Care Settings In Korea Research Articles

Validation of the Insomnia Severity Index among University Students in Korea

Insomnia is the most common sleep complaint in clinical practice, affecting both the physical and mental health of patients as well as many aspects of their life quality. Young adults, especially university students, are prone to a high prevalence of poor sleep quality or insomnia. Accurate assessment of insomnia severity among university students has become an important issue. One promising screening tool to identify clinically significant insomnia in the campus setting is the Insomnia Severity Index (ISI), a seven-item self-report measure designed to assess the nature and severity of one’s insomnia. Although the ISI has been validated in primary care settings in Korea, no studies have examined its factor structure for university students. This study aimed to analyze the psychometric properties of the Korean version of the ISI.<strong> </strong>A convenience sample of 252 undergraduate students aged 18-64 attending a four-year university in South Korea was recruited for the study. The collected data underwent exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), which tested alternative models to determine the factorial structure of the ISI. Internal consistency and convergent and discriminant validity were examined. CFA findings showed that a two-factor model best fit the data. The ISI was found to be significantly correlated with higher depressive symptoms and possess adequate internal consistency. Our study confirmed that the ISI had insufficient reliability and good convergent and discriminant validity.<strong> </strong>This study generally supports the validity and factor structure of the ISI. Its two-factor structure is a psychometrically robust measure for evaluating the prevalence of insomnia.

Exploring Orthopedic Occupational Therapy in Korea: Insights from a Survey on Occupational Therapists' Perspectives.

This study explores the perceptions and experiences of Korean occupational therapists (OTs) about their role in managing elderly patients with orthopedic conditions. The goal is to inform policy discussions for better integration of OT services in orthopedic care settings in Korea. A survey was conducted among Korean clinical OTs to gather data on their perceptions, experiences, and challenges in providing orthopedic OT services. Snowball sampling was used, and the survey addressed general characteristics, orthopedic OT status, perceptions, and competence. The data were analyzed using frequency and percentage calculations in SPSS 22.0. Out of 171 respondents, only 18 had experience working in orthopedic departments, while 78 (45.6%) had provided occupational therapy to orthopedic patients. Rehabilitation medicine physicians were the primary prescribers of orthopedic OT. Key challenges included a lack of awareness among professionals, an absence of appropriate fees, and insufficient knowledge among OTs. The majority of respondents agreed that providing OT in orthopedic departments was appropriate and expressed a need for education and clinical guidelines. The study examines the current state of orthopedic OT in Korea, showing low levels of experience and highlighting challenges, such as a lack of professional awareness, inadequate fees, and insufficient knowledge among OTs. Respondents mostly agreed on the necessity for education and clinical guidelines to improve their capabilities in orthopedic settings. This study emphasizes the need for healthcare system improvements that allow OTs to participate more widely without being confined to specific medical disciplines, promoting a more comprehensive approach to OT, especially as the aging population continues to grow.

"Leisure Life Satisfaction:" Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings in Korea?

ObjectivesWhile the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults.MethodsThis study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older.ResultsAfter controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization.ConclusionsThe findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.

Trends in Ambulatory Analgesic Usage after Myocardial Infarction: A Nationwide Cross-Sectional Study of Real-World Data.

Although current guidelines for myocardial infarction (MI) recommend caution in using non-steroidal anti-inflammatory drugs (NSAIDs), real-world studies of ambulatory settings are rare. This study aimed to explore the patterns and trends of analgesic prescriptions (especially NSAIDs) among patients with a history of MI in ambulatory care settings in Korea. We analyzed real-world data from the Korea National Health Insurance Service database. Patients aged 20 years or older hospitalized with incident MI were identified between January 2007 and December 2015. Ambulatory analgesics were administered after discharge from incident hospitalization for MI, and annual trends in the prescriptions of individual analgesics were evaluated. Among the 93,597 patients with incident MI, 75,131 (80.3%) received a total of 2,081,705 ambulatory analgesic prescriptions. Prescriptions were mainly issued at primary care clinics (80.3%). Analgesics were most frequently prescribed for musculoskeletal diseases (often NSAIDs, 70.7%); aceclofenac (13.7%) and diclofenac injection (9.4%) were the frequently used NSAIDs. Additionally, significant changes were observed in the trends for some analgesics, such as loxoprofen. This study suggested that NSAIDs are commonly prescribed to patients with a history of MI. Future real-world studies are needed to elucidate the drug–disease interactions of NSAIDs prescribed after MI, especially for patients with musculoskeletal diseases.

