Job crafting, positive psychological capital, and social support as predictors of job embeddedness on among clinical nurses- a structural model design.

BACKGROUND: This study establishes the relationships among role conflict, positive psychological capital, social support, job crafting, and job embeddedness among clinical nurses. The results are expected to provide a basis for efficient human resource management in hospitals. METHODS: Considering a 15% dropout rate, we distributed 300 copies of our questionnaire, of which 290 were returned. We used 260 responses in the final analysis after excluding 40 responses that were incomplete or showed an identical pattern in the item responses. Participants were clinical nurses with less than one year of experience in general and tertiary general hospitals in G province and D metropolitan city in South Korea. A structured questionnaire was administered from January 10 to February 28, 2022. The collected data were analyzed using SPSS 26.0 and AMOS 26.0. We assessed the statistical significance using the bootstrapping method. RESULTS: The direct and total effects (both ß = 0.806, p =.007) of positive psychological capital on job crafting were significant. The direct and total effects (both ß = 0.451, p =.004) of social support on job crafting were significant. The direct (γ = 0.292, p =.055), indirect (γ = -. 671, p =.003), and total (γ = - 0.379, p =.008) effects of role conflict on job crafting were significant. The direct (γ = - 0.382, p =.007), indirect (γ = - 0.208 p =.003), and total (γ = - 0.589, p =.006) effects of role conflict on job embeddedness were significant. The direct and total (both ß = 0.548, p =.005) effects of job crafting on job embeddedness were significant. CONCLUSIONS: Nurses' job embeddedness is directly influenced by their job crafting, which is shaped by high levels of positive psychological capital and social support. When job crafting takes place, role conflict increases, and if job crafting becomes difficult because of severe role conflict, job embeddedness decreases. Therefore, to increase job embeddedness among clinical nurses, hospitals must implement support systems and programs to increase job autonomy, and positive psychological capital to promote job crafting.

Analysis of latent profiles and affected factors according to the implementation of a protection system against customer bullying in Korea.

BACKGROUND: Instances of customers bullying employees at the workplace are increasing with the development of the service industry. Korea has established a worker protection system to prevent negative effects of customer bullying on workers' health. This study identified the latent profile types of protection against customer bullying in workplaces, and determined their predictors. METHODS: Data were collected over 28 days, from March 2 to 30, 2020. This study identified whether protection against customer bullying is implemented for workers in person-to-person services, the change effected by this protection, and worker monitoring scope. Data from 1,537 out of 1,550 participants were analyzed, excluding the missing values. Latent profile types were identified using Mplus 8.5 for data analysis, and the multinomial logistic regression analysis was performed to review the predictors. RESULTS: The results are as follows. There were four types of latent profile types: lagging, medium, relative preventive type, and excellent type. Variables predicting these types included age, gender, service period, position, occupational category, worker monitoring scope, decrease in the number of customers causing problems, decrease in disputes with customers, and worker satisfaction. CONCLUSIONS: First, a system to prevent customer bullying must be adopted in the service industry. Second, there must be a way to improve trust between customers and workers when protective measures are being adopted. Third, managers must establish a system that can both protect workers against bullying and provide customer satisfaction.

Predictors of end-of-life care stress, calling, and resilience on end-of-life care performance: a descriptive correlational study.

BACKGROUND: Prolonging the end-of-life process means that the duration of health care work increases and the management of death is delegated to health care providers by patients' families. Thus, it is important to explore measures to enhance the quality of end-of-life care by identifying the predictors thereof. End-of-life care should be people-centred, relieving serious health-related suffering, be it physical, psychological, social, or spiritual. Nurses who provide end-of-life care usually spend the most time with dying patients, administering care to help patients who wish to die with dignity; therefore, end-of-life nursing care is highly significant. METHODS: This study was conducted on nurses of 500-bed or larger university hospitals in city D and province C in South Korea from 20 August to 10 September 2020 using a structured questionnaire. A total of 213 nurses with a minimum clinical career of one year and at least one EOLC experience participated. The final analysis sample consisted of 206 nurses. Descriptive analysis, Pearson's correlation coefficients, ANOVA, t-test, and multiple-regression analysis were used to analyse the data. RESULTS: This study found that end-of-life care performance was significantly positively correlated with end-of-life care stress [r = .253, p < .001], sense of calling [r = .424, p < .001], and resilience [r = .397, p < .001]. End-of-life care stress [ß = .185, p = .003], sense of calling [ß = .259, p < .001], resilience [ß = .252, p < .001], and working in a hospice ward [ß = .140, p = .041] or intensive care unit [ß = .218, p = .008], as opposed to the emergency department, were identified as predictors of end-of-life care performance. These factors explained 28.3% of the variance in the end-of-life care performance in this study. CONCLUSIONS: Boosting the sense of calling and resilience among nurses providing palliative care can improve overall end-of-life care performances. Subsequent studies should develop and evaluate interventions and programs that could improve these factors to ensure a positive change in health care and enhance the quality of end-of-life care in hospitals.

