1.Impact of smoking on diabetes complications: a secondary analysis of the Korean National Health Insurance Service-health screening cohort (2002–2019)
Journal of Korean Academy of Nursing 2025;55(2):222-235
Purpose:
This study aimed to examine the effects of smoking on the incidence of macrovascular and microvascular complications in patients with type 2 diabetes.
Methods:
We analyzed 35,804 patients diagnosed with type 2 diabetes between 2004 and 2017 using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019). Smoking status was categorized into never, former, and current smoking, with further classification based on duration of smoking and daily smoking amount. We conducted survival analysis using a Cox proportional hazards model.
Results:
Both former and current smokers had significantly elevated risks of macrovascular complications compared to non-smokers, with hazard ratios (HRs) of 1.60 (95% confidence interval [CI], 1.49–1.66) and 1.10 (95% CI, 1.08–1.17), respectively. Long-term smokers (over 30 years) had significantly higher risks of both macrovascular (HR, 1.35; 95% CI, 1.29–1.42) and microvascular complications (HR, 1.36; 95% CI, 1.30–1.42). Heavy smokers (over 2 packs/day) more frequently developed macrovascular (HR, 1.46; 95% CI, 1.30–1.64) and microvascular (HR, 1.78; 95% CI, 1.60–1.98) complications than never smokers. Notably, former smokers had increased risks of developing neuropathy (HR, 1.40; 95% CI, 1.31–1.49), nephropathy (HR, 1.27; 95% CI, 1.16–1.39), and retinopathy (HR, 1.49; 95% CI, 1.39–1.60).
Conclusion
Patients with type 2 diabetes and a history of smoking are at higher risk of developing macrovascular and microvascular complications. Smoking cessation, along with reducing smoking duration and amount, is crucial for lowering these risks.
2.Impact of smoking on diabetes complications: a secondary analysis of the Korean National Health Insurance Service-health screening cohort (2002–2019)
Journal of Korean Academy of Nursing 2025;55(2):222-235
Purpose:
This study aimed to examine the effects of smoking on the incidence of macrovascular and microvascular complications in patients with type 2 diabetes.
Methods:
We analyzed 35,804 patients diagnosed with type 2 diabetes between 2004 and 2017 using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019). Smoking status was categorized into never, former, and current smoking, with further classification based on duration of smoking and daily smoking amount. We conducted survival analysis using a Cox proportional hazards model.
Results:
Both former and current smokers had significantly elevated risks of macrovascular complications compared to non-smokers, with hazard ratios (HRs) of 1.60 (95% confidence interval [CI], 1.49–1.66) and 1.10 (95% CI, 1.08–1.17), respectively. Long-term smokers (over 30 years) had significantly higher risks of both macrovascular (HR, 1.35; 95% CI, 1.29–1.42) and microvascular complications (HR, 1.36; 95% CI, 1.30–1.42). Heavy smokers (over 2 packs/day) more frequently developed macrovascular (HR, 1.46; 95% CI, 1.30–1.64) and microvascular (HR, 1.78; 95% CI, 1.60–1.98) complications than never smokers. Notably, former smokers had increased risks of developing neuropathy (HR, 1.40; 95% CI, 1.31–1.49), nephropathy (HR, 1.27; 95% CI, 1.16–1.39), and retinopathy (HR, 1.49; 95% CI, 1.39–1.60).
Conclusion
Patients with type 2 diabetes and a history of smoking are at higher risk of developing macrovascular and microvascular complications. Smoking cessation, along with reducing smoking duration and amount, is crucial for lowering these risks.
3.Impact of smoking on diabetes complications: a secondary analysis of the Korean National Health Insurance Service-health screening cohort (2002–2019)
Journal of Korean Academy of Nursing 2025;55(2):222-235
Purpose:
This study aimed to examine the effects of smoking on the incidence of macrovascular and microvascular complications in patients with type 2 diabetes.
Methods:
We analyzed 35,804 patients diagnosed with type 2 diabetes between 2004 and 2017 using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019). Smoking status was categorized into never, former, and current smoking, with further classification based on duration of smoking and daily smoking amount. We conducted survival analysis using a Cox proportional hazards model.