Understanding Nurses’ Experiences and Perceptions of End-of-Life Care for Cancer Patients in Korea: A Scoping Review

Quality end-of-life care for cancer patients is a global health priority, and nurses are instrumental in providing this care. However, little is known about nurses' experiences and perceptions in end-of-life care settings in Korea. Aims: This scoping review examined Korean nurses' end-of-life care experiences and assessed the state of research in this area. Systematic searches were conducted using 7 electronic databases (PubMed, CINAHL, Scopus, Embase, WPRIM, KCI, and RISS), and 17 studies were selected for review. Most studies were limited to cross-sectional, descriptive designs. Outcomes regarding end-of-life care measured in the studies were categorized into cognitive variables, emotional variables, participation/performance, and educational needs. Study results suggested low nurse knowledge and self-efficacy with regard to provision of end-of-life care. Perceived barriers to quality end of life care included difficulties in meeting family members' needs. In addition, emotional outcomes associated with end-of-life care included high levels of nurse stress and burnout. Predictors of elevated stress included inability to provide adequate pain control, inability to reconcile patient requests with physician orders, and heavy workload. Although most nurses had end-of-life care experience, fewer than half reported receiving related education. The lack of knowledge and skill related to end of life care was a primary contributor to stress. Korean nurses providing end-of-life care for cancer patients need additional education and support to help them manage high stress levels. Further study is needed to identify strategies for meeting nurses' end-of-life care education needs and of improving their overall performance in such practice.

Respiratory Protection Effect of Ear-loop-type KF94 Masks according to the Wearing Method in COVID-19 Pandemic: a Randomized, Open-label Study.

BackgroundEar-loop-type Korean Filter 94 masks (KF94 masks, equivalent to the N95 and FFP2) are broadly used in health care settings in Korea for the coronavirus disease 2019 pandemic.MethodsA prospective randomized open-label study was designed to identify differences in the fitting performance between mask wearing methods in three different types of KF94 mask with ear loops between January to March 2021. General-fitting involved wearing an ear-loop-type KF94 mask, and tight-fitting involved wearing a mask aided by a clip connecting the ear loops. Each of the 30 participants wore three types of masks according to a randomly assigned order in both methods and performed a total of six quantitative fit tests (QNFTs) according to the occupational safety and health administration protocol.ResultsAll fit factors (FFs) measured by the QNFT were significantly higher for tight-fitting method with the clip in all KF94 masks (P < 0.001). However, the total FFs were very low, with a median (interquartile range) of 6 (3–23) and 29 (9–116) for general-fitting and tight-fitting, respectively. When wearing tightly, the horizontal 3-fold type mask with adjustable ear-loop length had the highest FF, with a median of 125, and the QNFT pass rate (FF ≥ 100) increased significantly from 4 (13%) to 18 (60%).ConclusionEven with sufficient filter efficiency, ear-loop-type-KF94 masks do not provide adequate protection. However, in relatively low-risk environments, wearing a face-seal adjustable KF94 mask and tight wearing with a clip can improve respiratory protection for healthcare workers.Trial RegistrationClinicalTrials.gov Identifier: NCT04794556

Therapeutic duplicate prescribing in Korean ambulatory care settings using the National Health Insurance claim data.

Duplicate prescribing is known to occur across health systems and is one of the most frequent drug related problems. Therapeutic duplication (TD) increases the risk of adverse drug reactions without additional therapeutic benefits. This study aimed to develop TD criteria concerning four drug categories which are acid-related disorder drugs, antimicrobials, antihypertensives, and lipid modifying drugs and to estimate the prevalence of therapeutic duplicate prescribing at the ambulatory care settings in Korea. TD criteria were developed using the WHO anatomical therapeutic chemical classification and modified with an expert consensus panel using the Delphi method. The prevalence of TD including ingredient duplication (ID) of four drug categories was examined using National Health Insurance claim database including 15 million patients during one month in 2009 (December). TD was defined as prescribing medications within the same category in the developed TD criteria list. The numbers of patients who received acid-related disorder drugs, antimicrobials, antihypertensives, and lipid-modifying drugs in the study period were 10,049,292, 7,584,131, 4,349,945, and 1,425,292 respectively. In the field of acid-related disorder drugs prescribed, there were 0.3 % IDs and 2.5 % TDs within a prescription issued by one prescriber. There were 8.4 % IDs and 14.5 % TDs between prescriptions issued at different ambulatory visits. In the field of antimicrobial medicines, there were 0.1 % IDs and 2.6 % TDs within a prescription, while there were 5.0 % IDs and 7.6 % TDs between different prescriptions. Amongst the antihypertensives prescribed, there were 0.4 % IDs and 1.9 % TDs within a prescription, while there were 9.9 % IDs and 11.5 % TDs between prescriptions. Lastly, looking at lipid-modifying drugs prescribed, there were 0.3 % IDs and 0.5 % TDs within one prescription, while there were 8.9 % IDs and 9.4 % TDs between prescriptions. The prevalence of duplicate prescribing was substantial in the ambulatory care setting which is to be improved using the TD criteria developed from this study in the national drug utilization review system in Korea.