A study on macronutrient self-selection after acute aerobic exercise in college females.

[Purpose] This study was conducted to determine whether acute aerobic exercise (climbing) is associated with changes in the dietary intake pattern. [Subjects and Methods] Food intake and physical activity data for 15 female college students were sampled for 3 days and categorized according to routine activity or high-intensity activity such as hiking. Nutrient intake based on the data was analyzed using a nutrition program. [Results] Carbohydrate and protein intake was significantly decreased after exercise compared to before acute aerobic exercise, but lipid intake showed no significant difference. Calorie intake was significantly decreased after exercise compared to before exercise; however, calorie consumption was significantly increased after exercise. [Conclusion] Aerobic exercise causes a decrease in total calories by inducing reduction in carbohydrate and protein intake. Therefore, aerobic exercise is very important for weight (body fat) control since it causes positive changes in the food intake pattern in female students.

Inhibition of NADPH oxidase activation reduces EAE-induced white matter damage in mice.

BACKGROUND: To evaluate the role of NADPH oxidase-mediated reactive oxygen species (ROS) production in multiple sclerosis pathogenesis, we examined the effects of apocynin, an NADPH oxidase assembly inhibitor, on experimental autoimmune encephalomyelitis (EAE). METHODS: EAE was induced by immunization with myelin oligodendrocyte glycoprotein (MOG (35-55)) in C57BL/6 female mice. Three weeks after initial immunization, the mice were analyzed for demyelination, immune cell infiltration, and ROS production. Apocynin (30 mg/kg) was given orally once daily for the entire experimental course or after the typical onset of clinical symptom (15 days after first MOG injection). RESULTS: Clinical signs of EAE first appeared on day 11 and reached a peak level on day 19 after the initial immunization. The daily clinical symptoms of EAE mice were profoundly reduced by apocynin. The apocynin-mediated inhibition of the clinical course of EAE was accompanied by suppression of demyelination, reduced infiltration by encephalitogenic immune cells including CD4, CD8, CD20, and F4/80-positive cells. Apocynin reduced MOG-induced pro-inflammatory cytokines in cultured microglia. Apocynin also remarkably inhibited EAE-associated ROS production and blood-brain barrier (BBB) disruption. Furthermore, the present study found that post-treatment with apocynin also reduced the clinical course of EAE and spinal cord demyelination. CONCLUSIONS: These results demonstrate that apocynin inhibits the clinical features and neuropathological changes associated with EAE. Therefore, the present study suggests that inhibition of NADPH oxidase activation by apocynin may have a high therapeutic potential for treatment of multiple sclerosis pathogenesis.

Latent Class Analysis on Suicide-related Behavior and Associated Factors in Korean Adolescents.

PURPOSE: This study aimed to analyze the latent class of suicide-related behaviors among Korean adolescents and identify related factors. METHODS: This study used 2021 Korean Youth Risk Behavior Web-Based Survey data and analyzed 7300 participants using latent class analysis. RESULTS: Suicide-related behaviors were categorized into four classes: suicide ideation only (Class 1), suicide plan without ideation or attempt (Class 2), suicide attempt with ideation and plan (Class 3), and suicide attempt without ideation or plan (Class 4). Sexual intercourse experience, habitual drug use experience, and hospital treatment experience due to violence, which were set as risky behavior-related variables, were found to be factors influencing Class 3. However, these variables were not statistically significant factors affecting those belonging to Class 2 and Class 4. CONCLUSION: The findings emphasize the necessity of understanding the variances in suicide-related behaviors among adolescents to tailor interventions effectively. Adolescents who plan and attempt suicide despite having low levels of suicidal ideation exhibited high levels of stress and a tendency for sadness and despair compared to the suicide attempt with the ideation and plan group. These insights underscore the importance of addressing psycho-emotional factors and developing intervention strategies that cater specifically to the nuanced needs of each group to prevent potential suicide attempts.

