BACKGROUND: It is expected that the number of families who provide caregiving for hospice patients will be increased in this society. Family caregiver will have fi nancial, psychological, social burden and stress related to this responsibility. Hospice patients, facing death, need not only biomedical therapy, but also systematic and continuous treatments such as mental or psycho-social intervention. The purpose of this study was to investigate the family caregiver's depression level and the associated factors. METHODS: The survey was conducted with 62 family caregivers of the hospice patients who had been hospitalized at the Gwangju Veterans Hospital from December 2005 to May 2006. The questionnaire consisted of the general characteristics of the subjects, Beck's depression inventory (BDI) evaluating the depression level and family APGAR score evaluating the family function. RESULTS: The mean age of the subjects was 58.2 years. The relationship with patients as 'spouse' accounted for 42 individuals (67.7%). The mean (+/- SD) BDI score was 25.3 (+/- 10.1) points and 58 percent of the subjects were suggested to have depression tendency (> or = 21 point). There was no relationship between the caregiver's depression level and their gender, religion, household income and Family APGAR score. However, the depression level was signifi cant related to the total caregiving duration (P = 0.001), visiting frequency of visitors (P = 0.004) and caregiving hours per day (P = 0.005). CONCLUSION: More than half of the family caregivers were suggested to have depression tendency. The depression level was infl uenced by the burden of caregiving and the visiting frequency of visitors. There is a need to activate social resources to share the burden of caregiving and to develop continuous and comprehensive care for hospice patients and their families.
Apgar Score ; Caregivers ; Depression ; Family Characteristics ; Hospices ; Hospitals, Veterans ; Humans

BACKGROUND: The Korean-Mini-Mental Status Examination (K-MMSE) is a dementia-screening test that can be easily applied in both community and clinical settings. However, in 20% to 30% of cases, the K-MMSE produces a false negative response. This suggests that it is necessary to evaluate the accuracy of K-MMSE as a screening test for dementia, which can be achieved through comparison of K-MMSE and Seoul Neuropsychological Screening Battery (SNSB)-II results. METHODS: The study included 713 subjects (male 534, female 179; mean age, 69.3±6.9 years). All subjects were assessed using K-MMSE and SNSB-II tests, the results of which were divided into normal and abnormal in 15 percentile standards. RESULTS: The sensitivity of the K-MMSE was 48.7%, with a specificity of 89.9%. The incidence of false positive and negative results totaled 10.1% and 51.2%, respectively. In addition, the positive predictive value of the K-MMSE was 87.1%, while the negative predictive value was 55.6%. The false-negative group showed cognitive impairments in regions of memory and executive function. Subsequently, in the false-positive group, subjects demonstrated reduced performance in memory recall, time orientation, attention, and calculation of K-MMSE items. CONCLUSION: The results obtained in the study suggest that cognitive function might still be impaired even if an individual obtained a normal score on the K-MMSE. If the K-MMSE is combined with tests of memory or executive function, the accuracy of dementia diagnosis could be greatly improved.
Cognition ; Cognition Disorders ; Dementia ; Diagnosis ; Executive Function ; Female ; Humans ; Incidence ; Mass Screening* ; Memory ; Sensitivity and Specificity ; Seoul*

Background: Coffee is the most commonly consumed beverage worldwide and has a variety of health benefits. However, the relationship between coffee consumption and bone mineral density (BMD) is still controversial. This study aimed to assess the associations between coffee consumption and BMD in Korean men aged 50 years and older. Methods: The study included 271 Korean men aged 50 years and older from the Fourth Korea National Health and Nutrition Examination Survey 2011. Coffee consumption frequency was assessed using a questionnaire and categorized as follows: none, ≤1 cup/day, 2 cups/day, or 3 cups/day. The BMD of the total femur, femur neck, and lumbar spine were compared based on coffee consumption frequency. Multiple logistic regression analysis was used to analyze the association between coffee consumption and impaired bone health (osteopenia or osteoporosis). Results: The BMD of the total femur and femur neck significantly increased with higher coffee consumption (P<0.001). Participants with the highest coffee consumption had the lowest odds ratio for osteopenia or osteoporosis of the total femur and femur neck (P<0.001 and P<0.05, respectively). After adjusting for all confounding factors, this trend remained consistent in the femur neck (P<0.05); drinking 2 cups of coffee per day was found to be associated with the lowest risk of osteopenia or osteoporosis of the total femur. Conclusion Coffee consumption was found to decrease the risk of osteopenia or osteoporosis of the total femur and femur neck in Korean men aged 50 years and older.

