PURPOSE: The present study is a descriptive cross-sectional study of cause-and-effect relationship, which used the 7th year data of the Panel Study on Korean Children, to investigate the effects of parenting stress, depression, and family interactions of the parents of early school-age children on children's subjective happiness. METHODS: The present study included data of 1419 pairs of parents who participated in the mother and father survey of the Panel Study on Korean Children. The effects of parenting stress, depression, and parental family interactions on children's subjective happiness were analyzed as actor and partner effects using path analysis. RESULTS: Parenting stress had an actor effect on depression; maternal parenting stress (β=−.21, p < .001) and depression (β=−.30, p < .001) had an actor effect on maternal family interaction; and paternal parenting stress (β=−.18, p < .001) and depression (β=−.17, p < .001) had a partner effect on maternal family interaction. Paternal parenting stress was found to have an actor effect on paternal family interaction (β=−.30, p < .001), and parental depression was found to have actor effect (β=−.23, p < .001) and maternal depression had a partner effect on paternal family interactions (β=−.22, p < .001). Children's subjective happiness was found to have a statistically significant relationship with maternal family interaction (β=.40, p < .001). CONCLUSION: The significance of the study is in its provision of basic data for adjusting parents' family interactions that are closely related to the growth and development of children by confirming the effect of parents' parenting stress, depression, and family interaction on children's subjective happiness.
Child ; Cross-Sectional Studies ; Depression ; Fathers ; Growth and Development ; Happiness* ; Humans ; Mothers ; Parenting ; Parents*

Background: The prevalence of sleep disorders increases as pregnancy progresses, which affects the health of pregnant women, fetal health, and the outcomes of pregnancy. The aim of this study is to evaluate the quality of sleep and life in pregnant women in Korea. Methods: This study is a prospective cross-sectional, case-control study of pregnant women and age-matched controls. From July to September 2019, all participants completed Korean-language versions of the sleep questionnaires including Pittsburgh sleep quality index (K-PSQI), Insomnia severity index, Epworth sleepiness scale, Back’s depression inventory-2(K-BDI), STOP (Snoring, Tiredness, Observed apneas, and high blood Pressure), and short-form 36 (K-SF-36). Results: A total of 422 participants consisted of 385 pregnant women and 137 controls. Second and third trimester were 200 and 185, respectively. K-PSQI scores were higher in pregnant women compared with the controls (7.87±3.49 and 8.50±3.55 vs. 5.79±2.76, p<0.001). Total score of K-SF-36 was lowest in third trimester (62.07±17.72) and highest in the control group(79.41±13.36). There was no statistical difference between groups in K-BDI. Conclusions This study demonstrated worsening of sleep quality as well as life quality during pregnancy. More attention to sleep of pregnant women is needed.

Purpose: The purpose of this study was to review studies investigating the effect of bereavement care provided for parents in the neonatal intensive care unit. Methods: We conducted a literature review of databases (MEDLINE, Embase, Cochrane Library, and CINAHL) for studies published in English and four databases (RISS, KISS, NANET, and KoreaMed) for Korean studies. The selection criteria included original articles that evaluated the parents’ perceptions or responses to bereavement care provided in the neonatal intensive care unit. Of 889 articles from the initial screening, 66 articles underwent full-text review and five articles were finally selected for analysis. Results: None of the studies was conducted in Korea. Only one study used a randomized control trial design. The forms of bereavement care reviewed included a provision of a memory package, grief information, and emotional and/or social support from peers or health care providers. The effectiveness of bereavement care was measured by including grief, social support, and depression. Conclusion Bereavement care can be considered to be beneficial for relieving grief reactions and enhancing the personal growth of bereaved parents. Future research should assess the needs of bereaved parents in Korea. Nurses may play a role in developing the bereavement care for parents.