Moderating Role of Communication Competence in the Association between Professionalism and Job Satisfaction in Korean Millennial and Generation Z Nurses: A Cross-Sectional Study.

Millennial and Generation Z (MZ generation) nurses, the core of the Republic of Korean nursing workforce, are leaving hospitals. We, therefore, aimed to determine the mediating role of communication competence between nursing professionalism and job satisfaction of MZ generation nurses in Republic of Korea. A total of 188 nurses aged 20-39 years belonging to the MZ generation, who had been working in a general hospital for over six months, participated in an online survey from 27 October 2022 to 11 January 2023. Data analysis was conducted using the bootstrapping method with the SPSS PROCESS macro program to confirm the mediating role of communication competence. Job satisfaction, professionalism, and communication skills were significantly positively correlated (r = 0.36-0.72, p < 0.001). Communication competence was found to be a mediating factor in the relationship between professionalism and job satisfaction. The results showed that when professionalism related to job satisfaction, good communication further enhanced job satisfaction. In order to enhance MZ generation nurses' job satisfaction, it is necessary to improve nursing professionalism and implement training programs to improve communication skills considering generation-specific characteristics.

The Cycle of Verbal Violence Among Nurse Colleagues in South Korea.

In Korea, suicide by nurses due to workplace verbal violence has become a serious social controversy. This study used a descriptive survey to identify factors influencing nurses' experiences with being either victims or perpetrators of verbal violence among colleagues. Participants were 205 nurses working at large-scale general hospitals in D city in August 2019. Data were collected through standardized questionnaires on experiences of verbal violence, committing acts of verbal violence, demographic characteristics, and job stress. For experiences of verbal violence, statistically significant differences were observed in age, gender, and nightshift work. Committing acts of verbal violence showed statistically significant differences in age, gender, entire career experience, career experience in one's present division, and nightshift work. A significant correlation was found between experiences of verbal violence, committing acts of verbal violence, and job stress. Gender and nightshift work influenced experiences of verbal violence in Model 1, while gender, nightshift work, and relationship conflicts were extracted in Model 2. In Model 3, career experience and committing acts of verbal violence were found to be significant. For committing acts of verbal violence, gender, nightshift work, and career experience were extracted in Model 1; gender, nightshift work, and relationship conflict were extracted in Model 2; and nightshift work, career experience, and experiences of verbal violence were significant in Model 3. Regarding verbal violence among nurses, a vicious cycle caused by job stress exists, in which newly hired nurses are often victims of verbal violence; however, as they gain career experience, they become the perpetrators. Therefore, to reduce nurses' job stress, it is necessary to operate job stress-control programs by career level, promote conversations among nurses to increase understanding of each other, and build a culture of mutual respect.

Latent Class Analysis of Health Behavior Changes Due to COVID-19 among Middle-Aged Korean Workers.

The purpose of this study was to identify the latent class for changes in health behavior due to COVID-19, reveal the characteristics of participants by type, and identify predictive factors for these types. The participants of this study were office workers between the ages of 40 and 60 and secondary data from the 2020 Community Health Survey of G city was utilized. Latent class analysis was performed on physical activities such as walking and exercise, eating fast food or carbonated drinks, eating delivered food, drinking alcohol, and smoking. Three types of health behavior changes due to COVID-19 were found: (1) decrease in all health behavior type, (2) increase in fast food and delivered food type, and (3) increase in smoking maintenance type. Second, the variables predicting the three types after controlling for general characteristics were health problems, social distancing among the COVID-19 quarantine rules, refraining from going out, and meeting with friends and neighbors and had an impact on COVID-19 life. It is necessary to strengthen non-face-to-face health promotion activities along with quarantine rules for COVID-19. In addition, there is a need for a health management plan for people with non-visible risk factors such as obesity and high blood pressure.

The Relation between Worker Protection System in the Interpersonal Service and Workplace Violence as Well as Workers' Depression.