Prevalence of Chronic Widespread Pain and Chronic Fatigue Syndrome in Korean Livestock Raisers

Chronic widespread pain (CWP), the cardinal symptom of fibromyalgia (FM), is prevalent and co-occurs with numerous symptom-based conditions such as chronic fatigue syndrome (CFS). It was given a standard definition by an American College of Rheumatology (ACR) committee. This definition emphasizes that axial pain is a constant feature and that pain has to be present in the upper and lower quadrants and the right and left sides of the body. Recent studies have reported that CWP is common in the general population and its prevalence (7.3% to 14.0%) is comparable in reports from the United States, UK, Canada, Israel, and Korea . Although several definitions of CFS have been proposed, the criteria set by an international expert panel under the aegis of the CDC (Centers for Disease Control and Prevention) in 1994 is used in most studies as well as in clinical settings. Jason et al. estimated the current prevalence of CFS in the random community-based sample as 0.42%. Kim et al. reported the point prevalence of CFS was 0.6% in community-based primary care settings in Korea. There have been several population-based studies of CFS-like illness (generally defined as meeting all self-reported criteria for CFS but lacking a physical examination). The interview studies have yielded much lower prevalences than questionnaire studies, reporting current prevalence data in the 2–3% range. There have been many epidemiological studies of CWP and CFS in the general population or samples ascertained from clinical sources, but such studies have not been reported in the same occupation sample. It may be helpful to report in which occupation CWP and CFS are more prevalent for future research about the pathogenesis of these illnesses. Thus, we conducted this study to estimate the prevalence of CWP and CFS in Korean livestock raisers.

Nursing gaze as framework for nursing practice: a study from acute care settings in Korea, Norway and the USA

The aim of the study was to investigate the nature of nurses' clinical practice in terms of what frames their clinical engagement, and to examine how clinical constructions were made. The study is based on a descriptive design using a clinical field approach in acute care settings in Korea, the USA and Norway. A theoretical sample consisted of between four and six Registered Nurses in each country: up to three from medical wards and three from surgical wards. Data were collected through participant observation of and in-depth interviews with the nurses, as well as from nursing documentation about the patients. The result showed an overall model of a theory of nursing practice consisting of three processes: nursing gaze, clinical construction and clinical engagement. This first article outlines the overall descriptive theory of nursing practice and provides a detailed description of the first aspect: the nursing gaze. The model of the structuring of nursing gaze is set within the philosophy of nursing, consisting of the ontology of client and the ontology of practice. The dimensions of normality and needs constitute the ontology of client, and the dimension of clinical expectations constituted the ontology of practice.

병원 CEO 리더십 스타일이 조직구성원의 직무만족과 이직의도에 미치는 영향Turnover

The organizational effectiveness of hospital in various environmental fluctuations is a large and complex problem. Hospital CEO leadership characteristics may be a critical determinant of employees' job satisfaction and turnover intention. Several empirical studies on transformational leadership found that transformational leadership behaviors were positively related to workers' job satisfaction and turnover intention. Very little research related to this subject has been done in health care settings in Korea. The author explores the relationship between hospital CEO leadership style and its effect on job satisfaction and turnover intention among the all staffs of general hospital. The relationship of hospital CEO leadership style to employees' job satisfaction was investigated using the Bass's leadership paradigm of transformational and transactional leadership. The Multifactor Leadership Questionnaire(MLQ) and the index of job satisfaction and turnover intention were completed by 493 hospital employees(doctors, nurses, hospital administrators, technicians, and assistants). The findings show a similar trend to the previous studies. Hospital CEO leadership behaviors and employee outcomes were significantly correlated. Correlations showed a significant positive relationship between those hospital CEO exhibiting a transformational leadership style and the job satisfaction of their staffs. The results of multiple regression analysis indicate that the effect of charisma in transformational leadership behaviors is more higher than other variables. Transformational leadership style may be a more effective strategy and have a greater effect on staff outcomes, attitudes and behaviors. The findings of this study reveal implications for efficient hospital management and the importance of understanding relationship between hospital CEO's leadership style and subordinate behaviors in the context of CEO's desirable role and function for hospital strategy planning and future direction.

P4-175: A comparison of Pentagon copying and three clock scoring methods among illiterate or low educated elderly Korean

Illiteracy or low education is prevalent among current elderly Korean. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings in Korea. This study compared the dementia screening performance of Pentagon copying and three clock drawing test (CDT) scoring systems for elderly Korean. We reviewed the charts of consecutive subjects referred between 2004 and 2005 to the geriatric health clinic and research institute (GHCRI). Subjects included were 30 Alzheimer's disease (AD) subjects and 60 normal subjects. All subjects had all undergone the CERAD–K as well as an MMSE–K, pentagon copy (scored by Bourke method and MMSE method) and CDT (scored by 3 methods: the Sunderland method, the Rouleau method, and the Watson method). AD subjects with low education were found to copy significantly worse pentagons than those with high education or normal subjects. Copying scores and CDT scores significantly correlated with MMSE scores for the AD and normal groups. Using the CERAD–K as the good standard, the sensitivity and specificity of the pentagon copying scores and the Watson method of scoring CDT to predict an abnormal CERAD–K score were 65% and 72%, 60% and 71%, respectively. Deterioration in pentagon copying and CDT correlates with severity of global cognitive impairment in low educated elderly Koreans. This study suggests that in the socio–cultural context for Korean, pentagon copy as well as CDT are feasible for use in a clinical setting for dementia screening.