PURPOSE: Traffic accidents are one of the major health problems in the world, being the first cause of burden of illness and the second leading cause of death in Iran. The Sistan-Baluchestan province is one of the most accidental provinces of Iran with the highest rate of accidents-caused deaths. This study was conducted to determine the risk factors associated with traffic accidents in Zahedan through 2013 to 2016. METHODS: This analytical cross-sectional study was carried out on 223 drivers from Zahedan who were traumatized by traffic accident and sent to Zahedan hospitals. The data were obtained through interviews taken by the trained interviewers via refereeing to the medical records and collected in the researcher-made checklist. Census was obtained from the study subjects. For data analysis, independent t-test, one-way ANOVA, Chi-square and logistic regression were used with the Stata software version 11.0. RESULTS: In this study, 223 male subjects with the mean age of (32.54 ± 12.95) years, 39.8% single and 60.2% married, entered for investigation. Most accidents (38.8%) occurred between 12:00 to 17:59. While driving, 47.1% of the study subjects were using cell phones, 89.1% had manual use of mobile phones, 21.9% had a habit of sending short message service (SMS) and 23.4% had sent SMS within 10 min before the accident. The one way analysis of variance showed that the mean age of individuals with marital status, driving experience, education and accident with motorcycle were significantly different (p < 0.05). Also, the multivariate logistic regression test indicated a significant relationship of smoking, ethnicity, insurance and SMS typing while driving with motorcycle accident (p < 0.05). CONCLUSION In this study, SMS and smoking while driving had the highest risk among the variables studied in the motorcycle accidents. Therefore, effective education attempting to enhance people's awareness about the consequences of using cell phone and smoking during driving to reduce traffic accidents seems necessary.
Accidents, Traffic/statistics & numerical data* ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Automobile Driving ; Cause of Death ; Cell Phone Use/adverse effects* ; Cross-Sectional Studies ; Female ; Health Education ; Humans ; Iran/epidemiology* ; Male ; Marital Status ; Middle Aged ; Risk ; Smoking/adverse effects* ; Young Adult

BACKGROUND: The solitary death rate in Japan is expected to continue increasing because of its growing super-aged society and the rapid growth of home care in the country. To accurately determine the actual status of solitary deaths, we used a novel analysis method of combining vital statistics and ambulatory care information in Yokohama City. METHODS: Data of persons who died at home in 2013 were obtained from death certificate notifications. We also obtained the emergency transportation records that matched the cases of these death certificate notifications. Then, we gathered information regarding age, gender, marital status, and cause of death for the matched cases. RESULTS: There were 1890 "suspected unnatural deaths," in which most solitary deaths could be included, among all citizens who died at home (n = 4847). We were able to match 1503 of these cases with emergency transportation records. These 1503 cases were divided into two groups, "solitary death" (n = 349) and "un-solitary death" (n = 1154) according to the postmortem interval until finding (PMI-f). Pearson's χ tests conducted for the two groups revealed that there were significant differences regarding the proportion of persons who were elderly, unmarried, male, and had a hepatic disease and senility. A logistic regression analysis also showed that an increased likelihood of a prolonged PMI-f was associated with males and an unmarried status with hepatic diseases. CONCLUSIONS Unmarried, male sex, and liver diseases are independent risks for solitary death in Yokohama City.
Age Distribution ; Cause of Death ; Death ; Death Certificates ; Diagnosis ; Emergency Medical Dispatch ; statistics & numerical data ; Female ; Humans ; Japan ; epidemiology ; Male ; Marital Status ; Mortality ; trends ; Risk Factors ; Sex Distribution

BACKGROUND: The purpose of this study was to examine the cultural competence of nurses caring for foreign patients in general hospitals. METHODS: The subjects are 308 nurses who work in general hospitals in Seoul and Gyeonggi-do. The data, collected using a structured questionnaire on cultural competence, coping strategy, multicultural experience, intercultural uncertainty, and intercultural anxiety, were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation analysis, and hierarchical multiple regression. RESULTS: Cultural competence was significantly associated with marital status, level of education, type of ward, and number of cared foreign patients. In hierarchical multiple regression analysis, the level of cultural competence was significantly associated with married, master degree qualified, high level of coping strategy and multicultural experience, and low level of cultural uncertainty. CONCLUSION: The findings revealed the need for educational programs which can contribute to lower the intercultural uncertainty and to enhance coping strategies dealing with foreign patients. In addition, individual and organization efforts to provide opportunities to expand nurses' multicultural experience will affect nurses' cultural competence development.
Anxiety ; Cultural Competency ; Education ; Gyeonggi-do ; Hospitals, General ; Humans ; Marital Status ; Seoul ; Uncertainty