BACKGROUND: Dry eye is a common disease, and coffee is a popular beverage that is heavily consumed in Korea and worldwide. We examined the correlation between coffee consumption and dry eye.METHODS: This study was performed using data from the 5th Korean National Health and Nutrition Examination Survey, which was a cross-sectional study of the Korean population conducted from 24 months. We included adults aged ≥19 years who underwent ophthalmologic examination and excluded those who had comorbid conditions with dry eye. The subjects were divided into dry eye and control groups. The dry eye group consisted of those who had been clinically diagnosed with dry eye. A multiple logistic regression analysis was conducted to determine the correlation between coffee consumption and dry eye.RESULTS: An inverse correlation was found between coffee consumption and dry eye in the group that consumed 3 cups of coffee a day (P=0.001). However, after multivariate adjustment, the statistical significance of the correlation disappeared (P=0.283).CONCLUSION: Consumption of 3 cups of coffee a day in comparison to non-consumption group was negatively correlated with dry eye in an univariate analysis model, but the correlation was not statistically significant after adjusting for age, sex, body mass index, smoking, binge drinking, sun exposure time and history of eye surgery.
Adult ; Beverages ; Binge Drinking ; Body Mass Index ; Coffee ; Cross-Sectional Studies ; Dry Eye Syndromes ; Humans ; Korea ; Logistic Models ; Nutrition Surveys ; Smoke ; Smoking ; Solar System

Objective: To evaluate the safety and effectiveness of the community-based cardiac rehabilitation (CBCR) program that we had developed. Methods: Individuals aged >40 years with cardiovascular disease or its risk factors who were residing in a rural area were recruited as study subjects. The CBCR program, which consisted of 10 education sessions and 20 weeks of customized exercises (twice a week), was conducted in a public health center for 22 weeks. Comprehensive outcomes including body weight, blood glucose level, and 6-minute walk distance (6MWD) were measured at baseline, 11th week, and completion. Furthermore, the outcomes of young-old (65–74 years) and old-old (≥75 years) female subjects were compared. Results: Of 31 subjects, 21 completed the program (completion rate, 67.7%). No adverse events were observed, and none of the subjects discontinued the exercise program because of chest pain, dyspnea, and increased blood pressure. Body weight and blood glucose level were significantly decreased, and 6MWD was significantly increased following program implementation (p<0.05). Both young-old and old-old women exhibited an improvement in blood glucose level and 6MWD test (p<0.05). Conclusion We reported the results of the first attempted CBCR in South Korea that was implemented without adverse events during the entire program. Improved aerobic exercise ability and reduced risk factors in all participants were observed. These improvements were also achieved by older adults aged ≥75 years.

OBJECTIVE: Little is known about the characteristic differences in alexithymic construct in various psychiatric disorders because of a paucity of direct comparisons between psychiatric disorders. Therefore, this study explored disorder-related differences in alexithymic characteristics among Korean patients diagnosed with four major psychiatric disorders (n=388). METHODS: Alexithymic tendencies, as measured by the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), of patients classified into four groups according to major psychiatric diagnosis were compared. The groups consisted of patients with depressive disorders (DP; n=125), somatoform disorders (SM; n=78), anxiety disorders (AX; n=117), and psychotic disorders (PS; n=68). RESULTS: We found that substantial portions of patients in all groups were classified as having alexithymia and no statistical intergroup differences emerged (42.4%, 35.9%, 35.3%, and 33.3% for DP, SM, PS, and AX). However, patients with DP obtained higher scores in factor 2 (difficulties describing feelings) than those with SM or AX, after adjusting for demographic variables. CONCLUSION: These findings suggest that alexithymia might be associated with a higher vulnerability to depressive disorders and factor 2 of TAS-20K could be a discriminating feature of depressive disorders.
Affective Symptoms ; Anxiety ; Anxiety Disorders ; Depressive Disorder ; Humans ; Mental Disorders ; Psychotic Disorders ; Somatoform Disorders

