated risk of CVD mortality, in particular mortality from IHD regardless of obesity.


Asunto(s)
Enfermedades Cardiovasculares , Síndrome Metabólico , Obesidad Metabólica Benigna , Índice de Masa Corporal , Humanos , Estudios Prospectivos , República de Corea/epidemiología , Factores de Riesgo
7.
Endocrinol Metab (Seoul) ; 36(4): 769-777, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34474515

RESUMEN

BACKGROUND: Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. METHODS: The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. RESULTS: Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. CONCLUSION: Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.


Asunto(s)
COVID-19/sangre , COVID-19/diagnóstico , Tirotropina/sangre , Triyodotironina/sangre , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , COVID-19/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , República de Corea/epidemiología , Estudios Retrospectivos
8.
Korean J Med Educ ; 33(3): 163-170, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34474523

RESUMEN

It is necessary to reflect on the question, "How to prepare for medical education after coronavirus disease 2019 (COVID-19)?" Although we are preparing for the era of Education 4.0 in line with the 4th industrial revolution of artificial intelligence and big data, most measures are focused on the methodologies of transferring knowledge; essential innovation is not being addressed. What is fundamentally needed in medicine is insightful intelligence that can see the invisible. We should not create doctors who only prescribe antispasmodics for abdominal pain, or antiemetic drugs for vomiting. Good clinical reasoning is not based on knowledge alone. Insightology in medicine is based on experience through Bayesian reasoning and imagination through the theory of mind. This refers to diagnosis of the whole, greater than the sum of its parts, by looking at the invisible using the Gestalt strategy. Identifying the missing process that links symptoms is essential. This missing process can be described in one word: context. An accurate diagnosis is possible only by understanding context, which can be done by standing in someone else's shoes. From the viewpoint of medicine, Education 4.0 is worrisome because people are still clinging to methodology. The subject we should focus on is "human", not "artificial" intelligence. We should first advance the "insightology in medicine" as a new paradigm, which is the "essence" that will never change even when rare "phenomena" such as the COVID-19 outbreak occur. For this reason, we should focus on teaching insightology in medicine, rather than teaching medical knowledge.


Asunto(s)
COVID-19/epidemiología , Educación Médica/tendencias , Inteligencia Artificial , Difusión de Innovaciones , Humanos , Conocimiento , Pandemias , República de Corea/epidemiología , SARS-CoV-2
9.
Korean J Med Educ ; 33(3): 227-232, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34474529

RESUMEN

PURPOSE: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19. METHODS: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods. RESULTS: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item "Patients are not really aware of how safe their care is" had a lower score in 2020 than in 2019. CONCLUSION: Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.


Asunto(s)
Actitud del Personal de Salud , COVID-19/epidemiología , Seguridad del Paciente , Estudiantes de Medicina/psicología , Adulto , Femenino , Humanos , Masculino , Pandemias , República de Corea/epidemiología , SARS-CoV-2 , Encuestas y Cuestionarios
10.
Medicine (Baltimore) ; 100(35): e27115, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477153

RESUMEN

ABSTRACT: Gallbladder polyps (GBPs), especially GBPs ≥5 mm in diameter, are clinically important because they can progress to gallbladder cancer. The known modifiable risk factors for GBP are obesity, metabolic syndrome, and dyslipidemia; however, there is limited evidence regarding specific modifiable risk factors for GBPs ≥5 mm in diameter. Therefore, this study is aimed to investigate the existence of modifiable risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter in a Korean population.A total of 10,119 subjects who visited a single health-screening center at Jeju National University Hospital between January 2009 and December 2019 was included in this study. Binary logistic analyses were performed to identify risk factors affecting the prevalence of GBPs and GBPs ≥5 mm in diameter.The overall prevalence of GBPs and GBPs ≥5 mm in diameter were 9.0% and 4.1%, respectively. Multivariable analysis identified male gender as an independent risk factor affecting the prevalence of GBPs. Moreover, multivariable analysis revealed age and high-density lipoprotein cholesterol levels as independent risk factors for GBPs ≥5 mm in diameter.This study showed that gender was a risk factor affecting the prevalence of GBPs and that age and high-density lipoprotein-cholesterol levels were risk factors for the presence of GBPs ≥5 mm in diameter. High-density lipoprotein cholesterol levels could be a modifiable risk factor affecting the prevalence of large-diameter GBPs.