PURPOSE: This study was conducted to identify the effects of job embeddedness, nursing work environment, and nursing professionalism on turnover intention in nurses working at rehabilitation hospitals. METHODS: This descriptive study employed a cross-sectional research design. Questionnaires were collected from May to June, 2019. Participants were 200 nurses from three rehabilitation hospitals in Seoul and Gyunggi province. Data were analyzed using independent t-test, ANOVA, Pearson correlation, stepwise multiple regression. RESULTS: Mean scores for turnover intention, nursing work environment, nursing professionalism. and job embeddedness were 3.21±0.65, 2.90±0.43, 3.06±0.24, and 3.11±0.40, respectively. Turnover intention was negatively correlated with job embeddedness, nursing practice environment, and nursing professionalism. Nursing work environment was the most important predictor in turnover intention, followed by job embeddedness. CONCLUSION The findings in this study indicated that we need to investigate the level of job embededness, nursing work environment, and nursing professionalism in nurses working at rehabilitation hospitals. Hospital managers should develop and apply appropriate policies and strategies to reduce nurses' turnover intention, improve nursing work environment and enhance the level of job embededness.

We conducted this cross-sectional study to elucidate factors that predict persistent smoking of the Korean cancer survivors. The subjects were 130 adult (> or =19 yr old) cancer survivors who were smokers at the diagnosis of cancer and have participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2011. We categorized them into the persistent smokers and the quitters, according to change in smoking status between the time of cancer diagnosis and the time of the survey. Factors associated with persistent smoking were evaluated using the multiple logistic regression analysis. During 7.52 yr (standard deviation = 0.34) after the cancer diagnosis, 59.6% of the 130 cancer survivors have continued to smoke. After adjusting for covariates, following factors were independently associated with the risk of persistent smoking: female, low income, high-risk alcohol use, high body mass index (> or = 25 kg/m2), presence of household members who smoke, and longer duration of smoking. Alcohol Use Disorders Identification Test showed a positive association with the risk of persistent smoking (P for trend = 0.012). In conclusion, more efforts for smoking cessation should be in place for the cancer survivors with those risk factors associated with the persistent smoking.
Adult ; Alcohol Drinking ; Cross-Sectional Studies ; Female ; *Health Behavior ; Humans ; Male ; Neoplasms/*mortality ; Republic of Korea/epidemiology ; Risk Factors ; Smoking/*epidemiology ; Smoking Cessation/psychology ; Surveys and Questionnaires ; Survivors/*psychology

BACKGROUND: In Korea, clinical performance examination (CPX) has been included in license examination for medical doctors since 2009 in order to improve clinical performance of medical students. This study aimed to evaluate the contribution of CPX to medical education. METHODS: Clinical competency in the differential diagnosis of secondary headache was compared between the incoming interns in 2009 unexposed to CPX and the incoming interns in 2010 exposed to CPX, using the data of patients who visited the emergency department due to headache (181 patients seen by 60 CPX non-exposed interns and 150 patients seen by 50 CPX-exposed interns). We obtained the data by reviewing electronic medical records and nominal lists of doctors. Clinical competency was assessed by sensitivity and specificity between the diagnostic impression by interns and the final diagnosis. The association between CPX exposure and clinical competency in secondary headache diagnosis was evaluated using multiple logistic regression analysis. RESULTS: When we assessed clinical competency on the basis of all listed diagnostic impressions, sensitivity and specificity were 67.9% and 80.0%, respectively, for headaches seen by CPX-exposed interns, and 51.7%, and 71.7%, respectively, for headaches seen by CPX non-exposed interns. Multivariable adjusted logistic regression analysis showed exposure to CPX was not associated with increased competency for identifying secondary headache. CONCLUSION: Exposure to CPX as a part of the medical license examination was not effective for the improvement of clinical competency of interns in identifying secondary headache.
Competency-Based Education ; Diagnosis ; Diagnosis, Differential* ; Education, Medical ; Electronic Health Records ; Emergency Service, Hospital ; Headache* ; Humans ; Internship and Residency ; Korea ; Licensure ; Logistic Models ; Sensitivity and Specificity ; Students, Medical

We evaluated the influence of socioeconomic factors on female cancer mortality using death data from the Cause of Death Statistics and the Korean Population and Housing Census databases collected in 2001, 2006, and 2011. We estimated Relative Index of Inequality (RII) of female cancer mortality using Poisson regression analysis. RII greater than 1 indicates increased mortality risk for women at the lowest educational level compared with women at the highest educational level. The RII for cervical cancer mortality was persistently greater than 1 for the entire study period, with a gradual increase over time. Subgroup analysis stratified by age (25-44 and 45-64 yr) revealed that younger women had increased RIIs of mortality due to cervical cancer and ovarian cancer during the entire study period. Older women had higher RII only for cervical cancer mortality, but the value was much lower than that for younger women. The RII for breast cancer mortality was greater than 1 for younger women since 2006. In conclusion, socioeconomic inequality in female cancer mortality has persisted for the last decade in Korea, which was most evident for cervical cancer, and for younger women.
Adult ; Age Factors ; Breast Neoplasms/*mortality ; Educational Status ; Female ; *Health Status Disparities ; Humans ; Middle Aged ; Ovarian Neoplasms/*mortality ; Republic of Korea ; Socioeconomic Factors ; Uterine Cervical Neoplasms/*mortality ; Uterine Neoplasms/*mortality

