PURPOSE: This study aimed to verify the predictive validity of Comprehensive Korean Frailty Instrument (CKFI) among older adults. METHODS: A secondary analysis of data from a prospective cohort study was conducted. Frailty was determined in older adults (N=9,188) according to the data in 2008 and the effects of frailty on adverse outcomes (such as institutionalization and death) were evaluated according to the data in 2011. The Cardiovascular Health Study (CHS) index was used to compare with the predictive validity of CKFI. RESULTS: The prevalence of frailty was 26.3%. With the CKFI, the frail group had a higher risk of negative health outcomes compared to the robust and pre-frail groups after three years. The two of the highest risks identified using the CKFI and CHS index were institutionalization (5.522 times higher) and mortality (3.210 times higher). For both instruments, the survival analysis revealed that the risk of death increased as the degree of frailty increased. CONCLUSION: The CKFI consisting of self-report items and multidimensional aspects of frailty can be used as a simple instrument for assessing the frailty of older adults residing in a local community in Korea.
Adult ; Aged ; Cohort Studies ; Frail Elderly ; Humans ; Institutionalization ; Korea* ; Long Term Adverse Effects ; Mortality ; Prevalence ; Prospective Studies

PURPOSE: The purpose of this study was to develop and establish the psychometric properties of a clinical nursing competency evaluation tool to be utilized by clinical preceptors. METHODS: The initial items were identified through in-depth literature review and field interviews based on a hybrid model. Content validation of the items was evaluated through three rounds of content validity testing. Participants were 34 clinical preceptors and 443 nursing students participating in clinical practice. Data were analyzed using exploratory and confirmatory factor analysis, convergence and discriminant validity, internal consistency and inter-rater reliability. RESULTS: The final scale consisted of 23 items and four factors, fundamental nursing skills performance, critical thinking skills based on the nursing process, basic nursing knowledge, and professional attitude; these factor explained 69.7% of the total variance. The analysis with multi-trait/multi-item matrix correlation coefficients yielded 100.0% and 95.7 % convergence and discriminant validity, respectively. Cronbach's alpha for the total items was .95. The four subscale model tested by confirmatory factor analysis was satisfactory. Inter-rater reliability ranged from .912 to .967. CONCLUSION: This scale was found to be a reliable and valid instrument that clinical preceptors can apply for evaluating the clinical nursing competency of nursing students in clinical settings.
Clinical Competence ; Humans ; Nursing Process ; Nursing* ; Psychometrics* ; Reproducibility of Results ; Students, Nursing ; Thinking

Purpose: The purpose of this qualitative study is to explore the changed parenting experiences of mothers of elementary school kids living in the aftermath of the COVID-19 outbreak in Korea. Methods: From July to August in 2020, 10 mothers parenting elementary school students under the COVID-19 were interviewed in depth. For data analysis, a phenomenological research methodology suggested by Colaizzi was used. Results: According to the analysis, the experiences of mothers consisted of four categories: the ‘pain from the uncontrollable COVID-19’, ‘the problem of family relations due to the COVID-19 pandemic situation’, ‘standing firm against the drastic changes’, and ‘accepting the world changed by the COVID-19’. Conclusion The findings in this study vividly represent the parenting experiences of mothers of elementary school students after the outbreak of COVID-19. As the pandemic persists, mothers parenting elementary school students feel complex emotions and experience exhaustion, but in the process, they found family members growing positively and trying to adjust to each other to overcome the crisis. To support positive adaptation to catastrophic situations, an institutional and political foundation is needed to develop a systematic crisis management program customized for mothers and families of elementary school students. The results of this study can be used as basic data when establishing national policies and support systems so that mothers parenting elementary school students can better adapt to and overcome crisis situations.

This study investigated the cumulative effects of depressive symptoms on cognitive function over time in community-dwelling older adults. Methods: Data were investigated from 2,533 community-dwelling older adults who participated in the Korean Longitudinal Study of Aging (KLoSA) from the 5th (2014) to the 8th wave (2020). The association between cumulative depressive symptoms and cognitive function was identified through multiple regression analysis. Results: When the multiple regression analysis was conducted from each wave, the current depressive symptoms scores and cognitive function scores were negatively associated, regardless of the waves (B5th = - 0.26, B6th = - 0.26, B7th = - 0.26, and B8th = - 0.27; all p < .001). Further, when all the previous depressive symptoms scores were added as explanatory variables in the 8th wave, the current one (B8th = - 0.09, p < .001) and the previous ones (B5th = - 0.11, B6th = - 0.09, and B7th = - 0.13; all p < .001) were also negatively associated with the cognitive function score. The delta R2 , which indicates the difference between the model’s R2 with and without the depressive symptoms scores, was greater in the model with all the previous and current depressive symptoms scores (6.4%) than in the model with only the current depressive symptoms score (3.6%). Conclusion: Depressive symptoms in older adults have a long-term impact. This results in an accumulated adverse effect on the cognitive function. Therefore, to prevent cognitive decline in older adults, we suggest detecting their depressive symptoms early and providing continuous intervention to reduce exposure to long-term depressive symptoms.

Energy requirement is defined as energy expenditure in an energy equilibrium state.The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to ‘low active’ was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with ‘active’ and ‘very active’ PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.