OBJECTIVES: To evaluate the Community-Based Participatory Research (CBPR) professional periodontal care program model for patients with hypertension and diabetes. METHODS: This descriptive case study included 151 participants of the professional periodontal care program. The CBPR-based professional periodontal care program consists of 5-steps: ‘Issue identification and prioritization’ (Step 1), ‘Strategy development’ (Step 2), ‘Entry into community’ (Step 3), ‘Implementation’ (Step 4), and ‘Transition’ (Step 5). Quantitative data were analyzed using frequency analysis, and descriptive data with PASW 23.0 (SPSS Inc., Chicago, IL, USA). The results of the Focus group interview (FGI) were classified as ‘general opinions regarding the program planning and operation receptiveness’, ‘sustainability’, ‘potential spread of the program’, and ‘improvement of program’. The interviews were qualitative research involving seven people. RESULTS: 1. Participants increased their interest in health and oral health by managing their hypertension, diabetes, and periodontal disease using community resources. Through this, healthy practices and improved awareness helped to prevent complications and manage periodontal diseases. 2. Community organizations actively cooperated, resulting in positive changes in oral health practices (increased registration of patients in education centers for hypertension and diabetes, and increased number of patients visiting the local dental clinic). In the future, it was positive to participate in the program continuously. CONCLUSIONS: The most important step is ‘Entry into community’, which has led to active participation and cooperation of community organizations and participants. Therefore, community organizations and strategy development should be discussed, and the role of community leaders should be emphasized to build cooperative relationships. In addition, participation in and collaboration with health-based projects should be achieved through a search of various community organizations.
Chronic Disease ; Community-Based Participatory Research ; Consumer Participation ; Cooperative Behavior ; Education ; Focus Groups ; Humans ; Hypertension* ; Oral Health ; Periodontal Diseases ; Qualitative Research

The neurofibroma in oral cavity is typically associated with neurofibromatosis. The solitary neurofibroma is commonly observed in skin. It is relatively rare in oral cavity and usually observed in the tongue, buccal mucosa, and vestibule. The rare types of solitary neurofibromas have been reported as a case report and they were in the inferior alveolar nerve, infratemporal fossa, maxilla, and palatal ginviva. In our hospital, the presented case was the first case as reported as solitary neurofibroma in the oral cavity. The prognosis after excision and the review of literatures were presented.
Mandibular Nerve ; Maxilla ; Mouth ; Mouth Mucosa ; Neurofibroma* ; Neurofibromatoses ; Prognosis ; Skin ; Tongue

Background: A chronic disease management program including patient education, recall and remind service, and reduction of out-of-pocket payment was implemented in Korea through a chronic care model. This study aimed to assess the effect of a community-based intervention program for improving medication adherence of patients with diabetes mellitus in rural areas of Korea. Methods: We applied a non-equivalent control group design using Korean National Health Insurance Big Data. Hongcheon County has been continuously adopting this program since 2012 as an intervention region. Hoengseong County did not adopt such program. It was used as a control region. Subjects were a cohort of patients with diabetes mellitus aged more than 65 years but less than 85 years among residents for 11 years from 2010 to 2020. After 1:1 matching, there were 368 subjects in the intervention region and 368 in the control region. Indirect indicators were analyzed using the difference-in-difference regression according to Andersen’s medical use model. Results: The increasing percent point of diabetic patients who continuously received insurance benefits for more than 240 days from 2010 to 2014 and from 2010 to 2020 were 2.6%p and 2.7%p in the intervention region and 3.0%p and 3.9%p in the control region, respectively. The number of dispensations per prescription of diabetic patient in the intervention region increased by approximately 4.61% by month compared to that in the control region. Conclusion The intervention program encouraged older people with diabetes mellitus to receive continuous care for overcoming the rule of halves in the community. More research is needed to determine whether further improvement in the continuity of comprehensive care can prevent the progression of cardiovascular diseases.

OBJECTIVES: The aim of this study was to investigate brain activation during a Korean language-based 'theory of mind (TOM)' task and fMRI in Korean schizophrenic patients. METHODS: Fourteen Korean schizophrenic patients and 15 normal controls participated in this study. For all participants, several clinical states and psychosocial functions were evaluated. The subjects were then scanned while performing Korean language-based fMRI tasks. The tasks were comprised of conditions-first order false belief (TOM task), physical causality, and unrelated situations. Imaging data were analyzed using SPM2 software (uncorrected p<0.005, extent threshold kappa=10). RESULTS: 1) Compared with the control group, the patient group showed significantly poorer performance on the TOM task, and no significant correlation between TOM and empathic abilitiesy. 2) In the patient group, there were no significantly activated brain regions associated with the TOM task as compared to the physical causality task. With respect to between-group differences, the patient group showed significantly less activation of the left medial frontal region (primarily BA 8) and signifcantly different activation of the left precuneus (BA 7) associated with the TOM task. CONCLUSION: These results suggest that Korean schizophreniac patients show different brain activity associated with TOM functions, especially with respect to the Korean language-based first order false belief tasks.
Brain ; Humans ; Magnetic Resonance Imaging ; Schizophrenia ; Theory of Mind