• 한국노년학
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• v.40 no.4
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• pp.707-727
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• 2020

This study aims to empirically analyze the role that perception of the probability of lonely death among the elderly people living alone plays in the relationship between perceived social support and preference for institutional care based on Andersen's expanded Behavioral Model (2002). The subjects (n=676) of this study were the elderly people living alone, extracted from the "2018 Seoul Aging Survey." With "perceived social support" as an independent variable, "preference for institutional care" as a dependent variable, and "perception of the probability of lonely death" as a mediator variable, we conducted a Binary Logistic Regression to follow the three steps of analyzing mediation effect, as suggested by Baron and Kenny (1986). The results showed that perceived social support has a negative effect on the preference for institutional care and perception of the probability of lonely death among the elderly people living alone; at the same time, perception of the probability of lonely death was found to have a positive effect on their preference for institutional care. Lastly, perception of the probability of lonely death was found to partially mediate the effect of perceived social support among the elderly people living alone in terms of their preference for institutional care. Based on these findings, the practical implications of this study can be summarized as follows. First, various programs and support should be provided to the elderly people living alone in order to enhance the level of perceived social support, a factor that has been confirmed to increase preference for institutional care among the elderly people living alone. Second, as the perception of the probability of lonely death was confirmed to be a psychosocial factor of the preference for institutional care, we need to promote education and support for older people living alone to prepare them for lonely death. These efforts are expected to form a foundations for implementing a community-based integrated care system, "Aging in Place," which is the policy direction required for older people care.

• 한국노년학
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• v.41 no.2
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• pp.271-284
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• 2021

This study was conducted to derive factors that affect the satisfaction of home visiting health care services and to develop effective community care models by using the results of Seoul's outreach service which is the basis for Korean community care. The population of the study was the elderly aged 65 and 70 who participated in the Seoul's outreach community services 3rd stage (July 2017 - June 2018) and 4th stage (July 2018 to June 2019). 2,200 people were extracted by the proportional allocation method and home visit interviews were conducted on them. Subjects were divided into sub-groups based on chronic disease prevalence, and logistic regression was conducted to derive factors that affect the satisfaction of home visiting health care services. The results demonstrated that the elderly without chronic diseases were more satisfied when they received health education and counseling services, the elderly with one chronic disease were more satisfied when they received Community resource-linked services. In the case of elderly people with two or more chronic diseases, the service satisfaction level is increased when health condition assessment and Community resource-linked services are provided. Regardless of whether or not they have chronic diseases, service delivery time was a factor that increased satisfaction in home visiting health care. And the degree of explanation understanding was a factor that increased satisfaction for both single and complex chronic patients. Home Visiting health care services based on the community is a key component of the ongoing community care. In order to increase the sustainability and effectiveness of community care in the future, Community-oriented health care services based on the degree of chronic diseases of the elderly should be provided. In order to provide more effective services, however, it is necessary (1) to establish a linkage system to share health information of the subject held by the National Health Insurance Service to local governments and (2) to provide capacity-building education for visiting nurses to improve the quality of home visiting health care services. It is hoped that this study will be us ed as bas ic data for the successful settlement of community care.

• Journal of agricultural medicine and community health
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• v.47 no.3
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• pp.181-188
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• 2022

Objectives: The prevalence of diabetes mellitus was approximately 16% in populations of over age 30 years, and deaths from diabetes mellitus became the sixth most prevalent cause of death by disease. To assess the relationship between HbA1c and heavy metal level in blood and urine, targeted residents were evaluated in a vast steel industrial complex. Methods: We selected 414 subjects for analysis after applying the following exclusion criterion: 18 persons with diabetes mellitus. They took part in a questionnaire survey and underwent blood and urinary assessments. HbA1c and lead (Pb) level were measured in blood and, cadmium (Cd), inorganic arsenic (iAs) and mercury (Hg) were evaluated in urine. Two subgroups were divided by HbA1c 6.5%. Each subgroup was divided by 10th, 20th, 30th, 40th, 50th, 60th, 70th, 80th and 90th percentile levels of biological exposure index of the heavy metals for logistic regression. Results: Odd ratios have a tendency to increase as they go from the 90th to the 10th percentile of cadmium. However, lead, arsenic and mercury did not have significant relationships with HbA1c. In correction of age, region, gender and smoking history, a higher distribution in the subgroup with cadmium above 0.8318 ㎍/g creatinine (30th percentile) was demonstrated in the subgroup with HbA1c levels above the 6.5%, with an odds ratio of 5.26 (95% C.I. ; 1.44~19.17). Conclusion: This study found a significant correlation between urinary levels of cadmium and HbA1c in correction of several factors. It is meaningful that this outcome may be used as a basis for a study to establish the acceptable limit of urinary cadmium in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.111-120
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• 2021

Objectives : Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. Methods : This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were analyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. Results : Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship between shift work and alcohol in the case of men, but in the case of women, there was a significant positive relationship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. Conclusions : The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.119-126
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• 2022

Objectives : The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). Methods : 43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. Results : Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R²=0.407, p<0.05). Conclusions : The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate disorders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.127-136
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• 2022

Objectives : The study aimed to identify factors associated with suicidal attempt in Korean adults experiencing thoughts of suicide. Methods : This study analyzed outcomes of suicidal behavior in the Korea National Health and Nutrition Examination Survey (KNHANES) 2015, 2017, and 2019. This survey was administered by the Korea Centers for Disease Control and Prevention (KCDC). The suicidal idea group was divided into individuals who had attempted suicide (n=92) and those who had not (n=831). Complex samples crosstabs analysis was conducted to compare the two groups' sociodemographic, psychiatric, and clinical characteristics. In addition, factors related to attempted suicide were investigated using complex samples logistic regression analysis. Results : The attempted suicide group had significantly higher rates of depression, recent psychiatric counseling, and suicidal plan (p<0.001) than the non-attempting group. In addition, the groups differed significantly in the frequency of binge drinking and smoking (p<0.05). Adjusted multivariate analysis revealed that the presence of a suicidal plan (Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), daily binge drinking (OR=3.14, 95% CI=1.26-7.84), psychiatric counseling within the past year (OR=3.03, 95% CI=1.75-5.23), low income level (OR=2.89, 95% CI=1.17-7.10), and history of depression (OR=2.39, 95% CI=1.29-4.42) were significantly associated with suicidal attempt. Conclusions : Factors associated with suicidal attempt among suicidal ideators in the general Korean population were identified across all sociodemographic, psychiatric, and clinical variables. Assessment of and intervention in suicidal plan, binge drinking, income level, and depression might prevent progression to suicidal attempt among those contemplating suicide.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.120-140
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• 2022

Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B₁, vitamin B₂, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.404-412
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• 2021

Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm²) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.61-67
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• 2021

Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.

• Journal of agricultural medicine and community health
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• v.47 no.2
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• pp.90-98
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• 2022

Objective: This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community. Methods: The study included 1,019 subjects aged 60 and over. "Possible sarcopenia" was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutrition assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and sarcopenia. Results: MNA was significantly associated with social participation (OR = 1.747, p <0.001), fear of falling (OR = 2.905, p <0.001), and self-efficacy (high/low, OR = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, sarcopenia was significantly associated with MNA (OR = 2.529, p <0.001) and fear of falling (OR = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (OR = 0.589, p = 0.009) was significant. The factors related to possible sarcopenia include risk of malnutrition, fear of falls, and low self-efficacy. Conclusion: It will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises. Finally, it is also necessary to increase regular participation in community social activities.