BACKGROUND: The extent of coverage rate of the public health insurance is still insufficient to meet healthcare needs. Private health insurance (PHI) plays a role to supplement coverage level of national health insurance in Korea. It is expected that reduce unmet need healthcare. This study was aimed to identify relationship between PHI type and the unmet healthcare need and its associated factors. METHODS: Data were obtained from the 2014 Korea Health Panel Survey using nationally representative sample was analyzed. Respondents were 8,667 who were adults over 20 years covered by PHI but have not changed their contract. According to the enrollment form, PHI was classified into three types: fixed-benefit, indemnity, and mixed-type. To identify factors associated with unmet needs, multiple logistic regression conducted using the Andersen model factors, which are predisposing factors, enabling factors, and need factors. RESULTS: Our analysis found that subjects who had PHI with mixed-type were less likely to experience unmet health care needs compared than those who did not have it (odds ratio, 0.80; 95% confidence interval, 0.66–0.98). As a result of analyzing what affected their unmet healthcare needs, the significant factors associated with unmet medical need were gender, marital status, residence in a metropolitan area, low household income, economic activity participation, self-employed insured, physically disabled, low subjective health status, and health-risk factors such as current smoking and drinking. CONCLUSION: The results of this study suggest that having PHI may reduce experience of unmet healthcare needs. Findings unmet healthcare needs factors according to various subjects may be useful in consideration of setting policies for improving accessibility to healthcare in Korea.
Adult ; Causality ; Delivery of Health Care ; Diagnostic Self Evaluation ; Disabled Persons ; Drinking ; Family Characteristics ; Humans ; Insurance ; Insurance, Health ; Korea ; Logistic Models ; Marital Status ; National Health Programs ; Public Health ; Smoke ; Smoking ; Surveys and Questionnaires

BACKGROUND: Cerebrovascular disease is included in four major diseases and is a disease that has high rates of prevalence and mortality around the world. Moreover, it is a disease that requires a high cost for long-term hospitalization and treatment. This study aims to figure out the correlation between grip strength, which was presented as a simple, cost-effective, and relevant predictor of cerebrovascular disease, and cerebrovascular disease based on the results of a prior study. And furthermore, our study compared model suitability of the model to measuring grip strength and relative grip strength as a predictor of cerebrovascular disease to improve the quality of cerebrovascular disease's predictor. METHODS: This study conducted an analysis based on the generalized linear mixed model using the data from the Korea Longitudinal Study of Ageing from 2006 to 2016. The research subjects consisted of 9,132 middle old age people aged 45 years or older at baseline with no missing information of education level, gender, marital status, residential region, type of national health insurance, self-related health, smoking status, alcohol use, and economic activity. The grip strength was calculated the average which measured 4 times (both hands twice), and the relative grip force was divided by the body mass index as a variable considering the anthropometric figure that affects the cerebrovascular disease and the grip strength. Cerebrovascular diseases, a dependent variable, were investigated based on experiences diagnosed by doctors. RESULTS: An analysis of the association between grip strength and found that about 0.972 (odds ratio [OR], 0.972; 95% confidence interval [CI], 0.963–0.981) was the incidence of cerebral vascular disease as grip strength increased by one unit increase and the association between relative grip strength and cerebrovascular disease found that about 0.418 (OR, 0.418; 95% CI, 0.342–0.511) was the incidence of cerebral vascular disease as relative grip strength increased by unit. In addition, the model suitability of the model for each grip strength and relative grip strength was 11,193 and 11,156, which means relative grip strength is the better application to the predictor of cerebrovascular diseases, irrespective of other variables. CONCLUSION: The results of this study need to be carefully examined and validated in applying relative grip strength to improve the quality of predictors of cerebrovascular diseases affecting high mortality and prevalence.
Body Mass Index ; Cerebrovascular Disorders ; Education ; Hand ; Hand Strength ; Hospitalization ; Humans ; Incidence ; Korea ; Longitudinal Studies ; Marital Status ; Mortality ; National Health Programs ; Prevalence ; Research Subjects ; Smoke ; Smoking ; Stroke ; Vascular Diseases