Asunto(s)
Enfermedades de la Vesícula Biliar/epidemiología , Pólipos/epidemiología , Adulto , Factores de Edad , Anciano , Estudios Transversales , Femenino , Vesícula Biliar/patología , Enfermedades de la Vesícula Biliar/patología , Humanos , Masculino , Persona de Mediana Edad , Pólipos/patología , Prevalencia , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales
11.
World J Gastroenterol ; 27(31): 5126-5151, 2021 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-34497440

RESUMEN

Gastric cancer accounts for a significant proportion of worldwide cancer-related morbidity and mortality. The well documented precancerous cascade provides an opportunity for clinicians to detect and treat gastric cancers at an endoscopically curable stage. In high prevalence regions such as Japan and Korea, this has led to the implementation of population screening programs. However, guidelines remain ambiguous in lower prevalence regions. In recent years, there have been many advances in the endoscopic diagnosis and treatment of early gastric cancer and precancerous lesions. More advanced endoscopic imaging has led to improved detection and characterization of gastric lesions as well as superior accuracy for delineation of margins prior to resection. In addition, promising early data on artificial intelligence in gastroscopy suggests a future role for this technology in maximizing the yield of advanced endoscopic imaging. Data on endoscopic resection (ER) are particularly robust in Japan and Korea, with high rates of curative ER and markedly reduced procedural morbidity. However, there is a shortage of data in other regions to support the applicability of protocols from these high prevalence countries. Future advances in endoscopic therapeutics will likely lead to further expansion of the current indications for ER, as both technology and proceduralist expertise continue to grow.


Asunto(s)
Neoplasias Gástricas , Inteligencia Artificial , Disección , Gastroscopía , Humanos , República de Corea/epidemiología , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/epidemiología
12.
Nurs Open ; 8(3): 1030-1037, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-34482659

RESUMEN

AIM: This study aimed to examine the sleep pattern of breast cancer survivors and anxiety and depression associated with sleep quality to provide evidence-based information for the development of interventions to improve sleep disorders in these survivors. DESIGN: A cross-sectional study. METHODS: The subjects were 266 breast cancer survivors in South Korea. Structured questionnaires regarding sleep quality, anxiety and depression were used. The data were analysed using t test, ANOVA and multiple regression analysis. RESULTS: Sleep duration and sleep disturbance were found to affect anxiety, whereas sleep latency and subjective sleep quality were found to affect depression. These results suggest that various factors affecting sleep quality should be considered when providing care for anxiety and depression in breast cancer survivors.


Asunto(s)
Neoplasias de la Mama , Supervivientes de Cáncer , Ansiedad/epidemiología , Neoplasias de la Mama/complicaciones , Estudios Transversales , Depresión/epidemiología , Femenino , Humanos , República de Corea/epidemiología , Sueño , Sobrevivientes
13.
Medicine (Baltimore) ; 100(34): e27074, 2021 Aug 27.
Artículo en Inglés | MEDLINE | ID: mdl-34449507