Results:
Both former and current smokers had significantly elevated risks of macrovascular complications compared to non-smokers, with hazard ratios (HRs) of 1.60 (95% confidence interval [CI], 1.49–1.66) and 1.10 (95% CI, 1.08–1.17), respectively. Long-term smokers (over 30 years) had significantly higher risks of both macrovascular (HR, 1.35; 95% CI, 1.29–1.42) and microvascular complications (HR, 1.36; 95% CI, 1.30–1.42). Heavy smokers (over 2 packs/day) more frequently developed macrovascular (HR, 1.46; 95% CI, 1.30–1.64) and microvascular (HR, 1.78; 95% CI, 1.60–1.98) complications than never smokers. Notably, former smokers had increased risks of developing neuropathy (HR, 1.40; 95% CI, 1.31–1.49), nephropathy (HR, 1.27; 95% CI, 1.16–1.39), and retinopathy (HR, 1.49; 95% CI, 1.39–1.60).
Conclusion
Patients with type 2 diabetes and a history of smoking are at higher risk of developing macrovascular and microvascular complications. Smoking cessation, along with reducing smoking duration and amount, is crucial for lowering these risks.
4.Impact of smoking on diabetes complications: a secondary analysis of the Korean National Health Insurance Service-health screening cohort (2002–2019)
Journal of Korean Academy of Nursing 2025;55(2):222-235
Purpose:
This study aimed to examine the effects of smoking on the incidence of macrovascular and microvascular complications in patients with type 2 diabetes.
Methods:
We analyzed 35,804 patients diagnosed with type 2 diabetes between 2004 and 2017 using the Korean National Health Insurance Service–National Health Screening Cohort (2002–2019). Smoking status was categorized into never, former, and current smoking, with further classification based on duration of smoking and daily smoking amount. We conducted survival analysis using a Cox proportional hazards model.
Results:
Both former and current smokers had significantly elevated risks of macrovascular complications compared to non-smokers, with hazard ratios (HRs) of 1.60 (95% confidence interval [CI], 1.49–1.66) and 1.10 (95% CI, 1.08–1.17), respectively. Long-term smokers (over 30 years) had significantly higher risks of both macrovascular (HR, 1.35; 95% CI, 1.29–1.42) and microvascular complications (HR, 1.36; 95% CI, 1.30–1.42). Heavy smokers (over 2 packs/day) more frequently developed macrovascular (HR, 1.46; 95% CI, 1.30–1.64) and microvascular (HR, 1.78; 95% CI, 1.60–1.98) complications than never smokers. Notably, former smokers had increased risks of developing neuropathy (HR, 1.40; 95% CI, 1.31–1.49), nephropathy (HR, 1.27; 95% CI, 1.16–1.39), and retinopathy (HR, 1.49; 95% CI, 1.39–1.60).
Conclusion
Patients with type 2 diabetes and a history of smoking are at higher risk of developing macrovascular and microvascular complications. Smoking cessation, along with reducing smoking duration and amount, is crucial for lowering these risks.
5.Factors Influencing the Well-being of the Middle-aged Non-shift Female Workers: Using Secondary Data
Korean Journal of Occupational Health Nursing 2024;33(1):1-11
Purpose:
This study aimed to analyze the factors influencing the well-being of middle-aged non-shift female workers using health-determinant models.
Methods:
This study analyzed data from the fifth Korean Working Conditions Survey (KWCS), involving 5,449 participants. A hierarchical multiple regression analysis was employed to examine the relationships between various factors and well-being.
Results:
The analysis identified key factors affecting well-being in middle-aged female non-shift workers, including supervisor support, presenteeism, satisfaction with the working environment, autonomy in working hours, support from coworkers, workplace discrimination, occupation, work-life balance, sleep problems, workplace size, weekly work hours, and sickness absence. This study confirms that the well-being of middle-aged non-shift female workers is influenced by factors at the individual, social, and community levels as well as by conditions related to love.
Conclusion
To enhance the well-being of middle-aged female non-shift workers, it is essential to reinforce positive factors such as support from coworkers and superiors. Additionally, addressing and mitigating negatively influencing factors such as workplace discrimination and sleep problems is crucial in promoting well-being. By implementing measures to improve these aspects, organizations and policymakers can contribute to a healthier and more supportive work environment for middle-aged, non-shift female workers.
6.Exploring the Prevalence and Influencing Factors of Sexually Explicit Internet Material (SEIM) Consumption among Adolescents and Young Adults in Cambodia
Hyunjeong CHEON ; Youngran YANG
Journal of Korean Academy of Community Health Nursing 2024;35(3):284-296
Purpose:
This study investigates the prevalence and factors associated with the consumption of sexually explicit Internet material (SEIM) among adolescents and young adults in Cambodia.