BACKGROUND: The one-person households (OPH) are rapidly increasing and vulnerable to socioeconomic and health problems. Because it is predicted to be inequitable to health care utilization, we would like to find out about the equity of health care utilization of the OPH by comparison with the multi-person households (MPH). METHODS: This study followed the theoretical framework of Wagstaff and van Doorslaer (2000), O'Donnell and his colleagues (2008), where the horizontal inequity index is the difference between the concentration indices of actual health care utilization and health care needs. This study employed the 9th Korea Health Panel survey, and a total of 10,807 cases were analyzed. Health care needs were measured by age, sex, subjective health status, chronic disease count, Charlson's Comorbidity Index, limitation of activities, and disability. RESULTS: Compared with the MPH, there were pro-poor inequities in hospitalization, emergency utilization, hospitalization out-of-pocket payments, and pro-rich inequities in outpatient out-of-pocket payments for the OPH. The decomposition of the concentration index revealed that chronic disease count made the largest contribution to socioeconomic inequality in outpatient utilization. Age, health insurance, economic activities, and subjective health status also proved more important contributors to inequality. The variables contributing to the hospitalization and emergency utilization inequity were age, education, Charlson's Comorbidity Index, marital status, and income. CONCLUSION: Because the OPH was more vulnerable to health problems than the MPH and there were pro-poor inequities in medical utilization, hospitalization, and emergency costs, it is necessary to develop a policy that can correct and improve the portion of high contribution to medical utilization of the OPH.
Chronic Disease ; Comorbidity ; Delivery of Health Care ; Diagnostic Self Evaluation ; Education ; Emergencies ; Family Characteristics ; Health Expenditures ; Hospitalization ; Humans ; Insurance, Health ; Korea ; Marital Status ; Outpatients ; Patient Acceptance of Health Care ; Socioeconomic Factors

OBJECTIVES: The purpose of this study was factors affecting self-efficacy of cardiopulmonary resuscitation (CPR) in adults. Therefore, the provide basic data for strategy development to improve the performance rate of bystander CPR. METHODS: The data were collected from 164,165 adults of the 2016 Korean Community Health Survey. The survey method was 1:1 interview with households, and the survey period was from August 16, 2016 to October 31, 2016. The survey variables were as follows: self-efficacy of CPR, awareness of CPR, training experience of CPR, demographic characteristics, medical characteristics, health promoting behaviors, and safety practices. RESULTS: The rate of self-efficacy of CPR in adults was 60.6%. Factors affecting self-efficacy of CPR were age, sex, residence, education level, occupation, marital status, any CPR training, CPR training within the last 2 years, CPR training with manikin within the last 2 years, emergency room visit within the last 1 year, physical activity status, drive a bicycle, seat belts on rear seat, seat belts when riding a bus were statistically significant. CONCLUSIONS: In conclusion, in order to improve the self-efficacy of CPR in adults, the recent experience rate of CPR education, the practice rate of health promotion behavior, and the practice rate of safety behavior should be improved. The government should expand the provision of education programs to improve the self-efficacy of CPR and actively prepare national-level public advertisements strategies.
Adult ; Cardiopulmonary Resuscitation ; Education ; Emergency Service, Hospital ; Family Characteristics ; Health Promotion ; Health Surveys ; Humans ; Manikins ; Marital Status ; Motor Activity ; Occupations ; Seat Belts ; Surveys and Questionnaires