RESUMEN

ABSTRACT: The prevalence of hypertension has increased with the rise in the elderly population, and high blood pressure is a major cause of cardiovascular disease. Physical activity is an important strategy for preventing cardiovascular disease. The study aimed to explore the association between physical activity and cardiovascular risk indicators in community-dwelling older adults with hypertension.This study is a secondary data analysis of a prospective longitudinal study using data from the Elderly Cohort Database of the National Health Insurance Service in South Korea between 2002 and 2013. Participants included 10,588 older adults (≥60 years) with hypertension. Data assessing self-reported physical activity and directly measured blood pressure, fasting blood glucose, body mass index, and total cholesterol levels throughout the 12-year study were extracted from the original database and analyzed. Participants were categorized into 4 groups based on the reported changes in physical activity over time: Group I (Maintaining No Physical Activity Group), II (Changing from No Physical Activity to Physical Activity Group), III (Changing from Physical Activity to No Physical Activity Group), and IV (Maintaining Physical Activity Group). Cox proportional hazard model was used to confirm the risk of cardiovascular indicators over time in each group.Participants' mean age was 64.2 years in the initial year of 2002. The number of participants in Groups I, II, III, and IV was 4032, 2697, 1919, and 1940, respectively. Group IV showed a significant decline in risk for uncontrolled hypertension compared to Group I (hazard ratio = 0.87, 95% confidence interval [0.800-0.948]). Group II showed a significant decrease in risk for uncontrolled diabetes compared to Group I (hazard ratio = 0.94, 95% confidence interval [0.888-0.999]).The findings indicated that physical activity is a significant factor associated with indicators of cardiovascular risk in older people with high blood pressure. Healthcare providers should be aware of the importance of older adults' physical activity and encourage them to perform and maintain it steadily for better long-term cardio-metabolic outcomes.


Asunto(s)
Ejercicio Físico , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión/epidemiología , Factores de Edad , Anciano , Anciano de 80 o más Años , Glucemia , Presión Sanguínea , Índice de Masa Corporal , Femenino , Conductas Relacionadas con la Salud , Humanos , Vida Independiente , Lípidos/sangre , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , República de Corea/epidemiología , Autoinforme , Factores Sexuales , Factores Socioeconómicos
14.
Artículo en Inglés | MEDLINE | ID: mdl-34444154

RESUMEN

(1) Background: Although the number of people infected with COVID-19 has increased over time, its effects on workplace accidents are still poorly understood. On the one hand, COVID-19 can reduce workplace accidents through contracted economic activities or changes in work methods. On the other hand, it can increase workplace accidents by spreading in the workplace. The main purpose of this paper is to examine how COVID-19 affected workplace accidents in Korea during the early part of the pandemic. (2) Methods: This paper utilizes the administrative data on workplace accidents in Korea collected by Korea Occupational Safety and Health Agency. In particular, we use monthly data from February 2016 to August 2020. This period was chosen to rule out the effect from the Middle East Respiratory Syndrome outbreak in 2015 and to include COVID-19 effects in 2020, given the available data. To examine the impact of COVID-19 on workplace injury and illness, we estimate fixed effects regression models, allowing us to control for group and time effects. (3) Results: COVID-19 was generally found to reduce workplace accidents in Korea, particularly through a reduction in occupational diseases. However, we also found that COVID-19 increased occupational injuries for males and workers in the transportation industry. We provide some evidence that these workers experienced an increase in workload and were unable to change work methods including working from home during the COVID-19 pandemic. (4) Conclusions: Our results indicate that to reduce workplace accidents, government interventions should be directed at workers who are unable to change work methods and who are likely to suffer an increase in work burden due to COVID-19.


Asunto(s)
COVID-19 , Salud Laboral , Accidentes de Trabajo , Humanos , Masculino , Pandemias , República de Corea/epidemiología , SARS-CoV-2 , Lugar de Trabajo
15.
Artículo en Inglés | MEDLINE | ID: mdl-34444353

RESUMEN

This study estimated tourists' willingness to pay (WTP) for tourist sites or facilities in the prolonged COVID-19 pandemic by applying the dichotomous choice-contingent valuation method to two different tourism destination types. A survey was conducted among domestic tourists in South Korea who had visited destinations within the last six months. We conducted a logistic regression with 1283 effective samples. The results showed differences in tourists' WTP, depending on type, and the factors affecting WTP differed. Tourists with higher tourism attitude and knowledge of tourism risk exhibited a higher WTP. Tourists with higher perceived risk of infectious disease exhibited less WTP.


