INTRODUCTION: In this study, we aimed to identify the differences in sociodemographic variables and reasons for termination of pregnancy (TOP) between married women and single/divorced women. We hope that this study can guide future policies and interventions to reduce the incidence of unsupported pregnancies in this profile group of women. METHODS: We retrospectively evaluated the sociodemographic data of 802 women who underwent an abortion for social reasons at our institution in Singapore from January 2016 to September 2018. We compared the sociodemographic variables, reasons for and methods of TOP between married and single/divorced women. RESULTS: We analysed data from 524 married women (65.3%) and 278 single/divorced women (34.7%). Married women were more likely to be of older age (29.5 years vs. 24.5 years, P < 0.001), had more living children and higher educational qualifications. The top two cited reason for abortions among married women were having enough children (42.0%) and the inability to afford another child (18.7%). Multivariate analysis showed that women aged >19 years and having more living children were independently associated with recurrent TOPs. Having a tertiary education was noted to be associated with less recurrent TOPs. CONCLUSION The most common reasons married women cited for having TOP include having enough children and the lack of financial capacity to afford another child. Recommendations to support women ought to be personalised and comprehensive in addressing their needs rather than offering a standardised support method. Greater emphasis should be placed on post-TOP family planning counselling to reduce repeated TOP.
Pregnancy ; Child ; Female ; Humans ; Retrospective Studies ; Singapore/epidemiology* ; Abortion, Induced ; Hospitals, University ; Educational Status

university hospitals. A total of 1022 participants completed baseline health examinations from 2016 to 2017. All participants were scheduled for follow-ups every 2 years. Baseline health survey, laboratory testing of blood and urine samples, blood heavy metal concentration, urine polycyclic aromatic hydrocarbons (PAHs) metabolites, stress-related hormone test, natural killer cell activity, as well as physical and mental health examinations that focused on cardiovascular and mental disorders, were conducted. In addition, 3 Tesla (3T) brain magnetic resonance imaging (MRI) and neuropsychological tests were also performed to investigate structural and functional changes in the brains of 352 firefighters aged >40 years or new hires with less than 1 year of service.]]>
Brain ; Cardiovascular Diseases ; Cohort Studies ; Firefighters ; Follow-Up Studies ; Health Surveys ; Hospitals, University ; Humans ; Killer Cells, Natural ; Korea ; Magnetic Resonance Imaging ; Mental Disorders ; Mental Health ; Neuropsychological Tests ; Polycyclic Hydrocarbons, Aromatic ; Prospective Studies ; Republic of Korea ; Risk Factors

PURPOSE: Anaphylaxis is an immediate allergic reaction characterized by potentially life-threatening, severe, systemic manifestations. While studies have evaluated links between serious illness and posttraumatic stress disorder (PTSD), few have investigated PTSD after anaphylaxis in adults. We sought to investigate the psychosocial burden of recent anaphylaxis in Korean adults.METHODS: A total of 203 (mean age of 44 years, 120 females) patients with anaphylaxis were recruited from 15 university hospitals in Korea. Questionnaires, including the Impact of Event Scale-Revised-Korean version (IES-R-K), the Korean version of the Beck Anxiety Inventory (K-BAI), and the Korean version of the Beck Depression Inventory (K-BDI), were administered. Demographic characteristics, causes and clinical features of anaphylaxis, and serum inflammatory markers, including tryptase, platelet-activating factor, interleukin-6, tumor necrosis factor-α, and C-reactive protein, were evaluated.RESULTS: PTSD (IES-R-K ≥ 25) was noted in 84 (41.4%) patients with anaphylaxis. Of them, 56.0% had severe PTSD (IES-R-K ≥ 40). Additionally, 23.2% and 28.1% of the patients had anxiety (K-BAI ≥ 22) and depression (K-BDI ≥ 17), respectively. IES-R-K was significantly correlated with both K-BAI (r = 0.609, P < 0.0001) and K-BDI (r = 0.550, P < 0.0001). Among the inflammatory mediators, tryptase levels were lower in patients exhibiting PTSD; meanwhile, platelet-activating factor levels were lower in patients exhibiting anxiety and depression while recovering from anaphylaxis. In multivariate analysis, K-BAI and K-BDI were identified as major predictive variables of PTSD in patients with anaphylaxis.CONCLUSIONS: In patients with anaphylaxis, we found a remarkably high prevalence of PTSD and associated psychological distresses, including anxiety and depression. Physicians ought to be aware of the potential for psychological distress in anaphylactic patients and to consider psychological evaluation.
Adult ; Anaphylaxis ; Anxiety ; C-Reactive Protein ; Depression ; Hospitals, University ; Humans ; Hypersensitivity ; Interleukin-6 ; Korea ; Multivariate Analysis ; Necrosis ; Prevalence ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Tryptases