Background: We aimed to confirm the effect of interpersonal service worker protection system on workplace violence and depression and to determine the relationship among the protection system, workplace violence, and depression. Methods: Self-reporting survey was conducted for approximately a month beginning on 2 March 2020, among members selected using the convenience sampling method from seven labor unions in South Korea to which interpersonal service workers belonged. The questionnaire consisted of questions regarding the subjects' general characteristics, worker protection system, workplace violence, and depression. Overall, 1,541 workers participated in this study. Results: The basic model was used to test the relationship between the protection system and depression, with a mediating effect of workplace violence. Three of the hypothesized paths were significant (P<.001), but the basic model did not fit the data. In the revised model, the direct path from the protection system to depression was deleted. Path coefficient of the direct effect of the protection system on violence was -0.05, the direct effect of the violence on depression was 0.77, and the indirect effect of the protection system on depression was -0.04. The fit of this model was acceptable. Conclusion: Organizational interventions have an indirect effect on reducing depression by preventing workplace violence; however, there was no direct effect on reducing the depression of the workers. These results justify the need to invest in strengthening workplace protection systems for the interpersonal service workers.

Factors Affecting Zero-Waste Behaviours of College Students.

This study evaluated the recognition and attitude toward microplastic and zero waste among college students and investigated the factors influencing their zero-waste behaviours. The study was conducted from 20 August 2021 to 10 September 2021, including students at a university in G metropolitan city, Republic of Korea. A total of 196 data were analysed. Statements were developed to verify how the use of disposables and the recognition, attitude, and behaviours related to zero waste were affected during the COVID-19 pandemic. Family type and usage of disposables were the factors affecting zero-waste behaviour in Model 1. In Model 2, which included the subcategory of zero-waste recognition, the health effects of microplastics and environmental preservation were significant factors. In Model 3, which included the subcategory of zero-waste attitude, the health effects of microplastics (ß = 0.149, p = 0.016), use of eco-friendly products (ß = 0.342, p < 0.001), and environmental preservation (ß = 0.317, p < 0.001) were significant factors. The use of plastic products increased dramatically during the COVID-19 pandemic. Research and education are needed to promote zero-waste behaviours with a focus on microplastics. Raising awareness of the health effects of microplastics can enhance the effectiveness of education.

A Longitudinal Analysis of Alcohol Use Behavior among Korean Adults and Related Factors: A Latent Class Growth Model.

This study classified the changes in alcohol use behavior among Korean adults and explored the related factors. The study used data from the 4th (2009) to 14th (2019) waves of the Korean Welfare Panel Study. The subjects were 8267 adults aged 19-60 years. Latent class growth analysis was used to classify the latent classes of alcohol use behavior among Korean adults, and logistic regression analysis was performed to identify the specific factors that form the classes. Additionally, the 11-year trajectories of major variables associated with alcohol use behavior for the derived classes were analyzed using growth mixture modeling. Four classes were identified according to the trajectories of alcohol use behavior. There were statistically significant differences in the trajectories of depression, self-esteem, satisfaction in family relationships, and satisfaction in leisure activities according to the class of alcohol use behavior. In particular, self-esteem and satisfaction in family relationships indicated distinctly decreasing trajectories in the low- to moderate-risk class, which suggested the need for longitudinal analysis of the factors that influence alcohol use behavior. Moreover, it is recommended that interventions for the prevention of high-risk drinking target not only individuals but also family units.

A Latent Class Analysis of Health-Related Quality of Life in Korean Older Adults.

The present study aimed to confirm latent classes in health-related quality of life (HRQOL) in older adults and investigate the characteristics of participants in each class. It aimed to provide basic data to develop interventions for each quality-of-life class by analysing the predictors of each class. Secondary data from a community health survey in G province since 2019 found a total of 41,872 participants. Of them, 9027 were 65 years or older and residing in G Province in 2019, participated in this study. Mplus 8.5 was used to conduct a latent class analysis of five domains of HRQOL. Four latent classes in the HRQOL of older adults, namely, stable type, physical disability type, emotional disability type, and crisis type were found. Certain variables predicted these classes. Based on the findings of the present study, training on functional mobility and balance to prevent falls in older populations and individualised programmes to promote mental health in them should be provided. Moreover, policies should increase medical accessibility and provide social support for older people with low-incomes. Additionally, since physical, psychological, and social health in older adults are inter-connected, a comprehensive care plan is needed to improve their HRQOL.

Models for Developing Community Organizations to Reinforce Health Management in Small Businesses.