There are few studies on the severity and prognosis of patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) omicron variant. From January 11, 2022 to January 25, 2022, 181 patients were infected with the SARS-CoV-2 omicron variant in a single hospital in Korea. The initial clinical characteristics were investigated through the COVID-19 basic investigation form. Outcomes were reviewed using medical records. The median age of the patients was 57 years (range 1–90), and 95 patients (52.5%) were male. None were re-infected with SARS-CoV-2, and 127 (70.2%) were fully vaccinated (boosted or within 6 months after second vaccination). Forty-two patients (23.2%) were asymptomatic. Among symptomatic patients, the frequency of symptoms was as follows: cough (37.0%), sore throat (33.7%), and fever (30.4%). In terms of disease severity, 168 (92.8%) patients did not require supplemental oxygen, 6 (3.3%) required low-flow oxygen, 5 (2.8%) required high-flow oxygen, and 2 (1.1%) died. Four of the five individuals who required high-flow oxygen and the two who died were not vaccinated. Most of the patients who contracted the SARS-CoV-2 omicron variant exhibited mild clinical features; however, severe clinical features including mortality were encountered among individuals who were not vaccinated.

Neurofibromatosis type 1 (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous disorder characterized by abnormal skin pigmentation (cafe au lait spots and axillary freckling), cutaneous and plexiform neurofibromas, skeletal dysplasias, and Lisch nodules (pigmented iris hamartomas). Gastrointestinal stromal tumors (GISTs) are the most common tumors of mesenchymal origin in the gastrointestinal tract, mesentery, omentum, and retroperitoneum. Here, we report a case of GIST in the ileum of a 76-year-old woman previously diagnosed as NF-1. She was admitted due to sudden onset of abdominal pain. Contrast enhanced CT scan revealed a moderately defined, peripherally enhanced soft tissue mass of about 8.8 x 7.3 cm, originating from the small bowel in the left of the abdomen. Surgical excision was performed and the tumor was found to be composed of tumor cells that were positive for c-kit protein. The patient started imatinib treatment a month later, but stopped medication due to dyspepsia after a few months and eventually progressed after 18 months.
Risk Factors ; Neurofibromatosis 1/*diagnosis/pathology/surgery ; Humans ; Gastrointestinal Stromal Tumors/*diagnosis/pathology/surgery ; Female ; Aged ; Abdominal Pain

OBJECTIVES: Many patients diagnosed with cancer suffer from various psychiatric symptoms such as depression, anxiety and insomnia as well as cancer itself. Patients with cancer are more vulnerable to possible adverse events of psychotropic medications. Although antidepressants are widely used among cancer patients, there is little information about tolerability of antidepressants. This study was conducted to compare tolerability of antidepressants in cancer patients referred for psychiatric consultation. METHODS: The participants were cancer patients who had been referred to psychiatrist for their psychiatric symptoms. We retrospectively analyzed the data of patients diagnosed with cancer from 9 general hospitals in Korea. The discontinuation rate for a 6 months period after treatment initiation for three antidepressants(Escitalopram, Mirtazapine, Paroxetine) were compared. RESULTS: Antidepressants were prescribed for 96.3% of subjects and Escitalopram 150(47.2%), Mirtazapine 92 (28.9%) and Paroxetine 76(23.9%) were prescribed frequently in order There were no significant differences in discontinuation rates among the three antidepressants during the 6 month period after initiation of pharmacotherapy. But there was a difference in discontinuation rates between inpatients versus outpatients(p<0.0001). CONCLUSIONS: In a naturalistic setting for the antidepressant treatment for cancer patients, it seems that there are no differences in discontinuation rates among these three antidepressants. It is therefore essential that such interactions are carefully considered when treating patients of antidepressants who already have cancer.
Antidepressive Agents ; Anxiety ; Citalopram ; Depression ; Hospitals, General ; Humans ; Inpatients ; Korea ; Mianserin ; Paroxetine ; Psychiatry ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

The role that children play in the transmission of the omicron variant is unclear. Here we report an outbreak that started in young children attending various pediatric facilities, leading to extensive household transmission that affected 75 families with 88 confirmed case-patients in 3 weeks. Tailored social and public health measures directed towards children and pediatric facilities are warranted with the emergence of highly transmissible omicron variant to mitigate the impact of coronavirus diseases 2019 (COVID-19).

BACKGROUND: Thalidomide has been reported to have antitumor activity for treating metastatic hepatocellular carcinoma (HCC). We evaluated the safety and efficacy of using thalidomide for treating selected patients with unresectable or metastatic HCC, and their disease was refractory to systemic chemotherapy. METHODS: Eight patients with measurable and metastatic HCC that had progressed with prior systemic chemotherapy and who desired further active therapy were enrolled in this study. Thalidomide was given orally at bedtime and it was started at 200 mg/day with no further dose escalation. The response was measured at 2-month intervals. RESULTS: The median age was 44 years (range: 34-52 years) and all the patients had received doxorubicin-based systemic chemotherapy prior to their enrollment. Each patient received thalidomide for a median of 152 days (range: 5-422 days). One partial response was observed (12.5%, 95% CI; 0-42%) along with 4 cases of stable diseases. The most commonly encountered toxicity was somnolence; grade 3 somnolence was noted for one patient, which led to treatment discontinuation. Skin rash was observed in one responding patient. CONCLUSIONS: The results indicate that thalidomide may feasibly offer disease stabilization to metastatic HCC patients. Further dose escalation of thalidomide, or its combination with other chemotherapeutic agents, may be of interest and this should be investigated for treating patients with metastatic HCC.
Treatment Outcome ; Thalidomide/*therapeutic use ; Retrospective Studies ; Pilot Projects ; Middle Aged ; Male ; Lymphatic Metastasis ; Lung Neoplasms/drug therapy/*secondary ; Liver Neoplasms/*drug therapy/pathology ; Immunosuppressive Agents/*therapeutic use ; Humans ; Follow-Up Studies ; Female ; Carcinoma, Hepatocellular/*drug therapy/secondary ; Bone Neoplasms/drug therapy/*secondary ; Adult