PURPOSE: The incidence of drug-induced liver injury (DILI) has been increasing; however, few algorithms are available to identify DILI in electronic health records (EHRs). We aimed to identify and evaluate DILI with an appropriate screening algorithm.METHODS: We collected data from 3 university hospitals between June 2015 and May 2016 using our newly developed algorithm for identifying DILI. Among patients with alanine transferase (ALT) ≤ 120 IU/L and total bilirubin (TB) ≤ 2.4 mg/dL in blood test results within 48 hours of admission, those who either had 1) ALT > 120 IU/L and TB > 2.4 mg/dL or 2) ALT > 200 IU/L at least once during hospitalization were identified. After excluding patients with liver disease-related diagnosis at discharge, medical records were retrospectively reviewed to evaluate epidemiological characteristics of DILI.RESULTS: The total number of inpatients was 256,598, of whom 1,100 (0.43%) were selected by the algorithm as suspected DILI. Subsequently, 365 cases (0.14% of total inpatients, 95% confidence interval, 0.13–0.16) were identified as DILI, yielding a positive predictive value of 33.1%. Antibiotics (n = 214, 47.2%) were the major class of causative drug followed by chemotherapeutic agents (n = 87, 19.2%). The most common causative drug was piperacillin-tazobactam (n = 38, 8.4%); the incidence of DILI by individual agent was highest for methotrexate (19.4 cases/1,000 patients administered the drug). Common reasons for excluding suspected DILI cases were ischemic hepatitis and postoperative liver dysfunction.CONCLUSIONS: Using our EHR-based algorithm, we identified that approximately 0.14% of patients developed DILI during hospitalization. Further studies are needed to modify criteria for more accurate identification of DILI.
Alanine ; Anti-Bacterial Agents ; Bilirubin ; Diagnosis ; Drug-Induced Liver Injury ; Drug-Related Side Effects and Adverse Reactions ; Electronic Health Records ; Hematologic Tests ; Hepatitis ; Hospitalization ; Hospitals, University ; Humans ; Incidence ; Inpatients ; Liver ; Liver Diseases ; Mass Screening ; Medical Records ; Methotrexate ; Pharmacoepidemiology ; Retrospective Studies ; Transferases

PURPOSE: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.METHODS: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.RESULTS: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change.CONCLUSION: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.
Hospitals, University ; Humans ; Medical Records ; Motor Activity ; Numismatics ; Nursing ; Physical Fitness ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Smartphone

PURPOSE: Improving productivity in nursing practice is an important issue. This study investigated factors affecting nursing productivity of Korean clinical nurses. METHODS: A structured survey tool was used in a cross-sectional design with a convenience sample of 239 nurses working in university hospitals. Stepwise multiple regressions were done to identify influential factors. RESULTS: The level of nursing productivity was at a moderate level (3.3 out of 5). Those nurses who were over 36, married, over master-graduated, regularly employed, on day duty, and with experiences as a charge or head nurse reported better achievements in nursing productivity than the other groups of nurses. All three independent variables, age, and employment status explained 55.4% of the variance in nursing productivity. CONCLUSION: The leaders and managers of nursing organizations should develop educational programs aimed at increasing nurses' competencies in relation to emotion controls and communication skills, which consequently should improve nursing productivity.
Efficiency ; Emotional Intelligence ; Employment ; Hospitals, University ; Nursing ; Nursing, Supervisory