The incidence of occupational diseases in small businesses is higher than in big ones, and this fact puts the former in need of a healthcare management model they can administer. This study established a model based on community organizational development theory to reinforce worker empowerment for healthcare in small businesses, focusing on health centers for workers (HCFW). The researchers surveyed 408 workers at 39 small businesses in the B region of South Korea, according to the characteristics of business sites, general characteristics of workers, and elements of community organizational development theory, and analyzed their results with a structural equation. The research period was September, 2015. Five concepts were examined: empowerment in healthcare, community capacity, participation and relevance, critical consciousness, and issue selection. The results revealed that greater community capacity led to greater participation and relevance (γ = 0.39) and empowerment in healthcare (γ = 0.25), while greater participation and relevance led to greater empowerment in healthcare (γ = 0.76). In addition, greater critical consciousness led to greater participation and relevance (γ = 0.12). Finally, greater community capacity led to greater issues selection (γ = 0.56), which in turn led to greater participation and relevance (γ = 0.25). The study makes proposals for directions of health centers for workers and community networks. Confirmation of this model for worker empowerment suggests several directions to HCFW in relation to workers and community networks.

Unmet Healthcare Needs of Children in Vulnerable Families in South Korea: Finding from the Community Child Center Child Panel Survey.

Presented in this paper is a study that examined the status of unmet healthcare needs of children in vulnerable families and identified factors affecting such unmet needs. The Community Child Center (CCC) Child Panel Survey data in Korea were used. A multiple stepwise logistic regression analysis was performed to examine factors influencing unmet healthcare needs of children. Influencing factors comprised predisposing, enabling, and need factors based on the Andersen Behavioral Model of Health Services Utilization. A total of 340 sixth-graders from vulnerable families participated, and 96 (28.2%) children had unmet healthcare needs. Factors included absence of an after-school caregiver (OR = 1.95, 95% CI [1.16, 3.27]), perceived physical symptoms (OR = 1.33, 95% CI [1.02, 1.73]), parental indifference (OR = 1.33, 95% CI [1.002, 1.77]), duration of daily stay at CCCs (OR = 1.32, 95% CI [1.01, 1.71]), and satisfaction with CCC teachers (OR = 0.65, 95% CI [0.49, 0.85]). The relationship with parents and CCC teachers had the strongest influence on unmet healthcare needs of children. In order to reduce the unmet healthcare needs of children in vulnerable families, existing support structures should be expanded to offer financial and administrative support for children's parents and CCC teachers.

The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents.

As the smartphone has become an indispensable device in modern lives, consequential psychosocial problems such as smartphone addiction have been getting attention worldwide, especially regarding adolescents. Based on its positive effect on young individuals' mental health, mind subtraction meditation has been widely applied to many school-based programs in South Korea. This study aims to identify the effects of a school program based on mind subtraction on the smartphone addiction of adolescents. A total of 49 high school sophomores, 24 from the experimental group (mean age = 16), and 25 from the control group (mean age = 16) are included in this case-control study. The experimental group is given the meditation program sessions in the morning, two times a week for 20 min per session, for a total of 12 weeks. The experimental group shows improvements regarding the 'smartphone addiction' section (p < 0.001), for instant satisfaction (p < 0.001) and long-term satisfaction (p < 0.001). Concerning the 'self-control' section and decreasing stress (p < 0.001), problem focusing (p < 0.001), and social support navigation (p = 0.018), there are improvements in these 'stress coping strategies' sections. This study directly shows the positive effect of mind subtraction meditation on smartphone addiction in adolescents and, thus, provides guidance to the future development of smartphone addiction prevention programs for young individuals.

A Comparison Study: The Risk Factors in the Lifestyles of Thyroid Cancer Patients and Healthy Adults of South Korea.

BACKGROUND: In South Korea, there has been a rapid increase in thyroid cancer diagnoses, and the thyroid cancer incidence rate is the highest in the world. This study explored possible risk factors that may influence the development of thyroid cancer by comparing life habits of thyroid cancer patients and healthy adults. OBJECTIVE: The aims of this study were to identify lifestyle and habit differences in thyroid cancer patients and healthy adults and to investigate risk factors that influence the development of thyroid cancer. METHODS: The study was designed as a retrospective comparison survey study of thyroid cancer patient group and healthy adult group. One hundred two thyroid cancer patients in a university hospital and 115 healthy adults were recruited for this study. Data were analyzed using descriptive statistics, χ test/t test, and logistic regression with SPSS program. RESULTS: Previous smoking history, lower physical activity level, higher stress, and unhealthy eating habits (consumption of instant food products) were shown to be risk factors in the development of thyroid cancer. CONCLUSION: Based on the results of this study comparing thyroid cancer patients and healthy adults, it is recommended to encourage an increase in physical activity, minimize both direct and indirect exposure to smoking, develop healthy eating habits of consuming more vegetables, and effectively manage stress levels. IMPLICATIONS FOR PRACTICE: Lifestyle preferences and habits may influence the development of thyroid cancer. It is imperative to identify and modify the risk factors in order to prevent thyroid cancer development.