Asunto(s)
COVID-19 , Pandemias , Actitud , Humanos , República de Corea/epidemiología , SARS-CoV-2
16.
BMJ Open ; 11(8): e045845, 2021 08 26.
Artículo en Inglés | MEDLINE | ID: mdl-34446482

RESUMEN

OBJECTIVES: This study investigated the factors influencing unmet healthcare needs of people during the early stage of the COVID-19 pandemic in Seoul, South Korea. The findings help to identify people who have difficulty accessing healthcare services during a pandemic situation. DESIGN: We conducted a cross-sectional study using a proportionate quota sampling method according to five major districts, sex and age, using an online survey. We analysed the key characteristics of influencing factors of unmet healthcare needs based on the Andersen behavioural model of healthcare utilisation: predisposing factors (eg, sex, age), need factors (eg, health status, illness) and enabling factors (eg, income, efficacy belief). SETTING: The questionnaire was sent via email and mobile text messages from the end of April to the beginning of May 2020 during the first wave of the COVID-19 pandemic. PARTICIPANTS: A sample of 813 respondents was used, and the respondent information was anonymised in the analysis process. RESULTS: For the predisposing factors, sex, age, education level and occupational cluster were associated with unmet needs for healthcare. Chronic diseases and mental health were the influencing factors as an enabling factor that exerted an influence on the unmet need for healthcare in South Korea. Women, younger persons, those with lower education and persons with white-collar jobs were more likely to experience unmet healthcare needs. In addition, the more chronic diseases people had, the more COVID-19 negatively affected them mentally; and the more people felt fear of COVID-19, the higher chances they experienced unmet healthcare needs. CONCLUSION: Government and policymakers are guided to draw out measures such as health communication and telemedicine to reduce the unmet healthcare needs during the pandemic and to recognise the different influencing factors.


Asunto(s)
COVID-19 , Pandemias , Estudios Transversales , Atención a la Salud , Femenino , Necesidades y Demandas de Servicios de Salud , Humanos , República de Corea/epidemiología , SARS-CoV-2 , Seúl , Factores Socioeconómicos
17.
Artículo en Inglés | MEDLINE | ID: mdl-34360213

RESUMEN

Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70-84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.


Asunto(s)
Fragilidad , Alfabetización en Salud , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Estudios Transversales , Anciano Frágil , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Vida Independiente , República de Corea/epidemiología
18.
Health Qual Life Outcomes ; 19(1): 195, 2021 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-34372867

RESUMEN

BACKGROUND: Although several studies have reported an association between tuberculosis and health-related quality of life, the change in health-related quality of life after pulmonary tuberculosis has been rarely studied. The purpose of this study was to investigate the effect of past history of pulmonary tuberculosis on health-related quality of life using a nationwide, cross-sectional, observational study in Korea. METHODS: Among 72,751 people selected using a stratified multi-stage sampling method, 7260 Korean participants were included using propensity score matching. Past history of pulmonary tuberculosis was defined as a previous diagnosis of pulmonary tuberculosis excluding patients with active pulmonary tuberculosis. The primary outcome, health-related quality of life, was assessed by EQ-5D disutility. RESULTS: Before matching, the mean EQ-5D of individuals with pulmonary tuberculosis history was lower (0.066 vs. 0.056, p: 0.009). However, the difference was nullified after matching (0.066 vs. 0.062, p = 0.354). In multivariable Poisson regression analysis, EQ-5D disutility score was not associated with past pulmonary tuberculosis history. In subgroup analysis, past pulmonary tuberculosis history increased odds of low health-related quality of life in young (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.17-2.11, p = 0.003), unmarried (OR 1.98, 95% CI 1.05-3.73, p = 0.036), or separated patients (OR 1.30, 95% CI 1.02-1.66, p = 0.032). Age and marital status were modulating factors on the effect of past pulmonary tuberculosis history on health-related quality of life. CONCLUSIONS: There was no difference in health-related quality of life between individuals with and without past pulmonary tuberculosis history. Young and unmarried groups had increased odds for low health-related quality of life after pulmonary tuberculosis due to modulating effects of age and marital status.