Methods:
Utilizing a cross-sectional study design, data were collected through a survey administered to 1,271 participants. The survey focused on measuring SEIM consumption, sexual sensation seeking, perceived reality of SEIM, and sexual attitudes. Findings: The study revealed a SEIM prevalence of 27.2%, with notably higher rates among males (35.5%) than females (18.6%). Significant predictors of SEIM consumption included being male, having a father with a middle-level education, engaging in alcohol or substance consumption, spending more than five hours daily on electronic devices, having friends with sexual experience, frequent thoughts about sex, a heightened interest in sex compared to peers, perceiving SEIM as realistic, and maintaining a permissive attitude towards sex.
Conclusions
These findings underscore the importance of implementing education programs to address SEIM consumption and its potential risk factors. Such initiatives are crucial for preventing the use of SEIM among Cambodian youth, promoting a healthier understanding of sexuality, and fostering responsible online behavior.
7.Development and Feasibility Assessment of Mobile ApplicationBased Digital Therapeutics for Postoperative Supportive Care in Gastric Cancer Patients Following Gastrectomy
Ji-Hyeon PARK ; Hyuk-Joon LEE ; JeeSun KIM ; Yo-Seok CHO ; Sunjoo LEE ; Seongmin PARK ; Hwinyeong CHOE ; Eunhwa SONG ; Youngran KIM ; Seong-Ho KONG ; Do Joong PARK ; Byung-Ho NAM ; Han-Kwang YANG
Journal of Gastric Cancer 2024;24(4):420-435
Purpose:
This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy.Materials and Method: The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient’s body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice.
Results:
At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0–3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5–24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI.Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight.
Conclusions
The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition.
8.Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data
Yoonseok YANG ; Ju Won KWON ; Youngran YANG
Journal of Korean Academy of Nursing 2024;54(2):193-210
Purpose:
The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the “variable importance.”
Methods:
The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ2 tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix.
Results:
The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. “Variable importance” for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol.
Conclusion
Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.
9.Exploring the Prevalence and Influencing Factors of Sexually Explicit Internet Material (SEIM) Consumption among Adolescents and Young Adults in Cambodia
Hyunjeong CHEON ; Youngran YANG
Journal of Korean Academy of Community Health Nursing 2024;35(3):284-296
Purpose:
This study investigates the prevalence and factors associated with the consumption of sexually explicit Internet material (SEIM) among adolescents and young adults in Cambodia.
Methods:
Utilizing a cross-sectional study design, data were collected through a survey administered to 1,271 participants. The survey focused on measuring SEIM consumption, sexual sensation seeking, perceived reality of SEIM, and sexual attitudes. Findings: The study revealed a SEIM prevalence of 27.2%, with notably higher rates among males (35.5%) than females (18.6%). Significant predictors of SEIM consumption included being male, having a father with a middle-level education, engaging in alcohol or substance consumption, spending more than five hours daily on electronic devices, having friends with sexual experience, frequent thoughts about sex, a heightened interest in sex compared to peers, perceiving SEIM as realistic, and maintaining a permissive attitude towards sex.
Conclusions
These findings underscore the importance of implementing education programs to address SEIM consumption and its potential risk factors. Such initiatives are crucial for preventing the use of SEIM among Cambodian youth, promoting a healthier understanding of sexuality, and fostering responsible online behavior.
10.Factors Influencing the Well-being of the Middle-aged Non-shift Female Workers: Using Secondary Data
Korean Journal of Occupational Health Nursing 2024;33(1):1-11
Purpose:
This study aimed to analyze the factors influencing the well-being of middle-aged non-shift female workers using health-determinant models.
Methods:
This study analyzed data from the fifth Korean Working Conditions Survey (KWCS), involving 5,449 participants. A hierarchical multiple regression analysis was employed to examine the relationships between various factors and well-being.
Results:
The analysis identified key factors affecting well-being in middle-aged female non-shift workers, including supervisor support, presenteeism, satisfaction with the working environment, autonomy in working hours, support from coworkers, workplace discrimination, occupation, work-life balance, sleep problems, workplace size, weekly work hours, and sickness absence. This study confirms that the well-being of middle-aged non-shift female workers is influenced by factors at the individual, social, and community levels as well as by conditions related to love.
Conclusion
To enhance the well-being of middle-aged female non-shift workers, it is essential to reinforce positive factors such as support from coworkers and superiors. Additionally, addressing and mitigating negatively influencing factors such as workplace discrimination and sleep problems is crucial in promoting well-being. By implementing measures to improve these aspects, organizations and policymakers can contribute to a healthier and more supportive work environment for middle-aged, non-shift female workers.

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