BACKGROUND: With increased interest in oral health, several efforts have been made to improve oral health conditions. To achieve this, needs for oral health must be precisely determined and accurately measured. Therefore, factors influencing both objective unmet dental needs, which were determined by experts, and perceived unmet dental needs, which were determined by patients, were examined in this study. METHODS: Responses of 17,735 respondents aged greater than 19 years from the Korean National Health and Nutrition Survey collected using the fifth (2010~2012) rotation sample survey were analyzed. Based on the information collected from the survey and dental examination, we determined the associations between the independent (sex and socioeconomic level) and dependent variables using a chi-squared test. Moreover, ordinal logistic regression analyses on multiple categorical values were performed using perceived and objective dental needs as the dependent variables. RESULTS: Generally, factors influencing both perceived and objective dental needs were similar. These included sex, household income, educational level, private insurance, and subjective oral health status. However, the high-income groups had lesser perceived and objective dental needs compared to the low-income groups. Furthermore, factors such as sex, educational level, and marital status had different influence on both needs. CONCLUSION: Generally, factors that affect perceived and objective dental needs were similar. To minimize unmet dental needs, factors influencing both perceived and objective dental needs should be examined for a broad dental insurance coverage, and efforts to prevent oral diseases are also required.
Family Characteristics ; Humans ; Insurance ; Insurance, Dental ; Logistic Models ; Marital Status ; Nutrition Surveys ; Oral Health ; Surveys and Questionnaires

BACKGROUND: We evaluated the effects of socioeconomic factors and psychosocial factors, both individually and combined, on all-cause mortality risk (mortality risk). METHODS: We conducted an 8-year (2006–2014) longitudinal analysis of 10,247 individuals who took part in the Korean Longitudinal Study of Aging, a nationwide survey of people aged 45–79 years. Socioeconomic vulnerability (SEV) was assessed with factors such as education, household income, commercial health insurance, and residential area. Mental health (MH) was assessed with factors such as depression, social engagement, and life satisfaction. The covariates were age, gender, marital status, cohabiting, number of chronic diseases, and health behaviors such as regular exercise, smoking, and alcohol intake. We used a Cox proportional hazard analysis to investigate the effects of SEV and MH on mortality risk and also to analyze the superimposed effects of SEV-MH on mortality risk. RESULTS: After the controlling for the covariates, high SEV and negative MH were found to be strong predictors of all-cause mortality. The highest quartile of SEV (vs. lowest) had a 1.70 times greater mortality risk (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.24–2.33) and the highest quartile of MH (vs. lowest) had a 2.13 times greater mortality risk (HR, 2.13; 95% CI, 1.72–2.64). Being in the highest quartile for both SEV and MH (vs. lowest) increased mortality risk more than 3 times (HR, 3.11; 95% CI, 2.20–4.40). CONCLUSION: High SEV and negative MH were independently associated with increased mortality risk, and their superimposed effects were associated with an increased risk of mortality.
Aging ; Chronic Disease ; Depression ; Education ; Family Characteristics ; Health Behavior ; Insurance, Health ; Longitudinal Studies ; Marital Status ; Mental Health ; Mortality ; Psychology ; Smoke ; Smoking ; Socioeconomic Factors

BACKGROUND: Exposure to secondhand smoke (SHS) has been shown to cause health problems. Recent studies demonstrated an association of SHS with depression and poor mental health. The urinary cotinine concentration (Ucot) is an objective indicator of exposure to SHS. In this study, we evaluated the association between depression and Ucot in adult non-smokers adults in Korea. METHODS: We analyzed the data of 3,417 adults, aged ≥19 years, who participated in the seventh Korea National Health and Nutrition Examination Survey (2016). The eligible subjects were non-smokers. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). The subjects were dichotomized into two groups: the high depressive symptom group (PHQ-9 ≥10 [n=185]) and the low depressive symptom group (PHQ-9 <10 [n=3,232]). The demographic, socioeconomic, and clinical characteristics of the subjects were retrieved from the survey data. Ucot was dichotomized into high-Ucot (≥10 ng/mL) and low-Ucot (<10 ng/mL). The Ucot and other characteristics were compared between the two groups. To adjust for confounding variables, we conducted a logistic regression analysis and determined the difference in Ucot between the two groups. RESULTS: After adjusting for confounders, the high depressive symptom group was found to be associated with high-Ucot (odds ratio, 1.824; 95% confidence interval, 1.020–3.262). Sex, education, socioeconomic status, marital status, occupational status, limitation of activity, and the presence of an underlying diseases (diabetes and dyslipidemia) had a significant effect on depression. CONCLUSIONS: This concluded that depression was associated with high urine cotinine level in adult non-smokers.
Adult ; Confounding Factors (Epidemiology) ; Cotinine ; Depression ; Education ; Employment ; Humans ; Korea ; Logistic Models ; Marital Status ; Mental Health ; Nutrition Surveys ; Social Class ; Tobacco ; Tobacco Smoke Pollution