Asunto(s)
Calidad de Vida , Tuberculosis Pulmonar/psicología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas Nutricionales , República de Corea/epidemiología , Encuestas y Cuestionarios , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/epidemiología
19.
JMIR Public Health Surveill ; 7(9): e31409, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34348890

RESUMEN

BACKGROUND: The US Centers for Disease Control and Prevention and the World Health Organization emphasized vaccination against COVID-19 because physical distancing proved inadequate to mitigate death, illness, and massive economic loss. OBJECTIVE: This study aimed to investigate Korean citizens' perceptions of vaccines by examining their views on COVID-19 vaccines, their positive and negative perceptions of each vaccine, and ways to enhance policies to increase vaccine acceptance. METHODS: This cross-sectional study analyzed posts on NAVER and Instagram to examine Korean citizens' perception of COVID-19 vaccines. The keywords searched were "vaccine," "AstraZeneca," and "Pfizer." In total 8100 posts in NAVER and 5291 posts in Instagram were sampled through web crawling. Morphology analysis was performed, overlapping or meaningless words were removed, sentiment analysis was implemented, and 3 public health professionals reviewed the results. RESULTS: The findings revealed a negative perception of COVID-19 vaccines; of the words crawled, the proportion of negative words for AstraZeneca was 71.0% (476/670) and for Pfizer was 56.3% (498/885). Among words crawled with "vaccine," "good" ranked first, with a frequency of 13.43% (312/2323). Meanwhile, "side effect" ranked highest, with a frequency of 29.2% (163/559) for "AstraZeneca," but 0.6% (4/673) for "Pfizer." With "vaccine," positive words were more frequently used, whereas with "AstraZeneca" and "Pfizer" negative words were prevalent. CONCLUSIONS: There is a negative perception of AstraZeneca and Pfizer vaccines in Korea, with 1 in 4 people refusing vaccination. To address this, accurate information needs to be shared about vaccines including AstraZeneca, and the experiences of those vaccinated. Furthermore, government communication about risk management is required to increase the AstraZeneca vaccination rate for herd immunity before the vaccine expires.


Asunto(s)
Vacunas contra la COVID-19 , Conocimientos, Actitudes y Práctica en Salud , Internet/estadística & datos numéricos , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/administración & dosificación , Estudios Transversales , Humanos , República de Corea/epidemiología , Vacunación/estadística & datos numéricos
20.
J Korean Med Sci ; 36(34): e243, 2021 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-34463065

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic may increase the total number of suicide attempts and the proportion of low-rescue attempts. We investigated the factors affecting low-rescue suicide attempts using the risk-rescue rating scale (RRRS) among patients who visited the emergency department (ED) after attempting suicide before or during the COVID-19 pandemic. METHODS: We retrospectively investigated suicide attempts made by patients who visited our ED from March 2019 to September 2020. Patients were classified into two groups based on whether they attempted suicide before or during the COVID-19 pandemic. Data on demographic variables, psychiatric factors, suicide risk factors and rescue factors were collected and compared. RESULTS: A total of 518 patients were included in the study, 275 (53.1%) of whom attempted suicide during the COVID-19 pandemic. The proportion of patients who made low-rescue suicide attempts differed before and during the COVID-19 pandemic (37.1% vs. 28.8%) (P = 0.046). However, the proportions of patients who made high-risk suicide attempts and high-lethality suicide attempts did not significantly differ between the two periods. The independent risk factors for low-rescue suicide attempts were age and the COVID-19 pandemic (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = 0.006) (OR, 1.52; 95% CI, 1.03-2.25; P = 0.034). CONCLUSION: The COVID-19 pandemic was associated with low-rescue suicide attempts in patients visiting the ED after attempting suicide. Thus, we need to consider the implementation of measures to prevent low-rescue suicide attempts during similar infectious disease crises.


Asunto(s)
COVID-19/epidemiología , Fracaso de Rescate en Atención a la Salud/estadística & datos numéricos , Intento de Suicidio/prevención & control , Adolescente , Adulto , COVID-19/virología , Servicio de Urgencia en Hospital , Femenino , Hospitales Universitarios , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , República de Corea/epidemiología , Estudios Retrospectivos , Factores de Riesgo , SARS-CoV-2/aislamiento & purificación , Intento de Suicidio/estadística & datos numéricos , Centros de Atención Terciaria , Adulto Joven
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