PURPOSE: The aim of this research was to identify the relationships between occupational stress, ethical dilemma, burnout and turnover intention and the factors influencing turnover intention in hospital nurses. METHODS: The participants, 215 nurses, were recruited from two university hospitals located in two provinces of Korea. Data were collected through self-report questionnaires. Collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression with SPSS/WIN 22.0. RESULTS: Participants' scores for occupational stress, ethical dilemma, burnout and turnover intention were 3.96±0.45, 2.60±0.39, 3.71±0.70, and 3.50±0.90 respectively. The results show that the higher the score for occupational stress, ethical dilemma, and burnout the higher the score for turnover intention. The most important factor influencing turnover intention was burnout (β=.42, p < .001), followed by position (β=.21, p=.001), educational level (β=.21, p=.007), ethical dilemma (β=.13, p=.020) in that order. These factors explained 43.5% of total variance in turnover intention (F=19.34, p < .001). CONCLUSION: Changes in hospital structural management systems and support strategies should be developed and operated, taking into account burnout, ethical dilemma, and personal characteristics of clinical nurses in order to reduce turnover.
Ethics ; Hospitals, University ; Humans ; Intention ; Korea ; Personnel Turnover

PURPOSE: This study was done to identify the effects of nurses' time pressure on their safety care activities through the mediation of burnout. METHODS: Participants, 147 nurses with at least one year of work experience in two university hospitals were enrolled in this study. Data were collected using a self-reported questionnaire from July 31, to August 31, 2017 and analyzed with t-test, ANOVA, and Pearson's correlation coefficients. SPSS 23.0 was used for analysis. Mediating effects were examined with stepwise simple and complex regression, and statistical significance was verified with the Sobel test. RESULTS: Time pressure and burnout were significantly negatively correlated with safety care activities, and there was a positive correlation between time pressure and burnout. Regarding the mediating effects of burnout in the relationship between time pressure and safety care activity, time pressure had a significant effect on safety care activity both directly and indirectly through burnout, confirming a partial mediation effect of burnout. CONCLUSION: Strategies for enhancing work efficiency to reduce nurses' time pressure are needed to promote safety care activities. Furthermore, because burnout facilitated by time pressure among nurses influences their patient care activities, interventions for burnout management must also be implemented simultaneously.
Hospitals, University ; Negotiating ; Patient Care ; Patient Safety

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.
Anaplasmosis ; Animals ; Coinfection ; Hemorrhagic Fever with Renal Syndrome ; Hospitals, University ; Humans ; Incidence ; Korea ; Scrub Typhus

OBJECTIVES: The authors evaluated the environment and conditions of Korean psychiatric residents to identify important factors for them in determining their satisfaction with training programs. METHODS: Questionnaires on the residency training program were administered to 513 Korean psychiatric residents from 2016 to 2017. The questionnaire was composed of sociodemographic background, work environment and status of the training program. The authors analyzed questionnaire according to the residents' grade and hospital type and identified the significant factors for satisfaction with their training. RESULTS: Compared to the 1st grade, the 4th grade psychiatric residents have significantly less working time, duty days, and more sleep time, mealtime, and annual salary. In the hospital type, the residents of general hospitals and university hospitals have more working time, annual salary, and accessibility to educational material than mental hospitals. The satisfaction with their training is higher in the 1st grade than in the 4th grade, in those with more than six hours of sleep time, and in residents who are satisfied with the accessibility of educational materials. CONCLUSION: Compared to the 1st grade, the working intensity of 4th grade psychiatric residents is lower and their welfare is better. To improve the satisfaction with the training program, it is necessary to make efforts to increase the sleep time of residents, improve the accessibility of educational material, identify the problem of the training program, particularly in the 4th grade, and make institutional improvements.
Education ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Internship and Residency ; Meals ; Salaries and Fringe Benefits