BACKGROUND: Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers. METHODS: We included 392 subjects who visited the comprehensive medical examination center of Hallym University Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were excluded. Obstructive pulmonary impairment was defined as < 70% of the predicted value of forced expiratory volume in 1 second/forced vital capacity. Subjects were classified into the early (≤30 minutes) and late (>30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis. RESULTS: Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cigarettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impairment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61). CONCLUSION: Compared to current smokers with a late time to first cigarette, those with an early time to first cigarette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chronic obstructive pulmonary disease.
Anemia ; Forced Expiratory Volume ; Heart ; Linear Models ; Logistic Models ; Lung Diseases ; Mass Screening ; Motor Activity ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Smoke ; Smoking ; Social Class ; Spirometry* ; Statistics as Topic ; Tobacco Products* ; Tobacco Use Disorder ; Vital Capacity

Background: In 2015, tobacco prices significantly increased in Korea as part of the government’s smoking cessation policy. This study examined the changes in the stages of smoking cessation among Korean male smokers before and after the implementation of the tobacco price policy, and identified the predictors of such changes. Methods: The study population comprised 3,533 male current smokers (age ≥19 years) who participated in the Korea National Health and Nutrition Survey in 2012, 2013, 2015, and 2016. Current smokers were defined as persons who had smoked ≥100 cigarettes during their lifetime and are continuing to smoke. In accordance with the transtheoretical model, smokers were classified into the precontemplation stage (no plan to quit), contemplation stage, and preparation stage (planning to quit within 6 months). We examined the changes in the smoking cessation stages before and after the implementation of the policy. Multivariate logistic regression analysis was conducted to identify factors related to the likelihood of continuing smoking, after adjustments for potential confounders. Results: Immediately after the policy implementation, the percentage of smokers in the precontemplation stage decreased from 65.6% to 60.8% (P=0.014). However, this effect was temporary. Significant risk factors for remaining in the precontemplation stage were older age (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.002–1.018; P=0.004), being in the lowest income quartile (OR, 1.226; 95% CI, 1.001–1.502; P=0.049), and manual worker or unemployed status (OR, 1.256; 95% CI, 1.036–1523; P=0.020). Conclusion Increasing tobacco prices only temporarily change the stage of smoking cessation among Korean male smokers.

Background: Cancer survivors experience decreased physical function and reduced muscle strength, which leads to lower quality of life (QOL). The hand grip strength (HGS) can be a predictor of poor health-related QOL as a parameter of sarcopenia. The purpose of this study was to investigate the relationship between low HGS and QOL in cancer survivors and healthy controls. Methods: We analyzed 392 cancer survivors and 1,176 healthy controls from the Korea National Health and Nutrition Examination Survey, 2014–2017. We defined low HGS as 2 standard deviation values for healthy young Korean adults from a previous study. QOL was evaluated using the European Quality of Life Scale-Five Dimensions. A complex sample logistic regression model was used to assess the relationship between each dimension of low HGS and QOL. Results: The odds ratios (ORs) for decreased QOL were significantly higher in male cancer survivors with low HGS on self-care (OR, 8.51; 95% confidence interval [CI], 1.69–42.83) and usual activities (OR, 6.63; 95% CI, 1.22–36.03). The ORs for problems in mobility (OR, 5.87; 95% CI, 2.04–16.91), usual activities (OR, 14.46; 95% CI, 3.84–54.44), pain/discomfort (OR, 4.90; 95% CI, 2.00–12.01), and anxiety/depression (OR, 6.43; 95% CI, 2.16–19.12) were significantly high in female cancer survivors with low HGS. However, healthy controls showed no significant relationship between low HGS and QOL. Conclusion For cancer survivors, low HGS was associated with poor QOL in some domains. Strategies to increase muscle strength must be considered to improve the QOL of cancer survivors.