Effects of Repetitive Peripheral Magnetic Stimulation on Patients With Acute Low Back Pain: A Pilot Study.

OBJECTIVE: To investigate the effects of real repetitive peripheral magnetic stimulation (rPMS) treatment compared to sham rPMS treatment on pain reduction and functional recovery of patients with acute low back pain. METHODS: A total of 26 patients with acute low back pain were randomly allocated to the real rPMS group and the sham rPMS group. Subjects were then administered a total of 10 treatment sessions. Visual analogue scale (VAS) was assessed before and after each session. Oswestry Disability Index (ODI) and Roland-Morris Disability Questionnaire (RMDQ) were employed to assess functional recovery at baseline and after sessions 5 and 10. RESULTS: Real rPMS treatment showed significant pain reduction immediately after each session. Sustained and significant pain relief was observed after administering only one session in the real rPMS group. Significant functional improvement was observed in the real rPMS group compared to that in the sham rPMS group after sessions 5 and 10 based on ODI and after session 5 based on RMDQ. CONCLUSION: Real rPMS treatment has immediate effect on pain reduction and sustained effect on pain relief for patients with acute low back pain compared to sham rPMS.

Acute-onset chronic inflammatory demyelinating polyneuropathy in hantavirus and hepatitis B virus coinfection: A case report.

INTRODUCTION: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired autoimmune disorder with progressive weakness. Acute-onset CIDP resembles Guillain-Barre syndrome (GBS), a rapidly progressive disorder, and follows a chronic course. To our knowledge, no case of acute-onset CIDP in hantavirus and hepatitis B virus (HBV) coinfection has been reported previously. CLINICAL FINDINGS: We report a case of acute-onset CIDP that was initially diagnosed as GBS. DIAGNOSES: A 44-year-old male logger complained of acute quadriplegia and dyspnea. Mechanical ventilation was initiated. He was an HBV carrier with mild elevation of hepatic enzyme, and positive for hantavirus antibody. He was diagnosed with GBS and immunoglobulin therapy was administered. INTERVENTIONS: After 8 months, quadriplegia and hypesthesia recurred. Immunoglobulin therapy at this time had no effect, but steroid therapy had some effect. OUTCOMES: A diagnosis of CIDP was made. After 2 months, severe extremity pain and dyspnea developed again, and steroid pulse therapy was initiated. CONCLUSION: Besides GBS, acute-onset CIDP can occur with hantavirus and HBV coinfection. Patients with this coinfection in whom GBS has been initially diagnosed should be followed up for a long time, because of the possibility of relapse or deterioration, and acute-onset CIDP should always be considered.

Comparison of Effects of Botulinum Toxin Injection Between Subacute and Chronic Stroke Patients: A Pilot Study.

The aim of this study was to compare the effects of botulinum toxin injection between subacute and chronic stroke patients. Eighteen stroke patients (9 subacute and 9 chronic) with spasticity of 1+ or higher in the hemiplegic elbow or wrist joint, based on the modified Ashworth scale were recruited. Modified Ashworth scale, modified Tardieu scale, manual muscle testing, passive range of motion, Brunnstrom stage, modified Barthel index, and Fugl-Meyer scale evaluations of the hemiplegic upper extremity were performed just before the injection and 4 weeks later. A total dose of 200 U of botulinum toxin type A was injected into each patient. One or more of the elbow flexor muscles and one or more of the wrist flexor or finger flexor muscles were included. Modified Ashworth scale, manual muscle testing, passive range of motion, and modified Barthel index results were improved in subacute patients only. However, modified Tardieu scale for the elbow and Fugl-Meyer scale results were improved in both groups, and the improvement was comparable. In conclusion, botulinum toxin injection in subacute patients was more helpful for spasticity, contracture, and function than in chronic patients. However, beneficial effects of botulinum toxin injection on spasticity and function in chronic patients were found in the assessments of the modified Tardieu scale and Fugl-Meyer scale.